Everyone is different. The best prevention is to know your triggers and avoid them, but that is impossible 100% of the time. Keep allergen exposure to a minimum.
Medications usually start with antihistamines and/or a leukotriene modifier like Singulair. From there Inhaled Corticosteroid (ICS) are added, sometime along with long acting broncho-dilators (Long Acting Beta-2 Agonist (LABA). Never take an LABA without an ICS. Combination meds like Symbicort, Dulera and Advair are good options. ICS medications include AsthmaCort, Qvar, Pulmocort, Flovent and a few others.
It really sounds like you have Aspirin Exacerbated Respiratory Disease (AERD). AERD is a disease that MIMICS an allergy to aspirin. It causes an imbalance in prostaglandins which leads to over production of leukotriene's. The key symptoms are 1) Chronic Sinusitis (sinus infections) 2) Recurring Nasal Polyps 3) Asthma
20% of all asthmatics have AERD, but few are diagnosed. If you also have chronic sinusitis the probability that you have AERD jumps to 50%.
Typically this disease starts with the chronic sinusitis and nasal polyps in the late 30s and then in the early 40s the patient either develops asthma of their asthma suddenly worsens. The age is typical, but can vary greatly. This is a progressive disease which leads to prednisone dependent asthma if not treated.
The disease can be difficult to diagnose. If you have ever had an asthma attack that you know was triggered by aspirin or any NSAID you most likely have AERD.
The good news is that the treatment for AERD, aspirin desensitization, is 100% effective.
I strongly suggest you find a qualified allergist to test and treat you for AERD. I would recommend that you go to http://aaaai.execinc.com/edibo/FindAnAllergist to find an allergist in your area. Try to find one that has a fellowship from AAAAI and or ACAAI (both would be preferred). You can also use www.healthgrades.com to read patient reviews of the doctor you choose. Be sure to ask the staff if the doctor has experience treating AERD or performing "aspirin desensitization". This is a serious procedure, but is well worth going through if you have AERD. Some doctors only do it is it in the hospital. If the doctor's staff is well trained and has the proper equipment, it perfectly safe to do in the office.
The desensitization generally starts with a small dose of aspirin to try to trigger an asthma attack for diagnosis. If an asthma attack is triggered, it is treated and the treatment phase begins. Treatment is a series of increasing doses of aspirin until one full dose of aspirin is tolerated. You must then continue to take aspirin every day to maintain the treatment.
I was diagnosed with AERD prior to treatment (known reactions to NSAIDs), so I was allowed to stay on all medications. Most people have to stop taking their medications.
I did not do well on Symbicort. You may want to try one of the other combination meds like Dulera of Advair.
I you are in your late 30's to early 40's you should talk to your doctor about Aspirin Exacerbated Respiratory Disease.
I would recommend that you read as much as you can to be an informed patient. When choosing doctors be sure to use sites like www.healthgrades.com and specialty organization sites (the certification boards).
Health Grades lets you search for specialists in your area and has patients ratings so you can see how their patients feel about their care. It also tells about their educational background and advanced certifications.
I have been on Xolair since 2009. I was a week late with a shot a few months ago and boy could I feel it. I let it slide thinking it was not helping much, but I was wrong.
Has her IgE level been tested? My level the first time I was tested by my PCP was just over the lower threashold. When my allergist had me tested my level more than doubled.
Does she use NSAIDs? If she does, does she have an asthma attack within 12-24 hours of taking it (possibly sooner)? If so, you should have her treated for AERD (Aspirin Exacerbated Respiratory Disease). She is young for it, but kids have been diagnosed with it.
Also, you may want to talk to her doctor about alternatives to Singulair like Acolate or Zyflo. They are pricey, but very effective. You can get assistance for them if you need it.
Hi, The other poster gave some very good advice. Allergust who specialize in asthma are the best for us. They can treat the allergic component as well as the the asthma. Personally thw pulmo was a waste of time and money. Very few of them actually want to bother with asthma. The first one I saw almost forgot to listen to my lungs at my first apointment. Then said, "Sounds like an asthmatics lungs." Then she did not listen to my lungs at all at the second apointment despite the fact that I was coughing through the whole thing.
The sad thing about your experience with the paramedics is it is far too frequent. His poor lungs "sounded clear" because he was not moving enough air to produce sound. The retraction of the around his ribs should have been all they needed to start a breathing treatment with oxygen.
To find a good doctor go to www.aaaai.org. In the upper right they have a link to Find a Doctor. Look for a doctor who is a Fellow, you may be able to find one with a fellowship in ACAAI as well. Fellows have met additional educational requirements. Once you have a doctor you think you may like, look them up on www.healthgrades.com to see what patients have to say about them. Health Grades also lists a lot of info that is helpful.
Good luck. I hope you find some help for your precious little one.
As amcate said, everyone is different. I hope you are working with an allergist who has been trained to treat all triggers. Have you been allergy tested? Immuno-therapy works, but can takeawhile to become effective. It is essential that you treat all aspects of your asthma.
For me getting controll of my asthma was like peeling off layers if an onion. Allergies. GERD. Fungal infection. AERD (Aspirin Exacerbated Respiratory Disease). It took about three years to find and treat all the layers, but once that happened life did pretty much return to "normal", not like before but livable. I was on antibiotics and pred about every four to six weeks that third year. I was on them about 2/3s of the four months prior to AERD treatment.
Be patient and educate yourself as much as you can. Be sure to find a top notch spcialist to work with.
Hi, You sound a lot like I me a few years ago. Xolair has been very helpful for me. You may want to talk to your allergist about two other things. 1) Aspirin Exacerbated Respiratory Disease - causes impossible to control asthma without aspirin desensitization. 2) Zyflo - would replace Singulair. Instead of modifying leukotriine, this blocks the production of them. It is extremely pricey, but the manufacturer and several foundations help cover the cost.
That is why I suggested looking for a specialist with a fellowship. Additional education and continuing education is required to obtain and maintain a fellowship. Any asthma specialist with a fellowship should be very well versed in the special needs of exercise induced asthma.