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Asthmatic for year yet totally clueless
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awesomeani posted:
Hi All, I just found this community and I am so excited because I am hoping I can finally get some guidance for how to get the help I need.

Here's my situation. I had asthma as a kid and sort of grew out of it starting in my late teens. The biggest environmental change at that time is that I moved out of my moms house and no longer lived with smokers, yay me! So, for years I did well, no problems to speak of. Some time a year or so before my last pregnancy (child 3, aaaand were done!) I started having tightness in my chest. I started taking symbicort and albuterol and that seemed to help. But then pregnancy and much worse asthma and far fewer safe treatment options. Since then I have been dealing with tighness in my chest, pretty much always. It is worse in the spring and fall. Got an allergy test done, and woah nelly, yeah I have some pretty bad allergies. But alas, I couldn't afford the treatment so I had to do without. (maybe next year I can start tho.)

So now, I currently take Zyrtec daily and I am supposed to take my Flovent every day but it makes me worse so I don't (symbicort started making me feel tighter too). My albuterol doen't work at all most of the time, unless its a much worse attack. I only this year learned that the tightness I feel a lot is an attack, call me silly but I am just realizing that where it comes to my asthma, well, I am just completely clueless.

So the problem, lately I have been trying to get a decent (preventative measures) asthma control plan but every time I explain to my doctors how I wake up every morning and can barley take in a full breath because of the feeling of tight rubberbands around my chest, and how I feel like I have a toddler standing on my chest most of the time the most they do is listen and say "well, your lungs sound perfectly clear, no wheezing. Just take your Zyrtec and keep taking your inhalers, you'll be fine." But the inhalers don't work for me and it is as if they don't believe I am feeling tightness in my chest.

I had a breathing treatment once, at the hospital, with something in it that worked great. So far, it's the only thing that really helped. Does Atrivent sound right?

Anyway, I could really use some guidance here. What kind of doctor should I be seeing for this? Am I crazy when I feel like my flovent and symbicort made me feel tighter in the chest? I am so tired of feeling sick and tired. I have no idea what to do or who to ask for help.

Thanks for any input/support anyone can offer.
Ani

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sgbl88 responded:
Hi and welcome to the comunity.

Many of us have had a difficult time getting things under control at some point. I prefer an allergist for allergic asthma. They are well trained to treat the asthma and the main triger - allergies. Pulmonologists are frequently bored by asthma and don't effectively treat the allergies. There are generic nasal sprays (nasal steroid and antihistamines), Singulair (also generic now) a leukotriene modifier which is very effective for allergic asthma.

An allergist should treat you even though you cannot afford immunotherapy at the time. There are other things they can do to help reduce symptoms.

I find Zyrtec much more effective than Claritin.

Atrovent is a acnticholenergic that is sometimes included in breathing treatments. It works by reducing the amount of mucous that is produced. Combvent is an metered dose inhaler containing albuterol and atrovent. It used to be thought that atrovent had little to no effect on asthma, but a study that was presented at a conference in early 2011 proved otherwise. (My allergist came back from the conference and immediately put me on it. It was good for a while, but after aspirin desensitization it was to drying for me.)



Are you performing at least twice daily sinus rinses? They are very helpful in reducing exposure to allergens and symptoms. There are several other life style modifications that reduce exposure to allergens and therefore reduce symptoms.

It sounds like you may also benefit from discussion acid reflux with your doctors. Pregnancy is known to cause it, and reflux is a a major trigger for asthma.

You can always try to negotiate rates with your doctor. Also, there are foundations that help patients with medical treatments they need but can't afford. Health Well Foundation is one that helps asthma patients. Ask you doctor about assistance program you may qualify for. Your kiddos need a healthy mom.

I know it is no fun not feeling good when you have little ones to look after. Praying you find some answers soon.

Feel better and
God bless.
Sonya
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]
 
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awesomeani replied to sgbl88's response:
Thank you for the helpful information and support. My current allergist was very clear that they will not treat me unless I pay up front so I will have to wait until next year, and they don't specialize in asthma treatment so I am not sure why I was told to go there since my questions were about asthma. However, I did make an appointment today with a new allergist who specializes in Asthma. I wasn't going to but after reading your post I feel like I have a better idea of what I need to do, learn, and ask. It's interesting, what you mentioned about reflux, you guessed right on. I have GERD and my Asthma was in fact much worse before they diagnosed me and put me on meds for that. Also, I am glad you mentioned your thoughts on pulmonologists, the last thing I need is a doctor who just wants to throw the latest sample at me and call me fixed.

Anyway, have a great day, and thanks again for the information.
 
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amcate replied to awesomeani's response:
Board certified in Allergy, Asthma, and Immunology is good. I save money by seeing the physician assistant, but I go to an office that's seen me for 8 or 9 years and I'm at the point where I have a plan and am pretty independent with it. It costs 90 dollars for the physician assistant.

An allergist I saw in Houston said that Internal Medicine is another specialty that should know the basics of asthma, but I've not tried them.

In terms of the medicines making you worse, it may be due to being allergic to some component in the medicine?

Thanks, Sonya, for the information on Atrovent/Combivent. I didn't know of the new findings. They switched me from albuterol only to Combivent (albuterol plus atrovent) when they found out that albuterol by itself wasn't always cutting it back around 2001.
 
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sgbl88 replied to amcate's response:
To add to amcate's suggestion about finding an allergist

http://aaaai.execinc.com/find-an-allergist/

And

http://www.acaai.org/allergist/Pages/locate_an_allergist.aspx

are links to the allergy, asthma and immunology boards' "Find an Allergist" pages. If you are fortunate, you may find a doctor with a fellowship from both boards in your area. They are rare, but are amazing doctors.

You can also check how patients feel about the doctors you find by looking them up on http://www.healthgrades.com/

Happy doctor hunting.
Sonya
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]
 
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awesomeani replied to sgbl88's response:
Thank you everyone for the help! So much useful information! This is fantastic!
 
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kittenkan2 responded:
ok, first off i feel REALLY BAD 4 u and second off, you should be seeing a pulmonologist cause they have more training than a regular doctor would and make sure that the pulmonologist has had a lot of people that have the same thing that you do so that he is up to date with new treatments and the stuff that u took @ the er? ask the new guy if u can get that..
 
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bresky replied to kittenkan2's response:
Hi I am sorry to hear about your troubles

I am guessing atrovent is what they used in the nebulizer along with ventolin - that is what I get when I end up in emerg. I am on an atrovent inhaler that I use at home when my asthma acts up. I am also on spiriva which is a long term medication like atrovent that you take once a day.
Because you have allergies I would recommned seeing an allergy/asthma physician. I don't seem to have allergies although they did allergy testing when I was on high doses of prednisone. I see a pulminoloigst that specializes in COPD/Asthma and chronic cough and have found her to be quite good listens to me when I explain my symptoms.
Good luck I hope you find a doctor who works with you instead of ignoring you.
Bre
 
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amcate replied to bresky's response:
All I know of ventolin is that its a rescue inhaler. Here in the states, they have Duoneb, which is a combination of 0.5 mg ipratropium bromide (atrovent) and 3.0 mg albuterol sulfate. The drug information says that they did studies on the bronchodialator effects of albuterol alone versus albuterol plus ipratropium bromide (or atrovent) and found that the combination of the two drugs produced greater bronchodialator effects than albuterol sulfate alone. CombiVent is the MDI form of the combination drug. It's used in the states for people with a history of failing to reverse attacks with albuterol alone. They first called it in for me when I phoned the allergist office one night stating the albuterol inhaler was not working and what should I do? The combination drug also has a lot more side effects than albuterol alone, though. Still, I guess not breathing is a pretty bad side effect of not taking it .
 
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bresky replied to amcate's response:
Hi amcate

Yeah unfortunately you can't get the combivent inhaler in Canada anymore not sure why as they have them in nebulizer form. I utilize both ventolin and atrovent puffers when I am flared, I find the atrovent good for drying up the mucous that I cough up.
I don't like using it as there are side effects but sometimes ventolin is not enough. Hope your feeling well, sorry it took me awhile to respond.
Bre


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