no relief with Xopenex for tight chest?
sbslaton posted:
My 12 year old son has asthma and when he has an asthma attack, he often feels it as chest tightness. Xopenex doesn't ease the tightness he feels. I'm wondering if certain rescue inhalers work better for some than others? He is also on Flovent daily. Thanks for any experience you might have with a similar situation.
sgbl88 responded:

I have two thoughts:
First, his asthma could be worse that thought and he may need to be more agressive with treatment for a week or so. He may need to use his rescue inhaler at maximum dosage (frequency and number of puffs).

Second, he may also have Vocal Cord Dysfunction (VCD). This is a condition where the vocal cord go into spasms and cause difficulty breathing. The discomfort from the spasms can be
"referred" (felt) to the lungs when it is actually the vocal cords. VCD does not respond to rescue inhalers, but can be managed with speach therapy and breathing exercises.

I hope that helps some.

God bless.
Jeremiah 29:11 For I know the thoughts that I think toward you, saith the LORD, thoughts of peace, and not of evil, to give you an expected end... Ye shall seek me, and find [me]
Aqua14 responded:
I have a couple of thoughts.

Has he been taught proper inhaler technique by the doctor or a nurse educator? Could be he's not inhaling at the right moment, and hence the Xopenex isn't getting to his lungs (or not enough of it, anyway). Maybe having him re-taught would solve the problem.

Does he use a spacer? Sometimes that will help for younger kids. Even my 16 year old still uses a spacer. Using a spacer would be worth trying. Sometimes pediatricians' offices will give them to you for free. And if he used a spacer for his Flovent, too, he'd be getting more of the med in his lungs, which would help prevent attacks better.

It might be worth trying an albuterol inhaler. You're right, we all react differently to medications and sometimes it takes some trial and error to find the one that works best for a particular person. He could expect more jitteriness from albuterol, though, since Xopenex (levalbuterol) has been "purified" to remove that albuterol side effect. If not albuterol, then I think MaxAir (pirbuterol) is still being manufactured so might be worth a try.

Hopefully these ideas help you figure out what to do. Take care & good luck. Judy
amcate responded:
Yes, I've found that different rescue inhalers vary in their effectiveness for me. Albuterol by itself does not always work for me, though it is in general a good rescue drug. Therefore the medicine I use combines albuterol with ipratropium bromide to create a stronger effect in the lungs. Occasionally that won't work either, so it's the nebulizer with albuterol and ipratropium bromide as a liquid that is then put into small droplets in the air that I inhale.

Sometimes I have to take one neb treatment after another (piggyback) if the lungs don't open. My heart will feel like it's beating so fast that it will jump out of my chest and tear away from it's lining (or whatever it's called). So, the allergist told me to continue with the combination drug (albuterol and ipratropium bromide) in the nebulizer, but if I have to piggy back then the second neb treatment should be Xopenex since it doesn't have as many side effects, then the third should go back to the combination drug.

Also, as already mentioned, a more aggressive program for the FloVent might temporarily be needed, or if it's really bad (life threatening), then a short course of prednisone.
sbslaton replied to amcate's response:
Thanks to everyone who responded -- I appreciate all the comments. You all have good ideas/input and we'll begin working through these possibilities to see if any of them make a difference.

Thanks once again!