Monday, November 01, 2010

Mom's Asthma: Question for you guys

Hi, all -

As I enter my first full season as a newly-diagnosed asthmatic, I have a few questions for you. As you know, I took myself off Symbicort this spring - I just felt ill from that stuff. I intend to find a new pulmonologist soon and look at some different meds.

Anyway, this past week, everyone in my office, on the bus, apparently in most of lower Manhattan, has had a violent, horrible-sounding cough. Seriously, I thought my boss was going to break a rib in the office, the way he was coughing.

Yesterday, when I woke up, I felt run down and a little "fluffy-headed." I had a very slight fever. I'd been feeling a little tightness in my chest the day before, but not enough to make me think this was asthma-related.

Today I have the same feelings...fatigue, a little tightness, but no fever. Is this the start of a flare? What should I be doing?

Thanks for your tips!

PS - the kids have been doing well. B's had some bad allergies, but no major flares. Oz has been doing really well...but I'm terrified that I've caught whatever horrible illness the folks around me at work have, and that one of the boys (Oz, particularly) will end up in the ER again.

They're all getting flu shots in the morning!


Anonymous said...

I cant speak as an adult, but I can say that the symptoms you are describing sound a lot like the early stages of a flare for my daughter. Hers usually start with a cold/resp infection of some type.

Sarah said...

Nagging fatigue - especially with no identifiable reason - is nearly always an early-warning sign for me (and amazingly, I still have a hard time recognizing it - even though I've been asthmatic since birth - because fatigue is such a vauge feeling). That plus tight chest almost always means a brewing flare for me. If my exercise tolerance is reduced from normal, I'm definitely headed for a flare. Same if I've started coughing a bit more than normal.

Is it a flare for you? I don't know. Asthma is a very personal and variable disease, and unfortunately, the first year or two after diagnosis is a steep learning curve of getting to understand your symptoms and your disease. What heralds a flare for me doesn't necessarily herald a flare for someone else.

A good way to tell, I find, is compare to what you felt before prior flares (including symptom patterns that, in retrospect, seem more like asthma flares than whatever they were chalked up to before your diagnosis). If it seems to match, it could be that you've identified a warning pattern for your asthma.

If you don't like Symbicort, I'd suggest you ask the doc about Advair. It has the same mechanism of action, but the active ingredients are different so it may be easier on you.

If you think you are flaring, I have two suggestions: One, do you have an asthma action plan? If so, step up to your yellow zone. If not, go to the doctor and tell them you think you're starting an asthma flare but you don't have an asthma action plan and so don't know what you should do. Two, see if you can pick up a peak flow meter (some places they're prescription-only, others they're not) and monitor your PEFs... It's as useful a tool for an adult as it is for a kid, IMO. Especially if you're like me and have a tendency to move the goalpost on when you should treat (like, to be honest, what I've been doing most of today - brushing off nagging tight-chestedness that I really should have been treating... and just did because I got a guilty start when I wrote "move the goalpost" ;P). I find it's harder to argue with cold hard numbers than it is to argue with something subjective.

Aimee said...

Thank you, guys - so helpful!

Kevin O'Brien said...

Mom, I agree wholeheartedly with the comments about the condition being "personal." My son's is triggered by different things. We've been to the hospital, for instance after visiting a house with cats. Fun. One thing I found on is that for other patients, pulmicort may stunt growth. We have had our son on Singular with good results. Hope this helps!

Aimee said...

Kevin - with respect to pulmicort (and most other corticosteroids like Flovent and Qvar)they DO stunt growth, but only temporarily. In our case, we found that when our boys were taken off Flovent for even a season, they had massive growth spurts! I've heard/read that this is common, and I'll try to find some data to back it up.

We've also had good results with Sinular in the past. I'm hoping to get Ozzy off the Flovent this season - or at least down to 44 from 110 - and hoping Singular will be an option for him.

Sarah said...

Aimee - your comment about your boys' growth spurts reminds me of my own growth. When I was able to come off steroid during my one and only period of being a mild intermittent asthmatic (yay for teenage hormones, I guess), I went from being the shortest kid in the grade by far (I'm talkin' I barely broke 4' in grade 8) to being of average height in about 3 years.

Then again, that could have been due to genetics (there's a history of that sort of wierd growth pattern in my extended family - and at 23, I'm still growing a bit, which lends some credence to the genetics idea), due to being born a VLBW preemie (which put me behind on growth) or due to improved asthma control.