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Cold air and Asthma
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donmol posted:
Well since the winter has decided to come to the Northeast Kingdom here comes the asthma symptoms. I just got over pneumonia and now the cold air. I was on a taper of prednisone now back to 60 mg daily with a neb treatment lasting 3 hours. I am afraid this going back into pneumonia and my pulmonologist is suggesting IV steriods. I am getting scared with all the steriods that have been pumped through my body. Is there any other alternatives? I have tried everything and now the cold air. I do use a heavy scarf to cover my mouth when I go outside but I try to stay inside on the real cold days but I have to go out to go to work. Please send me any suggestions I would love to hear from anyone. My bone scan already shows osteopenia at the age of 36.
donmol
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amcate responded:
I do not know what will work for you, but this is how I managed to decrease pred dependence.

I probably had mild cough variant asthma for 8 years before it turned more aggressive and I got a formal diagnosis 12 years ago and went on asthma meds. I read a lot, and am very actively involved in my care, which can make me a difficult patient. The first meds were Flovent 110 and Albuterol. There was mold growing from my walls due to a flood and the asthma went south. I reasoned that corticosteroids decrease inflammation, that the mold must be causing an allergic response (which would result in inflammation) and so I needed to increase the Flovent. I went to ask the family practice doctor, and he refused, so I said "screw you" and got a second opinion from a specialist, who put me on prednisone right away. The first thing is that I read a lot and did not automatically follow the doctor.

As time went on, there continued to be problems. So, I made a journal of when the asthma attacks occured, such as "every time I get a cold there is a severe attack within 2-3 weeks, and half of the time I have a severe attack I had a cold beforehand" or "half of my total attacks occur while in the car, especially on the freeway". So, I was able to deduce pollution and infection as major triggers. I also had the allergy tests down, and learned how to avoid those things. However, I could not tolerate the shots and went into attacks with them.

After a year, still there were problems. I lived in one of the worse polluted counties, and I reasoned given the information about half of the attacks being in the car that perhaps I should move. I spent the next year and a half traveling in my job, and in fact when I moved out of that city my peak flow increased 20% in the first month.

I also notice how I respond to medicines depending on the trigger. For instance, I know that every time I have a cold, I will have a severe attack in a few weeks. The doctors said to wait for the attack before taking pred. But if I did that, I would have to take a lot of pred to get over it. So, I experimented with taking three day burst before the asthma got that bad, and discovered that prevented the severe attack from happening. Instead of taking 400-500 mg of pred after a cold, I was able to take 120 mg. If I had exposure to low amounts of allergens, typically that is a gradual decline, so I have time to try to double the inhaled corticosteroid. Those attacks normally do not go extreme for several weeks.

I also read a book on decreasing every respiratory irritant you can think of-using baking soda and vinegar to clean, using plants in the home that NASA research said absorbs indoor air pollutants, not using dairy (but no sodas and doing weight bearing exercise as well as calcium fortifide soymilk to help bones), eating high water content food high in antioxidants (also good at decreasing inflammation), changing out passanger air filter in car, using refrigerated air and no swamp cooler and a good filter, and wearing a mask to help prevent infection. It's a lot of stuff, and I grow tired and cranky of it all, but the pred did go down a lot. I also observed too low humidity or too high and unhappy lungs. So, I bought a humidifier which kills mold and a humidity measurer to keep it just right.

For me, it's not just one thing, but more of a web of causation. Meaning, each thing contributes a little to the unhappy lungs, and by addressing several little things all together it adds up to a big effect.

I still have to worry about the balance you speak of, though. I get concerned with wanting to take pred when it is needed, but not wanting the damage it can cause. It takes a lot of energy to figure out that balance and it's a very fine line. I don't think people without asthma can understand how much energy that can take and how difficult it is.

Good luck.


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