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Medical Forum / Diseases and Disorders / Asthma / July 2006Prednisolone?
About three years ago I was diagnosed with late onset asthma. I was completely taken by surprise as I had never ever suffered from any respiratory disorder. It started with an inocent cough which became continual, then followed with a wheezing chest and has now developed into continual bouts of just not being able to get my breath with a feeling of sheer panic as it gets worse. The question I am asking is....as the different inhalors I have used don't seem to control the onset of the asthma. The doctor prescribes courses of Prenisolone which I understand is a steroid (I might be wrong!). So far, in the last eighteen months I have had five courses of 30. 5mg tablets each to be taken at six a day. They seem to be the only way to effectively shift the asthma. Then after about month the cough starts again with a build up of phlegm, then the tight chest and difficulty in breathing until it becomes unbearable, especially in the heatwave we have been experiencing in the UK. Then it's back on the Prenisolone. After all that build up, the question I am really asking is, how harmful is it to take continual doses of Prednisolone? and are the side affects permanent, or do they repair after coming off the medication? This not questioning my doctors wisdom as I am sure he is doing his best to relieve my misery. James. If you were diagnosed with asthma following a cough or cold or bronchitis, and you're finding your asthma difficult to manage with regular asthma meds, you may have asthma that is caused by bacteria that's lingered in your chest. If that's what you have, you can eradicate the bacteria and get rid of the asthma. Studies feel this is especially true with adult onset asthma, although it can also be true with pediatric asthma, as well. I was diagnosed with asthma as a kid and it was cured 33 years later (more than 3 years ago). Take a look at the studies and support forum at www.asthmastory.com to learn more about this. > If you were diagnosed with asthma following a cough or cold or > bronchitis, and you're finding your asthma difficult to manage [quoted text clipped - 5 lines] > was diagnosed with asthma as a kid and it was cured 33 years > later (more than 3 years ago). I've been looking into this and talking with my Dr.'s about it. All of them say more studies are needed. While it very well maybe a valid course of action they all say there just isn't enough solid well structured studies being done for them to support this treatment at this time. > I've been looking into this and talking with my Dr.'s about it. > All of them say more studies are needed. While it very well > maybe a valid course of action they all say there just isn't > enough solid well structured studies being done for them to > support this treatment at this time. Of course you have to make your own decisions about your health, but just because your doctor tells you more studies are needed, and that it's not a valid course of action, doesn't mean the original posters doctor would feel the same way. I have found many doctors open to looking at the research and willing to treat people. If you wait for this to be an accepted across the board protocol, it more than likely won't happen in your lifetime. To the original poster, I would ask that you consider this. Many people are asthma free today because they were their own advocates regarding their health, and sought out an open minded doctor willing to use this benign protocol. > Of course you have to make your own decisions about your health, > but just because your doctor tells you more studies are needed, [quoted text clipped - 3 lines] > people. If you wait for this to be an accepted across the board > protocol, it more than likely won't happen in your lifetime. This is true but there are numerous asthma study experimental groups out there. Every one of my Dr's takes part in at least one or more such study groups of new trial treatments. ZHeck, most of them pay $'s too but I'm more interested in getting better. There are so many. Which one to try? All of them say more credible studies are needed before they even consider taking part in the bacteria treatment study. IOW's they all seem to prefer joining studies that at least have been acknowledged as having some credibility to them from 1st round studies. They've told me this new bacteria treatment has not met their qualifications yet although it holds interest to them. So which ones do I try? All of them? There are way too many study groups to partake in currently. I can't try them all. > This is true but there are numerous asthma study experimental > groups out there. Every one of my Dr's takes part in at least [quoted text clipped - 11 lines] > So which ones do I try? All of them? There are way too many > study groups to partake in currently. I can't try them all. You're talking about two different things here. An experimental study is not the same as protocol that has been tried and proven to work in some people. Researchers are now saying that asthma is caused by different things. The bacteria - asthma link has been studied for twenty years. People have been treated by Dr. Hahn for twenty years. By the way, your doctors get paid to conduct trials, so of course they're going to push those. They wouldn't get paid to try Dr. Hahn's protocol on you. I'm also guessing the experimental studies involve new medicine for the management of asthma. The protocol I'm talking about involves potentially curing the asthma completely. And your doctors wouldn't be taking part in the bacteria treatment study, they would be treating certain patients with antibiotics once a week for twelve weeks. I think your doctors are making excuses, but if you're happy with them, that's all that counts. > You're talking about two different things here. An experimental > study is not the same as protocol that has been tried and proven [quoted text clipped - 4 lines] > conduct trials, so of course they're going to push those. They > wouldn't get paid to try Dr. Hahn's protocol on you. Twenty years and still no solid well documented studies that follow protocol? > I'm also guessing the experimental studies involve new medicine > for the management of asthma. The protocol I'm talking about [quoted text clipped - 5 lines] > I think your doctors are making excuses, but if you're happy with > them, that's all that counts. They have no reason to make any such excuse. They don't believe in treating with unproven experimental treatments for which there is insufficient evidence to back it up. It may very well be a great treatment....so get the studies done, prove its worthiness and get on with it. Twenty years and no general acceptance? No independent verification? Sounds odd if it works so well. They are not paid for all the studies they do. My Dr. partakes in studies conducted through several non-profit organizations such as UofA medical center. These are not drug manufacture sponsered studies. No solid well documented studies? When was the last time you looked? And it takes a long time for what researchers have learned to trickle down and be accepted by traditional doctors. Some doctors have already accepted that asthma is caused by different things, and in some cases where it's caused by bacteria, it can be cured once the bacteria is eradicated. Some of my very own doctors have now accepted this - my internist, an integrative MD I see and my highly regarded ENT. Yours probably never will. But like I said, if you're happy...... >> You're talking about two different things here. An >> experimental study is not the same as protocol that has been [quoted text clipped - 31 lines] > such as UofA medical center. These are not drug manufacture > sponsered studies. > No solid well documented studies? When was the last time you > looked? Way too small of study groups and often inconclusive and conflicting results. Takes a long time? You stated it's been twenty years yet is still not even close to being an accepted proven course of action. Are you saying Dr.'s should be using this treatment based on the current level of knowledge of asthma/bacteria connection? >> No solid well documented studies? When was the last time you >> looked? [quoted text clipped - 5 lines] > this treatment based on the current level of knowledge of > asthma/bacteria connection? Some doctors ARE using this treatment, and according to many, the treatment is very benign. The people who have asthma caused by bacteria are sick a lot and on antibiotics and prednisone several times a year. Taking an antibiotic once a week for twelve weeks to stop that cycle isn't as risky as letting the cycle continue. You're right, the outcomes of some of the studies vary, but if you read the studies carefully you'll see why. Using Biaxin for six weeks isn't going to eradicate mycoplasma or chlamydia pneumoinae. Having said that, I'm sure you'll continue to think it's awful that doctors are actually treating some people walking around with a form of pneumoniae in them, causing other health problems. That's your opinion. After 33 years of suffering, I don't have asthma anymore - haven't had asthma or asthma meds in more than three years, so I'm grateful that the minds of some doctors, are open to what researchers have to say. > Having said that, I'm sure you'll continue to think it's awful > that doctors are actually treating some people walking around > with a form of pneumoniae in them, causing other health problems. > That's your opinion. I never said that so try not to assume. I'm asking if based on the current level of knowledge on the subject, should this course of action be accepted by the medical industry in general? Do you feel the current level of studies done is sufficient? > I never said that so try not to assume. I'm asking if based on > the current level of knowledge on the subject, should this > course of action be accepted by the medical industry in > general? Do you feel the current level of studies done is > sufficient? Based on the current level of knowledge on this, yes, this course of action should not only be accepted, but taken, by the medical industry, in general. Asthma caused by bacteria is not the same as asthma caused by other things. There's no reason why people should be told they're stuck with a lousy quality of life just because some people think hundreds of studies should be done first - particularly with a cure that's inexpensive and benign. > "miles" <nope@nopers.com> wrote in message >> I'm asking if based on the current level of knowledge on the >> subject, should this course of action be accepted by the medical >> industry in general? Do you feel the current level of studies done >> is sufficient? > Based on the current level of knowledge on this, yes, this course > of action should not only be accepted, but taken, by the medical [quoted text clipped - 3 lines] > because some people think hundreds of studies should be done > first - particularly with a cure that's inexpensive and benign. In the early 1980s, members of the group Act Up! demonstrated violently and even rioted over the FDA's slowness in approving new AIDS drugs. Act Up! claimed that the FDA should move more quickly and with less caution with respect to drugs that treat illnesses that are nearly certain to be fatal. They were right and the FDA did speed up approval of AIDS drugs. Then more recently, we've had a huge amount of publicity about problems with drugs like Vioxx and now acetominophen (spelling?) that have perhaps been approved without appropriate scrutiny. The bottom line is that there are perfectly good reasons for doctors to be cautious. Conservatism in medicine is fundamentally sensible. I can't blame doctors for not wanting to prescribe antibiotics in "off-label" ways. Being responsible for others health is a heavy burden even if doctors are paid accordingly.  SignatureAlison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Evolution whispers within us. It does not shout orders. -- L.A. Times editorial, 05/10/06, via gtb >> "miles" <nope@nopers.com> wrote in message >>> I'm asking if based on the current level of knowledge on the [quoted text clipped - 42 lines] > heavy > burden even if doctors are paid accordingly. Alison, why do you feel the need to swoop in and cloud the issue? We aren't talking about NEW DRUGS, are we? We're talking about approved antibiotics that according to doctros anyway, are benign. >Alison, why do you feel the need to swoop in and cloud the issue? >We aren't talking about NEW DRUGS, are we? We're talking about >approved antibiotics that according to doctros anyway, are >benign. But chronic antibiotic treatment of large group of individuals is far from benign as treatment resistant bacteria emerge as a result of the treatment. RC >>Alison, why do you feel the need to swoop in and cloud the >>issue? [quoted text clipped - 9 lines] > > RC I'll explain this one more time, because I get the feeling people really aren't reading what I've posted. People who have asthma caused by bacteria get sick a lot. If you're afraid of resistance, then it's absolutely imperative that you stop the cycle of having to be on antibiotics and prednisone several times a year every year. That is far more dangerous than taking an antibiotic once a week for twelve weeks, TO STOP THE CYCLE. I was on antibiotics four to six times a year for the past twenty years, and in the past three plus years have taken them twice. If someone would rather choose asthma and feeling sick all the time, and needing antibiotics and prednisone five or six times a year like I did, then good for them. Let them live that life, but they shouldn't expect others to just because they're frightened little creatures. I >>Alison, why do you feel the need to swoop in and cloud the issue? >>We aren't talking about NEW DRUGS, are we? We're talking about [quoted text clipped - 4 lines] > from benign as treatment resistant bacteria emerge as a result of the > treatment. I think one thing that is going to be a problem with statements like this is the word "benign". Of course no medication (or herbal or other treatment that actually does anything) is totally benign. Not treating is also not totally benign. Having asthma is not totally benign. I think no useful discussion can be had unless we get out of "yes/no" "all or nothing" dichotomies and into relative risks. Antibiotic resistance is one of many possible adverse effects of using any antibiotics. I'm not sure that a 12 week course is really any more likely to produce it than a 1 or 2 week course, however, macrolides in general are probably more prone to inducing resistance than other classes. Unfortunately, they seem to be the types that work best for this indication. To place the risk of antibiotic use in context one should consider that courses of one month or more of antibiotics are often given for such hard to establish diagnoses as sinusitis and prostatitis (both generally diagnosed and treated empirically without any objective confirmation). Multiple weeks of antibiotics are often used for wound care management despite a lack of objective evidence to support the practice. Immunocompromised patients are often also kept of several antibiotics (including weekly azithromycin) indefinately with a low incidence of adverse reactions. Lastly, as I often point out, we routinely give long term (much longer than 12 weeks) antibiotics to children for completely cosmetic reasons. Clearly, long term antibiotics are generally considerd safe enough to give in situations with unproved benefit and even for non-health promoting reasons. The argument of some community harm through creation of resistance, I think, is mostly refuted by the fact that the vast majority of antibiotics used are given to farm animals for no other purpose than to lower the price of meat (and so induce most of us to eat too much if it, eat it instead of fish, and so actually harm the population). Even if every asthmatic is eventually given a trial of 12 weeks of antibiotics and even if we eventually consider all of that to have been useless and inappropriate it will still be dwarfed by the innappropriately given antibiotics for other indications (like the 50% of non-strep sore throats that get them) and that will always be dwarfed by the antibiotics given in the name of cheap meat. Yes, resistance is a problem but antibiotics given in an attempt to cure asthma will never be more than a drop in the bucket. If this really concerns you then there are more potentially fruitful places for you to direct your objections. You could start by voting against the farming practices with your wallet. I since it can be hard to distinguish asthma flares from infections antibiotics are often given during them. I don't think it is safe to assume that a single course of antibiotics will not result in a total decrease in antibiotic use over longer time courses. Yes, this would need to be proved before it can be asserted positively and it has not been proved yet but it is also not a rediculous notion that can be dismissed without some proof to the contrary. Signature00doc > In the early 1980s, members of the group Act Up! demonstrated > violently and even rioted over the FDA's slowness in approving new > AIDS drugs. Act Up! claimed that the FDA should move more quickly > and with less caution with respect to drugs that treat illnesses that > are nearly certain to be fatal. They were right and the FDA did > speed up approval of AIDS drugs. The FDA gets blasted for not approving drugs quick enough, and then blasted yet again for sometimes approving too quickly drugs that are later to be found deadly. Hit from both sides. >> In the early 1980s, members of the group Act Up! demonstrated >> violently and even rioted over the FDA's slowness in approving [quoted text clipped - 10 lines] > then blasted yet again for sometimes approving too quickly > drugs that are later to be found deadly. Hit from both sides. Yeah. Too bad that's not what we're talking about. >> In the early 1980s, members of the group Act Up! demonstrated >> violently and even rioted over the FDA's slowness in approving new [quoted text clipped - 6 lines] > blasted yet again for sometimes approving too quickly drugs that are later > to be found deadly. Hit from both sides. The truth is that practicality limits the size of preapproval studies to levels that cannot pick up any but common events and sometimes not even the common ones. Of course, lately it has also come to light that it is far too easy for drug companies to alter and hide data. Where the FDA goes wrong is in not mandating more post marketting studies, not mandating enough pre-approval study in special groups, and in not aggressively enough ferriting out and prosecuting deception. The FDA never had enough bite to take on big-pharma and over the last few years it has been further defanged instead of stregthened. Signature00doc >> Having said that, I'm sure you'll continue to think it's awful that >> doctors are actually treating some people walking around with a form [quoted text clipped - 5 lines] > be accepted by the medical industry in general? Do you feel the current > level of studies done is sufficient? I agree with Miles. As a Pulmonologist, I would never treat patients based on extrapolations from basic science unless there were controlled 'blinded' treatments the mimic a real life clinical setting. If there are novel theories, I would accept treatments if they are safe and if they are effective. The more novel an idea is, the more the burden of proof is on the proponent to show safety and efficacy. In my 30yrs in practice, more harm has been done by treatments based on logical extrapolations of basic science observations without clinical validation. I would accept current gold standard treatments but keep an open mind about new treatments that meet the standard of safety and efficacy when administered by disinterested(not to obtain credit or remuneration by the result) observers. JMHO > I agree with Miles. As a Pulmonologist, I would never treat patients based > on extrapolations from basic science unless there were controlled > 'blinded' treatments the mimic a real life clinical setting. Ummm....... we are not talking about extrapolations of basic science here. Clinical trials on human asthma patients have been, and continue to be, done. Are you familiar with the studies? > If there are novel theories, I would accept treatments if they are safe > and if they are effective. Azithromycin is not a novel therapy and is generally considered safe and effective for the treatment of a wide variety of infectious diseases. Signature00doc >> I agree with Miles. As a Pulmonologist, I would never treat patients based >> on extrapolations from basic science unless there were controlled [quoted text clipped - 3 lines] > Clinical trials on human asthma patients have been, and continue to be, > done. Are you familiar with the studies? There have been similar ideas in the past including the macrolide, Troleandomycin, that seemed to improve patients when used with methylprednisolone. There was excitement that maybe it was treating an unsuspected infection but in the long run, it just interfered with the degradation of methylprednisolone having the effect of a higher dose thereby exposing the patients to a hightened steroid effect and side effect. Not an infectious mechanism. I am happy there are those who have been seemingly cured of asthma, a disease of exacerbations and remissions. Testimonials of small numbers of subjects are hard to evaluate because asthma consists of a collection of a variety of abnormalities that produce bronchospasm and inflammatory changes. My only point is not to abandon tried and tested effective treatments without proper validation. Novel treatments such as xolair and environmental controls give us optimism. >> If there are novel theories, I would accept treatments if they are safe >> and if they are effective. > > Azithromycin is not a novel therapy and is generally considered safe and > effective for the treatment of a wide variety of infectious diseases. >>> I agree with Miles. As a Pulmonologist, I would never treat >>> patients based on extrapolations from basic science unless [quoted text clipped - 24 lines] > treatments without proper validation. Novel treatments such as > xolair and environmental controls give us optimism. This doesn't seem to improve patients. There are people who have been asthma free for ten to twenty years once they eradicated the bacteria. Yeah, I know - they're all in remission. Tell ya what. I'd rather have a ten to twenty year period in remission than to suffer. > There have been similar ideas in the past including the macrolide, > Troleandomycin, that seemed to improve patients when used with [quoted text clipped - 3 lines] > thereby exposing the patients to a hightened steroid effect and side > effect. Not an infectious mechanism. I agree. I've pointed out similar things to people here many times when they post a few small studies and don;t understand why the results are not immediately accepted. > I am happy there are those who have been seemingly cured of asthma, a > disease of exacerbations and remissions. Testimonials of small numbers of > subjects are hard to evaluate because asthma consists of a collection of a > variety of abnormalities that produce bronchospasm and inflammatory > changes. I agree that asthma is probably a collection of different pathologies that all end in airway inflammation and bronchospasm and will probably never respond uniformly to any one "cure". However, the studies of azithromycin and other antibiotics given over several month courses are well beyond the testimonial stage which leads me to ask again if you are familiar with the set of studies to which I am referring. (specifically azithromycin given for approximately 12 week courses). > My only point is not to abandon tried and tested effective treatments > without proper validation. Novel treatments such as xolair and > environmental controls give us optimism. Agreed. I've repeatedly stated here that for people who are well controlled on standard therapy that trials of less proved therapies are probably not warranted and they should sit tight and wait for more data. However, surely you agree that there is a small but significant subset of patients that are not optimally controlled despite the best or our standard regimens. Signature00doc > Ummm....... we are not talking about extrapolations of basic science here. > Clinical trials on human asthma patients have been, and continue to be, > done. Are you familiar with the studies? Yes but they are widely varying in results and therefore inconclusive. There does not seem to be a consensus on the treatment of bacteria caused asthma by the medical industry in general. >> Ummm....... we are not talking about extrapolations of basic >> science here. Clinical trials on human asthma patients have [quoted text clipped - 5 lines] > treatment of bacteria caused asthma by the medical industry in > general. Only widely varying in results because they're not all following the same protocol. If they did follow the same protocol, this wouldn't be the case. >>> Ummm....... we are not talking about extrapolations of basic science >>> here. Clinical trials on human asthma patients have been, and continue [quoted text clipped - 7 lines] > protocol. If they did follow the same protocol, this wouldn't be the > case. True. No two studies ever look at exactly the same thing and so different results are not necessarily incongruous. Often a body of literature with differing results are more enlightening than one or a few trials with similar results because invite comparison and making distinctions about what works and what doesn't. One expects to see stronger effects in more highly selected populations so it is not surprising that studies on people with severe asthma featuring recurrent infection like exacerbations show response rates in the 30-50% range while studies on unselected asthmatics show a weak or non-existant response. This is not conflicting. It is also not conflicting if shorter courses, lower doses, and different antibiotics don't produce the same results as other regimens. It just means that those other things aren't as likely to work (whichis also valuable information). Signature00doc >> Ummm....... we are not talking about extrapolations of basic science >> here. Clinical trials on human asthma patients have been, and continue to >> be, done. Are you familiar with the studies? > > Yes but they are widely varying in results and therefore inconclusive. I think you are overstaing that. There is great variation when you consider all the antibiotics trials. When you look at just azithromycin the data is much more consistant. It is at least as consistant as the data supporting most of our "well established and standard" cardiac treatments. > There does not seem to be a consensus on the treatment of bacteria caused > asthma by the medical industry in general. No, there isn't. There can be many reasons for that. I've never described this as standard or broadly well accepted. I think it should be mostly tried when the well accepted treatments are not giving the results that are well accepted to be optimal. Signature00doc > I agree with Miles. As a Pulmonologist, I would never treat > patients based on extrapolations from basic science unless [quoted text clipped - 14 lines] > > JMHO Well, thank God I didn't go to you then, because I would still have asthma if I did, and you would still be justifying that somehow. If treating mycoplasma or chlamydia pneumoniae that hasn't been fully eradicated with antibiotics is a novel idea to you, then you're not the type of doctor I would wish to partner with regarding my health. > If treating mycoplasma or chlamydia pneumoniae that hasn't been > fully eradicated with antibiotics is a novel idea to you, then > you're not the type of doctor I would wish to partner with > regarding my health. Dr. Hanhs method does not suggest testing for such bacteria prior to treatment. It's trial and error. There are many experimental treatments for most illnesses. Some people get lucky and one of them works for them. That in itself is not a valid reason for a wide use of such treatments. >> If treating mycoplasma or chlamydia pneumoniae that hasn't >> been fully eradicated with antibiotics is a novel idea to you, [quoted text clipped - 6 lines] > lucky and one of them works for them. That in itself is not a > valid reason for a wide use of such treatments. He recently stopped recommending testing because the tests are inconclusive. Antibiotics used to treat bacteria is not experimental or dangerous and you sure like to exaggerate about nothing. If you're a doctor, I feel sorry for your patients. >> If treating mycoplasma or chlamydia pneumoniae that hasn't been fully >> eradicated with antibiotics is a novel idea to you, then you're not the >> type of doctor I would wish to partner with regarding my health. > > Dr. Hanhs method does not suggest testing for such bacteria prior to > treatment. It's trial and error. No, it is just acknowledgement that there is no sufficently accurate test. We give a lot of antibiotics (actually most) without culture data. > There are many experimental treatments for most illnesses. Some people > get lucky and one of them works for them. That in itself is not a valid > reason for a wide use of such treatments. No, but it is also not an argument to throw out one that does have sound theory and some experimental evidence to support it. I don't think anyone here has advocated for widespread use. Signature00doc > .... of them say more credible studies are needed before they even > consider taking part in the bacteria treatment study. IOW's they all seem > to prefer joining studies that at least have been acknowledged as having > some credibility to them from 1st round studies. They've told me this new > bacteria treatment has not met their qualifications yet although it holds > interest to them. That makes me wonder if they have really looked at the studies or if they are just assuming that if it had been done they would know about it. I understand and agree with their position that treatment of asthma patients with long term antibiotics is not well characterized and that there are many questions to be answered. I would also have a hard time arguing with their position that it should not yet be standard therapy and automatically given to large groups of patients. I'm glad they are interested but wish that interest would extend to knowing enough about it to not mistake it for being in "the first round" (whatever that means). Numerous studies have been done and are well passed the "1st round" (their statement to the contrary actually makes no sense if you understand the research process). Several medium sized trials have been done with relatively consistant results (at least not totally inconsistant) and large clinical trials are currently being done at major medical centers such as Johns Hopkins (recently named the #1 hospital in the US for the 16th year in a row by U.S. News & World Report). http://www.usnews.com/usnews/health/best-hospitals/honorroll.htm > So which ones do I try? All of them? There are way too many study groups > to partake in currently. I can't try them all. No, you can't. I guess the first decision is whether to try one at all. If you want to do that then you have to pick and choose form the ones available to you. Look them over and see what you think about how likely you think they are to work and whether you are willing to take the study treatment (or be in the placebo group) and if you are willing to do the follow-up studies that they require. If you don't want to participate in a research study (which I am biased toward saying would be the better of these two options) then all you have left, other than accepting the current standard therapies (which are successsful in all but a small minority of patients), is to try less accepted therapies outside of a research protocol. You could trawl the Internet looking for promises of cures and take the word of the guys selling the stuff that it is safe and effective or you could look into things that have at least some published research to back them up. There are several choices. One of the easiest to get and safest to take would be the antibiotic treatment. Antibiotics are not without risk, however, when you consider that more toxic antibiotics are commonly prescribed for longer periods of time to children for such conditions as acne it becomes fairly clear that they are pretty safe. Surely the risk: benefit ratio of treating for acne is not totally out of the league of asthma. So it is up to you. Make up your own mind. If you want to reject all non-generally accepted treatments outside of research trials that is not unreasonable. However, your characterization of the research into antibiotics for asthma is. It is much further along than you suggest. Signature00doc >To the original poster, I would ask that you consider this. Many >people are asthma free today because they were their own >advocates regarding their health, and sought out an open minded >doctor willing to use this benign protocol. Yeh, and a lot of them are dead! >>To the original poster, I would ask that you consider this. Many >>people are asthma free today because they were their own >>advocates regarding their health, and sought out an open minded >>doctor willing to use this benign protocol. > > Yeh, and a lot of them are dead! Got a citation to back that up--that anyone was ever harmed in any way by that protocol? Post the link. >>>To the original poster, I would ask that you consider this. >>>Many [quoted text clipped - 7 lines] > Got a citation to back that up--that anyone was ever harmed in > any way by that protocol? Post the link. ARoberts is right (as usual) - you can't make a claim like that without posting evidence, so let's see it. >>>>To the original poster, I would ask that you consider this. >>>>Many [quoted text clipped - 10 lines] >ARoberts is right (as usual) - you can't make a claim like that >without posting evidence, so let's see it. Dead men tell no tales:-) Long term antibiotic treatment is not without risk. And long term antibiotic treatment can put everyone at increased risk as bacteria become antibiotic resistant. A major public health issue is the unnecessary use of antibiotics and emergence of treatment resistant infections. Before a large group of individuals be given chronic antibiotic treatment I think that convincing evidence should be present for its efficacy. RC > Before a large group of individuals be given chronic > antibiotic treatment I think that convincing evidence should be > present for its efficacy. Agreed. However when compared to the groups of people given antibiotics for pharyngitis, sinusitis, and bronchitis (probably 90-99% inappropriately) the group of asthmatics not doing well on standard therapy could never be characterised as being even close to large. Signature00doc >> Before a large group of individuals be given chronic >> antibiotic treatment I think that convincing evidence should be [quoted text clipped - 6 lines] >group of asthmatics not doing well on standard therapy could never be >characterised as being even close to large. Irrelevant. If a large group of individuals are being put on antibiotics inappropriately for other indications that should stop also. In fact it is because of all the people that are inappropriately treated with antibiotics that we have the problem with antibiotic resistance. The last thing we need is to *add* to the problem by inappropriately treating still another group of people antibiotics. However if antibiotic treatment is convincingly shown to be efficacious then of course it should be used. RC >>> Before a large group of individuals be given chronic >>> antibiotic treatment I think that convincing evidence should [quoted text clipped - 26 lines] > > RC Doc, you do know what you're getting with this one, right? > Doc, you do know what you're getting with this one, right? Eh, I'll give him a few chances to answer my questions, point it out when he doesn't, and then go back to ignoring him. Signature00doc > Irrelevant. If a large group of individuals are being put on > antibiotics inappropriately for other indications that should stop > also. I agree. It is just that I find your indignation about this to be interesting considering what a smal percentage of the problem it might be (you still have not established that it would be a problem at all). > In fact it is because of all the people that are inappropriately > treated with antibiotics that we have the problem with antibiotic > resistance. Farmers are giving more antibiotics than doctors so they probablly should recieve more of the blame. The thing is that you can do some small thing to curtail that by buying beef from farms that do not use antibiotics. Do you? >The last thing we need is to *add* to the problem by > inappropriately treating still another group of people antibiotics. 1) There is considerable evidence that it might not be inappropriate in some cases. 2) You have not established that it would be a problem. It is possible that the treatment may end up reducing long term antibiotic use. Nobody really knows. This lack of information means that it would be just as unfair for me to claim the benefit as for you to claim there is a problem. > However if antibiotic treatment is convincingly shown to be > efficacious then of course it should be used. OK - so if an MD is convinced that the evidence shows that the potential benefits outweight the potential risks for an individual patient you would have no problem with that MD prescribing the course? Signature00doc >> Irrelevant. If a large group of individuals are being put on >> antibiotics inappropriately for other indications that should stop [quoted text clipped - 3 lines] >interesting considering what a smal percentage of the problem it might be >(you still have not established that it would be a problem at all). My indignation? Over-prescribing antibiotics is a major public health problem. I simply was pointing out that unless there was compelling evidence that antibiotics can be useful for asthmatics that this practice should not add to the already growing problem. Do you have a problem with that? >> In fact it is because of all the people that are inappropriately >> treated with antibiotics that we have the problem with antibiotic >> resistance. > >Farmers are giving more antibiotics than doctors so they probablly should >recieve more of the blame. What do farmers have to do with this discussion? Even if it were true that farmers give more antibiotics this is a discussion group about using antibiotics for asthma and I was commenting on that issue. > The thing is that you can do some small thing to >curtail that by buying beef from farms that do not use antibiotics. Do you? I am mostly a vegetarian although I do eat fish, eggs, milk, cheese, etc. I have not eaten beef, pork or poultry for decades. I am not even sure why you are trying to suggest that I am being hypocritical about this issue. You seem to be sensitive to my suggestion that doctors over-prescribe antibiotics and it would be good to stop that practice. Farmers should stop the practice too but it is pretty irrelevant to discussion in this group and seems to me to be a diversion. Maybe you should try working on cleaning your own house before telling others what to do. >>The last thing we need is to *add* to the problem by >> inappropriately treating still another group of people antibiotics. > >1) There is considerable evidence that it might not be inappropriate in some >cases. If it is appropriate then I have no problem with it. >2) You have not established that it would be a problem What have I not established would be a problem? Prescribing antibiotics for asthma if there is not good evidence to justify their use? I think that would be a problem. If you are a doctor and don't think that would be a problem then I think we have some insight into why we have over-prescribing of antibiotics as such a major public health problem. > It is possible that >the treatment may end up reducing long term antibiotic use. Nobody really >knows. This lack of information means that it would be just as unfair for me >to claim the benefit as for you to claim there is a problem. The point I made was that unless there is good information that antibiotic use is helpful for asthmatics it should not be used due to the ever growing bacterial resistance problem that is a major public health issue. The last thing we need is doctors to start unnecessarily prescribing antibiotics to a very large group of individuals like asthmatics. Asthma is a fairly common illness (seemingly becoming more common) afflicting millions of people worldwide. You do the math. >> However if antibiotic treatment is convincingly shown to be >> efficacious then of course it should be used. > >OK - so if an MD is convinced that the evidence shows that the potential >benefits outweight the potential risks for an individual patient you would >have no problem with that MD prescribing the course? No, I did not say that. There are a lot of flaky MDs out there who think there is evidence of all kinds of things and inappropriately prescribe medications and other treatments. I would like to see well controlled replicated studies demonstrating efficacy and not rely on a single MD who is convinced (for whatever reason) that antibiotics are useful for asthmatics in the absence of bacterial infection. RC > My indignation? Over-prescribing antibiotics is a major public health > problem. I simply was pointing out that unless there was compelling > evidence that antibiotics can be useful for asthmatics that this > practice should not add to the already growing problem. Do you have a > problem with that? I have a problem with several of your assumptions. 1) There is not already compelling evidence for a trial of antibiotics in some cases. 2) That giving these antibiotics will contribue to "the problem" rather than make no real difference (almost certainly the case) or decrease it (also not unlikely). >>> In fact it is because of all the people that are inappropriately >>> treated with antibiotics that we have the problem with antibiotic [quoted text clipped - 6 lines] > that farmers give more antibiotics this is a discussion group about > using antibiotics for asthma and I was commenting on that issue. You are claiming (without evidence) that treating asthmatics with antibiotics will have the over-all effect of contributing to drug resistance. I am putting the possible magnitude of that contribution (if any) in context. Context is always key and always has everything to do with any discussion. > I am not even sure why you are trying to suggest that I am being > hypocritical about this issue. Hypocritical would be putting it strongly. I am just saying that if you view this as such a huge problem (and I don't disagree) that you are misplacing your focus on a place that is unlikely to have any significant contribution. Getting farmers to stop giving them to livestock and doctors to stop giving them for non-strep pharyngitis, nearly all bronchitis, and most sinusitis would have orders of magnitude more effect (and be certainly correct). > You seem to be sensitive to my > suggestion that doctors over-prescribe antibiotics and it would be > good to stop that practice. No. I admit that doctors over-prescribe antibiotics. In my previous responses to you I pointed out several common examples of just that. I think much more good could be done by stopping clearly inappropriate practices than spending a lot of time and energy lamenting potentially appropriate use of them. >>>The last thing we need is to *add* to the problem by >>> inappropriately treating still another group of people antibiotics. [quoted text clipped - 4 lines] > > If it is appropriate then I have no problem with it. Then we have no problem. Glad to hear it. >>2) You have not established that it would be a problem > > What have I not established would be a problem? You have not established that treating at least some asthmatics with a course of antibiotics would be a problem. > Prescribing > antibiotics for asthma if there is not good evidence to justify their > use? I think that would be a problem. That's a big "if". > If you are a doctor and don't > think that would be a problem then I think we have some insight into > why we have over-prescribing of antibiotics as such a major public > health problem. I think we have more insight into your propensity to make snap judgements before gathering all the relevant information. >> It is possible that >>the treatment may end up reducing long term antibiotic use. Nobody really [quoted text clipped - 6 lines] > the ever growing bacterial resistance problem that is a major public > health issue. There's that big "if" again. You are using circular logic. Basically your arguement, which I am sure you find quite unassailable, is that if it is bad it is bad. That's all well and good but it's totally useless unless you are willing to go out on a limb and make a comment about whether or not you think it is bad. Of course, that would require you to actually do some homework. So why don't we do this: We'll agree that prescribing antibiotics without evidence that they have some reasonable chance of helping is a bad thing to do. If you wish to come back and argue that you think there is insufficient evidence to support the use then please do so. However, I do expect that you will have made some attempt at looking at the literature and are ready to discuss it without me having to spoon feed you. Responses to the effect that I should list the studies (do your homework for you) will be ignored or mocked depending on my time and energy. Signature00doc > Responses to the effect that >I should list the studies (do your homework for you) will be ignored or >mocked depending on my time and energy. If you are asserting that there is good evidence to demonstrate that some asthmatics would benefit from antibiotic treatment the burden of proof is on you to provide evidence for that assertion and specify which specific asthmatics you think would benefit and why. Most doctors who make assertions of efficacy for a treatment are more than willing to provide documentation to support their claim. Any doctor who says he will mock or ignore such requests is a discredit to his/her profession. Your response suggests to me that you are not a real doctor. If you are please provide your full name and credentials. Otherwise I will assume you are just playing doctor on the internet and ignore or mock you accordingly depending on my time and energy. RC >> Responses to the effect that >>I should list the studies (do your homework for you) will be ignored or [quoted text clipped - 16 lines] > > RC I've got a better idea--the rest of us can just ignore you and your rabid musings. >>> Responses to the effect that >>>I should list the studies (do your homework for you) will be ignored or [quoted text clipped - 19 lines] >I've got a better idea--the rest of us can just ignore you and your rabid >musings. Rabid musings? You mean my expressing concern about worsening the public health problem of antibiotic resistance by prescribing antibiotics to a large group of individuals when no convincing evidence of efficacy exists? RC > I've got a better idea--the rest of us can just ignore you and > your rabid musings. That's the plan, since it's obvious he ignores what we post. I already explained the bit about the overuse of antibiotics - more than once. > > I've got a better idea--the rest of us can just ignore you and > > your rabid musings. > > That's the plan, since it's obvious he ignores what we post. I > already explained the bit about the overuse of antibiotics - more > than once. Time is short. Interest is low. The information he seeks has already been posted - if only he would care to look. Think I'll go the ignore route as well. Signature00doc >> > I've got a better idea--the rest of us can just ignore you and >> > your rabid musings. [quoted text clipped - 9 lines] >The information he seeks has already been posted - if only he would >care to look. Funny that I could not find a double blind, placebo controlled study in which a group of asthmatics were given antibiotics, another group placebo and there was a significant improvement in the group given the antibiotics in a certain time period. Of course if such a study existed you would have posted it instead of your hand waving. Unfortunately many people become convinced that a particular treatment works with studies that are either poorly designed or have too few subjects. This seems to be the case with antibiotic treatment and asthma. If there is a study, published in the peer reviewed literature that has been double blinded, randomized and placebo controlled, and shows that antibiotic treatment results in significant benefit in asthmatics I would like to see it. But I won't hold my breath (no pun intended) waiting for anyone to provide such a study and instead expect the usual gratuitous insults from various posters in this newsgroup. I will likely be told to look for this study myself even though it does not exist. If it did exist I can be sure someone would be happy to post it. >Think I'll go the ignore route as well. I'll go for the mocking route. RC Gee doc, haven't we already gone through this? At the very least, I've pointed out a site where several studies are shown. And now, the typical, "I don't believe you're a real doc" argument when no intelligent reply comes to mind. I don't think this is really about the asthma-bacteria connection. This is more about a blowhard who loves to hear himself pontificate. Please! For the love of God and all that his holy - don't encourage him. >Gee doc, haven't we already gone through this? At the very >least, I've pointed out a site where several studies are shown. >And now, the typical, "I don't believe you're a real doc" >argument when no intelligent reply comes to mind. I only questioned his credentials because of his strange statement that he would not provide studies supporting his contention and would mock or ignore me if I asked for studies. No self respecting doctor would respond like that. Anyone who believes that someone is a medical doctor just because they say so in a usenet newsgroup is very gullible. Anyone can make any claims they want on usenet without having to provide any evidence. >I don't think this is really about the asthma-bacteria >connection. This is more about a blowhard who loves to hear >himself pontificate. Now that is an intelligent response. I expressed the very real concern that a large group of individuals be treated with antibiotics resulting in super bugs that are resistant to the antimicrobial agents, when there is not compelling data to support their use. And instead of providing replicated clinical studies demonstrating the efficacy I will be ignored and/or mocked. Sorry for pontificating. >Please! For the love of God and all that his holy - don't >encourage him. Yeah. Don't provide evidence for your assertions. Just ignore and/or mock me. That's the ticket:-) RC >>Gee doc, haven't we already gone through this? At the very >>least, I've pointed out a site where several studies are shown. [quoted text clipped - 30 lines] > >RC Please excuse me, but yet once again, I am moved to song: I think he's gonna be sad, I think it's today, yeah. The issue that's driving him mad Is hopefully fading away. He's got the ticket; deride, He's got the ticket, deri -i- ide, He's got the ticket; deride, And should we care? It's said that posting with him Is like going around and around. For he won't click posted links It's enough to astound, yeah. He's got the ticket; deride He's got the ticket; deri -i- ide He's got the ticket; deride But do we care? I don't know why he's riding so high, He ought to read twice, He ought to be nice, o' ye. Before he gets to saying goodbye, He ought to think twice, He ought to act right; can it be? I think I'm gonna be glad, I think it's today yeah. The guy with rhetorical jive May be going away, yeah. He's got the ticket; deride He's got the ticket; deri -i- ide He's got the ticket; deride But we don't care. > Please excuse me, but yet once again, I am moved to song: > [quoted text clipped - 34 lines] > He's got the ticket; deride > But we don't care. I usually don't care for these things, but in this case, I'm giving you a standing ovation, Bob. The funny thing is, he's pompous enough to believe that nobody is posting studies he's demanding to see, because they don't exist. It never dawned on him nobody wants to help him out because he's an @$$#o!*. >> Please excuse me, but yet once again, I am moved to song: >> [quoted text clipped - 37 lines] >I usually don't care for these things, but in this case, I'm >giving you a standing ovation, Bob. So you found your sense of humor. Ausgezeichnet! >The funny thing is, he's pompous enough to believe that nobody is >posting studies he's demanding to see, because they don't exist. >It never dawned on him nobody wants to help him out because he's >an @$$#o!*. An @$$#o!*? It could be worse. At least he's not a $#i+#*@d > Please excuse me, but yet once again, I am moved to song: As soon as I saw your name in the subject line I knew this was what you were up to. You are very predictable - but still very funny. Nice work. Signature00doc >> Please excuse me, but yet once again, I am moved to song: > [quoted text clipped - 4 lines] > >Nice work. You know, it's been awhile since someone thanked you for all the time and effort you invest to educate folks on this newsgroup. Thank you. > You know, it's been awhile since someone thanked you for all the time > and effort you invest to educate folks on this newsgroup. > > Thank you. YW >>To the original poster, I would ask that you consider this. >>Many [quoted text clipped - 3 lines] > > Yeh, and a lot of them are dead! Linkd, where is proof of your statement? You've had several days to reply. >>>To the original poster, I would ask that you consider this. >>>Many [quoted text clipped - 6 lines] >Linkd, where is proof of your statement? You've had several days >to reply. Dead men tell no tales. RC > About three years ago I was diagnosed with late onset asthma. I was > completely taken by surprise as I had never ever suffered from any [quoted text clipped - 22 lines] > > James. Is your doctor an allergist or pulmonologist? You really need a specialist here. Asthma is nothing to take lightly. There are a lot of treatments. You want someone who knows them all well and can do a good diagnosis for you. -- Lou Pecora (my views are my own) REMOVE THIS to email me. Probably not the smartest thing to do. Get another opinion. There are a lot of doctors that really do not understand asthma. Someone prescribing so much Predisone is not treating your asthma just making you feel better. I changed to a doctor who really understand asthma and there are so many courses you can go. >This not questioning my doctors wisdom as I am sure he is doing his >best to relieve my misery > Probably not the smartest thing to do. Get another opinion. > > There are a lot of doctors that really do not understand asthma. > Someone prescribing so much Predisone is not treating your asthma > just making you feel better. I changed to a doctor who really > understand asthma and there are so many courses you can go. I've spent over 20 years going to many specialists. For me they all take the exact same course of action. Prescribe one drug after another that have shown time and again to be ineffective. They all prescribe prednisone or medrol when my symptoms get bad enough. In talking with many others with asthma I'm finding it is very common to have chronic asthma that effects their lives on a 24/7 basis for which no current drugs other than steroids have much effect. > I've spent over 20 years going to many specialists. For me they all take > the exact same course of action. Prescribe one drug after another that [quoted text clipped - 3 lines] > asthma that effects their lives on a 24/7 basis for which no current drugs > other than steroids have much effect. That makes your resistance to even consider trying something still in the experimental stage that much harder to understand. Just to be clear: When I say "experimental" I don't mean that five people who may or may not be real are quoted on a website or some guy in South America has been using it for years with fantastic results but hasn't published the data or released the formula. I mean a well known treatment that is actively being studied at major medical centers by respected doctors. Signature00doc > That makes your resistance to even consider trying something still in the > experimental stage that much harder to understand. Possibly but I currently see 3 different Dr's, one general and two specialists. Each of them participate in several asthma study groups and each of them is different from the other Dr's. So which one should I try? All of them? One at a time? Why this specific treatment over another? That is my point. There are numerous treatments that are actively being studied at major medical centers. Each Dr. has his own reasons for which one to try over another...but they never agree with the other Dr's. So which one to try? > Just to be clear: When I say "experimental" I don't mean that five people > who may or may not be real are quoted on a website or some guy in South > America has been using it for years with fantastic results but hasn't > published the data or released the formula. I mean a well known treatment > that is actively being studied at major medical centers by respected > doctors. >> That makes your resistance to even consider trying something >> still in the experimental stage that much harder to [quoted text clipped - 16 lines] >> the formula. I mean a well known treatment that is actively >> being studied at major medical centers by respected doctors. I'll know doc will reply to you as a doctor, and I'd like to reply to you as a patient. Each of your doctors is going to be promoting their own study. In the study you'll be another number. The goal of these studies isn't to find the best medication for Miles, it's to see if some newly develooped medication will work for you. If it doesn't, it doesn't. Why not find a doctor who will look at this research and possibly treat you? If your asthma isn't managed well with any asthma meds, then it's really possible you have asthma caused by bacteria. That IS one of the telltale signs. If that's what you have, you'll either get worse if the bacteria isn't eradicated, you may go into remission for a while if you take Azithromycin for something else and if it's enough to calm the bacteria down a little, or you can find a doctor who will treat you and see how your asthma is affected. You may find you still have asthma, but it's much more manageable. Asthma can also be exacerbated by bacteria, not just caused by bacteria. If I were you, I'd try something different. So far, what you're doing, doesn't seem to be working, so why keep doing the same thing? > Why not find a doctor who will look at this research and > possibly treat you? If your asthma isn't managed well with any [quoted text clipped - 11 lines] > doing, doesn't seem to be working, so why keep doing the same > thing? I don't keep trying the same thing. Currently I'm trying Xolair which is indicated for those like me with severe asthma and bad allergies where traditional treatment fails. There are numerous treatments to try. Why this bacteria one over any other? >> Why not find a doctor who will look at this research and >> possibly treat you? If your asthma isn't managed well with [quoted text clipped - 18 lines] > numerous treatments to try. Why this bacteria one over any > other? That's not what I meant by trying the same thing. Why the bacteria one over any other? Because based on your difficulty to manage your asthma, it sounds like your asthma is either caused by, or exacerbated by, bacteria. If it's caused by bacteria, wouldn't you want to get rid of the bacteria and get rid of the asthma altogether? If it's exacerbated by bacteria, wouldn't you want to get rid of the bacteria so your asthma can actually be managed with the medication? I should have said that the bacteria protocol isn't really "instead of any other one", it should be "between" any trials you decide to participate in. If your asthma is caused by bacteria, you may never find relief with asthma meds, no matter what they come out with. >> That makes your resistance to even consider trying something still in the >> experimental stage that much harder to understand. [quoted text clipped - 4 lines] > All of them? One at a time? Why this specific treatment over another? > That is my point. I'm not suggesting that you pick this one over any other. I'm just saying that if you are not happy with the current "well accepted" options that there are some others that are legitimate areas of research with good theory, some published data, and the opinions of respected "mainstream" docs behind them - i.e not Internet anecdotal cure-all nonsense. Truth be known, if you have access to research trials of new treatments I would prefer to see you choose one of them. So, no, I am not trying to talk you into anything. I'm just trying to point out that you are being a bit to quick to dismiss one legitimate option. > There are numerous treatments that are actively being studied at major > medical centers. Each Dr. has his own reasons for which one to try over > another...but they never agree with the other Dr's. So which one to try? By definition every reasearcher thinks what he is studying has a great chance of success. If he didn't he would study something else. I don't think I can give you any great objective means to make a decision. Just review them all, go with your gut, and don;t be paralyzed by indecision. Signature00doc >>> That makes your resistance to even consider trying something still in the >>> experimental stage that much harder to understand. [quoted text clipped - 23 lines] > I can give you any great objective means to make a decision. Just review > them all, go with your gut, and don;t be paralyzed by indecision. Well said. AMEN Dear All. I am the original poster of this topic. I seem to have raised a hornets nest, for which I am appreciative of the interest. However, nobody has answered the original question. Is too much Prednisolone harmful? Roger James Murray. > >>> That makes your resistance to even consider trying something still in the > >>> experimental stage that much harder to understand. [quoted text clipped - 25 lines] > > > Well said. AMEN > Dear All. I am the original poster of this topic. I seem to have raised > a hornets nest, for which I am appreciative of the interest. However, > nobody has answered the original question. Is too much Prednisolone > harmful? Long term use can be harmful. Others will have more knowledge but from what I've seen long term use can cause bad joint problems and large weight gains. Shorter term side effects tend to correct themselves when removed from prednisone. > Dear All. I am the original poster of this topic. I seem to have raised > a hornets nest, for which I am appreciative of the interest. However, > nobody has answered the original question. Is too much Prednisolone > harmful? Short bursts usually don't cause a lot of problems. Most often if they do it is that they upset the stomach, cause jitteriness, increase blood glucose levels, and cause increased appetite and fluid retention. Long term use, even at low doses, frequently has adverse effects inlcuding diabetes, weight gain, brittle bones, cataracts, increased susceptibility to infections, depressed adrenal gland function, increased cholesterol, vascular disease, hypertension (high blood pressure), easy bruising, gastrointestinal bleeding and others. Taking several bursts per year is somewhere in between with some relationship between total cummulative dose and side effects. Then again, not being able to breath also presents problems. You and your doctors should be doing what you can to keep the use of prednisolone as low as possible but not be afraid to use it if needed. Requiring several bursts of oral steroids such as prednisolone per year is not well controlled. I believe that many generalists are quite competant to manage most asthma (and ocassionally some specialists aren't) and so am not one of the ones here who automatically cries that you must see a specialist immediately. However, as in any condition, if the generalist is not controlling the problem well then a referral to a specialist is prudent. Signature00doc You wrote: "I believe that many generalists are quite competant to manage most asthma (and ocassionally some specialists aren't) and so am not one of the ones here who automatically cries that you must see a specialist immediately. However, as in any condition, if the generalist is not controlling the problem well then a referral to a specialist is prudent." Yes, but here ignorance seems to be bliss. How can the medical profession go on making such sweeping statements, when its understanding of breathing itself is so peculiar? Its "management of asthma" is just a fiasco. "Asthma farming" would be a better expression: A medical curiosity can only beget a curious unfathomable disease. The crucial point is that man does not differ from most mammals in not basically being an obligate nose breather. Lung inflation is still dependent on a stenosis producing negative pressure. A moralist could say that asthma is due to human vanity with a conceit about being able to breathe better than mean beasts (the birds and the bees) and hiding a basic misunderstanding. Snoring is an obvious primary result of insufficient normal airway resistance, or did you ever hear of a cat or dog snoring? Taking a healthy deep breath involves a feeling of resistance in the nose. This is not wasted energy and "work of breathing" which should be minimized in accordance with a current medical fad. Yoga techniques involving increased stenosis on an inhale may stimulate the sympathetic nervous system be a sort of adrenaline pump. Surely this is preferable to pred. For a western-reader-friendly yoga text on this, see http://jeksite.org/yoga/resp.doc Most yoga descriptions make weird reading for sure, but are they really less consistent in substance than western activities on asthma with drugs turning out to much more dangerous than people were led to believe. Surely a patient should be able to expect less intellectual apathy, less no-braining, from docs when they spend such a long time in academia but fail to consider yoga and prefer to read the latest official asthma research (see postings here) however haywire it is. No wonder that I r o n j u s t i c e figures his stuff is relevant. In short, take Dr House (Hugh Laurie) seriously when he puts his thinking cap on when the patient seems to be dying under his treatment. House takes a radical change in course. And of course stay around and also do some ujjayi to help your breathing and put yourself in a good mood. In sincere appreciation of your efforts on this ng, Richard Friedel |
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