ASthma help/assvice

Triathlon Forum
1

First off, I don’t have a doctor’s diagnosis and I’m not going to be doing it anytime soon as it involves a 3-day trip and hotel.

I spent all of Nov 2011 on Advair q.12 (it is actually Seretide Evohaler) and then came off (after my IM) in December and found myself needing albuterol up to twice a day almost every day so I went back on Seretide (Advair) until I coudl find Pulmicort and transitioned to it and had no use of albuterol). I’m doing Pulmicort Turbuhaler 100 mcg 1 inhalation q.12. yesterday my head felt woozy and I had a headache and when I got on the bike I got coughy and eventually had to stop and use albuterol. I did 3 puffs and was able to finish my ride wiht less coughing and still woozy head at a low HR (high teens) and very occassionly it felt like the veil “lifted” and my head cleared and my legs got strength but then the curtain would fall again. This seemed to happen some 3 times over the hour of the ride but I would still be incredibly short of breath after taking in water or trying to talk.

when I got home I ended up doing a Combivent neb (albuterol and ipap) and while I got super shaky I was still SUPER short of breath (just walking around) and head woozy and headachy. I found I had to sit way up for the chest tightness to decrease (orthopnea?) and about 4 to 6 hours after the Combivent neb I did 4 puffs of albuterol and then quickly the chest tightness left, the orthopnea was gone, the headache gone and the head woozy feeling gone. Today I did 4 puffs of albuterol along with the Pulmicort at my usual Pulmicort time as the chest tightness was creeping back.

So questions. Was the woozy and headache likely low o2 sats? What do you do when you have an attack and you’re exercising? Should I have not finished my ride? Did I make my “attack” worse by finishing the ride (I was about 15 min into a 1:15 ride then)? I’d like to go for a run today, any reason I shouldn’t? Will I make things worse if I do? I have a 5km out and back I do so I’ll be close to home.

Any advice for the future?

2

Any advice for the future?

Yes. Make the trip. I understand that it’s highly inconvenient, but an episode like you are describing is nothing for amateur night on the interwebs.

John

3

What is this “assvice” you’re seeking?

4

Well Kathy, you didn’t get much help from the peanut gallery today. I will throw in my nickel of thoughts. Asthma is a lifestyle adjustment and constant treatment process. As you grow older you will have some remissions and some advances of the disease process. Sounds like you have a command of medications types and names. The best news about asthma is that we have lots more choices of medicines to stack and treat asthma. The bad news is we are losing ground and getting more asthma people on drugs every year.

Sometimes changes in triggers will cause changes in what you have to do to stay controlled. I live in Hawaii and the volcano from the Big Island has been dumping a bunch more vog in the past 10 years that the previous 100 years. So all asthma sufferers in Hawaii are having more control issues. I have friends in Kona that are really thinking of moving as it gets worse and worse. With that said, other common triggers like cold weather (and hard exercise), pollen, molds, animals and enviromental issues like traffic and industrial fumes may cause problems different times of the year. I live on Oahu and some days when the winds come from the South (Kona), my control goes crazy and I have to double up on inhalers.

Two things I advise to all the asthma people I know is to get a peak flow meter to find out what your norms are, and learn how to use a Netti Pot.( It is a nasal washing device.) It takes a few weeks to get a curve on your peak flows, but write them down as see what your trends are. The Netti Pot helps with nasal issues.

Now about the meds. Most treatment plans are sort of a stacking procedure. They usually involve an inhaled steroid like Flovent, a beta2 agonist (smooth muscle relaxer), sometimes a leukotriene receptor antagonist (like Singulair), and some use of Albuterol as a bronchodilator. Some of these meds to people who have a sensitivity can cause anxiety, lightheadedness, and increased pulse. Sound like you got tagged by one of them. I think the trick is to figure out what your base dose/treatment is and what to do when you start losing control. I personally try to take the minimum dosage, but realize that sometimes I need to pick up the dosage. That is where the hard part is and where the peak flow graphs help out a lot. There is no magical formula that works for everyone, so be patient as you figure out what works to control you the best. It may take some time, and changes from time to time as well.

My biggest problem is our cat also has asthma. You ought to try and give the cat inhaled drugs, and keep him in control. I am a much more complient patient than my cat.

That is my concept on asthma, it never goes away, but sometimes gets better.Good Management and keeping a sharp eye on symptoms keeps you out of the doctors office and the ER. First sign of a cold and decreased peak flows I am all over the symptoms with the meds I know and understand. I always travel with a dose of antibiotics if things happen away from my doctor. We have build up a good relationship over the years and she pretty much trusts my judgement as to when to start antibiotics and to increase dosage of the inhaled drugs. I know it is going to be a long trip for you to go to the MD, but start keeping a log of drug dosage and peak flows and sometimes you can do some stuff over the phone with your doctor. But the MD needs to have some data on what is going on.

Words like yellow sputum,productive cough, decreased peak flows, getting jitters from some meds, fever, and wheezing all can help the MD in diagnosis and prescription. Have the name and phone number of your home pharmacy handy is always good as well. I always travel with a Tamiflu dose too. I have never used it, but not a bad idea to take one at the first sign of flulike symptoms. Don’t get discouraged, I have been dealing with my asthma and athletics since grade school and have done pretty well over the last 50 or so years. Good luck and be smart. I don’t hang out on the Slowtwitch so much any more, but PM me if you have other thoughts/questions. I will do what I can to help.

5

thanks so much. this was really helpful. I had been researching after posting and already have a peak flow meter in my amazon shopping cart so it was great to hear that it wouldn’t be frivolous.

I’m also (I think?) seeing that there doesn’t seem to be any reason to stop a training session due to decrease in airflow or “attack” or whatever as long as you don’t fall over dead :slight_smile: so that is good to know. Also it is starting to sound like continuing training won’t make the attack worse or lengthen it?

I really thought the Pulmicort had everything under control so I was really surprised by this attack. I’ve not yet had an attack while on medication. I will most likely go see the MD but I keep reading reports of how people who don’t fit the limited criteria of some doctor’s definition of asthma don’t get the label and just keep doing their meds anyway (like I’m doing) so I guess I’m not really seeing the advantage of a 3-day inconvenience to do so. i’ve had a chest xray (hyperinflation) and no lung nodules or masses. :slight_smile: At any rate, I’ll get the peak flow meter and start seeing if there is a pattern. Another thing I’ve read is that people seem to be able to predict an attack by monitoring peak flow so that would be exceedingly helpful.

Thanks again!

6

Any advice for the future?

Yes. Make the trip. I understand that it’s highly inconvenient, but an episode like you are describing is nothing for amateur night on the interwebs.

John

yeah, I know, but I seem to be able to pretty much have it under control and reading other asthmatic experiences, I’m really not that bad at all, AND I’m concerned that I’ll put out all kinds of effort to see the MD, have him decide it isn’t classic asthma (I don’t wheeze AFAIK at all) and I’d just keep doing the meds I’m doing now. Any pulmonologists want to make a trip to the Caribbean? :slight_smile:

7

Glad I’m not the only one who feels that way. It’s doesn’t seem that bad on Oahu as compared to the Big Island but damm those days do suck. I hardly go back home since dealing with the vog is quite a drag.

8

Yes, and I hope you get a great pulmo. I finally found a great one in Tampa who I continue to use.

-Robert