Asthma/COPD

[Willow7733]

Just curious. I have had asthma most of my life. Recently my lung function started to steadily decrease to 65% (then within a month to 41%. My pulmonologist took me off my asthma I haler (Dulera) and started me on Breztri. What I could get in my research of the new puffer is that it is for COPD only. Nothing was mentioned about COPD in my appointments. I have Ventolin for rescue if needed and take Singular at night. I have read you could have both asthma and COPD, so I am wondering for those who do, what do you take? Just out of curiosity.

[Caspiana]

Hi Willow. I don't have asthma or COPD so I'm no expert but that is a rather severe stop in just a month. I am surprised your doctor did not order a CT scan, X-ray or a bronchscopy to see what is going on. In any case you need to know exactly what is going on. Can I suggest making another appointment and addressing this? Do you have any other symptoms other than shortness of breath? Any phlegm? Coughing? Fever? Loss of appetite? Have you had any infections ?

Although cold weather does cause the airways narrow and tighten, I would get it checked out.

Best wishes,

Cas 🙂

[Willow7733 in reply to Caspiana]

At first I was given prednisone and a z pack. Then I was sent for another pulmonary function. It was still low, so I was given the new puffer. After a few weeks, back to get another pulmonary function. It went up to 61%. So I go for another pulmonary function test in 6 months. I have no fever, not flu or cold.

[PW_R]

I have both & lost alot or lung function in a short space of time (but that was due solely to an rsv infection). Did you smoke? Nearly everyone who is diagnosed with copd has smoked. Having underlying asthma coupled with copd means you tend to progress faster, as has definitely happened with me. There is also a strong predisposition to chest infections in my family, which has been a big factor also.

[Willow7733 in reply to PW_R]

I have never smoked a day in my life - but I grew up being around a ton of second hand smoke. At my family gatherings, most smoked, and the air inside the house would be grey/green. It was so bad, the smokers would go outside for fresh air. Lol I. Also prone to a lot of chest infections. At the time of the decrease in lung function, I had no respiratory infection at all.

[PW_R in reply to Willow7733]

I understand from some people on here that prolonged second hand smoke could cause copd in people who are susceptible to it. I guess asthma may increase that susceptibility. In my opinion chest infections are a real issue. My dad got bad chest infections all winter for years (no asthma - never smoked a cig in his life). I inherited that, but unfortunately also had mild asthma, and then very stupidly smoked from an early age until my early 30’s. When I stopped after getting whooping cough I never knew that 6/7 years later I would get an infection that would destroy my lung healthy& throw me into copd territory. This horrible disease takes many many forms is what I understand. Are you symptomatic or effected by all this?

[Willow7733 in reply to PW_R]

I am so sorry you are going through all that. I have a hard time being short of breath. I work in the local hospital, but people don't really see how hard it is to walk any distance or lift heavy objects. I get eye rolls, people were assigned to help me but haven't. They tell me I am out of shape. I need to go to the gym like they do. I would! I used to go every day after work. But the fighting for air saps all energy out of me, so when I go home at 3pm, I get something to eat and go to bed right away. I have nothing left in me.

Mornings I cough so much I sound like I have been a smoker for years. I also have a blood clotting problem (and have had over 12 pulmonary embolisms in the past 4.5 years). So that has damaged my lungs a bit. I am way too you g to be going to bed at 4pm! I feel my life is being taken. I have no life. My father died 6 months before the DVRs and PEs. My mother keeps telling me other people my age are married and have young kids and work where I work without any problems. It is all in my head. So now, I feel depressed and a total loser. (Thanks mom).

[Yendo]

I also have asthma and COPD. Earlier this year my inhaler was changed from Breo Ellipta to Breztri Aerosphere and it seems to be working very well for me. Hope it does the same for you. Good luck from a fellow Canuck.

[Willow7733 in reply to Yendo]

I have a quick question. You both asthma and COPD, so you were given just the Breztri aerosphere? It made me worry because everything I read up on Breztri, it says not for use for those with asthma. Mine seems to be working well for me too. I sound horrible in the morning, but after the coughing is done, I feel much better. Still pretty short of breath at work, but I can live with it well enough so far.

[Yendo in reply to Willow7733]

Hi Willow. I am just as puzzled as you that Breztri is not recommended for asthma since two of the three medications, budesonide and formoterol are both asthma medications. The third ingredient, glycopyrronium, seems to be the hang up as far as asthma is concerned, and from what I have read it may be only because Breztri has not yet been tested on asthma patients. I’m not a medical person though, just a layman, so others more qualified than I am on this forum may have better information. The only medication I have at present for asthma is Ventolin, the rescue inhaler.

[kflatt]

Hi. Brezti is for the long-term treatment of COPD. It doesn't mean asthmatics can't use it - it's just not approved (as a treatment) for asthma.

[Willow7733 in reply to kflatt]

So an asthmatic (without COPD) would not be taking Breztri? He didn't tell me why I was changed to this medication from Dulera.

[kflatt]

No, they wouldn't be taking it. I guess he's treating COPD, which also helps with asthma. Regarding Dulera - "while Symbicort is FDA-approved to treat asthma and COPD, Dulera is only indicated for the treatment of asthma."

[kflatt]

Yes, it's strange because Dulera is approved for asthma only. Sybicort is what I take (emphysema). If you have COPD (which your results indicate), then Dulera doesn't seem to be the drug of choice.

[Willow7733 in reply to kflatt]

Well it makes sense now from what you explained, because Dulera wasn’t helping me that much. I was still having wheezing and breathlessness (especially when I did anything - even brushing my teeth). It wasn’t a seasonal thing, which my allergy tests showed I was mainly allergic to pollen and grasses. Then my pulmonary function dropped from 65% to 41 within a month.

[kflatt]

Dulera is similar to Symbicort but not for COPD. Maybe you need to speak to your doctor.

[Willow7733 in reply to kflatt]

I see him in four months.

[O2Trees in reply to Willow7733]

Call his secretary with your questions

[kflatt]

Anyway, see how it goes. COPD drugs often help with asthma. Wait for the next lung function test.

[Normc]

I keep getting these requests but I may be the wrong man to ask. Ventolin is not working very well for me at present whereas I considered it a miracle when I first got it a lot of years ago as in gasping for breath, take Ventolin, 10 minutes later settled breathing ok. Now it’s not so effective. I am now told I don’t have asthma just COPD & Bronchiectases maybe that’s why. I have just had a respiratory test so will be asking the consultant why Ventolin is not so effective now. If you have asthma as I had from childhood then it’s very effective so stick with it. I am 79 years of age.

[O2Trees in reply to Normc]

Hi Norm, ventolin stops working as over time as we build a tolerance to it - and you've been using it for a long time! I dont bother requesting it on my repeat prescriptions any more. I have symbicort and I find the bronchodilator part of that works pretty well for asthma/airflow restriction. The basic dose is 2x2 puffs daily but Symbicort also has what they call a SMART system whereby you can take up to four extra puffs in one day as needed.

I was told that I dont have asthma by my new (and pretty arrogant) consultant. Reason being i never wheeze. So he ordered a FENO test and, haha, right enough it did show asthma.

[Normc in reply to O2Trees]

thanks for that I didn’t know Ventolin (the drug is salbutamol ) stopped after a time. I will see if symbicort should be any good for me when I see a doctor next. I have currently being referred to the consultants at my local hospital so things are moving on & I am having various tests. So we shall see if they can help me.

[O2Trees in reply to Normc]

The degree of tolerance that builds up during long term usage will probably vary from person to person. I hope the consultants can help you.

[Eccles44]

Hi Willow, I have a form of asthma called eospinillic asthma and I have bronchiectasis. I take Fostair and Alvesco inhalers for my asthma that has got progressively worse over the years. Ventolin does not help me. I'm also on biologics. It's worrying your peak flow has dropped so low and the change to an inhaler not specified for asthma without an explanation why. It is good to hear you have regained some benefit but I'd want to know why the change.

Do you check your peak flow regularly at home? I've been struggling lately despite all my treatments and have been writing a peak flow diary which I took to show the doctor and am now on a short course of oral steroids. Chest clinic at my hospital have been great for me but they always say go to your GP as soon as there is a problem. Perhaps you could make an appointment and ask them to check your breathing and to ask if they know why your inhaler was changed? I hope you can get some answers. Let us know how you get on.