Hi, I'm new here and was recently diagnosed with asthma.
I had a Covid-like virus at the end of March before testing was available in the UK, with breathlessness and low-grade fever. The fever lasted 18 days and still comes back occasionally. My bloods and chest x-ray were clear, and I had a negative antibody test. The breathlessness never went away, and I was given salbutamol which worked most of the time and Qvar (beclometasone) but I still had that chest tightness and horrid, intense itching in my lungs. I had my first face-to-face appointment with a respiratory nurse 2 weeks ago, and she diagnosed me and increased my Qvar dose. That helped, and now I mostly just have heaviness in my chest.
I was also given Omeprazole in case it was silent reflux. Again, the lower dose helped a little but I seem to need 40mg a day.
I find it very difficult to get a telephone consultation with a GP. 2 weeks ago I rang 75 times from 8am, and when I finally got through at 10:35 there were no appointments left. I was asked to do an E-Consult, spent an hour filling it out, and had to fib through most of it because as soon as I mentioned a tight chest or breathlessness it all went red and told me to ring the surgery! All I got was a text message telling me they had sent a prescription to the pharmacy. None of my questions were answered. Nobody rang me back.
So I'm asking here. Everything I read says that both asthma and reflux are worse at night. Mine isn't. I wake up feeling pretty good, although my peak flow is a little lower. The slight burning in my gullet, itchy lungs and discomfort (and tight chest but not so much now) all come on as the day progresses, and are worst after dinner in the evenings.
Lying down helps. Am I just an anomaly with asthma and silent reflux, or could this be something different entirely?
Thank you!
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AirIsUnderrated
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I have reflux and laying down is a no no. Asthma again don't like laying down.
You say it's worse after your evening meal, might I suggest you keep a notebook and not down what you do during the day and how it affects you also what foods you are eating and how you react to them.
When my chest is tight I'm more comfortable lying on my side than my back, but better on my front or standing up.
It's at its worst by the evening. Sitting is uncomfortable, particularly driving. Even sitting at the 90 degree angle, it feels as if there is less space inside me for air after I've eaten food as well. The type of food doesn't seem to make a difference. I've researched the acid reflux diet and I already follow it pretty much. I cut back on tomatoes, stopped my small evening glass of red wine and limited my already frugal chocolate ration, but it didn't seem to change anything. I've already worked out and eliminated the foods that give me headaches or make me sick, and I don't react to anything I eat regularly these days.
I'm not overweight. I've actually lost nearly a stone since all this started, and not on purpose, although I'm glad to see it go! I'm less active now than I was, because all the things I used to walk to are now closed, but I still try to go for long walks. I walked 5.5 miles through the fields, woods and hills on Saturday with no trouble - until the home straight when I walked through someone's barbecue smoke 🙄. Had to take salbutamol after that.
I must clarify - I haven't got reflux symptoms. I have asthma symptoms which may or may not be caused or exacerbated by silent reflux.
Update. I managed to speak to the asthma nurse and she said some people are better lying down, and the time of day it is better or worse can depends on the triggers. It can still be asthma if you're OK at night.
I want to address this that you said: I was also given Omeprazole in case it was silent reflux. Again, the lower dose helped a little but I seem to need 40mg a day.
Does that mean that when you take 40mg a day you are fine? Much better? I take that does and find that less is not enough too.
The reply that suggested you keep a log is right. There may be certain activities, venues, circumstances, foods, etc... that you could pinpoint by keeping the log. Maybe it is your Great Aunt Selma that kicks it off everytime. Could be her expectations of you cause silent anxiety, or maybe it is her perfume.
These things are NOT easy to figure out but sometimes you CAN. Good luck -
Omeprazole 20mg a day is better than none for my breathing, but not as good as 40mg. But 40mg gives me awful heartburn, constant slight nausea and extreme gastric discomfort. I can’t even describe to myself just how it feels but it’s nasty - much nastier than a slightly tight chest.
The nurse practitioner has now taken me off Omeprazole completely to prep for a helicobacter pylori rest. It’s now day 2 and all the discomfort has gone except for tight chest & I feel much better.
Bottom line is that stomach contents are coming up, whether acidic or not, and they didn’t used to, so we need to find out why and stop it. 😊
ETA: apologies, I forgot to address the diary suggestion. I work 3 days a week, shop once a week and stay at home the rest of the time. With Covid we don’t visit & have no visitors. I do keep a health diary though, and need to add food to it. 👍🏻 Thank you for your input. 🥰
Watch out for and look up the use of Omeprazole. It is a short term use med. I was on it for two years and got "Rebound" which is known, but only by few and those that read up, from the over use of it. Also aspirating stomach acid can give you Asthma.
I was on a great self imposed rehab track, since I was getting no assistance by my 14th, 11 years, 15th Pulmonary person, 2 years, over 20 years which at that time all they did was fill scripts whenever I asked for whatever I or they felt I needed. When I got my 16th group, including the Chair of the Department at this Major Medical Organization, after all the tests and whatnot they were amazed at how well I was doing all on my own. This was in August. They were talking about taking me off all the drugs including 3mg/day of Prednisone that I just couldn't get off of. It was more of a mental addiction from the rotation of Drs over the years and that was their go to med.
Early on one Dr that was having a Mental Breakdown from seeing 63 patients a day, had prescribed a 40mg Burst of Prednisone when I was doing fine. That caused me to gain 60 pounds in a month and ruined the "drug free" progress that I had made and my body. The next appt I had with him which was, as he put it, to cover my "Obesity" that he caused, he finally cracked and was wheeled out on a gurney.
When I was going over the results with Group 16, at the time I told them although I was on Omeprazole, and had been for a couple of years, I was having mild Acid Reflux all Summer. They didn't listen. A couple of weeks later, two nights within one week I had two of the "worst" Reflux Attacks I have ever had. I kicked into my self-learned mode of having everything slam shut recovery which took 2 and half hours to be able to breathe halfway normally. What a Nightmare! That basically set me back to far before square one. I remember trying to set up for Halloween and we go all out and it was painful. While I was trying to recover from those episodes Group 16 was no help. Rather they were combative in my care and truly abandoned me to the tune of direct ridicule. But all through this no one caught the Omeprazole issue. No One!
I limped through the holidays and finally had had enough and being that anxiety and stress were my trigger, early January I had had it and the stress triggered an attack and I went to the ER. The hospital that we ended up at purely by accident saved and changed my life. Not only did they take great care of me. But I found Pulmonary Team Number 17 and the last. These days the care teams are from outside medical groups and you can see them outside the hospital. "FINALLY some INTELLIGENCE!!!" Upon leaving the hospital they change the Omeprazole to Famotidine acknowledging the "Rebound" affect that over use of Omeprazole can cause. Now we rotate through these meds quarterly. I am now taking 20mg of Famotidine in the mornings and 20mg of Omeprazole in the evening and mostly observing the Do's and Don'ts related to eating at night. Mostly.
No dangerous Acid Reflux since. But because of the complications of it, hospitalization and one visit with my new Pulmonary Doctor and a simple Blood Test, I was diagnosed with Eosinophilic Asthma. Being the fact monger that I am I looked up all this and what I had been through made perfect sense now. Now a year and a half later and having been on Nucala, same thing as Fesenra, to treat the Eosinophilia, I'm human again. But I still have chronic acid reflux that is being controlled with a rotation of meds. And stay far away from anything that is Ranitidine related. Read up on that too. Some of what is being said about it is wrong and mostly hype.
When you get a drug look it up and read EVERYTHING about them. Especially the Side Effects. I missed the Omeprazole, but then that turned out to be a good thing. These days it's a team effort between you and your doctor. And the days of the doctors' actions are not the end all be all that they once were are over. Do your Homework and know that you have Manage your Care!
But yes, I work for in a doctor's surgery, my father was a pharmacist and my mother was a nurse. I am also trained in complementary therapies myself, so I didn't start Omeprazole lightly, and it was only going to be for 3 weeks max then review. Unfortunately the "review" was the experience I described above, and all they did was to send another script to the pharmacy. It must have been a busy day for them. 🙄
Ranitidine has been discontinued in the UK since last year. 👍
I discovered the links between asthma and reflux. The trouble is that silent reflux irritates the lungs and exacerbates asthma, and the steroids in the asthma inhalers can relax the stomach sphincter, causing reflux. Proton pump inhibitors such as Omeprazole can cause rebound symptoms leading to increased doses and side effects, exactly as you said, so it's all a bit self-perpetuating.
And I am one of the best people I know for getting the side effects of any drug worse than the effects, and often worse than the original problem. Sometimes I don't read the leaflets, just in case my side effects are caused by the psychological effect of merely knowing about them. The last antibiotic I had, I just noted all the side effects and then consulted the leaflet afterwards. I impressed myself with just how many of the more obscure ones I had, like hallucinations and night terrors - I couldn't have imagined those!
This is day 3 I've been off Omeprazole now. The afternoon/evening rebound heartburn is unpleasant but it is improving, and Rennies (like Tums I believe) are helping. My airways are tightening up a bit again but I've got the blue inhaler if I really need it. I'll try not to.
I'm not overweight and I have pretty much given up potatoes, wheat and corn, other than a pizza every once in a while. I don't have milk, coffee or tea either, and have cut down a lot on my beloved tomatoes and cheese lately. I'll reintroduce those last two once the reflux is under control.
Thank you for sharing your story. I'm glad you're on top it at the moment. Where are you at with losing weight and eating right?
I don't think that they were having a busy day and wrote you a repeat script. That's what they do. Get stuck on a remedy and stay with it until someone explodes. I have been watching the side effects of all this stuff and really have had none. Except for the Omeprazole. I usually have the opposite effect of the drug than is intended. These days I read up on everything before taking it. There's been a couple times that I have called the Dr back and told them, "Thanks, but try again".
I was heavy for many years until I was told that I was borderline Pre-Diabetic and had to lose weight. I instantly went from 250lbs to 230. All my life I have been about 190 and a "Gym Rat". The Prednisone also ate about 75% of my muscle mass. Leaving me unable to do things that I never gave a second though about and now looking too well. Since I was losing weight and the damage of the Omeprazole really killled my stomach, I wasn't all that hungry anymore. I couldn't eat much because it either hurt or I felt like crap. I decided just to go with it and try to keep going and was able to get to 195. Then a Dr gave me some "stress meds" and I really lost my appetite and fell to 170. So I hovered there for a year or so. It felt good. You really can feel the difference in just moving around and being able to wear nicer clothes that you've had really helps the psyche.
Now having been in "Slug Mode" I am putting weight back on. All the meds I'm taking are known for losing weight. So here could be the "opposite effect" kicking in. It's been a short amount of time and I am getting more and more active now that we are getting adjusted to our new COVID-19 World. That's the one thing that was the center of my rehab that got curtailed before I could get started.
I'm trying to be charitable about the GP who repeated my script, otherwise I get angry and that isn't helpful. Anyway, I'm hopefully on the right track now. Heartburn has not been good today, but chest is OK.
The depression/aggression that you feel when you lose weight too quickly is miserable, but you do get a funny kind of high from it too, don't you? Or is that just me? Haha!
Keep up the good work. Don't let Covid break that part for you. You can still do this. 👍
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Eosinophilic Asthma
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