Several questions here. Just wondered if anyone has any positive or negative views to share about Symbicort SMART.
I've just been switched from Seretide to Symbicort. I understand the principle, however I'm slightly paranoid about bone density at the moment (with good reason), and I'm not sure I really want any more steroids in my system. I do understand, however, that if SMART cuts down on prednisolone courses then that'd be useful, and probably good for my bones. I also understand that inhaled does are very low, but I've had some very broken bones this year, and am now concerned (I'm waiting for a dexa scan). Maybe my bone issues are a coincidence, and I'm sure it's quite rare if it's not a coincidence - I certainly don't want to start a inhaled-steroid-fear.
I was told that I should take Ventolin alongside Symbicort, considering how much reliever I use. Am I right in assuming that I might as well use Ventolin over Symbicort if it's for exercise, or because I'm in contact with a (temporary) trigger? Because these are bound to cause asthma issues, and are different to 'underlying inflammation' - right?
SMART sounds like a great idea in some respects though - I am terrible at admitting I need Pred, and often regret not taking it, or not taking it sooner, so this may work well for me. I was also told that doubling Seretide (which I used to do a lot, not knowing I wasn't meant to!) means the salmeterol can make you very shaky. I'm totally up for being less shaky, if Symbicort achieves this.
I was prescribed Symbicort SMART 400/12 by a consultant yesterday - I was feeling this was a pretty high dose to be taking two times twice a day, and up to 12 if needed - and searching old posts says my guess on that would be correct. I used to be on Seretide 250, two puffs twice a day - so I would have thought Symbicort 200 would be OK? No doctors were available over the phone today, but I'll try and speak to someone on Monday. Does anyone know if the doses of the steroid component of both have equivalent effects (isn't there one steroid which you only need to take half of to get the same effect as others?)
Question 2: I'm waiting for a histamine challenge test. The cons said this was to check I did have asthma (fair enough, as my peak flows often don't mirror how I feel). However, skin prick tests are negative on me. (I've never noticed being worse around typical triggers, except some pollens - and these were still negative on skin test). I didn't have a particularly big skin reaction to histamine. So, I guess I have non-allergic asthma. So, if a histamine challenge test for asthma is negative, does that totally rule out asthma, or just mean its not allergy based? (I am very 'asthma-allergic' - I think - to wine, although a sulphite challenge test was negative.)
Question 3: Does anyone know if it's possible to get atrovent inhalers which do not contain an ethanol propellant? (I think the wine allergy has roots in an ethanol allergy, as I've been very ill after using Salamol. I respond well to atrovent nebs.)
Phew. Question overload. Sorry! Cheers.