Just diagnosed with asthma.33y old female.Taking prednisone, duoneb (ipratropium bromide and albuterol), advair hfa, ventolin, montelukast.

[Dekili]

Hi all, I have been diagnosed with asthma 3 weeks ago as a consequence of viral infection. I was started on symbicort. But my reaction was bad with a lot of yawning and difficulty breathing in first 3-4 h after inhaling. I went to pulmonary doc. And I was started with Montelukast, duoneb nebulizer 4xday on may 5th and prednisone 40mg with taper on may 10th. I didn't have many side effects form prednisone, mostly felling depressed, shaking, nervous, and got stomach acid. Since my breathing condition didn't change on may 18th Dr bumped up prednisone to 60 mg 3 days, 40 mg 3 days, 30 mg 3 days, 20 mg 3 days and 10 mg 3 days. Also added 0.5 mg budesonide nebulizer treatment and changed symbicort to advair 230. Yesterday I had bad reaction with trouble breathing, yawning and hipper shaking feeling when I tried taking 15 breath of budesonide using nebulizer so I stopped using it. I think I might not be tolerating well budesonide which also is part of symbicort. And maybe because of that my asthma didn't improve over last couple of weeks. Today was my first time using 60 mg of prednisone and advair. I feel like my breathing was better during the day, but it got worse in the evening. I feel like my throat and my chest are tight and air is heavy. Duoneb helps a little bit. But my throat started hurting, my voice got harsh and my nose got dry and stuffy. I have been sleeping in seating positions for month now. And I have been waking up every 2-3 hours, not being able to fall asleep before 2am and getting up at 7-8 am. So I was wondering does anyone know how long it can take to get asthma under control? Did anyone have similar experience? And whether prednisone taper looks good? Any advice is welcome. Thank you.

[Poobah]

Have you been tested for an aspirin sensitivity? You describe having a reaction to the inhalers so it may be the propellant that's the problem. An aspirin sensitivity is the indication that you can't tolerate wet inhalers and so dry powder inhalers can be prescribed. There will also be other things to avoid but your doctor will be able to advise.

The steroid tapering looks OK but if your symptoms return as you reduce the dose then contact your doctor as you may require a different maintenance dose before reducing.

Unfortunately with asthma it's trial and error where treatment is concerned. You should have follow up appointments with your doctor until the right combination of treatment has been found.

The type of asthma may also help the doctor decide on the best course of treatment. Tests to identify which type of asthma are available, especially if you are seeing a specialist.

Asthma is a learning curve and it can be very individualistic. Noting your symptoms and reactions to meds in a diary, including how much you wake at night, when you feel worse, what you eat that triggers symptoms etc can be valuable in spotting patterns and triggers.

All the best.

[Dekili in reply to Poobah]

Thank you very much for your answer.

I haven't been tested for aspirin sensitivity. But I have used aspirin before and haven't had any problems. Also I use ventolin and I didn't notice bad reaction. I started making notes of how I feel during the day.

[EmmaF91 Community Ambassador]

Hi

How sure are they that it is actually asthma? Viruses can linger for a long time and give a false presentation of conditions (like asthma) when it’s actually your body still recovering. They seemed to have thrown an excessive amount of asthma medication at you in a short time which doesn’t seem to have had an effect. Have you looked into any of the asthma mimicers (which are also known to appear post viral) like VCD/ILO or a breathing dysfunction? I may be misreading but it sounds like you get a lot of throat issues more than chest issues which can be a VCD thing... and you don’t want to be dealing with drugs and their side effects if you don’t actually need them in the first place! (As I said they seem to have thrown you from 0 asthma meds to ‘extreme/severe’ asthma meds in just a couple of weeks (in the UK it would take months/year to escalate to the end level you are now on... I myself with severe asthma am on less extreme meds)

Pred weans are odd. If you’ve never been on pred before you can just stop. It’s only when you’ve been on for more than 3 weeks that you have to wean... listen to your body. If you don’t feel bad during the weans (ie breathing worsens, nausea/vomiting etc) then the wean is ok, however if you have any issues you need to slow it down. Some people can wean quickly others need to go slow...

Hope this helps...

[Dekili in reply to EmmaF91]

Hi Emma thank you for your detail response. Dr. never did spirometry due to coronavirus issues. But they did CT scan and chest X ray and my lungs seem fine. I was treated when I was 14 from asthma after pneumonia. But I haven't used inhaler for 20 years till now. I don't feel like medication help a lot. I cut down prednisone to 30 mg today from 60 mg that I took just 1 day. But I was using prednisone 9 days before dr bumped up my dosage to 60mg. I hope I will not have withdrawing symptoms. I would like to stop using prednisone.

I think my throat started hurting from nebulizer treatment. I feel fine 1 h after nebulizer, and after that chest tightens and difficulty breathing start again. With prednisone I was a little bit better but I think the dosage is to high with all side effects. I will go to Dr today again for consultation.

[twinkly29]

I agree with EmmaF91 - it's an awful lot of medication to throw at something (a) all at once and (b) at the first hint of possible asthma.

[Dekili in reply to twinkly29]

Thank you.

[texas0035 in reply to Dekili]

I happen to agree with the replies, as I read, it sure seems like a whole lot is being aggressively applied in such a short amount of time. Typically, it takes a while for this type of aggressive treatment unless a person is in a critical condition in the hospital. As much fight that our own immune system has to battle a condition is better. I'd request a transfer to a pulmonary specialist to evaluate me if I were you.

Not trying to scare you but Budesonide that's not mixed with Formoterol has shown to be fatal in asthma patients, please look into that. I jope that your doctor had you or have on a regime of that together, as a doctor, he or she she understand this.

[HungryHufflepuff in reply to texas0035]

I thought it’s only non steroid inhalers, on their own, that are a risk to people with asthma. So an inhaler with fluticasone would be a steroid. But that’s just my understanding of things.

[wiserlady]

Feel for you and understand as am in a similar situation. Just about to try monkelust. How are you getting on with it now? Hope you feel better now. Hope you do not mind but posted a prayer for you on the free - non religious - prayer board at accuratepsychicreadingsonli.... Everyone is going through such a hard time now, and worse with the virus and lock down. Those who live alone are struggling not being able to go out and loneliness too. I get the vulnerable persons parcel and find the doctors are quite helpful but you still have your problems to deal with. How are you coping? I found that 5 htp could help sometimes and make it worse at others. And acupuncture has helped me.

[Bertyboy]

Hi Dekli. I get where your coming from. My journey is similar. I've never had Asthma and I'm 67. This has resulted from 2 nasty chest infections. Left me non stop coughing. GP went down asthma route. Om currently on Fostair and no coughing now. I also take antihistamine and omeprazole as reflux issues which maybe a factor. You will get great support from friends on this site. They have been so supported. Like you my x Ray's are good.Speak to Asthma UK nurses. They are amazing. You mentioned ventolin. That can make you shake. I spoke to asthma nurse ans she us currently speaking to Gp with a view to taking me off fostair as I get persistant throat inhaled tickles. Seems this could be due to recipients which could be a factor. As mentioned by others its so much trial and error. Keep in touch with your GP and asthma nurse. And tap into the Asthma UK nurses. Keep well and don't despair

[Dekili in reply to Bertyboy]

Thank you.

[Gwalltarian]

It sounds to me as though you have an allergy to something in your environment since you feel ok immediately after using nebuliser but revert to problems after a few hours. You do seem to have been given a heavy load of medication to start off with, I always thought steroid inhaler - at lowest dose possible plus short term relief inhaler like ventolin should be initial treatment then add on - I take montelukast tablets - helps stop allergic reactions - plus omeprazole to counteract raised stomach acidity because of medication plus above inhalers. You could Ask for antihistamines, perhaps that would be a good starting point and look at irritants in your environment- pollution, dust, pollen, wood/cigarette smoke, mould, pets/ animals - and at food and drink you consume. Drink lots of water - as much as you can and gargle after taking inhalers.

[Janet2017]

Hello Dekli,

l hope you're much better.

My suggestions are that you watch what you eat before every attack and try to avoid such foods for a while.For your neb, salbutamol/ ventolin is milder and effective but if you are still having issues, you may have to see you doctor who can get you on hydrocortisone intravenous injection or aminophiline.

[Nozzam]

Hello lovely. I think you must be in the US as you call it Advair? What is your Advair dosage? You are taking a great deal of medication - and I am not suprised you are feeling so unwell. How sure are you that it is asthma and how can they diagnose it so soon and with no spirometry or FeNO2? You shouldn’t diagnose on symptoms alone. I would possibly get a second opinion if I were you. Exactly the same happened to me when I lived in the US, they kept adding and adding on - my chest and throat were on fire and so dry/hoarse. I couldn’t breathe and was coughing up so much stuff.

I moved back to the UK - the doctor cut it right back, everything and voila much much better. I do have asthma.

Please get a second opinion.

[Dekili]

Hi, thank you. Yes I am currently in US.

I am using advair hfa 230/21. And I haven't had bad side effects from it.

I am still on prednisone, but since I had bad reaction dr lower down dosage to 30 mg. This is 5 day. Tomorrow I should do 20 mg. I hope I will feel better when I stop taking prednisone.

[Smoggy1990Boggy]

I am really shocked at how much medication you have been put on in such a short time as well. My advice would be to phone Asthma UK and give one of the respiratory nurse specialists a ring on the helpline they are very knowlegeable and friendly.