Stomach issue and asthma connection?

[Beefull8]

I was wondering if anyone else see a relationship between stomach flu type symptoms and asthma? I got asthma for the first time last year when I had the stomach flu and this year the same thing happened. Stomach issues for a few weeks and then worsening asthma.

[d2read]

Hi again, Bee😂. Many asthmatics are triggered by infections of different sorts (remember asthma is also a type pf immune system disfunction). It’s particularly important, since you’ve learned this, that you talk to your doc about ways to reduce your exposure.

Become a hand-washing fanatic, keep alcohol-based sanitizers and alcohol wipes with you (wipe down handles, phone, key pad, arm rests, tray table, remote, ear buds, keyboard, door/purse/luggage handles). Get flu shots as soon as they are available in your community. Make sure any other vaccines are up-to-date.

If you’ve had a stomach flu, it’s particularly important to take additional hygiene precautions: replace your toothbrush (and soak the bristles in pure vodka or other pure alcohol between brushings), make certain toilet lids are always closed before flushing, wash towels in hot water and more frequently while sick.

Single greatest cause of asthma in the fall is the common cold, the National Institutes for Health has found. So learning to make a few changes, like being careful to take extra precautions like not kissing people who have small children (who are constantly sick), may sound harsh but the alternative can be repeated asthma attacks.

Hopefully you won’t need to go so far. But it makes it easier to know what you need to do to get and stay well most of the time. Then, if it’s important to spend a weekend in close contact with small kids who are all sick, hopefully you’ll be able to fight off some of the germs.

Hang in there. D

[Beefull8 in reply to d2read]

Thank you! I have two small children so it’s hard to avoid getting sick. But I talked to an integrative doctor who thinks things like SIBO might cause or trigger asthma. I’ve always had stomach issues and I wonder if over time it triggers other health issues.

[d2read in reply to Beefull8]

It can. Just out of curiosity, have you been tested for eosinophilia?

[Beefull8 in reply to d2read]

I’m not sure. What does the test entail? I’m on day 3 of prednisone and still feel unwell though not as bad as before. My peak flow is what it normally is but not as high as when I use my rescue. Is this all normal? Thank you so much! Feels like a real community here. So grateful to have others like you to give advice.

[d2read in reply to Beefull8]

Eosinophil is just a blood test. Hold off on that until you get further along - it causes a rarer type of asthma for some of us.

You are improving on the prednisone - that’s what’s important. If you stop improving - your peak flows decrease again, you need your rescue inhaler more often - you need to see or talk to a doctor right away. You might need a stronger dose of prednisone (you are on a low dose with a pretty fast taper). You probably also need nebs instead of trying to do it with inhalers - they are notoriously bad at actually delivering a full dose of medication to the lungs and bronchial passages.

Normally during an attack, you’d be using nebs at home/work plus prednisone and inhaled corticosteroid, like Flovent/Breo etc. Asthma attacks don’t end quickly - and they are sneaky. Prednisone, once you’ve been on it and feel a lot better, can make you think you are well before you are. So it’s important to watch for relapses or any worsening.

You’re welcome. It’s the way we all feel. I’ve started my own blog/website to try to share what I’ve learned - for doctors as well as patients/caregivers. I couldn’t have made it thru the worst of my experiences in 2013-2016 without friends, but would have loved to have had people who understood to reach out to.

Just remember to pay it forward😘

[Beefull8 in reply to d2read]

Thank you! I looked up e asthma and I have a lot of the symptoms. Actually a year ago my eosinophils were high and no one said anything about it. Since then it’s been back to normal but wonder if that’s why? I called myvallergist in Hawaii so hopefully I’ll find out what to do.

[d2read in reply to Beefull8]

Okay. Guess it's time for a mini-lesson on eosinophils. First of all, it is COMMON to have elevated eos when you have an infection, or are having allergies. That is completely normal. When it becomes abnormal is when your bone marrow starts producing far more than are necessary or can be linked to any other explanation, and they stay elevated for a long LONG time.

For example, usually any given patient will have between 0 and up to 7% eos (it's a percentage of the total white blood cells). And it might even, especially with lots of allergies, stay elevated for several months.

And then you have someone like me. I started running eos levels of 25-40% and they would last for months. And it did so over a period of years (in my case it's been 7+). I was diagnosed with "eosinophilia" (the persistent increased levels above 7% -- this is actually kinda rare in terms of overall allergic/asthmatic patients in the US, but more common than they realized a few years ago) in 2012, but by 2013 there was concern I had developed a very rare version now called HyperEosinophilic Syndrome (HES for short -- bet you can understand why we call them eos and the syndrome HES, huh?). But I wasn't formally diagnosed with it by NIH until 2017 (2 years ago). NIH's top researcher thinks there's about 4000 people like me in the US, and she's identified about 3500.

So here's the thing: Do NOT get freaked by eosinophilia! First of all, there are a lot of different reasons for your body to decided to start producing the cells. The problem for people like me is that those cells (I explain they are sort of like the Special Forces of the white blood cells) are not being developed to fight say, a cancer. They are touring around my body looking for things to attack here.

And that's the problem. See, eos among other things, fuels inflammation in the body -- which isn't always a bad thing. But uncontrolled inflammation in different areas can be deadly. Which is why it's so serious for us.

One of my weird aspects is that -- like in just about every other way -- in HES I am also atypical. Most people with HES get a high level and it never drops. Mine would cycle up and down. It got to the point over the years when I could feel my body start to do it. Strangely enough, I've get that slightly achy, tired, grouchy feeling as it was starting to climb. Those symptoms would get worse, to the point where I'd almost feel like I was coming down with the flu.

And then the strangest thing would happen -- for a few days, as my blood hit the max level -- I'd feel pretty good. I'd have more energy, get stuff done.

THEN A FREIGHT TRAIN WOULD HIT ... AND KEEP HITTING ... AND KEEP HITTING ...

until I slid down to the bottom. I'd practically have to crawl my way out of bed. And a few days later, maybe a week, and it would start all over again.

No one knows why.

One of the hardest things is wondering what they are attacking and damaging -- because the way they damage cells can kill them. And what was actually hard for me was not knowing. Kinda like being in a slasher movie. Knowing there's a killer out there somewhere, just not where or when.

And that's why Fasenra has been such a miracle. I'm not a religious person, and don't believe in miracles. But from the first dose of Fasenra June 2018, my eos dropped to 0 and it's stayed at 0 ever since.

That's had an incredible impact on my life -- I'm slowing getting stronger, and able to do things I've been unable to do for the past 7 years. But it's my last shot. The other biologics didn't work for me. And last year we found the first organ the eos had been damaging -- it's been attacking my lungs, killing some of the cells. Which is why I now have e-emphysema.

So. End of lecture. Don't worry. If you develop eosinophilia, your doctor will catch it early and there are new meds out that can make a real difference. I had almost 7 years when nothing stopped them from attacking anything they wanted to. We think they damaged other things, but so far I've actually been very lucky because none of the tests done on different parts of my body have shown any other serious damage, but these other systems are performing better the longer I'm on Fasenra. My theory is that it's about the inflammation. I think eventually the inflammation (I think of it as e-infl) will turn out to be a precursor that may cause damage, but may also stop short of killing cells.

Enough. Stop scaring yourself. There are other white blood cells -- baso, neutrophils -- they are all important. Based on my experience, I think it's unlikely that you have even eosinophilia just because you sound like a pretty active person, small kids, able to take a big vacation. Get off the computer and enjoy the state. My kid brother and his family are in Claremont CA -- it's a great state.

Have a good night.

debbie

[Beefull8 in reply to d2read]

Wow Debbie! It sounds like you’ve been through a lot. I can’t imagine all you’ve been through but it’s inspiring and I’m so glad you found something that worked. It actually sounds like what my endo had told me once your body doesn’t like you. She thought my body was attacking itself too. First thyroid now my lungs. I guess everything is related to inflammation. Thank you for educating me on eosinophils! My allergist said I can check when I get back. I don’t wheeze. I got asthma later in life. I had a recent ear infection and my inhalers dont help a whole lot which are all symptoms I read which is why I thought maybe I have it. My friend with asthma has more of a textbook case and she said mines sounds different. I’m hoping I don’t have it but it sounds similar. I am having a good trip, but just out of breath to even walk and just nervous to get back on the plane in a few days. I’m on day 3 of prednisone and while I slept better and could breathe last night. I still don’t feel significantly better. Anyway thank you again for being a listening ear and a teacher!

[d2read in reply to Beefull8]

I’m all for people learning about differences in types of symptoms and responses. Like I said before, doctors now realize there is a constellation of lung conditions called “asthma,” not just one. So your different response to your friend is not that uncommon. Adult-onset does seem to present differently, at least initially.

Frankly, if I had questioned my former physician in the ‘90s more, I might have saved myself some serious complications. (Sometime you should read the backstory on my blog asthmaodyssey.com. It’s still being set up, so ideas/etc gratefully accepted!).

It’s important to keep trying meds until you find some that work well (or better, with fewer/more manageable side effects). Another reason why I think notes and journaling make a difference. (I put notes in my calendar to discuss with my doctor at next appt if it can wait, and in “notes” on my phone.). Some things work well for years, some for months, some for days. It can be incredibly frustrating. All I can tell you is to keep trying. Keep a list of what you’ve tried, for how long, and if you’ve stopped, why. You’ll need to refer to the list periodically over the years - so don’t just rely on what’s in your chart.

Talk to your doctor again before your flight. While you are doing better, it might be worthwhile to ask if you should double up on prednisone for the day before and of the flight, before seeing the doctor as soon as you get home and can start a new taper. You might need a somewhat higher steroid dose for long air trips than for attacks at home.

Again, I’m not a doctor, but I’ve found that long flights and planes can be problematic. They can be dustier than you might think, frequently those going to/from states like HI are sprayed with insecticide for ag reasons; and there’s just something about the hours/air pressure/vibrations that are troublesome.

And as for the endo point - it’s true. I was born with a number of endocrinological problems (many of them run in my mother’s family in an unusual cluster). One reason all my doctors are at George Washington University in DC is so they can study it all for the rest of my life. When I die, they get what’s left to hopefully get even more answers from. Anything that can be recycled - yay, but the best thing I figure I can do is help them learn from me. I’ve benefited so much from medical research and committed doctors.

Have fun