Treament for Cough Variant Asthma

[Shellydon]

Does anyone here have cough variant asthma?  I have been dealing with this for a decade, but my usual treatments are not working.  I am on my third trial inhaler and I just cannot quit coughing.  Having a cough during Covid is NOT a good thing.  I take allergy meds and singulair in addition to a daily inhaler.  I used Breo for years, but it just quit working.  I have tried Symbicort and Dulera, but not luck.  I did a round of oral steroids, which worked, but 3 days after stopping I am coughing again. 

[PeterPan]

Well this is a totally out there suggestion, but it's what worked for me. One, I bought a roomba and started running it religiously. Two, I started taking turmeric. https://www.vitaminshoppe.com/p/triple-strength-curcumin-900-mg-120-capsules/vs-2564  This is the exact product I take. There are some studies on turmeric and asthma, and the general idea is reducing inflammation. I was stable on 3 capsules a day for about a year then coronamess started. Now I take 4 a day. The stress definitely makes it flare up, and you've probably been under stress.

I can't say how far those things would get you. 

[Tanaqui]

Well, is it possible that your home cleaning routine needs to be more stringent? More mopping, change the HEPA filters more frequently, triple check for mold and bugs in weird places, have everybody change their clothes (especially taking off shoes) and wash their faces and hands when coming in from outdoors, and so on?

[Paige]

Have you tried a shot? I've had to get shots a few times when the oral meds aren't enough. I expected them to work within 24-48 hrs but they didn't. It took about a week for the cough to significantly improve. This spring I avoided the shots by using a nebulizer at least 3-4 times a day for at least a week. They gave me something different in the nebulizer this time- I think it was ipratropium. It definitely made me cough more while I was using the nebulizer but it helped more throughout the day than the other stuff I'd been using.

I have cough variant asthma that is not allergy induced. Do you know your triggers? Mine is triggered the most by viral infections so cleaning wouldn't help. Inhalers have never been enough to settle it down.

 

[Pippen]

Have you seen a pulmonologist?  I have a friend who was treated for asthma for several decades and it turned out it wasn't asthma, but instead was a vocal cord problem. Hers was a similar situation--not responding to meds--and it was a pulmonologist that got to the bottom of it. 

My asthma didn't get under complete control until my allergies were under control, which in my case included years of allergy shots. 

[Monica_in_Switzerland]

Much sympathy.  My DH is stable right now, but has very difficult to control asthma.  And hearing someone cough all night is heartbreaking.  

[Laura Corin]

For my eldest, running an air purifier overnight in the bedroom was a complete cure.

[Ottakee]

Even though my nose was never runny, or stuffy, I added Flonase twice daily along with the Airduo and it really helps.

[MEmama]

Ugh, I hope you find the solution soon. Before DS's asthma was identified and brought under control, he used to cough so much he’d throw up. It could last for weeks, so we had to send him to school that way. It was awful, and like a pp said, heartbreaking and scary.

Are you working with your asthma specialist? Do you have fall allergies? Ours are terrible this year. 

[almondbutterandjelly]

You need to discuss this with your doctor.  They have additional things they can do, but they can't help you if you don't contact them.

I just got upped from Breo to Advair.  Apparently Breo is on the low end of things.  It's only available in 100 and 200.  Advair is 250 to start and can be 500.  I don't know about Symbicort and Dulera.

Please contact your doctor.  There are lots of things they can do to get this under control.

[G5052]

I've had it for some forty years. I use the NeilMed sinus rinse system, antihistimines, Symbacort, Floanase, and allergy shots. I use a CPAP which I think has had a positive effect because of the moisturized air from that. 

We are renting a carpeted house, and I know that it's not good for me because we had wood floors and a whole house filter in our previous house that we sold. Still, I haven't had near as much coughing as I did say 5-6 years ago.

When I go into significant allergy situations, I take an additional antihistamine. When I worked in receiving at Macy's I always took one because it was moldy, and I take one now before church because they have black mold that wasn't properly treated in the basement. Even not going into the basement, it fires me up. 

When I have trouble sleeping because of the coughing, I take a cough suppressant.  

[PeterPan]

9 hours ago, Pippen said:

Have you seen a pulmonologist?  I have a friend who was treated for asthma for several decades and it turned out it wasn't asthma, but instead was a vocal cord problem. Hers was a similar situation--not responding to meds--and it was a pulmonologist that got to the bottom of it. 

My asthma didn't get under complete control until my allergies were under control, which in my case included years of allergy shots. 

If op is interested in exploring this, there are some things she can do at home to see if it's part of the problem. I sorted my breathing problems out using a peak flow meter (under $20 on amazon) and a pulse oximeter. The vocal cord dysfunction causes the problems on the *in* (at least for what I had going on) and the asthma causes the problems on the *out*. So I set up a chair or bench and did a step test for something like 2 minutes. I'm not sure I even finished because I was so about to have serious problems. Did my peak flow meter, and my output was HIGHER than before. My oxygen was also higher. So it was not my asthma causing those particular symptoms but the vocal cord constriction. 

I looked into testing for it, but it was sort of complicated, with exclusions to make, etc. Fortunately, just making the changes in breathing patterns, relaxing that area of the throat, etc. was enough to get me improvement. But yeah, it can be a pretty serious issue and there is a lot of overlap symptomatically with asthma. I had the really classic stridor, so you can hear me wheezing on the *in* during exertion. It also caused a severe sensation of not being able to get enough air and eventually panic attacks.

If op googles vocal cord dysfunction, she'll find lists of exercises. Part for me was learning to relax that area very intentionally. I also used this book https://www.amazon.com/Runners-World-Running-Air-Revolutionary/dp/1609619196/ref=sr_1_5?dchild=1&keywords=running+on+air&qid=1599920883&sr=8-5  to learn how to regulate my breathing. I would go run/walk at the track very intentionally practicing. It took a while for it to become more automatic. Now when I inhale for an exercise I relax that area. 

Inhalers are kind of a funny thing, because you're relaxing other things too. I had been having some problems with what I didn't realize was a bit of a hiatal hernia (not diagnosed, but the symptoms fit) and my inhalers improved it. I thought those symptoms (which I didn't realize had a name) were somehow connected to the asthma, and I didn't realize I was incidentally improving them breathing in the muscle relaxers. So once I realized what the problem was, I found other ways to get it done. (cranial sacral, intentionally releasing that area, etc.)

Oh, and my pulmonologist was bunk. I'm sure there are good ones. I was just too small fry for the guy even to care. I ended up sorting it all out on my own. I've heard there are pulmonologist nurse practitioners. Maybe find someone who wants to spend some time and actually help sort it out.

Well this is crazy. I was trying to find that old thread on vocal cord dysfunction and it's not showing up in the searches, sorry. But yeah, if you have a peak flow meter you can sort out some of that yourself to know what you need to pursue further. If it's the asthma, your output should drop on the peak flow meter. 

Edited September 12, 2020 by PeterPan