I need asthma help

[1confused1]

I put this in the randoms the other day. I was recently diagnosed with asthma and ended up in the ER the other night. I have an appointment with my primary care physician on Tuesday and could use all the advice that I can get.

I’m going to be open here so apologies in advance.

The bad attacks that I have had this week, especially the one that landed me in the ER, make me completely unable to catch my breath, I lose bladder control and on Wednesday night I fell. The ER did take a chest X-ray (clear) and sent me home with nebulizer treatments, oral steroids, cough medicine and I already had a rescue inhaler, steroid inhaler and am on Singulair.

What should I be asking my doctor? Is there something you take that might be worth asking her about?

[gretchenindisguise]

I'm on daily qvar and singulair. During good days - I do 2 puffs am/pm and when I'm sick - I up it to 4 puffs am/pm.

For my 9yo, when he's sick - he needs consistent nebulizers, even if he thinks he doesn't need it. We need to do 2-3 a day for a week or so to get it back in check. He's also now also on qvar, and if he uses it, he's good. If he misses a dose or two, we can tell easily.

So we have had good luck with qvar, but I would also just say that consistently doing the nebulizer, even if you don't think you need it can help you get over the hump.

[mommyatty]

It helps to understand if there is something that triggers your asthma, so I would ask for a list of things to look for, like exercise or certain smells or heat or cold or allergies. I was diagnosed a few years ago, and my asthma is generally allergy-induced. So I use Flonase every day as well as Allegra as needed. Plus a steroid inhaler I use twice a day, and I have a rescue inhaler and nebulizer as needed. I agree that if you get sick, if you are congested or at all wheezy, use the nebulizer! Even if you think you’re staying on an even keel, just do a breathing treatment. You’ll be shocked at how much it opens up your lungs.

[meanie]

Ditto mommyatty, do you know what triggers it?

I had severe asthma as a kid, turned blue and had many hospital stays. I did breathing treatments daily and had a nebulizer.

I had a bad attack while on vacation and I guess my parents had to bring me to a Dr where we were and they put me on some daily treatment that totally improved my life. It was two pills with crushed powder that you would inhale - similar to the Advair Diskus.

My symptoms were gone by the age of 7, I have asthma now as an adult that is managed with an inhaler that I only use when I am sick or if I exercise in the cold.

Just keep going back to your doctor until you find the right combination. I had a rough time in January when I was getting over some upper respiratory virus and had similar symptoms - shortness of breath, coughing spells that knocked me down, I was wearing a diaper made from paper towels 24/7....not fun! I hope you find a solution soon. 

[ProfessorArtNerd]

Eventually, I went to an asthma specialist. My asthma is exercise and allergy induced. And lucky me, I’m allergic to dust mites and mold spores. I took singular for a long time (gave it up while pg and nursing). You might need oral steroids. Also, it takes a while, or at least it did for me, to get things under control.

Also, I hear that re:bladder control. When I’m in a flair, I use pads bc I’m constantly peeing a little.

I hope you feel better soon!

[purplinsky]

I vote for a specialist. I see an allergist for my asthma, but mine is allergy and exercised induced. I'm on a maintenance medicine, take allergy medicine, and get allergy shots and my asthmas is super well controlled now. Before going to the allergist I was having attacks almost daily, sometimes multiple times a day. I didn't have to go to the ER, but it was bad enough that it would take me out of everyday life. I've been asthmatic since childhood so I know enough of my triggers and early signs that I was able to prevent the attacks from getting too severe, I just wasn't being proactive with my treatment.

[rhian]

I'm so sorry you're dealing with this! Adult onset asthma can be really difficult to diagnose and manage. My partner was diagnosed 6-7 years ago, and the process also involved some ER visits. It's taken awhile, but it is reasonably well controlled now. He can identify and avoid most triggers, though he does sometimes still have some unexplained bad days.

I'd try to see a specialist - my partner sees a pulmonologist, since he has found that GPs are just not at all equipped to handle his kind of asthma. I'd also not hesitate to get a second opinion or switch doctors if you don't think one is working for you. He has found that some are better than others at trying to problem solve his asthma, since it is pretty atypical, especially compared to those who were diagnosed as children. He's on several daily inhalers and meds, and it took awhile of switching and trying different things to get the combination that works for him, since things that often work for other asthma patients have not always worked for him. The two game changers for him were Spiriva (typically used to treat COPD, but sometimes used for asthma) and Xolair (monthly injection). He also has bad negative reactions to albuterol, so takes prednisone if he's experiencing really bad symptoms. I'd recommend not hesitating to tell your doctor if it doesn't seem like the meds/inhalers you're on are working for you. He's needed to really advocate for himself often in the process of getting on the right combination of medication.

I agree with trying to identify triggers. My partner has been really attuned to what he does/eats when he has bad asthma days. He's figured out that he is sensitive to many fragrances, so we have stopped using some products (e.g. I no longer use any perfume) and switched over to many fragrance free products. We also avoid any aerosolized products (we do regular sprays if needed). He's also found that some foods seem to trigger his asthma - not clear if they are actual food allergies, but he just avoids them. If you're experiencing a lot of bad days/asthma attacks, I'd try to keep a log of what you did, pollen levels, foods you ate, etc, to try to see if you can identify patterns.

I also recommend asking about a sick plan - since having asthma, respiratory illnesses (colds etc) often hit him harder, so he knows that he needs to try to treat symptoms early to try to avoid ending up on a course of prednisone.

Good luck!

[picksthemusic]

I agree with PPs about seeing a pulmonologist and getting on a good regimen of medications that control your flare-ups. Knowing your triggers is also key. I have exercise-induced asthma, and cold outdoor air is a huge trigger for me (makes going Girl Scout camping in the Fall SUPER fun). Seeing an allergist might also help so you can find out if you are allergic to anything that could also be a trigger, and getting on medication to assist with that as well.

It's complex and can be scary when you can't get it under control (I have had to help treat several new-onset adults in my urgent care days), so I hope you can get some answers and help soon.

Good luck!

ETA: Here is a quiz that we use in clinic (when I was in primary care) to see how well a patient's asthma was controlled. This is useful for your provider so they know how you're doing.


www.asthmacontroltest.com/quiz/adult-quiz/

[wanderlustmom]

Thinking of you! Our 19 year old son has had it his whole life and Qvar has worked really well with him. And of course taking the inhaler when he's got a flare. We have also done oral steroids a few times but luckily not in a long time. His is viral induced so his symptoms are worse when he has a cold. We also saw a pulmonologist and now he's managed well enough through his regular doctor. But if we ever have a big issue, we will go back to the pulmonologist. They can test your breathing and figure out (like others mentioned) what causes yours. I agree that asthma is so complex.

[twinmomma]

Have you only done the chest x-ray? Have they done a CT scan or pulmonology exam/tests?

I ended up with a bunch of small pulmonary embolisms after getting covid and it presented like really bad asthma attacks. They were small enough that it didn't show up on xray but did show up on CT scan.

A pulmonologist can also test your breathing. They measure lung capacity and all kinds of other stuff to help establish a baseline and a treatment plan.

[fluffycookie]

I vote specialist - either a pulmonologist or asthma specialist. Several years ago I had a flare that was caused by an illness and allergies and I could not get rid of the cough and asthma symptoms for almost 6 weeks. When I would have these fits I would have to stop what I was doing because I couldn't catch my breath and often I would have bladder leakage. I was put on something else in addition to multiple rounds of steroids and rescue inhalers, but I can't remember what it was. Good luck! I hope you get some relief soon.