[Elmo]

Hi all new member here asthmatic for years. I was a smoker from about 20 to a year ago when I quit. I know bad idea an asthmatic smoking not one of my brightest moments. I have allergies as well and am now having to take reactin daily to help with that. I was diagnosed when I was 16 and am now in 40s. I have made a doctor appointment due to my asthma worsening and my relief inhalers not doing what they should be, I go on Jan 5(was the earliest I could get in) I am on ventolin and my steroid puffer ad vir.

I am overweight and have been doing light indoor exercising as well as dieting. I can no longer do that as any amount of exercise will bring on the wheezing and shortness of breath. My peak flows have dropped as well.

I am not sick so don't think it is an issue of me needing steroids. I have been hospitalized before but never intubated(sp?) though there was once they thought I would have to be. I have also been on oxygen in hospital once during a bad bout.

Now that my background is out there, time for my question.

Does my symptoms sound like worsening asthma or should I be concerned about copd and euphuism (sp?). They do run in the family and I meet the criteria being I smoked and have asthma What should I ask my doctor to do? Should I ask for a referral to the asthma clinic or just ask for testing?

I have educated myself about my asthma but am just unsure of the worsening of my symptoms as they don't match on how my asthma usually rears its ugly head.

Thank you for all advice and suggestions

[Davy9]

Hello Elmo,

Technically asthma is within the spectrum of diseases called COPD. They are all characterized by difficulty exhaling which you know is part of your asthma. COPD is usually a combination of processes of which reactive airways is nearly always involved. So you have COPD. I do not know what you mean by 'euphuism'. If you mean emphysema, which is also a COPD, then I would say probably not. From your self description I would think that chronic bronchitis with asthma might better fit the diagnosis. But, as you know, the actual diagnosis is in the testing and my guess is just speculation.

As to your current situation it sounds as though you do understand what is happening. If you become worse do not hesitate to make an ER run. I would ask your doctor about a more formal respiratory rehabilitation program. Get the asthma back in line and get a prescribed routine to help you lose some weight and improve your stamina.

[Elmo]

Thank you for the post and you have taught me something I did not know that they were all in the same spectrum of diseases. I do appreciate the time you took to respond to my post.

My fear is I will get referred to the asthma clinic(which is a good place) but will wait months to be seen as the waiting list can be long. I am also concerned my family doctor will decide to take a wait and see approach instead of adjusting meds.

Also the worsening of my breathing concerns me as even a walk from downstairs to the upstairs will leave me breathless and lightheaded. My doc appointment is on the 5th and can not come soon enough. I also keep thinking too that I have done this to myself with my smoking in the past, which stresses me out more and we all know how that is so good for an asthmatic.

If need be I will be going to ER. I find the new asthma protocal odd though as they get you to take your relief inhaler 10times instead of a mask treatment. I guess that is the new way although I find a mask helps more as it gets deeper in the lungs. The asthma nurse I last seen in ER explained that this was being done this way to help teach us how to use our puffers better.

BTW I am in Canada not sure if other countries do things the same way or not.

[Davy9]

When you do see a physician you need to emphasize that you have exertional dyspnea and ask them to measure your 02 saturations while you do some exercise. Have them do peak flows before and after you do the work as well. Make sure they pay attention to what your heart is doing during this study.

Using your inhaler 10 times in the ER is not uncommon for an initial shot at treating an acute event. There, under medical supervision, they feel comfortable using an inhaler in that fashion. If you do better with an extended aerosol type treatment you can get those for use at home. There are portable neb drivers that can be used away for electricity.

I am not aware of how Canada approaches treating these problems. Ideally you need to lose weight and improve your physical conditioning. Those 2 facts alone could be accounting for your shortness of breath on exertion. In other words anyone without any lung disease and in very poor physical condition can get short of breath if they exert themselves. Having asthma on top of that adds another layer to the situation. You're going to need to recondition while having the asthma. That is where a respiratory rehab program can help.

[Elmo]

I have had my doc appointment and he has increased my advair to the 500mcg from the 250. We are trying that for 2 weeks to see if there is an improvment. If there is not then I have to go on predisone or if I get worse before the two weeks are up.

He also mentioned a chest xray if the increase in meds don't work.

For the time being he does not want me exercising but does want me staying the same for my activities. The doc said to get asthma back under control and then I can go back to exercising and working on losing the weight to get in better shape.

That is my update now to wait and see if it works and I can get control back

[adriennecasey]

My allergist/immunologist always gives me a steroid shot to stop my asthma when it can't be controlled with my inhaled meds. He believes that it is important to stop the asthma, then deal with a treatment plan, including testing and other treatments and medications as needed. I get very few of these injections, averaging way less than one a year. Steroids save lives, and are not dangerous if used properly. The GPs and internists I've seen when I couldn't get to my allergist (I live a thousand miles away now) just give me more and more inhaled stuff and pills that don't do the job. Don't let your asthma get worse without asking if a steroid shot is in order. A specialty clinic is probably what you need, but if I were you I wouldn't wait too long for relief.