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Medical Forum / Diseases and Disorders / Asthma / October 2006Question for 000doc
My doctor referred me to a specialist to determine if I had asthma. The specialist (after looking at my CAT skan and lung X-rays) determined that I did NOT have asthma but instead had calcium deposits (non-cancer) on my lungs. Do you know whether or not my breathing problems will stay the same or will get worse as I get older. I am now 56 years old. I have some of the symptoms of asthma. I should note that the specialist had his nurse conduct a standard asthma test. The results of that standand asthma test were that I did NOT have asthma. Jason > My doctor referred me to a specialist to determine if I had asthma. > The specialist (after looking at my CAT skan and lung X-rays) determined [quoted text clipped - 5 lines] > of that standand asthma test were that I did NOT have asthma. > Jason The "asthma test", by which I think you mean office spirometry (where you breath into the machine several times), cannot rule out asthma. It can confirm that you have asthma if the results are typical and if they reverse after giving a bronchodilator (usually albuterol). If you are having symptoms during the test and the test does not show obstruction then it can make asthma unlikely, but alone it cannot rule out asthma. Asthma by definition is a reversible process so on a good day you may have no signs or symptoms and normal tests. In some people, especially people with mild or very intermittent problems it can be hard to "catch" it on the testing and we have to go more with the descriptions of the problem and response to medications (and or keep repeating the test until you get it). The best thing to do in this situation is to try to provoke an attack, either by a methacholine challenge (they have you breath something that brings it on in the lab) or some other maneuver (many pediatric pulmonologists will have the kid run around for a bit and then try it). I have found where I am that it is exceedingly difficult to get a methacholine challenge test - the pulmonologists just don't want to do them - so it is often hard to figure out. In any event - if you are seeing a pulmonary specialist about a pulmonary problem it is fair game to ask why you are having the symptoms and expect a reasonable diagnosis and treatment plan. After-all, you were sent to evaluate the symptoms - not just to rule in or out any one particular disease. If the one you are seeing is not doing this then it would be reasonable to seek a second opinion. Again, I am guessing - but usually the calcium deposits are from old infections and irritations and have nothing to do with breathing problems. If it is more extensive than I am imagining then this is another fair question for the pulmonologist. On Oct 15, 4:24 pm, j...@nospam.com (Jason Johnson) wrote: > My doctor referred me to a specialist to determine if I had asthma. > The specialist (after looking at my CAT skan and lung X-rays) determined [quoted text clipped - 5 lines] > of that standand asthma test were that I did NOT have asthma. > Jason The "asthma test", by which I think you mean office spirometry (where you breath into the machine several times), cannot rule out asthma. It can confirm that you have asthma if the results are typical and if they reverse after giving a bronchodilator (usually albuterol). If you are having symptoms during the test and the test does not show obstruction then it can make asthma unlikely, but alone it cannot rule out asthma. Asthma by definition is a reversible process so on a good day you may have no signs or symptoms and normal tests. In some people, especially people with mild or very intermittent problems it can be hard to "catch" it on the testing and we have to go more with the descriptions of the problem and response to medications (and or keep repeating the test until you get it). The best thing to do in this situation is to try to provoke an attack, either by a methacholine challenge (they have you breath something that brings it on in the lab) or some other maneuver (many pediatric pulmonologists will have the kid run around for a bit and then try it). I have found where I am that it is exceedingly difficult to get a methacholine challenge test - the pulmonologists just don't want to do them - so it is often hard to figure out. In any event - if you are seeing a pulmonary specialist about a pulmonary problem it is fair game to ask why you are having the symptoms and expect a reasonable diagnosis and treatment plan. After-all, you were sent to evaluate the symptoms - not just to rule in or out any one particular disease. If the one you are seeing is not doing this then it would be reasonable to seek a second opinion. Again, I am guessing - but usually the calcium deposits are from old infections and irritations and have nothing to do with breathing problems. If it is more extensive than I am imagining then this is another fair question for the pulmonologist. ~~~~~~~~~~~~~~~~~~~~~~~~ doc, Thanks. The pulmorary specialist that I was referred to had the best equipment that is available related to testing people for asthma. The equipment is controlled by a computer. The test took about one hour. The nurse had me inhale something but I don't know what it was. It may have been a methacholine challenge test but I am not sure. The end result was a computer print out. I recall that the doctor had that same print-out in front of him when he told me that the test indicated that I did not have asthma. My major symptom of asthma (or perhaps of the symptoms of calcium deposits) is that I have a difficult time breathing during the night hours when I am lying flat on my back. If I am setting up or lying on my side, I breath much better. I don't have this problem during the day if I am lying flat on my back. I suspect the reason the problem is worse at night is because various hormone levels are lower at night. One of those hormones is cortisol which reduces swelling. I found out that cortisol levels are highest in the morning and lowest at night. Do you believe that I should have another asthma test in the near future--perhaps during the late evening hours? There is a product called Isocort that has hydrocortisone in it--do you believe that I should try taking a dose of it during the evening hours to see if it helps me to breath better when I am lying flat on my back? Jason ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >My major symptom of asthma (or perhaps of the symptoms of calcium >deposits) is that I have a difficult time breathing during the night hours [quoted text clipped - 3 lines] >reason the problem is worse at night is because various hormone levels are >lower at night. Difficulty breathing while lying flat and improving upon sitting up is not asthma nor due to calcium deposits. What you are describing is called orthopnea and characteristic of a heart problem such as congestive heart failure due to fluid accumulation in the lungs while lying down. Fluid accumulation improves upon sitting up resulting in breathing easier. Do you also awaken from sleep with shortness of breath? If so I would suggest getting checked out by a cardiologist. As I recall you also spoke of ankle swelling. This is also a sign of a heart problem such as CHF. Good luck. RC On Sun, 22 Oct 2006 12:06:00 -0700, jason@nospam.com (Jason Johnson) wrote: >My major symptom of asthma (or perhaps of the symptoms of calcium >deposits) is that I have a difficult time breathing during the night hours [quoted text clipped - 3 lines] >reason the problem is worse at night is because various hormone levels are >lower at night. Difficulty breathing while lying flat and improving upon sitting up is not asthma nor due to calcium deposits. What you are describing is called orthopnea and characteristic of a heart problem such as congestive heart failure due to fluid accumulation in the lungs while lying down. Fluid accumulation improves upon sitting up resulting in breathing easier. Do you also awaken from sleep with shortness of breath? If so I would suggest getting checked out by a cardiologist. As I recall you also spoke of ankle swelling. This is also a sign of a heart problem such as CHF. Good luck. RC ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RC, Yes, I do have edema. My regular doctor tested my blood pressure while I was setting down and tested it again when I stood up. It was lower when I stood up. He told me that I had edema. He told me that is was not a major case of edema so refused to prescribe a loop diurectic. I made a note related "orthospnea" and will do a medlineplus search for that term and will discuss it with my regular doctor. He is an internist. He may or may not refer me to a cardio. I had a stress test by a cardio. last year and he told me that my heart was working great. I did have a case of shortness of breath when I had a case of bronchitis. My father died of heart disease when he was about 65 years old. I am now 56 years old. I ride an exercise bike 4 miles per day at a high rate of speed. Believe it or not, I breath well while riding a bike but have a hard time breathing normally at night when I am lying flat on my back. My doctor seems to think that I have NO medical problems. He actually stated, "Lots of people have edema so you have nothing to worry about." I should have stated, "That's true but it's your job to figure out the reason I have edema." I know that it's not related to medications because I do not take any medications. Thanks for your post and advice, Jason ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > In article <d3qnj2d0scksjpskhv90i8eljjsdlo2...@4ax.com>, > [quoted text clipped - 50 lines] > Jason > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unfortunately, most cases of edema are what we call lymph edema - just from being upright/gravity and there are no abnormal tests. The doc can try to make sure it is not due to other things like heart problems, low protien levels, thryoid problems, problems with the veins but usually there is no abnormal test. Whether it is worth taking a loop diuretic for it depends on how bad it is and how risk adverse you are about the medication. It is a judegment call. On Oct 23, 3:33 pm, j...@nospam.com (Jason Johnson) wrote: > In article <d3qnj2d0scksjpskhv90i8eljjsdlo2...@4ax.com>, > [quoted text clipped - 50 lines] > Jason > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unfortunately, most cases of edema are what we call lymph edema - just from being upright/gravity and there are no abnormal tests. The doc can try to make sure it is not due to other things like heart problems, low protien levels, thryoid problems, problems with the veins but usually there is no abnormal test. Whether it is worth taking a loop diuretic for it depends on how bad it is and how risk adverse you are about the medication. It is a judegment call. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes, I agree. I read about the side effects of diurectics and want to avoid taking them unless I have no choice. One of the side effects of loop diurectics is "Ringing or buzzing in the ears, hearing loss, deafness, fainting, etc" source: "The Pill Book" Needless to say--I don't want to risk deafness. Now I understand why the doctor did not conduct any tests--he probably assumed that it was lymph edema based upon info. from my medical file such as a stress test that was conducted last year. Jason ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >One of the side effects of loop >diurectics is "Ringing or buzzing in the ears, hearing loss, deafness, >fainting, etc" >source: "The Pill Book" > >Needless to say--I don't want to risk deafness. Sometimes a little information is a dangerous thing. You are probably as likely as getting deaf from not taking loop diuretics as by taking them assuming you don't overdose on them. It is important to recognize that just because a condition is associated with a medication does not mean it has a causal connection. Correlation does not imply causation. Look up any medication in the PDR and look at the side effects. You would probably not want to take any of them. They include side effects that may not even be connected to the medication in order to CTA. RC On Mon, 23 Oct 2006 16:17:07 -0700, jason@nospam.com (Jason Johnson) wrote: >One of the side effects of loop >diurectics is "Ringing or buzzing in the ears, hearing loss, deafness, >fainting, etc" >source: "The Pill Book" > >Needless to say--I don't want to risk deafness. Sometimes a little information is a dangerous thing. You are probably as likely as getting deaf from not taking loop diuretics as by taking them assuming you don't overdose on them. It is important to recognize that just because a condition is associated with a medication does not mean it has a causal connection. Correlation does not imply causation. Look up any medication in the PDR and look at the side effects. You would probably not want to take any of them. They include side effects that may not even be connected to the medication in order to CTA. RC ~~~~~~~~~~~~~~~~~~~ RC, Good points. You are correct. I tend to worry too much. I developed some memory problems as a result of taking statins so that causes me to worry more than most people about listed side effects of various medications. I have weak kidneys and have problems with every medication that indicates that the medication can cause kidney problems. You would be amazed about the number of medications that have that warning. If you have a copy of the PDR--you already know that I am correct. Jason ~~~~~~~~~~~~~~ >RC, >Good points. You are correct. I tend to worry too much. I developed some >memory problems as a result of taking statins so that causes me to worry >more than most people about listed side effects of various medications. Unfortunately the effect of your worrying is that you may be reluctant to takes meds that you really need or your worrying will result in your developing more intense side effects when you do take the medication. . > I >have weak kidneys and have problems with every medication that indicates >that the medication can cause kidney problems. Drinking too much water can screw up your kidneys too. And do watch the air you breathe as it could really do a number on your kidneys. Btw, your belief that you have "weak kidneys", whatever that means, is likely another manifestation of your obsessive worrying about your health and physical condition. Has any doctor told you that you have something wrong with your kidneys? If so exactly what is the problem? > You would be amazed about >the number of medications that have that warning. No I would not be amazed. I know quite well that the list of side effects is far in excess of what is actually a causal relationship between the med and the side effect. The worst effect of all the side effects listed in the PDR is worriers like you who obsess about the possibility of getting a side effect that likely will not occur unless of course your worrying ends up making it a self fulfilling prophecy > If you have a copy of >the PDR--you already know that I am correct. I do know you are correct. Hopefully you will realize that the list of side effects does not accurately portray the actual risk. Have you seen the list of side effects from placebo? Sometimes placebo causes more side effects than the real medication. The mind is a very powerful thing and can cause physical symptoms as a result of anxiety/worrying. RC >Jason On Mon, 23 Oct 2006 17:14:54 -0700, jason@nospam.com (Jason Johnson) wrote: >RC, >Good points. You are correct. I tend to worry too much. I developed some >memory problems as a result of taking statins so that causes me to worry >more than most people about listed side effects of various medications. Unfortunately the effect of your worrying is that you may be reluctant to takes meds that you really need or your worrying will result in your developing more intense side effects when you do take the medication. . > I >have weak kidneys and have problems with every medication that indicates >that the medication can cause kidney problems. Drinking too much water can screw up your kidneys too. And do watch the air you breathe as it could really do a number on your kidneys. Btw, your belief that you have "weak kidneys", whatever that means, is likely another manifestation of your obsessive worrying about your health and physical condition. Has any doctor told you that you have something wrong with your kidneys? If so exactly what is the problem? > You would be amazed about >the number of medications that have that warning. No I would not be amazed. I know quite well that the list of side effects is far in excess of what is actually a causal relationship between the med and the side effect. The worst effect of all the side effects listed in the PDR is worriers like you who obsess about the possibility of getting a side effect that likely will not occur unless of course your worrying ends up making it a self fulfilling prophecy > If you have a copy of >the PDR--you already know that I am correct. I do know you are correct. Hopefully you will realize that the list of side effects does not accurately portray the actual risk. Have you seen the list of side effects from placebo? Sometimes placebo causes more side effects than the real medication. The mind is a very powerful thing and can cause physical symptoms as a result of anxiety/worrying. RC ~~~~~~~~~~~~~~~~~~~~~~~~ RC, When I was a baby I had nephrotic syndrome. My creatinine level rose from 1.1 to 1.9 MG/DL while I was taking statins so I stopped taking statins. My creatinine level is now 1.1 MG/DL. Last year, my doctor prescribed a thiazide diurectic and I had really bad side effects. I developed a bad case of hyponatremia. I have not tried taking Loop diurectics. I read that Loop diurectics work better for people that have hyponatremia. My doctor told me that I may have Distal Renal Tubular Acidosis based upon various blood tests. I have some of the symptoms of nephrotic syndrome such as edema. I know that I do not have ESRD. I control the high acid levels by avoiding high acid foods and liquids. I realize that I worry about my health more than most people. My sister died of a heart attack at the age of 64 years old and I am now 55 years old. Sarah said that I have hypocondria and she is correct. I do not take any medications but I would take a medication if I really needed to take a medication. I may have to start taking a Loop Diurectic if I can not find a non-medication solution to my serious edema problems. Jason ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >Sarah said that I have hypocondria and she is correct. I agree with Sarah, whoever she is. RC >RC, >Yes, I do have edema. My regular doctor tested my blood pressure while I >was setting down and tested it again when I stood up. It was lower when I >stood up. He told me that I had edema. He told me that is was not a major >case of edema so refused to prescribe a loop diurectic. Just because edema is mild does not mean that it is not a manifestation of a more serious disorder. >I made a note related "orthospnea" and will do a medlineplus search for >that term and will discuss it with my regular doctor. It is "orthopnea". Waking up in the middle of the night short of breath is called "paroxysmal nocturnal dyspnea" if you happen to have that in the absence of asthma. > He is an internist. >He may or may not refer me to a cardio. I had a stress test by a cardio. >last year and he told me that my heart was working great. If your heart is working "great" then I doubt that you have congestive heart failure which is due to the heart not working so great and therefore having fluids backed up into lungs and lower extremities causing difficulty breathing and dependent edema. >My father died of heart disease when he was about 65 years old. Genetics plays an important role in disease. Your symptoms suggest possible heart disease and your family history dictate that your symptoms be taken seriously. > I am now >56 years old. I ride an exercise bike 4 miles per day at a high rate of >speed. >Believe it or not, I breath well while riding a bike but have a hard time >breathing normally at night when I am lying flat on my back. If you are able to exercise at high intensity without unusual shortness of breath I doubt you have congestive heart failure. Are you obese? A smoker? >My doctor seems to think that I have NO medical problems. Yes, and you think you have many medical problems. That must cause you great distress. >He actually stated, "Lots of people have edema so you have nothing to >worry about." It is true that a lot of people have edema. But it is also true that the edema may be a sign or precursor of more serious malady. > I should have stated, "That's true but it's your job to >figure out the reason I have edema." I don't know if I would word it that way. You might say that you understand that edema may be a sign of more serious problem and you would like to determine the cause of the edema. > I know that it's not related to >medications because I do not take any medications. >Thanks for your post and advice, My pleasure. RC On Mon, 23 Oct 2006 12:33:38 -0700, jason@nospam.com (Jason Johnson) wrote: >RC, >Yes, I do have edema. My regular doctor tested my blood pressure while I >was setting down and tested it again when I stood up. It was lower when I >stood up. He told me that I had edema. He told me that is was not a major >case of edema so refused to prescribe a loop diurectic. Just because edema is mild does not mean that it is not a manifestation of a more serious disorder. >I made a note related "orthospnea" and will do a medlineplus search for >that term and will discuss it with my regular doctor. It is "orthopnea". Waking up in the middle of the night short of breath is called "paroxysmal nocturnal dyspnea" if you happen to have that in the absence of asthma. > He is an internist. >He may or may not refer me to a cardio. I had a stress test by a cardio. >last year and he told me that my heart was working great. If your heart is working "great" then I doubt that you have congestive heart failure which is due to the heart not working so great and therefore having fluids backed up into lungs and lower extremities causing difficulty breathing and dependent edema. >My father died of heart disease when he was about 65 years old. Genetics plays an important role in disease. Your symptoms suggest possible heart disease and your family history dictate that your symptoms be taken seriously. > I am now >56 years old. I ride an exercise bike 4 miles per day at a high rate of >speed. >Believe it or not, I breath well while riding a bike but have a hard time >breathing normally at night when I am lying flat on my back. If you are able to exercise at high intensity without unusual shortness of breath I doubt you have congestive heart failure. Are you obese? A smoker? >My doctor seems to think that I have NO medical problems. Yes, and you think you have many medical problems. That must cause you great distress. >He actually stated, "Lots of people have edema so you have nothing to >worry about." It is true that a lot of people have edema. But it is also true that the edema may be a sign or precursor of more serious malady. > I should have stated, "That's true but it's your job to >figure out the reason I have edema." I don't know if I would word it that way. You might say that you understand that edema may be a sign of more serious problem and you would like to determine the cause of the edema. > I know that it's not related to >medications because I do not take any medications. >Thanks for your post and advice, My pleasure. RC ~~~~~~~~~~~~~~~~~~~~~~ RC, No, I am not obese. I will use your words (re: edema) instead of my words. Your words sound much better than my words and may have a better result. Doctors see lots of patients that are near death so seem to ignore people like me that appear to be be healthy based on blood tests and urine tests. There are lots of causes for edema and many busy doctors don't want to take the time needed to figure out the cause of edema. They usually give the patient a prescription for a diuretic without conducting any tests or any referrals. I have an HMO (Hurry Me Out) insurance program which makes it even harder for my doctor to make referrals or spend time conducting expensive tests such as CAT skans. I don't know the true cause of the edema but I would like to find out. I will take your advice related to scheduling an appointment with the asthma specialist. I can usually see any specialist that I have seen before without a referral. Of course, the specialist must agree to see me--otherwise--my insur. will not pay for it. One person referred to it as "HMO Hell". Thanks again for your help and advice. Jason ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >RC, >No, I am not obese. I will use your words (re: edema) instead of my words. >Your words sound much better than my words and may have a better result. Yes. Many doctors become defensive if they think that you are questioning their professionalism. >Doctors see lots of patients that are near death so seem to ignore people >like me that appear to be be healthy based on blood tests and urine tests. This is true. I don't know if you have a serious medical disorder. As I have told you in the past I am suspicious that you worry unnecessarily about your health although I remain open minded that you may have a real problem. Even paranoid people get persecuted sometimes. >There are lots of causes for edema and many busy doctors don't want to >take the time needed to figure out the cause of edema. They usually give >the patient a prescription for a diuretic without conducting any tests or >any referrals. This is true. Most cases of edema in older individuals is due to benign causes such as incompetent leaky vessels as you get older and there is no treatable illness. > I have an HMO (Hurry Me Out) insurance program which makes >it even harder for my doctor to make referrals or spend time conducting >expensive tests such as CAT skans. This is a problem with HMO's which maximize profits by doing fewer tests. However failure to make an early diagnosis by doing a test may cost them more in the long run, not to mention potentially costing the patient his life. > I don't know the true cause of the >edema but I would like to find out. You may never find out. >I will take your advice related to scheduling an appointment with the >asthma specialist. I don't think I suggested scheduling an appointment with an asthma specialist. I thought your asthma test was negative. I suggested a cardiac workup by a cardiologist but it sounds like you may have already had a cardiac workup when you had stress test and were told that your heart was fine. > I can usually see any specialist that I have seen >before without a referral. Of course, the specialist must agree to see >me--otherwise--my insur. >will not pay for it. One person referred to it as "HMO Hell". >Thanks again for your help and advice. Good luck. RC >Jason On Mon, 23 Oct 2006 16:08:26 -0700, jason@nospam.com (Jason Johnson) wrote: >RC, >No, I am not obese. I will use your words (re: edema) instead of my words. >Your words sound much better than my words and may have a better result. Yes. Many doctors become defensive if they think that you are questioning their professionalism. >Doctors see lots of patients that are near death so seem to ignore people >like me that appear to be be healthy based on blood tests and urine tests. This is true. I don't know if you have a serious medical disorder. As I have told you in the past I am suspicious that you worry unnecessarily about your health although I remain open minded that you may have a real problem. Even paranoid people get persecuted sometimes. >There are lots of causes for edema and many busy doctors don't want to >take the time needed to figure out the cause of edema. They usually give >the patient a prescription for a diuretic without conducting any tests or >any referrals. This is true. Most cases of edema in older individuals is due to benign causes such as incompetent leaky vessels as you get older and there is no treatable illness. > I have an HMO (Hurry Me Out) insurance program which makes >it even harder for my doctor to make referrals or spend time conducting >expensive tests such as CAT skans. This is a problem with HMO's which maximize profits by doing fewer tests. However failure to make an early diagnosis by doing a test may cost them more in the long run, not to mention potentially costing the patient his life. > I don't know the true cause of the >edema but I would like to find out. You may never find out. >I will take your advice related to scheduling an appointment with the >asthma specialist. I don't think I suggested scheduling an appointment with an asthma specialist. I thought your asthma test was negative. I suggested a cardiac workup by a cardiologist but it sounds like you may have already had a cardiac workup when you had stress test and were told that your heart was fine. > I can usually see any specialist that I have seen >before without a referral. Of course, the specialist must agree to see >me--otherwise--my insur. >will not pay for it. One person referred to it as "HMO Hell". >Thanks again for your help and advice. Good luck. RC ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RC, The stress test was done about a year ago by a cardio. Doc told me that pulmonary specialists can do some sort of cardio work up to determine if heart problems are the cause of breathing related problems. It would be great to have that sort of test to rule in or rule out my heart as a cause of my edema problems and breathing problems. Of course, the pulmonary specialist that done the asthma test may or may not want to conduct such a test. My HMO insur. company might not even let me get such a test. I know that I worry more than I should worry about my breathing problems and edema problems. My neighbor has serious thyroid problems and does not even seem to be concerned about all of the symptoms that she is having. Everyone is different. Jason ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > ~~~~~~~~~~~~~~~~~~~~~~~~ > [quoted text clipped - 5 lines] > been a > methacholine challenge test but I am not sure. In the regular test they do it once (usually three breaths - but maybe more if they are not consistent enough) then they have you inhale some albuterol and then repeat it. In a methacholine challenge test they keep repeating the test after having you inhale increasing doses of methacholine until one of them makes you wheeze. > The end result was a > computer print out. I recall that the doctor had that same print-out in [quoted text clipped - 13 lines] > breath better when I am lying flat on my back? > Jason It would probably be heard to schedule the test outside of normal office hours. You could follow peak flows at home and see if they drop at night. It is not as good but still something. While asthma is often worse at night the part about worsening symptoms wth lying down could be from a number things (the heart as well as other things). Pulmonologists often recommend cardiac work-ups and it sounds like this is not impossible in this case so I would be surprised if he didn't recommend it in you. Again, even if he doesn't think it is asthma it is fair to ask him to arrive at some other diagnosis. If he is not working with you to find out what it is, not just what it is not, then you need a second opinion. As for the Isocort - I wouldn't. For one thing if the product really does have corticosteroids in it (or get your body to produce more of them) then it is a toxic drug that should be used with great caution and with close monitoring. It is also a very expensive verison of one of the cheapest drugs around ($25 would keep you in prednisone for over a year). If it does not then it is just a total scam. Either way it is a scam.  Signature00doc "Jason Johnson" <jason@nospam.com> wrote in message news:jason-2210061206000001@66-52-22-102.lsan.pw-dia.impulse.net... > ~~~~~~~~~~~~~~~~~~~~~~~~ > [quoted text clipped - 5 lines] > been a > methacholine challenge test but I am not sure. In the regular test they do it once (usually three breaths - but maybe more if they are not consistent enough) then they have you inhale some albuterol and then repeat it. In a methacholine challenge test they keep repeating the test after having you inhale increasing doses of methacholine until one of them makes you wheeze. > The end result was a > computer print out. I recall that the doctor had that same print-out in [quoted text clipped - 13 lines] > breath better when I am lying flat on my back? > Jason It would probably be heard to schedule the test outside of normal office hours. You could follow peak flows at home and see if they drop at night. It is not as good but still something. While asthma is often worse at night the part about worsening symptoms wth lying down could be from a number things (the heart as well as other things). Pulmonologists often recommend cardiac work-ups and it sounds like this is not impossible in this case so I would be surprised if he didn't recommend it in you. Again, even if he doesn't think it is asthma it is fair to ask him to arrive at some other diagnosis. If he is not working with you to find out what it is, not just what it is not, then you need a second opinion. As for the Isocort - I wouldn't. For one thing if the product really does have corticosteroids in it (or get your body to produce more of them) then it is a toxic drug that should be used with great caution and with close monitoring. It is also a very expensive verison of one of the cheapest drugs around ($25 would keep you in prednisone for over a year). If it does not then it is just a total scam. Either way it is a scam. ~~~~~~~~~~~~~~~~~~ doc, Thanks for your advice. I'll call the pulmonologist and see if he will arrange for me to get a cardiac work-up. I am also trying to get a referral to a Endocrinologist since I recently found out that high levels of cortisol and/or Aldosterone can cause people to excrete high levels of potassium and retain sodium. When people retain sodium, they also retain water. The end result is edema and I have edema. It's much worse when I eat any foods that contain high levels of salt. I now avoid any foods that have high levels of salt. What a drag it is getting old. I am only 55 years old but during the night hours, I feel like I am 75 years old. Thanks again, Jason ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
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