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Remember my pneumonia and asthma thread from a year ago...


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#1 PeterPan

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Posted 12 November 2017 - 11:18 PM

Well can we dredge that up again? Jist was I had pneumonia twice in a year with back to back bronchitis after the pneumonia the 2nd time, so they sent me to a pulm, diagnosed asthma. Did a flurry of stuff (some kind of strong powdery inhaler, steroids, etc.), got religion about cleaning with a roomba, and got it under control. Thing is, now I'm fighting some kind of bug. And I don't want to be paranoid, but I'm not sure I'm doing it right.

 

So normally my breath, with the peak flow meter, is 530-550. I've even seen 570. It wasn't like that when I was sick, obviously. It was half that or less. But as we got it under control, that's what it got to. And I work out, weight lifting, which is a lot of deep breathing. I think it may have gone up recently from that. 

 

Anyways, it started as an occasional cough, added headache Friday and Saturday. I did the steam room Saturday, trying to kill viruses and just help. Today my energy is pretty good but I've been needing to use my inhaler. I think my lungs are getting a little worse. I'm coughing more now. And I don't understand because overall I'm hardly sick. It's like it just picked my lungs, kwim? 

 

I did my inhaler 10 minutes ago and I actually sound WORSE now than I did. And most of the day it was under control.

 

Well that's why I'm coughing. It's down to 390-430. 

 

So now I don't know what to do. I took some mucinex. I can monitor it. I mean I'll I've got is a runny nose and my breathing is going down.


Edited by OhElizabeth, 12 November 2017 - 11:19 PM.


#2 Jaz

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Posted 12 November 2017 - 11:21 PM

Don't risk waiting. With your background I'd call the doctor's office. Sorry you're sick again!


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#3 PeterPan

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Posted 12 November 2017 - 11:28 PM

It went down to 380-400. I found that stronger inhaler. It's called Arnuity. Used that. I could do that a few days. Normally I don't need it. I'll recheck. I'm concerned why it's going down. It's almost midnight here, and I don't know if I need to go in, if I wait till morning, or what. I'm not particularly coughing up mucus. Just a little, and it's clear and it only started today. 

 

This is really just like a hello, after 2 months of no inhaler needed at all, now let's get sick and have our breathing CRASH.



#4 PeterPan

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Posted 12 November 2017 - 11:44 PM

Ok, the better inhaler is helping. Breathing is stabilizing and the coughing is getting better. It went down to 350, but now it's going back up and at 400. I'm not feeling so frantic now.

 

If I call the pulm in the morning, they'll just talk it through? They'll say to come in anyway? Like I hate to go in unnecessarily. I thought I was winning, and then it just all crashed. Am I ok if there's no mucus or it's clear? Will just having the flu or whatever this bug is (it's going around) aggravate the asthma without turning it into pneumonia? How do I know if I need more?

 

I have scarring, I think, from the first time I had pneumonia, because we had no clue and let it go on a long time. 

 

Whoa, that was strong stuff. I'm getting loopy between the mucinex and the arnuity. I'm gonna take it easy. Breathing is now 400-410. Much better. 


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#5 JIN MOUSA

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Posted 13 November 2017 - 12:01 AM

Does your insurance have a nurse line you can call? I've found them to be helpful about what's (more or less) normal and what's concerning. Plus they're available 24/7.


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#6 PeterPan

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Posted 13 November 2017 - 12:34 AM

Good question! I'll have to look into that. It makes sense they might, but it wouldn't have occurred to me it would be 24/7, hmmm. 

 

I don't know why it decided to flare up. My numbers are slowly going back up again. Assuredly that's why I was feeling so frantic, because it actually really was a problem. I just got 430-450, so that's a lot better. It had stayed stable around 510 with the inhaler all day. It was that crash to 350 and going south that was an issue. 

 

But, like you say, it's just sorting out. If I can keep the breathing under control and I'm not kicking out problem mucus, then maybe I'm ok? 

 

I'll check in the morning. I'm actually tired now. Really tired. I think all that stuff is kicking in. Thanks



#7 PeterPan

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Posted 13 November 2017 - 12:37 AM

Btw, how do we feel about christmas trees? I'm going in circles trying to decide this. I usually do 2 trees, and last year my asthma didn't clear up till I got rid of the last tree. We've also tended to get the smelliest (most fragrant) trees and keep them the whole season. 

 

So I had been looking at artificial and dh was like oh can we *try* doing real again... And tonight I'm at 350 and going south on my breathing and thinking wow, that's pretty dumb. I know I'm going to buy at least the basement tree artificial. But does this propensity to have something happen in a FLASH mean I could have real issues with the real tree? Or is it ok to chance it? The main floor tree would be 10'. Yeah...



#8 PeterPan

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Posted 13 November 2017 - 12:39 AM

Says the nurse line number is on the back of the insurance card and that it's 24/7. Who knew!



#9 Ottakee

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Posted 13 November 2017 - 03:17 AM

Do you have an asthma action plan? If not you need one.

One that says if you are in the green (80%+ of your max) then use this daily med (or possibly none). If you hit the yellow zone (50-80% of your max) then use this med/meds...inhalers, steroids, debulizer, etc. If you are under 50% use this med at this dose and if not better in an hour or gets worse call doctor/go to ER/ call 911, etc.

It would be personalized to you. I know for my daughter the first sign of a cough and we hit things hard as viruses are her main trigger.

I would talk to your doctor about the tree. Honestly I would strongly hesitate.
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#10 amo_mea_filiis.

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Posted 13 November 2017 - 06:08 AM

I’m walking and reading, so I didn’t read it all.

Arnuity is a daily inhaler, NOT rescue. Why are you not taking it daily?

It’s “normal” to sound worse after a dose of a rescue inhaler if you were really bad. You can be so tight that you don’t wheeze or sound too bad. Then the meds open you up just enough to sound terrible.

Both of my kids’ asthma plans allows for 3 doses in an hour before having to seek medical attention.
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#11 kiwik

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Posted 13 November 2017 - 06:19 AM

Guess it varies person to person. Mine has never been above 470, has been around 360 since I had kids and has been as low as 60, I was fairly sick then though.

You need a plan like earlier posters said.

Edited by kiwik, 13 November 2017 - 06:19 AM.

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#12 Pippen

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Posted 13 November 2017 - 06:22 AM

I’m walking and reading, so I didn’t read it all.

Arnuity is a daily inhaler, NOT rescue. Why are you not taking it daily?

It’s “normal” to sound worse after a dose of a rescue inhaler if you were really bad. You can be so tight that you don’t wheeze or sound too bad. Then the meds open you up just enough to sound terrible.

Both of my kids’ asthma plans allows for 3 doses in an hour before having to seek medical attention.

 

I often sound worse after using inhaler/nebulizer because it breaks up mucous.

 

My asthma plan is for me to start treating with both a brochodilator and a steroid as soon as I have symptoms of a cold. I don't wait for asthma symptoms to show up but start preventative treatment. If I wait until asthma symptoms appear then about 50% of the time it's too late to prevent a flare-up.

 

I typically don't need to treat for asthma at any other times.


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#13 J-rap

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Posted 13 November 2017 - 06:28 AM

It's been awhile since my dd lived at home and we worked on controlling her asthma, so things may have changed...

 

Are you on a preventative med?  My dd was on an inhaled steroid inhaler daily during seasons when she was more likely to have an attack.    I see someone above mentioned that Arnuity -- which I'm not familiar with -- is a preventative inhaler than you do need to take every day.  That's different than a rescue inhaler.  From what I understand, a preventative inhaler taken daily keeps the inflammation under control.  The rescue inhaler helps with the spasms.  For ongoing asthma type problems, you need both.

 

My dd learned that she seemed to have a threshold amount of environmental stuff that she could handle, but if there were too many environmental factors, or one really bad one or a cold on top of it all, then, then she'd have an attack.  Fall was the worst time of year for her, and my guess is that it had something to do with the mold growing on old leaves and crops.  (We're in a farming area.)  But also, being in a room with old mold or cigarette smoke, or lots of cat hair, could set it off.  

 

Even then, as long as she was on both the daily preventative AND the rescue inhaler, she could usually prevent an attack. 

 

The times when the attack broke through anyway, we pulled out our nebulizer.  We could always stabilize things with that, although during a bad attack we'd sometimes have to double dose it.  (Do people even have home nebulizers anymore?)

 

Things can go bad quickly though with asthma, so I'd definitely put a call into your nurse or clinic if things aren't turning around.


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#14 Ausmumof3

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Posted 13 November 2017 - 06:58 AM

Well can we dredge that up again? Jist was I had pneumonia twice in a year with back to back bronchitis after the pneumonia the 2nd time, so they sent me to a pulm, diagnosed asthma. Did a flurry of stuff (some kind of strong powdery inhaler, steroids, etc.), got religion about cleaning with a roomba, and got it under control. Thing is, now I'm fighting some kind of bug. And I don't want to be paranoid, but I'm not sure I'm doing it right.

So normally my breath, with the peak flow meter, is 530-550. I've even seen 570. It wasn't like that when I was sick, obviously. It was half that or less. But as we got it under control, that's what it got to. And I work out, weight lifting, which is a lot of deep breathing. I think it may have gone up recently from that.

Anyways, it started as an occasional cough, added headache Friday and Saturday. I did the steam room Saturday, trying to kill viruses and just help. Today my energy is pretty good but I've been needing to use my inhaler. I think my lungs are getting a little worse. I'm coughing more now. And I don't understand because overall I'm hardly sick. It's like it just picked my lungs, kwim?

I did my inhaler 10 minutes ago and I actually sound WORSE now than I did. And most of the day it was under control.

Well that's why I'm coughing. It's down to 390-430.

So now I don't know what to do. I took some mucinex. I can monitor it. I mean I'll I've got is a runny nose and my breathing is going down.


Given that it's a year ago is there anything seasonal that grows or you eat that you are allergic to? Or is it just winter?
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#15 ktgrok

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Posted 13 November 2017 - 07:03 AM

Btw, how do we feel about christmas trees? I'm going in circles trying to decide this. I usually do 2 trees, and last year my asthma didn't clear up till I got rid of the last tree. We've also tended to get the smelliest (most fragrant) trees and keep them the whole season. 

 

So I had been looking at artificial and dh was like oh can we *try* doing real again... And tonight I'm at 350 and going south on my breathing and thinking wow, that's pretty dumb. I know I'm going to buy at least the basement tree artificial. But does this propensity to have something happen in a FLASH mean I could have real issues with the real tree? Or is it ok to chance it? The main floor tree would be 10'. Yeah...

 

As kids my sister and I had asthma (outgrew it) and Christmas trees were very much a trigger. 

 

As an adult they don't bother me at all.

 

Are you allergic to pines/firs? 

 

Also, when we did do live trees in our teens (after outgrowing it but still being cautious) my dad would wash off the tree with a hose outside, then let it dry before coming in the house. Just to get the pollen off of it that may have been on it from standing around in a forest or whatever. 

 

As for why your numbers are bad now, yes, a virus can be a trigger. As kids we only had asthmatic issues when we got sick...asthmatic bronchitis they called it. 


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#16 Monica_in_Switzerland

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Posted 13 November 2017 - 07:05 AM

I often sound worse after using inhaler/nebulizer because it breaks up mucous.

 

My asthma plan is for me to start treating with both a brochodilator and a steroid as soon as I have symptoms of a cold. I don't wait for asthma symptoms to show up but start preventative treatment. If I wait until asthma symptoms appear then about 50% of the time it's too late to prevent a flare-up.

 

I typically don't need to treat for asthma at any other times.

 

Ditto for my husband.  If he gets anything, ANYTHING viral, it turns into asthma.  As soon as he gets the sniffles, he's on an extra inhaler plus cortisone.  It might not be the right action plan for you, but that's something to set up with your pulmonologist.  This plan is what the doc came up with after multiples cold/flu seasons involving trips to the ER for asthma.  Now we know to just call in the cortisone.  He just saw a new pulm who is adding in a third inhaler in the hopes of reducing the need for cortisone because my poor DH has been taking so much and it's not great for the body long-term.  


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#17 PeterPan

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Posted 13 November 2017 - 09:16 AM

In my doc's defense, he might have said the plan if I had gone back after 3 months like he had said. ;)  I'm a really terrible patient. Other than the Urgent Care and then a pulm for the pneumonia, I haven't been to a doctor in 15+ years for myself, and that includes through childbirth. I got messed up by a doctor and stopped going. That's why the UC guy was pleased when I at least said I'd go to the pulm, lol.

 

He had told me he'd be aggressive if I started to get sick, but I thought he meant antibiotics. I didn't realize they would do steroids to fend it off. That actually would make a lot of sense! My breathing is still nasty this morning and I put in a call to the nurse at the pulm office. All this was late over the weekend, but now it's Monday and easier to get help.

 

I like that idea that they could mix, like adding the preventative inhaler in cold season or only when dealing with stuff, and then back off. I didn't feel good on it. I'm really sensitive to stuff and get headaches, etc. The daily preventative inhaler was making me not feel right. I forget exactly. Just remember it was enough that I was really glad when my numbers got good enough to go off.

 

As for why my numbers are so big compared to someone else's, I don't know. Maybe I have big lungs? I'm a big girl. Like emaciated I'm a size 12.  It took a while to go up that high, after everything was under control. It's way higher than it was in college, because I can tell that when I sing. Like I'm not a professional or anything, just singing with the congregation in church, but my breath is SO much bigger than it was in college. But I'm obsessive now about the cleaning. A lot of my life, looking back, was probably pretty dirty. We had cats in trailer with carpet, then dorms. Just dust and dirt city. Now I have solid surface floors and a roomba. The roomba makes a huge difference. Well up until the virus, lol. 

 

I missed one virus my ds had and this one got me. I think part of it is stress-related. Before when I got sick, I was under a lot of stress. Have had some stress again lately, and that plus the virus plus the asthma and boom. So I guess you could say my action plan was not to get sick, and it was working when I didn't get that other virus. But add the stress and now I'm down. So I think the steroid makes a lot of sense, a lot. Just waiting for them to call back. And I'll probably have to do the rescue again. My numbers were low this morning and it doesn't feel good. Thanks for explaining and verifying that I'm not crazy that I seem to cough more after the inhaler.

 

Oh, my numbers were in that like 230-280 range, I forget exactly, when he diagnosed me. That *is* low for me. That's really tight for me, can't walk. I can't even imagine sub-100. I'd probably die. Like that would just be awful on me. I'd be in the ER way before that.

 

 



#18 PeterPan

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Posted 13 November 2017 - 09:19 AM

Ooo, thanks for confirming washing the tree! I did some reading last night and they're saying it's the *mold* that is the issue. I know the mold sets me off, because we had to kill and paint dabs of mold we had in the bathrooms, etc. Even small amounts like that set it off. So that makes me think I'm not crazy about the tree. 

 

I'm thinking I'll buy fake and do a washed real just at the end to satisfy the dh, with the threat that if it's bad it has to go.

 

Calling back the pulm office. 



#19 PeterPan

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Posted 13 November 2017 - 09:32 AM

Got the nurse and she took everything and is talking with the doc. Thinks they'll try calling something in first. He's at the hospital now, seeing patients. It's kind of a fancy practice, where they do whiz bang amazing things way beyond what I need. I'm just small fry, lol. So anyways, they're on it. I'm gonna take it easy and use the rescue some more and try to get it up. Thanks for explaining that I had more options. I had no clue, and that's really my bad about not going back. It didn't occur to me he'd want to see me if I were doing BETTER, kwim? He's such a high end doctor, I hate to waste his time if I don't need to be there. But hey, if showing up and being his friend means he can keep me well, I can show up, lol. 


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#20 prairiewindmomma

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Posted 13 November 2017 - 11:47 AM

OhE, I have an asthma action plan. 

 

If I see a gradual creep down, I go from 1x a day on my preventative to 2x/day.

If I see a sudden drop or I feel a cold coming on, I start my albuterol inhaler every 4-6h and I bump my preventative to 2x/day immediately.

If I am still struggling, I call in.  Sometimes I get a three day boost of prednisone.

 

I got super, super sick like a month ago. I was under strict orders to come in when I hear the train wreck coming, iykwim. I got a 80mg prednisone shot in the bum, and that thing was like magic. I was sure I was going to end up with pneumonia again.  You can only get a couple of those a year.....but just know that there are options.  Permanent lung damage from pneumonia is a problem...

 

And, uh, yeah, you should be going in every 6 months for visits, even if you are well, at least for the first year or two newly diagnosed.


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#21 prairiewindmomma

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Posted 13 November 2017 - 11:49 AM

There is no freaking way I could handle a live tree.  I think you're a wee bit crazy for trying it.

 

Also, have you had allergy testing? I'd bet a $1 that you have an allergy to leaf mold.


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#22 Ausmumof3

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Posted 13 November 2017 - 12:59 PM

In my doc's defense, he might have said the plan if I had gone back after 3 months like he had said. ;) I'm a really terrible patient. Other than the Urgent Care and then a pulm for the pneumonia, I haven't been to a doctor in 15+ years for myself, and that includes through childbirth. I got messed up by a doctor and stopped going. That's why the UC guy was pleased when I at least said I'd go to the pulm, lol.

He had told me he'd be aggressive if I started to get sick, but I thought he meant antibiotics. I didn't realize they would do steroids to fend it off. That actually would make a lot of sense! My breathing is still nasty this morning and I put in a call to the nurse at the pulm office. All this was late over the weekend, but now it's Monday and easier to get help.

I like that idea that they could mix, like adding the preventative inhaler in cold season or only when dealing with stuff, and then back off. I didn't feel good on it. I'm really sensitive to stuff and get headaches, etc. The daily preventative inhaler was making me not feel right. I forget exactly. Just remember it was enough that I was really glad when my numbers got good enough to go off.

As for why my numbers are so big compared to someone else's, I don't know. Maybe I have big lungs? I'm a big girl. Like emaciated I'm a size 12. It took a while to go up that high, after everything was under control. It's way higher than it was in college, because I can tell that when I sing. Like I'm not a professional or anything, just singing with the congregation in church, but my breath is SO much bigger than it was in college. But I'm obsessive now about the cleaning. A lot of my life, looking back, was probably pretty dirty. We had cats in trailer with carpet, then dorms. Just dust and dirt city. Now I have solid surface floors and a roomba. The roomba makes a huge difference. Well up until the virus, lol.

I missed one virus my ds had and this one got me. I think part of it is stress-related. Before when I got sick, I was under a lot of stress. Have had some stress again lately, and that plus the virus plus the asthma and boom. So I guess you could say my action plan was not to get sick, and it was working when I didn't get that other virus. But add the stress and now I'm down. So I think the steroid makes a lot of sense, a lot. Just waiting for them to call back. And I'll probably have to do the rescue again. My numbers were low this morning and it doesn't feel good. Thanks for explaining and verifying that I'm not crazy that I seem to cough more after the inhaler.

Oh, my numbers were in that like 230-280 range, I forget exactly, when he diagnosed me. That *is* low for me. That's really tight for me, can't walk. I can't even imagine sub-100. I'd probably die. Like that would just be awful on me. I'd be in the ER way before that.


I understand a bit as I have had a bad doctor experience and now have bad anxiety about going. But your kids need you and you are talking about asthma so you really need to be incredibly strong and keep your appointments.

Gentle hugs... And if I'm out of line sorry I just know I need a push sometimes so I'm giving you one. A gentle loving and concerned one.
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#23 kiwik

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Posted 13 November 2017 - 02:18 PM

Well sub 100 does feel like dying from what I remember. It may actually have been close to dying but i have blocked that bit.

I would skip the real tree and look for other triggers if it has been a year.

Edited by kiwik, 13 November 2017 - 02:20 PM.

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#24 sbgrace

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Posted 13 November 2017 - 07:36 PM

My son, who didn't have asthma, developed viral triggered asthma after pneumonia. The bacteria that most often causes "walking" pneumonia can trigger asthma development according to a study I saw. I think he may have cleared it over the years. But for a while every single virus he got caused asthma.

 

He did a daily maintenance steroid based inhaler (the one you mentioned is that) until things got completely controlled. During viruses we immediately started his rescue inhaler every so many hours. We didn't wait for things to take a turn because it was tough to climb out. If he had trouble, we could do the rescue inhaler more frequently. 

 

(My other son has allergy mediated asthma. He does not handle live Christmas trees well at all. We haven't had a live one in 9 or 10 years, when it became clear it affected him. I would be reluctant to risk that if you know you've reacted in the past and your asthma is clearly not 100% controlled right now. In my experience, you'll likely be more reactive for a while after this.)

 

Basically, I think you need a plan from pulmonology.

 

If you want to do it yourself/won't see a doctor, I would use that maintenance inhaler daily or twice daily (however it was prescribed) at least through the winter, keep monitoring my numbers, and use the rescue as soon as I started getting sick or saw a number dip. Best would be to see a specialist. 

 

 


Edited by sbgrace, 13 November 2017 - 11:51 PM.

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#25 Peach

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Posted 13 November 2017 - 10:05 PM

November is always my worst month for bronchitis/pneumonia/asthma issues. Here, I think it's because the leaves have all fallen and are starting to decay as it begins to snow and it always sets me off.


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#26 PeterPan

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Posted 14 November 2017 - 01:05 AM

OhE, I have an asthma action plan. 

 

If I see a gradual creep down, I go from 1x a day on my preventative to 2x/day.

If I see a sudden drop or I feel a cold coming on, I start my albuterol inhaler every 4-6h and I bump my preventative to 2x/day immediately.

If I am still struggling, I call in.  Sometimes I get a three day boost of prednisone.

 

I got super, super sick like a month ago. I was under strict orders to come in when I hear the train wreck coming, iykwim. I got a 80mg prednisone shot in the bum, and that thing was like magic. I was sure I was going to end up with pneumonia again.  You can only get a couple of those a year.....but just know that there are options.  Permanent lung damage from pneumonia is a problem...

 

And, uh, yeah, you should be going in every 6 months for visits, even if you are well, at least for the first year or two newly diagnosed.

 

I didn't know you could do the preventative more often! That could make me actually like it. It clearly works. I just don't like the side effects. And I had the sense things were going south 24 hours before they started going south. And I had 24 hours before that where I knew I was fighting something and didn't know what to do. It was a Friday night and you kinda don't think through things very well I guess. I just thought well I'll hit the steam room and take C and beat it. Saturday night, I had the same feeling that I had the other two times before it went to bed and woke up with pneumonia. 

 

He went ahead and did a steroid and antibiotic. I wasn't thrilled about the antibiotic, but green is green, sigh. I figured if I didn't take it and got worse he wouldn't be happy. Meanwhile, yes, they scheduled me to get in and get a better game plan. I like hearing y'all's game plans. These are all kinds of iterations I had no clue I could have. I just thought it was take the albuterol and win or lose and end up on the antibiotic. I'm also going to, drum roll, go see a family practice doctor. Haven't done that, in, um, well lotsa years. I scheduled it today. It's the day before the pulm. So between the two, joy joy, we can make me a purring engine woman or something, I don't know, lol. This family practice guy focuses on hormones, and I'm thinking he might end up wanting to do some saliva testing for cortisol. I hate to go that route, but if my levels are low anyway, that could explain why I'm prone. Well that and having a round of pneumonia that I let go way too long one year because I had no clue. I think that's why I'm prone, that and maybe some low adrenals. I don't know. But I can't get answers if I don't launch out and try. 

 

So yeah, I'm now committed to becoming besties with this pulmonologist. I had no clue he'd want to see me when I wasn't sick. I just thought I would be bothering him. It's sort of a swanky place, with really fancy stuff they do. I'm just small fry in comparison. 

 

On the tree, yeah, it's crazy. My ultimatum is wash it and dry it or don't bring it in. That may make him give up. I don't know. I'm hopeless of it being safe, even with washing. I know last year it was a problem. When it's not the other people's lungs, they don't get how it feels. 


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#27 PeterPan

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Posted 14 November 2017 - 01:10 AM

Nope, haven't done the allergy testing. I definitely agree on the mold. He said if I didn't get the asthma under control he'd refer me off. I got it under control by dealing with all the things that were clearly setting it off (dander, dust, mold), and wasn't even needing the inhaler except for emergencies. So as long as I'm diligent with what works, I have an environmental plan that works.


Edited by OhElizabeth, 14 November 2017 - 01:11 AM.


#28 PeterPan

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Posted 14 November 2017 - 01:24 AM

I understand a bit as I have had a bad doctor experience and now have bad anxiety about going. But your kids need you and you are talking about asthma so you really need to be incredibly strong and keep your appointments.

Gentle hugs... And if I'm out of line sorry I just know I need a push sometimes so I'm giving you one. A gentle loving and concerned one.

 

Oh you're not out of line. I probably needed some reinforcement. I went ahead and made a family practice doctor appt as well, so I'm going to have TWO doctors, lol. I'm pretty nervous about it. I had thyroid labs 10 years ago showing I was low and didn't choose a doctor and go. I've just been eating rabbit food and taking kelp and hoping for the best, which hasn't totally worked. So yeah, I don't know what will happen. I think I'm kind of excited in a way, like I'm maybe ready to move on and try it or embrace a change. I'm scared about contradictions, like one person saying to do this and another saying to do that. But at this point I'm just going to TRY. 

 

I think this family practice doc specializes in hormones. I've never been to an OB. I don't know if I want to go THAT far. I guess I could, so long as I'm being radical, lol. Maybe they could screen with blood instead? 


Edited by OhElizabeth, 14 November 2017 - 01:25 AM.


#29 PeterPan

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Posted 14 November 2017 - 01:31 AM

I understand a bit as I have had a bad doctor experience and now have bad anxiety about going. But your kids need you and you are talking about asthma so you really need to be incredibly strong and keep your appointments.

Gentle hugs... And if I'm out of line sorry I just know I need a push sometimes so I'm giving you one. A gentle loving and concerned one.

 

And yes, it actually is scary when it's precipitous. Right now, my ds can't even call 911 for help. So if I were incapacitated, he literally couldn't help me. I think that needs to be part of the discussion with the pulm, to have a better action plan for when things go wrong. Like my everyday is pretty solid now, but the sudden ones, like once every three months, can be crazy. Like one day I laid down on the bed, and it must of been dusty or doggish or something. I don't know. I just woke up so bad and was going south so fast. Once I stayed in a hotel room that was dirty and set it off. Like you just don't know. But that's so infrequent that I don't want the side effectives of the preventative all the time. I just need a good plan for when that happens and then a virus exposure plan. 

 

I think I didn't want to go back and deal with explaining that I didn't want to take the preventative all the time. And yet, it's dumb because HE didn't want me to have to take it all the time either! He had said that, that he was hoping we'd get off of it after 3 months. So, hello, why didn't I go back? I must be a dingbat. 

 

Anyways, it's good to talk this out. I had no clue there were so many iterations and options and tools. 



#30 PeterPan

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Posted 14 November 2017 - 01:44 AM

My son, who didn't have asthma, developed viral triggered asthma after pneumonia. The bacteria that most often causes "walking" pneumonia can trigger asthma development according to a study I saw. I think he may have cleared it over the years. But for a while every single virus he got caused asthma.

 

He did a daily maintenance steroid based inhaler (the one you mentioned is that) until things got completely controlled. During viruses we immediately started his rescue inhaler every so many hours. We didn't wait for things to take a turn because it was tough to climb out. If he had trouble, we could do the rescue inhaler more frequently. 

 

(My other son has allergy mediated asthma. He does not handle live Christmas trees well at all. We haven't had a live one in 9 or 10 years, when it became clear it affected him. I would be reluctant to risk that if you know you've reacted in the past and your asthma is clearly not 100% controlled right now. In my experience, you'll likely be more reactive for a while after this.)

 

Basically, I think you need a plan from pulmonology.

 

If you want to do it yourself/won't see a doctor, I would use that maintenance inhaler daily or twice daily (however it was prescribed) at least through the winter, keep monitoring my numbers, and use the rescue as soon as I started getting sick or saw a number dip. Best would be to see a specialist. 

 

I had forgotten about being more reactive for a while. You're right, sigh. Double sigh. Triple sigh.

 

So they call that viral triggered asthma? Interesting. I'll try to read about that. That's definitely what happened, because I went from fine (like I had refilled the albuterol 2 months ago and hadn't needed it at all, making lots of data to be sure), to needing the rescue every HOUR. Not every 4-6 but every hour. 

 

It's a logical question to explore, whether it was controlled without the daily preventative. But really I keep that meter out on the counter to remember to check it. I was checking it a variety of times, with enough frequency that I felt pretty certain we were nailing it. And I use the meter because I don't trust my own assessment/guess. So sometimes if I thought I was feeling something, I'd check, rather than just doing the inhaler willy nilly. So I really think my numbers were good and consistent. Just this virus came along and shot it all up, sigh.



#31 PeterPan

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Posted 14 November 2017 - 01:49 AM

FDA Panel Recommends HPV Test As Replacement for Pap Smear – WebMD

 

Ok, is this for real? Are docs doing this?


Edited by OhElizabeth, 14 November 2017 - 01:57 AM.


#32 kiwik

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Posted 14 November 2017 - 04:04 AM

One other thing. It stinks but you do need to see the doctor regularly. Here you get a prescription that is good for 3 months worth of meds then you need to ring up and get another. After a couple of times (6 to 12 months depending on your situation) they refuse to give you more unless you see them first. Asthma inhalers cannot be bought any other way here so you have to be seen regularly.

And yes, first sign of something double your preventer and take your treatment inhaler at the same time as it seems to help you the preventer absorb.
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#33 transientChris

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Posted 14 November 2017 - 06:31 AM

I didn't know you could do the preventative more often! That could make me actually like it. It clearly works. I just don't like the side effects. And I had the sense things were going south 24 hours before they started going south. And I had 24 hours before that where I knew I was fighting something and didn't know what to do. It was a Friday night and you kinda don't think through things very well I guess. I just thought well I'll hit the steam room and take C and beat it. Saturday night, I had the same feeling that I had the other two times before it went to bed and woke up with pneumonia. 

 

He went ahead and did a steroid and antibiotic. I wasn't thrilled about the antibiotic, but green is green, sigh. I figured if I didn't take it and got worse he wouldn't be happy. Meanwhile, yes, they scheduled me to get in and get a better game plan. I like hearing y'all's game plans. These are all kinds of iterations I had no clue I could have. I just thought it was take the albuterol and win or lose and end up on the antibiotic. I'm also going to, drum roll, go see a family practice doctor. Haven't done that, in, um, well lotsa years. I scheduled it today. It's the day before the pulm. So between the two, joy joy, we can make me a purring engine woman or something, I don't know, lol. This family practice guy focuses on hormones, and I'm thinking he might end up wanting to do some saliva testing for cortisol. I hate to go that route, but if my levels are low anyway, that could explain why I'm prone. Well that and having a round of pneumonia that I let go way too long one year because I had no clue. I think that's why I'm prone, that and maybe some low adrenals. I don't know. But I can't get answers if I don't launch out and try. 

 

So yeah, I'm now committed to becoming besties with this pulmonologist. I had no clue he'd want to see me when I wasn't sick. I just thought I would be bothering him. It's sort of a swanky place, with really fancy stuff they do. I'm just small fry in comparison. 

 

On the tree, yeah, it's crazy. My ultimatum is wash it and dry it or don't bring it in. That may make him give up. I don't know. I'm hopeless of it being safe, even with washing. I know last year it was a problem. When it's not the other people's lungs, they don't get how it feels. 

Long time adult asthmatic whose sister had a first hard attack almost certainly precipitated by not following exact directions on a medication at age 32, DO NOT take your preventative more than prescribed without following your doctor's instructions.  I just looked up prescribing information for Arnuity,  It is inhaled flutucasone.  I take flutucasone for asthma in my nose.  This is a steroid and for one time a day.  If your DOCTOR prescribes that one more than once a day, fine. IIf you are worried about medications and how often the doctor prescribed them, talk with you pharmacist.  Pharmacists know more about drug interactions/etc than do doctors.  They are doctors- of Pharmacy.  Specifically, the stronger asthma daily preventatives like Advair, etc.  have a documented chance of higher death for asthmatics though overwhelmingly it saves more people than it kills.  I highly suspect that the higher death rate may partially or wholly be due to not following directions both because of confusion about what to do and no asthma plans and accidentally taking wrong inhaler, etc,  Asthma education is super important and all too frequently and probably in particular segments of the society, both the education isn't offered both because of overscheduling of doctors and lack of resources.  Poor people who depend on salaries and lose their job if they call out sick, have two jobs and are responsible for taking care of their children are all too often poorly served by our medical establishment.  But what ever the cause, DO NOT take more than prescribed with the asthma medicines without guidance.

 

I had forgotten about being more reactive for a while. You're right, sigh. Double sigh. Triple sigh.

 

So they call that viral triggered asthma? Interesting. I'll try to read about that. That's definitely what happened, because I went from fine (like I had refilled the albuterol 2 months ago and hadn't needed it at all, making lots of data to be sure), to needing the rescue every HOUR. Not every 4-6 but every hour. 

 

It's a logical question to explore, whether it was controlled without the daily preventative. But really I keep that meter out on the counter to remember to check it. I was checking it a variety of times, with enough frequency that I felt pretty certain we were nailing it. And I use the meter because I don't trust my own assessment/guess. So sometimes if I thought I was feeling something, I'd check, rather than just doing the inhaler willy nilly. So I really think my numbers were good and consistent. Just this virus came along and shot it all up, sigh.How

How are you taking the rescue inhaler- you did get a spacer or chamber- right?  If that isn't working, getting a nebulizer is even better.  I now don;t have to do ER runs in the middle of the night or Urgent care on weekends.  It really helps when stuff is bad.  I think the stats are something like 1x effective for without spacer, 8x more effective with spacer, 20 something more effective with nebulizer. 

FDA Panel Recommends HPV Test As Replacement for Pap Smear – WebMD

 

Ok, is this for real? Are docs doing this?

 

I have been tested a few times.  I am negative.  I have also had questionable paps a few times which involved more invasive testing and no cancer.  I talked with my OB/gyn about FDA regulations.  I already knew that while most cervical cancers are due to HPV (which is why FDA makes these pronouncements-CDC says you can now have a PAP every three years) not all are.  He explained that this is the way it is- if they catch the cancer, the first year- he and his collegeas in the office are able to just treat you with topical medicine and you will do fine.  If second year, it was more involved,  If third year, yes, you will survive but even more involved.  I can't recall exactly the progression of what he had to do but I understood and am back to yearly testing.  Especially since in my other discussions with my dermatologist who discovered my basal cell carcinoma- one of the medications I take increased the chances of me getting that- and my newest medication- Humira - also increases chances for cancer.

 

But that takes me back to your original complaint about the Asthma rescue inhaler-  all medications have side effects and risks.  I am not sure which side effect you didn't like- I don't like the fact that I get trush which I have to keep at bay with another medication at times- but welcome to life as a chronic illness patient.  We make our life choices and take our risks.  I withheld begging for a biologic because I made the bargain of what risks I was willing to take when my children were not in college yet.  I am now on one.  It has a boatload of potential side effects.

One other thing. It stinks but you do need to see the doctor regularly. Here you get a prescription that is good for 3 months worth of meds then you need to ring up and get another. After a couple of times (6 to 12 months depending on your situation) they refuse to give you more unless you see them first. Asthma inhalers cannot be bought any other way here so you have to be seen regularly.

And yes, first sign of something double your preventer and take your treatment inhaler at the same time as it seems to help you the preventer absorb.

My daughter has really had issues controlling her asthma in New Zealand because of various issues.  She had her epipen stolen and now has a syringe and a bottle of epinephrine as far as I know which really is not appropriate in her case, She needs an autoinjecter so the steward on a plane or stranger can inject her when her blood pressure plummets.  She has almost died numerous times and I am so scared of that.


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#34 ktgrok

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Posted 14 November 2017 - 07:11 AM

 

On the tree, yeah, it's crazy. My ultimatum is wash it and dry it or don't bring it in. That may make him give up. I don't know. I'm hopeless of it being safe, even with washing. I know last year it was a problem. When it's not the other people's lungs, they don't get how it feels. 

 

Having spent many a Christmas laying in bed, too low on oxygen to even want to unwrap presents, I get it. The tree isn't worth it. It just isn't. I LOVE going to pick out a live tree, but my mom was right to make our new tradition drinking cocoa and putting together the artificial one. It really did make a difference. If I thought any of my kids or myself were bothered by a live tree now I'd get a fake one in a heartbeat. 


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#35 prairiewindmomma

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Posted 14 November 2017 - 10:22 AM

Is the he ds or dh?  My dc got over the live tree business the year I bought Star Wars cookie cutters from Williams Sonoma and we made applesauce/cinnamon ornaments.  They are beautiful and smell good.....it turns out that they just wanted a tree that had a good smell.


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#36 PeterPan

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Posted 14 November 2017 - 11:19 AM

Chris, that's a really good point on the meds. I definitely won't go dosing it a different way until I see the doctor. I'm scheduled and they said if I had ANY more problems they'd get me in with a sick appt. So there's no reason for me to guess at this point, as they would get me in pronto if anything happens. 

 

 

Is the he ds or dh?  My dc got over the live tree business the year I bought Star Wars cookie cutters from Williams Sonoma and we made applesauce/cinnamon ornaments.  They are beautiful and smell good.....it turns out that they just wanted a tree that had a good smell.

Ooo, I like this! I was thinking about doing this with ds. You're right that it would be nice and maybe smooth things over. Need deer shapes though, haha.

 

Having spent many a Christmas laying in bed, too low on oxygen to even want to unwrap presents, I get it. The tree isn't worth it. It just isn't. I LOVE going to pick out a live tree, but my mom was right to make our new tradition drinking cocoa and putting together the artificial one. It really did make a difference. If I thought any of my kids or myself were bothered by a live tree now I'd get a fake one in a heartbeat. 

 

Yeah, that was my vision, focusing on the together part and less on the chop chop. I had another compromise hit me. He could chop down a tree and keep it on the porch! It would keep better that way, and it's all the rage to have outdoor trees here. I've been trying to improve my outdoor decorating plan, which essentially had been nill till last year. So that could be an acceptable compromise.

 

So now I'm just trying to pick the basement tree. I picked the main floor tree, because there's only one option that comes in the size. For the basement, I have a bunch of options since it's that common 7.5' thing. I admire people who have these artistic trees (scrawny and filled with ornaments), but we always get FAT trees. So I've narrowed it down to the FATEST tree the company sells or the SCRAWNIEST, which seems like an impossible contradiction.  :lol:



#37 ktgrok

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Posted 14 November 2017 - 11:28 AM

I LOVE LOVE LOVE the idea of the outdoor tree!!!

 


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#38 pumpkin spice surprise

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Posted 14 November 2017 - 11:38 AM

I know you don't like doctors, and they can be a pain, but I'm glad you're going. Asthma and lung issues are nothing to fool around with. 

 

As far a primary care doctor goes, it's nice to have someone who has some history with you when you do get sick. They can also work with you to sort out a preventative care schedule that works for you. 

 

Someone mentioned "knowing" the decline was coming... that is totally a thing... and maybe explains some of the "anxiety" I've been having...

 

I hope you're feeling better soon!


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#39 Southern Ivy

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Posted 14 November 2017 - 11:41 AM

Btw, how do we feel about christmas trees? I'm going in circles trying to decide this. I usually do 2 trees, and last year my asthma didn't clear up till I got rid of the last tree. We've also tended to get the smelliest (most fragrant) trees and keep them the whole season. 

 

So I had been looking at artificial and dh was like oh can we *try* doing real again... And tonight I'm at 350 and going south on my breathing and thinking wow, that's pretty dumb. I know I'm going to buy at least the basement tree artificial. But does this propensity to have something happen in a FLASH mean I could have real issues with the real tree? Or is it ok to chance it? The main floor tree would be 10'. Yeah...

Late to the game, but I stay the heck away from them. I haven't had much asthma trouble since my late teens, but holy Moses - I can tell when there is a real Christmas tree around. 

I really think it's unwise to have an ongoing asthma condition and taunt it with something that is going to keep you sick until you get rid of it. 
For what its worth, my whole family used to be constantly sick around the holidays. My dad would always have sinus issues, I'd have bronchitis, etc. We recognized the trigger and the year we got our first artificial tree was the 1st year in 6 that none of us were sick. Real trees are banned in my home now.


Edit: I just read that you decided on an artificial. Smart lady. ;) 


Edited by Southern Ivy, 14 November 2017 - 11:42 AM.

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#40 Ottakee

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Posted 14 November 2017 - 04:00 PM

I know you don't like doctors, and they can be a pain, but I'm glad you're going. Asthma and lung issues are nothing to fool around with. 

 

 

As the respiratory therapist said at the hospital when my dd was little, If you can't breathe than NOTHING else matters.  Seriously, breathing needs to rank right up at the top. :-)


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#41 PeterPan

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Posted 14 November 2017 - 10:43 PM

As the respiratory therapist said at the hospital when my dd was little, If you can't breathe than NOTHING else matters.  Seriously, breathing needs to rank right up at the top. :-)

 

This is so real! 

 

Ivy, yes, I took the plunge on going artificial. Hopefully dh likes what I ordered.  :crying: 


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#42 PeterPan

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Posted 14 November 2017 - 10:44 PM

I LOVE LOVE LOVE the idea of the outdoor tree!!!

 

Yeah, I was feeling kinda brilliant there, lol. Then it occurred to me it didn't have to chop chop, that it could be the live kind that you plant somewhere. So I could get smart and figure out how to do that maybe. But I thought it was really fun either way. 



#43 kiwik

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Posted 15 November 2017 - 01:36 AM

Long time adult asthmatic whose sister had a first hard attack almost certainly precipitated by not following exact directions on a medication at age 32, DO NOT take your preventative more than prescribed without following your doctor's instructions. I just looked up prescribing information for Arnuity, It is inhaled flutucasone. I take flutucasone for asthma in my nose. This is a steroid and for one time a day. If your DOCTOR prescribes that one more than once a day, fine. IIf you are worried about medications and how often the doctor prescribed them, talk with you pharmacist. Pharmacists know more about drug interactions/etc than do doctors. They are doctors- of Pharmacy. Specifically, the stronger asthma daily preventatives like Advair, etc. have a documented chance of higher death for asthmatics though overwhelmingly it saves more people than it kills. I highly suspect that the higher death rate may partially or wholly be due to not following directions both because of confusion about what to do and no asthma plans and accidentally taking wrong inhaler, etc, Asthma education is super important and all too frequently and probably in particular segments of the society, both the education isn't offered both because of overscheduling of doctors and lack of resources. Poor people who depend on salaries and lose their job if they call out sick, have two jobs and are responsible for taking care of their children are all too often poorly served by our medical establishment. But what ever the cause, DO NOT take more than prescribed with the asthma medicines without guidance.

How are you taking the rescue inhaler- you did get a spacer or chamber- right? If that isn't working, getting a nebulizer is even better. I now don;t have to do ER runs in the middle of the night or Urgent care on weekends. It really helps when stuff is bad. I think the stats are something like 1x effective for without spacer, 8x more effective with spacer, 20 something more effective with nebulizer.

I have been tested a few times. I am negative. I have also had questionable paps a few times which involved more invasive testing and no cancer. I talked with my OB/gyn about FDA regulations. I already knew that while most cervical cancers are due to HPV (which is why FDA makes these pronouncements-CDC says you can now have a PAP every three years) not all are. He explained that this is the way it is- if they catch the cancer, the first year- he and his collegeas in the office are able to just treat you with topical medicine and you will do fine. If second year, it was more involved, If third year, yes, you will survive but even more involved. I can't recall exactly the progression of what he had to do but I understood and am back to yearly testing. Especially since in my other discussions with my dermatologist who discovered my basal cell carcinoma- one of the medications I take increased the chances of me getting that- and my newest medication- Humira - also increases chances for cancer.

But that takes me back to your original complaint about the Asthma rescue inhaler- all medications have side effects and risks. I am not sure which side effect you didn't like- I don't like the fact that I get trush which I have to keep at bay with another medication at times- but welcome to life as a chronic illness patient. We make our life choices and take our risks. I withheld begging for a biologic because I made the bargain of what risks I was willing to take when my children were not in college yet. I am now on one. It has a boatload of potential side effects.
My daughter has really had issues controlling her asthma in New Zealand because of various issues. She had her epipen stolen and now has a syringe and a bottle of epinephrine as far as I know which really is not appropriate in her case, She needs an autoinjecter so the steward on a plane or stranger can inject her when her blood pressure plummets. She has almost died numerous times and I am so scared of that.


Yeah epipens are unfunded here so they prescribe vials and syringes. Most people buy epipens at high cost anyway - can you imagine trying to fill a syringe out of a vial while your 3 year old is going into analphylactic shock.

With the doubling of the preventers - You set up a plan with your doctor. Eg above 450 normal meds, below 450 take reliever, if it keeps dropping double preventers, below 300 see doctor urgently, below 100 call an ambulance. Varies from person to person but you have pre discussed actions. Doubling the preventer short term (days to a week) is preferable to prednizone.
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#44 prairiewindmomma

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Posted 15 November 2017 - 09:36 AM

FWIW, the latest studies show that you can pre-fill the syringes and they are stable for up to 3 months. I take an injectable medication regularly and I can't imagine trying to draw a syringe while anaphylactic myself.



#45 PeterPan

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Posted 15 November 2017 - 11:17 AM

Is a nebulizer expensive? I've had 2 occasions now in this calendar year where I would have used it if I had it. If it's expensive or a maintenance issue, it's cheaper and easier to go to Urgent Care. But if it's not expensive or hard to maintain, it's the kind of thing that I could actually have on-hand. Like I think during this virus gig, where I was having a hard time getting it under control, the nebulizer would have been brilliant. If I had it, I'd probably use it more liberally on those borderline things. But I actually pay for my stuff (HSA, high deductible), so I don't want to go crazy here.

 

The pulmonologist appt is in a month, so I'm sure we'll be talking through game plans. I can ask him for anything I want. He seems pretty agreeable. 

 

If you do the nebulizer and buy it, then do you buy a separate vial of medication that is used with it? So then I'd have issues of it being stable, stable when opened and partially used, etc., yes? Or can you hook your regular albuterol inhaler up to it? Like if I could just use the medication I have but with a machine, that would be very efficient and a good buy. Yes, I have the extender. It's AWESOME, would never want to be without it. Like when I go out and take my inhaler, I always take the extender too. Way, way, way more effective. 

 

I think I'm still fighting the viral component of this, because I'm still tired. 



#46 prairiewindmomma

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Posted 15 November 2017 - 11:28 AM

Our insurance covered the nebulizer, because ER trips are expensive.  I think the cash price was <$100 for our tabletop and tubing. Cleaning it is super easy.  I've had the same nebulizer since 2005.   You buy separate vials of whatever (albuterol, pulmicort) and tip it into the dispensing cup which then gets aerosolized.  Vials of albuterol are WAY cheaper than inhalers, at least under my insurance plan.

 

If I were to buy one, cash price, for myself now...I think I'd get a travel nebulizer for portability. The tabletop takes up space. I like the looks of this one: https://justnebulize...em-ne-u22v.html  My asthma attacks rarely happen conveniently at home.

 

 


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#47 prairiewindmomma

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Posted 15 November 2017 - 11:31 AM

I looked up on goodrx what a box of liquid albuterol is---25 vials. <$10. https://www.goodrx.com/albuterol

 

So, for <$100 you could get a tabletop nebulizer + albuterol, or for under $200 you could get a portable neb + albuterol.


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#48 Ottakee

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Posted 15 November 2017 - 12:27 PM

For under $100 you could get a table top nebulizer, the tubing and mask/mouth piece, a 25 dose set of albuterol, a peak flow meter, and an oximeter.  The peak flow meter and oximeter both help with seeing how well/poorly you are doing.  They are not an end all/be all but if you see drops in either numbers you know it is time to take action.  Some people have one drop before the other.


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#49 PeterPan

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Posted 15 November 2017 - 01:10 PM

Wow, those are really good prices. I had no clue. I assumed it was a bulky, $300-400 kind of thing. For those kinda prices, and for just the peace of mind, it would be a nice thing to have. You're right, I could pay for it with one trip to Urgent Care, and I've had two times now where I was that close to going. And that's just one calendar year not even completed, sigh. So that would be smart.

 

Ottakee, yes, I'm all over the peak flow meter. I don't have an oximeter. 

 

How often do you use the nebulizer when you're using it? Not to sound dumb here. It seems like when those sudden things come on that are low, you end up needing it much more frequently. So is the nebulizer so much more powerful that you're like oh, one and done? Or do you do it every hour or something? And do you go by the numbers to decide when to use the regular with extender and when to use the nebulizer? 

 

And then is there some kind of clean-up gig with nebulizer use? Like if you're just using it for emergencies, then is there 30 minutes of clean-up or something?


Edited by OhElizabeth, 15 November 2017 - 01:11 PM.


#50 Ottakee

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Posted 15 November 2017 - 01:44 PM

Wow, those are really good prices. I had no clue. I assumed it was a bulky, $300-400 kind of thing.

 

Ottakee, yes, I'm all over the peak flow meter. I don't have an oximeter. 

 

How often do you use the nebulizer when you're using it? Not to sound dumb here. It seems like when those sudden things come on that are low, you end up needing it much more frequently. So is the nebulizer so much more powerful that you're like oh, one and done? Or do you do it every hour or something? And do you go by the numbers to decide when to use the regular with extender and when to use the nebulizer? 

 

And then is there some kind of clean-up gig with nebulizer use? Like if you're just using it for emergencies, then is there 30 minutes of clean-up or something?

I saw nebulizers online for the basic table top model which does the job just fine for $35-45.  The tubing kits I think are $7 each but I could be wrong.  They generally last 3-6 months or so depending on how often you use it.  If you rarely use it we have gone a year.

 

When you use the nebulizer for us it is a several time a day thing for several days.  So if numbers are low, dd gets out nebulizer and does it.  Then 4-6 hours later does it again, repeating the cycle for 2-3 days.  Each treatment takes 10-15 minutes or so but easy to watch TV, read, etc. while doing it.  Depending on the medication in the neb treatment (we have used Albuterol, Xeopenex, and Duo Neb) it can be used as often as treatment, wait 20 minutes, treatment, wait 20 and treatment again (for really bad attacks) but at that point you need to be calling your doctor most likely for an oral steroid burst or trip to ER.

 

We have learned over the past 20 years with dd when to start treatments (better early than late), how often, when we need ER, when to just start oral steroids, call the doctor, etc.

 

Make sure the doctor knows you need an asthma action plan that spells out if A then B, if response is good then do C, if response is fair, then do D, etc. and on and on.  It all sounds confusing but once you have a good plan it is really quite easy.

 

For my daughter we know that if she is traveling, camping, or has the very first hint of a cold/cough/nasal congestion, etc. we start the preventative inhaler right away and if she is already using it we double it....even before any drop in peak flow.  Then if we have a cough she does Duo Neb twice a day and goes from there based on her responses.  Our doctor gave me a 5 day steroid burst to have on hand for nights, weekends, etc. so we can start it if needed and call them vs. having to try to go out and get a prescription filled at 2am or go to ER.

 

The whole key to asthma management is to be proactive and prevent as many big attacks as you can.  You can't prevent them all but we have reduced the need for steroids, the albuterol, etc. just by addressing it with the first hint of a symptom.

 

As to cleaning the nebulizer, you just rinse the med cup and you are good to go for the most part.  Maybe a 30 second clean up :-)


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