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Medical Forum / Diseases and Disorders / Asthma / April 2004Asthmatic wife, meds not helping, need advice.
Hello all, I'm new to the group and hoping I could get some help. My wife had been able to live with her asthma simply by using her albuterol inhaler as necessary. However, a few months ago her condition worsened. In November 2003 my wife's MD diagnosed moderate, persistent asthma and prescribed Azmacort; drug was completely ineffective. At this time the my wife also received a nebulizer since her attacks didn't respond well to the albuterol inhaler. In December 2003 my wife was prescribed Advair 250/50 (discontinued Azmacort); this helped some for a short while but now helps only minimally, if at all. We found this troubling since my wife had used Flovent successfully in the past. Wednesday, my wife had an episode that didn't respond at all to albuterol and went to our 24 hour clinic. That doctor confirmed asthma and treated my wife with a Combivent nebulizer solution (seemed to help). That doctor prescribed Combivent and Singulair to be used in conjunction with the Advair. My wife followed up with the regular MD who recommended Advair (2x/day), Combivent (every 4-6 hrs, taken a few hours prior to the Advair), and Singulair (1 tablet per day). The Singulair just started today since the pharmacy was out of stock. Notably, my wife's regular doctor was hesitant about the Singulair. The precise comment was "if it works for you, you'll be taking it for the rest of your life". This comment is open to interpretation but troubling nonetheless (the doctor did not comment on any of the other medications). So, my wife condition continues to worsen even with all the medication; we're at the point that she can't climb more than 1/2 staircase without resting. She is 30, just slightly overweight, and otherwise healthy. Except for the first hour after taking the Combivent, she pretty much feels crappy all the time. Some concerns/questions I'd like feedback on: 1. Even though two separate doctors have diagnosed asthma, could something else be going on here? 2. Should I be concerned about what appears to be a high medication level, especially since my wife doesn't seem to get much out of it? 3. Are the side effects of Singulair particularly troublesome? I'm concerned that the Singular will weaken the body and create a dependency (like some nasal decongestants have been known to do). 4. I perceive that my wife's doctor's are just throwing pills at her (rather than taking a disciplined approach). Any thoughts? Have others out there been treated in such a "shotgun" manner, and how did it work? 5. At what point do we insist on referrals to appropriate specialists? At this point, I'm becoming convinced either that my wife was misdiagnosed or that the doctors to date simply are not up to the task of managing this condition. Absent marked improvement, we plan on insisting on specialist referral at the next appointment (3/15/04). Any and all feedback is appreciated. Thank you for your time. >Hello all, > >I'm new to the group and hoping I could get some help. Get her onto a course of Buteyko therapy. At her age she is young enough to do extremely well and get off all that medication. Her problems stem from chronic hyperventilation and not withstanding the rubbish people on this group say about Buteyko, it is very effective for all chronic hyperventilation disorders such as the one your wife is suffering from. There have now been five clinial trials and they all point to the effectiveness of this therapy. Please see our web site for full details. Also we have an excellent support group which is far more useful than anything you'll find on this group. Peter Kolb BSc(Eng) MSc(Med) Biomedical Engineer pkolb@wt.com.au ___________________________________________________ Free information provided by grateful ex-asthmatics http://members.westnet.com.au/pkolb/buteyko.htm __________________________________________________ >Her problems stem from chronic hyperventilation and not withstanding >the rubbish people on this group say about Buteyko, it is very >effective for all chronic hyperventilation disorders such as the one >your wife is suffering from. One would be prudent to avoid diagnosing without a degree, without an examination, and without a doubt... Especially one who is: >Peter Kolb BSc(Eng) MSc(Med) >Biomedical Engineer >One would be prudent to avoid diagnosing without a degree, without an >examination, and without a doubt... Especially one who is: > >>Peter Kolb BSc(Eng) MSc(Med) >>Biomedical Engineer I suspect that this claim is inflated. IIRC he is a tech who repairs medical equipment at a hospital. (Not an actual engineer.) No electrons were harmed in the posting of this message. >>Hello all, >> >>I'm new to the group and hoping I could get some help. > >Get her onto a course of Buteyko therapy. At her age she is young >enough to do extremely well and get off all that medication. Ignore Kolb. B* is nothing more than a scam. And terminating medications can place your wife's life in danger. >Her problems stem from chronic hyperventilation and not withstanding >the rubbish people on this group say about Buteyko, it is very >effective for all chronic hyperventilation disorders such as the one >your wife is suffering from. There have now been five clinial >trials and they all point to the effectiveness of this therapy. Name one published clinical trial that states that B* "is a safe and effective treatment for . . .". The best you have is the rather dubious term "more research is necessary." Quit lying to people Peter. No electrons were harmed in the posting of this message. You may want to look at the research posted on http://www.AsthmaStory.com and consider the possibility that her asthma could be caused by a Chlamydia pneumoniae or Mycoplasma bacterial infection. Jim Quinlan http://www.AsthmaStory.com > Hello all, > [quoted text clipped - 54 lines] > > Any and all feedback is appreciated. Thank you for your time. >You may want to look at the research posted on http://www.AsthmaStory.com >and consider the possibility that her asthma could be caused by a Chlamydia >pneumoniae or Mycoplasma bacterial infection. Or we can drop all the pet theories and patent remedies and get her to competent medical care? No electrons were harmed in the posting of this message. Pet theories? Leave my cat out of this !!! Jim Quinlan http://www.AsthmaStory.com >Pet theories? > >Leave my cat out of this !!! Cats do not have theories. To a cat everything is either a certainty or irrelevant. No electrons were harmed in the posting of this message. >>Pet theories? >> >>Leave my cat out of this !!! > >Cats do not have theories. To a cat everything is either a certainty >or irrelevant. But it gets more irrelevant than that: When a cat is dropped, it always lands on its feet, and when toast is dropped, it always lands buttered side down. It was proposed to strap giant slabs of hot buttered toast to the backs of a hundred tethered cats. The two opposing forces will cause the cats to hover, spinning inches above the ground. Using the giant buttered toast/cat array, a high-speed monorail could easily link New York with Chicago... >Notably, my wife's regular doctor was hesitant about the Singulair. The >precise comment was "if it works for you, you'll be taking it for the rest of >your life". This comment is open to interpretation but troubling nonetheless >(the doctor did not comment on any of the other medications). Sounds like this guy is the problem. He seems to be out of touch with current methods for controlling asthma. Ask for a referral to an asthma specialist. >Some concerns/questions I'd like feedback on: > >1. Even though two separate doctors have diagnosed asthma, could something >else be going on here? Maybe. This is why you need to see a specialist. >2. Should I be concerned about what appears to be a high medication level, >especially since my wife doesn't seem to get much out of it? Yes. >3. Are the side effects of Singulair particularly troublesome? I'm concerned >that the Singular will weaken the body and create a dependency (like some nasal >decongestants have been known to do). Asthma medications do not 'create' a dependency. They control a chronic illness. Current medical doctrine is that all asthmatics should be on some for of long-term treatment. BTW, Singulair's side effects are rare, typically mild in nature and terminate if the medication is discontinued. >4. I perceive that my wife's doctor's are just throwing pills at her (rather >than taking a disciplined approach). Any thoughts? Have others out there been >treated in such a "shotgun" manner, and how did it work? I had a similar type of care several years ago. It did not work. >5. At what point do we insist on referrals to appropriate specialists? A long time ago. No electrons were harmed in the posting of this message. When your wife's asthma is not being controlled, she should make an appointment at National Jewish in Denver Colorado. They are wonderful and are #1 across the country in dealing with asthma. The complete program at National Jewish would take almost a week.....and is well worth the trip! I was first diagnosed with asthma nearly ten years ago and am now on my fourth lung doctor (pulminologist) A trip to Jewish Medical in Denver is surely a good idea. Short of Denver, see if you can find a university with a medical school nearby and look for specialist there. In schools a situation exists where all the doctors and students are looking at each other. This tends to keep any of them from practicing "country medicine", which, owing to my experience here in New York, I'm afraid is happening everywhere. Certainly by lung doctors. A great deal is not yet known about the lungs. New things come up regularly. Important to be in the swim of things. Best of Luck---Jack > Hello all, > [quoted text clipped - 54 lines] > > Any and all feedback is appreciated. Thank you for your time. Hello,Do not know about your health insurance coverage but a second opinion is needed as suggested by other posters. From reading your post it is possible that there may be other problems. Take Care. beamish. Has your wife seen a pulmonologist? IMO (not a doctor), if the asthma drugs are not helping her, either her asthma is not under control or it's not asthma. There are other conditions that can appear to be asthma. Without thorough & proper testing, the distinction cannot be made. If all else fails, as mentioned above, make an apt at National Jewish - it's the best place in the country for those with hard to define or hard to control lung problems. Good luck. Singulair is problaby one of the best drugs that have came out for me. In fact it replaced a drug that was very hard on the system and could cause an overdose and even damage to the body. To me it sounds like you need to take your wife to a pulmonary specialtist and get some sound advise and treatment. MDs just do not spend the time and properly treat asthma patients, especially since I have found most do not have a clue. Took me a long time of suffering to realize it. The wrong treatments can cause more damage in the long run. A lot of physician do not want to prescribe Singulair because of the cost and in some cases in some medical groups they discourage it. It really makes me wonder why he made the comment about it that he did since it is meant to be taken for life since most asthma patient normally have asthma for life. Many of the asthma drugs sole purpose is to stablize the asthma and improve the patients life. Albuterol inhalers are really not the way to go if at all possible and the mission of the doctor should be to reduce it to as little as possible and only for emergencies. That is why Singuliar and support drugs such as Advair and Flovent are used. What happened to me was like your wife where the albuterol just seemed to go hand in hand with making me worse the more I used of it. I think your wife is on the right track and if she can just get the proper treatment and proper diagnostic the Singulair should be a great asset and a real plus. I think your statement about a specialist is the smartes thing you said. Also, she may need breathing treatments with thearpist to get her over the immediate need. MDs just normally do not have the desire or knowlege in my estimation. >Hello all, > [quoted text clipped - 54 lines] > >Any and all feedback is appreciated. Thank you for your time. Thank you everyone for your input. Latest update: regular M.D. prescribed a steroid injection (not sure what medication) and Atrovent nebulizer soln to use instead of the Combivent inhaler if she's feeling bad. Also, the doc prescribed 30 days of Theophylline and provided a referral to the visiting Allergist/asthma specialist. Noticable improvement after a short time with injection, waiting to see how much the Theophylline helps. Paul Garcia wrote: >Also, the doc prescribed 30 days of Theophylline and >provided a referral to the visiting Allergist/asthma specialist. Theophylline?! I didn't think anyone even used this anymore. There are *much* better drugs out there - can you move up your appt with the specialist? :/ That's what I hate about GPs messing around in areas where they can't keep up with the latest advances. (I was taken off theophylline something like 10 year ago on my first visit to a pulmonologistt, after relying on GPs up to that point. I was never so glad to get off a drug.) WolfKat ^..^ >^^< If you can't be a good example, then you'll just have to be a horrible warning. -Catherine Aird > Paul Garcia wrote: > >Also, the doc prescribed 30 days of Theophylline and [quoted text clipped - 8 lines] > year ago on my first visit to a pulmonologistt, after relying on GPs up to > that point. I was never so glad to get off a drug.) I agree that theophylline has been taken down a few notches and is no longer used early or much but it is still used by knowledgable specialists. When you consider that in addition to the theophylline prescription the doc also has given an inhaled steroid, three different formulations of short acting bronchodilators (one nebulised), a leukotriene antagonist, a long acting bronchodilator, systemic corticosteroids, and a referral to a specialist I think that the management sounds fairly reasonable. There certainly is nothing glaringly wrong with it that is apparent from the posts that have appeared here. Giving just a short trial of the theophylline while waiting for the specialist evaluation suggests to me that the doc is aware of the side effects and is using due prudence.  SignatureCBI, MD Sorry to hear about your wife. I have asthma and have been working hard to find a cure. I do not accept that this is a life long disease nor do I accept the arsenal of medications that three different doctors and specialists reccomended to me. (Advair, Cromylin, Albuterol etc...) While I do not have this thing licked yet I can tell you that what is working for me has little to do with medication and everything to do with diet. A few months back I stopped eating Dairy( butter, cheese, etc),Wheat, Rice, and Sugar( chocolate, high fructose corn syrup etc...) I substituted a constant flow of apples, pears, oranges, bananna, dates, figs, and lots of vegtables. I also drink a cup of strong coffee in the morning. My asthma seems to be under control. I no longer use any of the medications although I keep the Albuterol on hand just in case. Just as an interesting side note: I have been traveling for the last 2 weeks and have had no problems. The last coule of days I broke my diet,( I'm on vacation right?) Yesterday I had a nice big omelet cooked in butter with a large side of butter saturated potatoes. For dinner I had a dish that included cream, butter, and wheat. And to top it off I had a number of sweet drinks full of high fructose corn syrup sugar. This morning at around 4 AM I woke up with a serious asthma attack. I have had to use my Alberterol a couple of times today. I have a thick mucus and a back drip. The home I am staying in is than one year old and pets have never ben in it. The windows have been closed and we are in the high country so there is no pollen, and the brand new beding is primaloft not down. I am reasonalby certain that slipping on the diet made the difference. It can't hurt to change the diet, so long as you are also taking the medications for a while. After a month try backing off the medications and see if it helps. I removed the foods that made sense to me. She may have to remove even more and then slowly add foods back to figure out what the problem, if anything, is. Also, I do not consider this to be the end of my search for a cure. Its just a step along the way. Best of luck! Matt > Singulair is problaby one of the best drugs that have came out for me. > In fact it replaced a drug that was very hard on the system and could [quoted text clipped - 81 lines] > > > >Any and all feedback is appreciated. Thank you for your time. > I am reasonalby certain that slipping on the diet made the > difference. I don't doubt your experience but just as another data point, I'll note that my loved one with asthma completely cut out dairy, meat and most starches as part of a general health-improving diet. 30 pounds and 3 months later, he looks a lot better and is in general much more fit, but his asthma has not changed one whit. As we head into pollen season, he continues to take pulmicort, atrovent, serevent and singulair daily. I admire the determination of those who refuse to accept a bad asthma prognosis and who vow to change their habits to improve their health. Many folks who have a food allergy may be helped by a dietary change, but a lot of people will see no impact on their asthma at all. Of course this doesn't mean that elimination of unhealthy foods from your diet is a bad idea. SignatureAlison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ With how many things are we upon the brink of becoming acquainted, if cowardice or carelessness did not restrain our enquiries. -- Mary Shelley, _Frankenstein_ I'm new to group. Was just diagnosed the end of Feb. I think that asthma is an indiviual thing. I do try what has worked for others but if it doesn't work for me I move on to the next thing. I have found some things cause my asthma to worsen: being around too much perfume at one time, blue cheese and tuna helper but things that didn't work is I tried to put myself on a all fruit and vegetable diet that someone told me about that didn't work for me. I have several attacks week last wek I had 7 attacks the week before that I had 6 so far this week I've had 8 being day 4 on this week. I was having 12 a day so med is working a little. But exercise is making it worse I just don't know if I can stop exercising. Just my 2 cents worth. -Helping Hand >Subject: Re: diet and asthma (was Re: Asthmatic wife, meds not helping, >From: howcanihelp@webtv.net (Helping Hand) [quoted text clipped - 4 lines] >Content-Type: Text/Plain; Charset=US-ASCII >Content-Transfer-Encoding: 7Bit > But exercise >is making it worse I just don't know if I can stop exercising. A very recent study has shown exercise lowers the antioxidant levels in the body and the recommendation from the study was the athletes must raise their antioxidant intake while exercising. Since asthma has been shown to be an oxidative stress related disease .. exercise .. logically then .. would lower the antioxidant potential of the body leaving one .. deficient in antioxidants .. namely vitamin E which is required to carry oxygen .. Who loves ya. Tom SignatureJesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking A very recent study has shown exercise lowers the antioxidant levels in the body and the recommendation from the study was the athletes must raise their antioxidant intake while exercising. Thanks! A very recent study has shown exercise lowers the antioxidant levels in the body and the recommendation from the study was the athletes must raise their antioxidant intake while exercising. Since asthma has been shown to be an oxidative stress related disease .. exercise .. logically then .. would lower the antioxidant potential of the body leaving one .. deficient in antioxidants .. namely vitamin E which is required to carry oxygen .. I wonder if this means I'm low in vitamins. Hi I am new to the group too! I have had the worse winter ever with my asthma. I am allergic to mold and smoke and perfumes and the list goes on, but the one thing I have done in the last three weeks is cut out the dairy products for the most part and chocolate and nuts and my asthma has improved dramtically. I hope this keeps working so far it is looking very promising. -Lorna- > Sorry to hear about your wife. I have asthma and have been working > hard to find a cure. I do not accept that this is a life long disease [quoted text clipped - 123 lines] > > > > > >Any and all feedback is appreciated. Thank you for your time. Thank you all very much for the input. The latest: we saw the specialist last Wed (3/31). He ordered the following: 1) An allergy irritant test to see what triggers she may have (if any) that worsen her condition. 2) A air flow test 3) A sputum test to see what kind of asthma responses her body has been producing, and to determine if any other disease is present. 4) A bone density scan (the previous one had a very odd result). So, it appears that this doc is attempting to discern and treat the underlying problem rather than throw more medications on it. For now, no changes to the medicine regimen until he knows more about what's going on here, but I get the impression he plans on making changes in the near future. As always, suggestions/input always greatly appreciated. > Sorry to hear about your wife. I have asthma and have been working > hard to find a cure. I do not accept that this is a life long disease [quoted text clipped - 37 lines] > > Matt I did something like you....... I noticed an increase in ashtma attacks when I ate large amounts of carbs especially after wheat bread consumption. I began low carbing a couple of years ago and when wheat especially was removed from my diet, the attacks diminished. I do notice a slight increase in mild attacks, bit of coughing, slight wheezing, a few productive clearing coughs and it over at " my time of the month",,, well until now I am in an exacerbated state( I have been in a constant state of "attack" with lots of wheezing, coughing and tightness right now due to URI ( see my sweating post) Laureen |
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