Dear Tokarra9696, I'm so sorry to hear about the medical issues your niece is suffering from. I am sure it is a very difficult time for you now since she is comatose and in the hospital.
Not knowing the full details of this case, I would say that it is possible that during the first admission to the hospital, she had not yet developed the symptoms of the pneumonia fully. The physicians may have felt that it was asthma at the time, perhaps based on her history, a physical exam, and her symptoms (if she was improved). It is also possible that she developed the symptoms in the few days she was home. Only her doctors can really answer this question in retrospect if they were the ones examining her.
Seizure disorders are also very tough on the body. When someone is seizing, if they have aspiration (breathing in) of something in the mouth into the lungs, this could lead to an aspiration pneumonia. The mucus on her face could have been related to the seizure--since patients who are actively seizing can lose control of their actions (and potentially body secretions).
If she is currently on a breathing machine (due to continuous seizures), this could increase the risk for a ventilator related pneumonia. There are many risk factors for pneumonia in her case. The organism and type of pneumonia also are important factors in determining the severity of her case.
Unfortunately, It is impossible to predict her prognosis or know how permanent or temporary this is. The best people who can give you this information are her actual physicians, since they are the ones who know her intimate medical problems, severity of illness, and extent of disease (like how bad the pneumonia is), so I'm sorry I cannot comment on this.
I would encourage you to have a dialogue with your family and doctors to address the concerns you have. I hope your niece has a quick and full recovery. Best Regards.View Thread
Asthma is a very heterogeneous respiratory disorder meaning that it can take many forms (coughing, wheezing, tightness), and can be triggered by many different things from person to person. Some folks are bothered by their allergies, which trigger asthma, and others get asthma attacks from viral infections.
If your asthma is primarily triggered by cold viruses, there are a few things you can do to help reduce the chance of having an asthma attack. Firstly, form an asthma action plan with your doctor to figure out "what to do" if you start having asthma symptoms like coughing or wheezing. Secondly, if you find that you are using your rescue inhaler a lot, you may not have your asthma under control in the first place, which puts you at risk for a flare from even a mild cold that would not affect others. Talk to your doctor about your asthma to see if they feel that it is under control or not. Some patients with persistent symptoms may need to be on a daily "controller medication" which can also help reduce the chance of an asthma attack if you were to get a viral infection.
Try your best to avoid exposure to sick people and practice good hygiene. This means washing your hands, not sharing utensils or drinks with others who might be sick, keeping surfaces clean (like the keyboard you are typing on), and getting a flu shot in the winter if there is no contraindication.
Some habits may also increase your susceptibility to infection, such as smoking cigarettes (I hope you are not a smoker).
I have many patients who have infection triggered asthma symptoms and once we get them under control, it improves their chances to Not have an asthma attack if they get a cold. I hope this helps!
I lived in Los Angeles for 6 years during my training and for my Allergy/Immunology fellowship. We had many asthma patients that were affected by the air quality, and I completely agree with Mathchickie's advice.
The freeways are an important generator of diesel exhaust which can worsen your asthma control and symptoms. I would recommend keeping your windows closed and limiting outdoor activities when the air quality alert level is high. This holds true especially if you live near the freeways.
I would encourage you to get into a low-cost health clinic or community health center to have your asthma evaluated and consider a controller medicine if this is necessary. If asthma symptoms go unmanaged, you could have a bad asthma flare and this would incur a much higher cost (to your health and wallet) if it becomes serious.
I am so glad to hear that you are doing well since having treatment for your AERD (for those of you who don't know, it stands for Aspirin-Exacerbated Respiratory Disease)--I am assuming you had an Aspirin desensitization done.
Your response to the therapy is what your doctor had hoped for and expected to occur. I have had many patients with AERD who have had such a good response, they have been able to wean some medications that they previously relied on to control symptoms. While you may still have allergy symptoms because it doesn't stop your allergies, you may experience fewer exacerbations from colds.
I hope you continue doing well--thanks for sharing! Best wishes.View Thread
Firstly, I want to congratulate you for making a great, life changing decision to quit smoking after 30 years. The sooner that is out of your life, the better it will be for your health and the health of those around you. Unfortunately, it sounds like there has been damage already and you have asthma that sounds like it is persistent.
In my experience, patients who have quit smoking have an improvement in their overall respiratory symptoms even if they already have chronic lung disease or asthma. However, if they already have severe asthma or COPD and it is tough to control, even quitting smoking may not be enough to relieve their symptoms if the lungs are too badly damaged (thus, they are still prone to attacks).
The fact that you have gotten a few asthma attacks since quitting may be coincidental--it may be that your allergies are more active (this time of year, tree and grass pollens dominate), or it may also be related to air quality. If you live in an area where the air quality index is reported on the news, your symptoms may be worse when there is more ground level ozone (you might hear on the news "Orange" or "Red" air quality index). It could be related to a recent infection (cold virus), or flu. Or it may not be coincidental but a sign that your lung function has declined from the 30 years of smoke exposure.
I would strongly encourage you to have a close relationship with a pulmonary or allergy/asthma specialist who can measure your lung function, follow your symptoms, and get you on a regimen that will control your symptoms to prevent your asthma symptoms from getting more out of hand. Hopefully if you get on the right regimen, you can stay out of the hospital and breathe clearly for good!
Firstly, I want to commend you for making a commitment to exercising and working out every day. It is a great habit to have and will lead you to have a healthier lifestyle overall if you stick to it.
As for your asthma, you are not alone. I have many patients who are asthma sufferers and are generally under good control but still seem to have symptoms with exercise. Some of my patients have trouble with exercise because of their weight, which may be a possibility. They feel "out of shape" or deconditioned, which may make their exercise tolerance low when they are just starting to make exercise a habit. Once they get "into shape," their tolerance should go up.
However, other patients may just have exercise-induced asthma. Have you discussed this symptom with your doctor before? They may want to do some further testing and decide on a change in your therapy if you do have this. There is a video on WebMD about this: HERE
It is also possible that you might have allergy driven asthma symptoms, if you notice that you have more symptoms when you are outdoors (that is, if you exercise outdoors), particularly if it is during a certain season. You should also discuss this with your doctor (or a Board Certified Allergy specialist) if you have not had allergy testing done.
Exercise is a known trigger for asthma. It may be that you just have this as one of your triggers and you can try to prevent it with pre-exercise treatment (such as pre-exercise use of rescue inhalers), which you should discuss with your doctor before trying. Many famous athletes have asthma including Olympian Jackie Joyner-Kersee, NFL star Emmitt Smith, NBA star Juwan Howard, and Tennis star Justine Henin.
If other people reply to your post, I'm sure you'll see that many other asthma sufferers get some symptoms when they exercise. I believe your doctor will be more than happy to discuss this with you and come up with a plan that will help keep these symptoms at a minimum.
Dear wildflowr1, It is certainly possible that your "dose" of allergen exposure has increased a...
It is certainly possible that your "dose" of allergen exposure has increased a great deal with the addition of your puppy, and this may be why you're experiencing more symptoms. Unfortunately, when asthma symptoms are driven by allergies or at least sometimes brought on by allergies, the best way to prevent the asthma symptoms is to avoid the allergen trigger. This is one of the main ways to prevent asthma or allergy symptoms. However, it is not always possible to avoid your allergen triggers, especially if you have developed a relationship with your pets.
A wise allergist who trained me told me once that "a patient is more likely to get rid of their allergist than their pet" and I believe that if you've got an "old faithful companion" that it is near impossible to even consider this. Have you tried taking any medication for your symptoms? It may be helpful to consider preventative medical therapy (either antihistamines or other choices) or consider something like allergy shots or immunotherapy, which could decrease your sensitivity to the dog and cat. I would recommend discussing this possibility with a board certified allergy specialist. good luck!View Thread
I agree completely with Mathchickie and Romantic1989. There is no clear evidence that a food like honey would "coat" your airways. In fact, one would probably choke on any food that coats the airway. I do not tell my patients with asthma that they need to avoid honey if it makes a difference.... (except maybe if they're hyperactive 6 year olds)
Seriously speaking, though, there have been rare (very rare) reports of allergic reactions to honey in patients who have significant atopy. I have not encountered this before but read about it in the literature. Sometimes honey can be unsafe if it contains any botulinum toxin in it (this would be more likely from home-made honey probably). This is the reason pediatricians don't recommend giving honey to infants (botulism). So find a reputable place to get your honey and you should enjoy it. Good luck!View Thread
The dose counter on this medication will count down each time you use a dose, so the lower it gets, the closer it is to being empty. Depending on how often you need to use it, as you get closer to zero, you may want to go ahead and call the pharmacy for your refill so you don't get to zero and have nothing. Let your doctor know how quickly you use up your rescue inhaler--if it seems pretty quick (from frequent use), they will definitely want to know. It also makes a difference if you started off with the 200 puff or the 60 puff counter.
I have a number of patients who have persistent asthma symptoms and need to be on a daily inhaled steroid medication to get things under control. There are many different corticosteroid inhalers out there and if you ask 10 asthmatics, you probably would get 10 different answers on what they take every day. Mometasone, Beclometasone, Fluticasone, Budesonide--why is it so complicated? Well, there are different reasons that doctors may want to change your therapy. One may be that the delivery device has a better chance of getting you the medication--sometimes people prefer dry powder inhalers, and some prefer a metered-dose inhaler (a pump). Some metered dose inhalers have counters to keep track of dosing, and some don't. Some dry powder inhalers have counters as well. There are different dose strengths to the inhalers that may allow for flexibility in weaning the dose (if the doctor wants to start you at a higher dose and then wean down). Sometimes the doctor wants to do you a favor and give you a medication that works just as well as another, but costs less for you (maybe they're trying to save you some money).
To answer your question, I think there's probably a good reason your doctor wanted to change your asmanex to QVAR. Perhaps it was because he/she felt that your asthma has not been under good enough control (since you are still needing Prednisone), and wants to try a different dosing device to try to change the drug delivery. Are you using a spacer device with your QVAR? I would encourage the use of a spacer if you are going to be using a metered dose inhaler. This will help you get all the medication. If it makes you feel better, I have patients on both Asmanex, QVAR, as well as many of the other brands of daily inhalers. I switch patient's medications for some of the reasons I mentioned above.
Are you seeing an asthma specialist? I would encourage you to bring up your concerns with your doctor regarding how to develop the best asthma management plan for you. You could discuss other therapies to consider including combination (inhaled steroid/LABA), theophylline, Omalizumab (Xolair), immunotherapy (allergy shots), or leukotriene antagonists as possible ways to spare you from too many systemic steroids. I hope you can get off the prednisone with better asthma control!