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...but they might use BMV instead. (bad BMV...bag mask ventilation).I'm not sure what exactly you're asking regarding the difference of asthma treatment. From looking it up, Symbicort is a combination maintenance drug like the Advair 500/50 I take. I've never had an allergist tell me to take Advair more than twice a day because of concerns with asthma related deaths due to the salmeterol component. They tell me to double or at times triple the inhaled corticosteroid component by adding FloVent 220. Usually it is a mild exacerbation they are trying to reverse early on to avoid the need for prednisone.
In terms of the medical system, if a person is disabled and has no one to take care of them, they go to a nursing home. Some are good, some are inhumane. I would have no one to take care of me and could end up in an inhumane situation since I wouldn't have someone on the outside keeping tabs on the nursing home and moving me if needed. So, I avoid that by having DNR/DNI orders, but sometimes hospitals ignore it especially if the person is young. So, I try to avoid hospitals and handle it at home. I've lost consciousness from attacks, but I still feel the same because my biggest fear is not death, it's spending 40 years in an inhumane nursing home.
So, in my case it's very important I get my nebs in on time. I've not lost consciousness from an attack in 8 years as I am aggressive with the nebs early on and I detect a decline early. I've tried to educate people in my life who care about me what to do in an emergency, but some refuse the education. So, that's been my challenge and why I was searching youtube.
I've not experienced socialized medicine, so I don't know the differences. The good part of the USA system is if you have money, you can get excellent care and there are many research centers.
Otherwise, the system is fragmented, which is what the second video is addressing. When I had mild asthma, I saw a general practitioner and it was okay....only when I started having attacks in which the albuterol failed to clear it and I would pass out for 5 min at a time, his assessment was that nothing was wrong and he refused to change my meds. I self referred to an allergist since it was a emergency situation, and I've been treated for asthma for over a decade. It was only last year, at my own request, that other diseases where ruled out. Even so, I had to request the pulmonologist rule out sleep apnea, alpha 1 deficiency, etc. Differential diagnosis should have been years ago, but an asthma specialist only treats asthma. So, it's not coordinated.
I can't qualify for disability in my state even if my doctors believe I need it and even if I'm on a ventilator every month for a week for years. My state is strict in using predicted values of spirometry instead of personal best. My personal best varies a lot from the norms....meaning I won't ever be able to access that benefit.
My state is good at providing me my controller meds at $3 for each one per month. It's a long story, but being on this program ends up disqualifying me from going to National Jewish...it's because the programs are not coordinated together, and so I can only access one, but not both.
So, overall, lack of coordination between providers has been an issue. I was impressed by asthma UK as their advice line also addresses psychosocial components of the disease. In my experience in the USA, they have problems just making sure everyone has access to controller medicines such that the psychosocial aspects get ignored. This is what the second video addresses.
However, the good thing is that if you have knowledge you normally can get decent asthma care in the USA, but it falls on the patient to advocate for themselves.
Let me know if you were wanting other information instead.View Thread

I had been searching for videos of folks with asthma who have struggled with unhelpful responses of others while they are having a severe attack and trying to get their emergency medicines in on time. I've had issues of people who care about me choosing this momoment to quote scripture to me and confronting me about sin, I've had people not understand what is going on and yell at me for not cleaning the sink immediately, and I've also had people respond very usefully by staying calm and asking if they can help me get my medicines or if they need to call 911.
I found a group called asthmaUK and they have posted a number of patient stories, including one that talks about having to kick out her boyfriend and sister routinely whenever she has a severe attack because she can't cope with her own breathing issues and also trying to help them deal emotionally at the same time. Their channel is called "asthma UK" and it has a number of other good videos, mostly aimed at moderate persistent or severe persistent severity ranges. They seem like a good group.
Also, as a side effect, I found another video, if you search, "asthma uc inner city", and see a title that is something like "asthma in inner city children", you will find a general practitioner talking about asthma care in the USA for those at or close to the poverty line where specialists are often not available and the ignorance of general practitioners. He has a group that seeks to certify general practitioners working in those circumstances to basic asthma management.
View Thread


Yes, prednisone is the love/hate relationship. If you go to youtube, type in prednisone in the search box, then look down the list to a lady holding a guitar she sings a song I love and it usually puts a smile on my face. There's another video that is something like "giggling about the side effects of prednisone" which I also like, but perhaps it would be more funny to those who could relate to having trouble getting dressed more, like a rheumatoid arthritis patient.View Thread

Sometimes my asthma will crash, meaning after months of strong green zone readings it will go down rapidly, sort of in an uncontrolled free fall. Literally, the peak flows even that morning may have still been strong green zone readings....then wham! Usually that happens when I've been exposed to pollution from industrial accidents or fires or when I have an infection. So, they normally don't take CBCs or wait for the results of any cultures. That's why they want me to hold off unless there are signs of infection....to be sure I can get a highly effective antibiotic in my system quickly (and they hope it's a bacteria and not a virus). He's concerned if I use it too much, then organisms will become resistant and it won't work when I need it.
I just felt bad because the signs of infection didn't show until after I had been at work 2 days and I had seen patients. Thanks for your response...I was thinking of you and wondering how you were doing.View Thread

I also emailed him to educate him about nebulizers used in emergency management and how it doesn't always completely reverse the attack for me, but it keeps the severity less and stablizes it until prednisone kicks in, which sometimes can be a matter of days due to steroid resistance. I tried to explain to him what 55% peak flow means in terms of risk of becoming unresponsive, what an incomplete response to the neb means, and that most of the time I can prevent the attack from getting that severe (where I lose consciousness) as long as I catch the deterioration in time by monitoring the peak flows and aggressively nebbing early on when it starts to drop. I'm not sure he's interested in understanding all of that, though. He's my best option for a medical POA, though.
Mostly, I just would like it if he could deal with it so if I do end up one of these days dying at home, then I won't have to die alone....but for some reason he can't and I guess still sees me as a healthy 16 year old, when he first met me.
So, your adrenal glands stopped functioning from the prednisone, and the hydrocortisone pills are to replace the corticosteroids the body normally produces?...or are they to treat the asthma? I've never heard of hydrocortisone pills used to treat asthma. I'm fortunate in that so far I've not had major effects from the prednisone, but I've had to make major life style changes including moving away from friends and family to minimalize it since I was taking about 4000 mg a year. Even so, my allergist is not happy with the amount of prednisone I use (now about 1500 mg a year), but I've done all I know to do. Still, I am fortunate as I've not had any major medical effects from it so far....except being crazy while on it
. Anyway, thanks again for your support and I don't ever mean to sound like I take things for granted or complain while others are on vents all the time. With me, I'll never qualify for disability due to the state regs as I've discussed on other threads...but fortunately I can work on call and I make enough for my needs, but it is unstable employment. I wish sometimes I could work full time and contribute to the community that way...but we'll see. I'm trying to use the experience to somehow grow into a more loving and kind person, but I'm still learning. I'm trying to be like a flower that takes the fertilizer stuff of life and turns it into something good. Thanks again for your kind prayers and responding.View Thread
I had a bad exacerbation like that a few years ago due to the forest fires around here. I couldn't carry my laundry to the laundry room, and the most I could do was walk to the bathroom. Fortunately, my apartment was very small, so I didn't have to walk long distances. After that, I moved to another apartment and bought a washer/dryer to put in the apartment so I wouldn't have to have dirty clothes again if the same thing happened.
I normally just walk outside to build it back up and wait a week or two and then add weight training.View Thread

I usually have some deconditioning after an exacerbation, and I build back up by walking outside gradually increasing the length of time or the slope (I live amoung hills). I also have the luxury of working on call, so I can turn down working on specific days if I want to. It I'm really deconditioned, I'll build up my work schedule gradually. I wait about a week if I took Levaquin and prednisone close together before doing any weight lifting or aggressive exercise.
I don't know if this helps you or is applicable to your situation, so disregard if it's not. I don't know how bad you get during exacerbations.View Thread

The allergist told me I was steroid resistant, so it takes high doses and repeated doses to get a response. However, he doesn't feel comfortable with me taking more than 40mg at a time as he said he thought it would be too hard on the body to ramp up that fast.
However, as always...I don't know your specific situation or what happened so for sure listen to what your doctor is telling you. Maybe it's an idea to bring up to him/her - to not take it all at once and break it up between two doses during the same day.
Hope you continue to feel better.View Thread

It's hard sometimes to know what is triggering asthma. I respond also to air pollution, humidity changes, allergens, cigarette smoke, laughing, crying, cold air, dry air, on and on....when it first started acting up, everyone around where I live told me their allergies were acting up. Even the last day I was at work, the technician was blowing her nose like crazy and saying her allergies were killing her. My boss was the same way the day before. A friend told me she and her husband were down for the count due to sinus allergies. I've not had an allergy test for over 10 years since I don't tolerate the shots and the asthma goes crazy with them, but I just figured I must have developed a new allergy since moving here and that's what was causing it.
Anyway, thanks again for your support and it does mean a lot. With any luck, I"ll stay stable until the summer fires come around in a few months.View Thread
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