Involuntary inhale and traveling

[Beefull8]

I have two questions. Being new to asthma, I traveled on an airplane for the first time since I was diagnosed. I’m not sure if it was the altitude but I think it might have been or the fact that I was recovering from the stomach flu that made me struggle on the plane. I didn’t take my rescue inhaler though I had it with me because I didn’t realize I was having a hard time breathing from asthma. I thought it was anxiety. But when I got off the plane I felt so much better. The next morning my peak flow was lowest ever and I just felt horrible like I had been hit by a truck. I was taking my rescue inhaler like five puffs in the first day and still feeling out of breath so my allergist told me to get on prednisone. The entire trip I was feeling weak and tired which I’m assuming was from the prednisone. The interesting thing was I was ok on the ride back home which may also be due to the prednisone but it took me 2 weeks where I finally feel ok. The only weird symptom I have now is this weird involuntary sharp inhale that comes out when I’m tired or walking. It feels like what happens if you sprint. Does anyone have any idea what this is and if it’s normal to be so tired from either the prednisone or traveling with asthma? Thanks!

[Wheezie1]

After over 30 years dealing with the various stages of asthma, my opinion is that prednisone is sometimes a "necessary evil". I believe that your asthma, with it's attendant low blood oxygen level, further contributed to by flying at high altitude, made you feel more short of breath and exhausted. Anxiety can make this worse, although it does not cause it. When you have an exacerbation of your asthma, for whatever reason, it is likely that your doctor will suggest putting you on a brief course of prednisone, which should both improve your breathing and your energy level. If you are still short of breath, perhaps, your doctor may want to extend your prednisone for another brief period, but unless the course is very brief, you will usually be tapered off the prednisone gradually to avoid any problem with your adrenal glands. When taken briefly, there is little to no risk of taking prednisone. However, if your asthma worsens in the future, you could require more frequent courses of prednisone, other types of inhalers, or a maintenance dose of prednisone all the time. At this point, depending upon any other health issues you may have (diabetes, osteoporosis, etc.), you and your doctor may consider further testing to see if you would be a candidate for the newer Biologic medicines. If you are having to use your rescue inhaler more often than twice a week (3-5 times a day) that is a good sign that your asthma is out of control and you need to be treated with the next step up in therapy, which could include prednisone, for the short term, and then likely a steroid inhaler and/or a Long-acting Beta Agonist inhaler to take on a daily basis to help prevent frequent exacerbations that could damage your lungs. If you have not yet seen a Pulmonologist, you may want to at this point, as they are experts at managing the different stages of asthma and the complex medications. Follow your doctor's lead and also educate yourself about asthma. You will find that asthma is different in everyone and that your asthma can vary from time to time.

I note that you are seeing an Allergist and, of course, an Allergist is also well-equipped to treat asthma.

As for the sensation you are having with exercise, it sounds like an element of Exercise Asthma. I just caution you to always have your rescue inhaler with you whenever you are out and about. And, of course, mention this to your Allergist.

[Beefull8 in reply to Wheezie1]

Thank you! I’m on preventer inhalers and have done a pulmonary function test. It resulted in moderate to severe lung restriction and obstruction. I’m finally feeling better after six weeks of feeling sick triggered by stomach flu. I know there’s a lot of research Out in gut bacteria and asthma. I think this might be the reason I got triggered.

[Wheezie1 in reply to Beefull8]

Interesting theory! There are sooo many things that can trigger an asthma exacerbation from weather/humidity/temperature changes, to various allergens, to food allergies, to travel and schedule changes, etc., etc. Discovering your own triggers - measuring Peak Flows is very helpful, although my current Pulmonologist poo poos it. Even keeping an asthma diary for a while can be helpful in pinpointing your personal triggers. Mine are weather changes, mold, mildew, dust, pollens, extreme stress, exercise, and, recently, anesthesia or, perhaps, one of the myriad of drugs used during spinal surgery. I assume you have been tested for elevated IgE (Allergic Asthma), as well as Eosinophilic Asthma. I wish you a smoother course and hope you can learn to control your asthma in less time than it took me. I had to experience severe limitations to my quality of life before I finally asked for Biologics. I am now on 3 inhalers, montelukast (Singulair), and 2 Xolair (omalizumab) injections a month for Severe Allergic Asthma. I can now walk the dog, be outdoors, which I love, and do most normal things within reason. There is so much hope now for people with Moderate and Severe Asthma!

[Gigionthehill]

Hi. I e only flown when on a high dose of prednisone so I don’t know what it would be like without. I use my inhaler, 2puffs every 15-20 minutes during an attack. If it doesn’t work by 3rd dose I usually just neb. Are you on a controller inhaler? If not, that (or 2) should be in place before using prednisone.

[Mom2kb in reply to Gigionthehill]

Using your rescue inhaler more often than 2 puffs every 2 hours can make the attack worse. This is when you should be using a nebulizer or heading to the ER.