Health Wanted, Apply within

February 12, 2009 12:05 PM

I have been growing progressively sicker over the last five years getting chronic bronchitis every few months and my separate doctors (A lung specialist, an ENT and my GP) have been treating me without success this entire time, and I am growing gradually more and more weak and exhausted. This has gotten so bad that I realized that, it would be a relief if I just died in my sleep from one of my severe infections.

Even when I don't have bronchitis I am exhausted much of the time. I do not have Chronic Fatigue Syndrome, it's been ruled out. I have chronic sinus infections which we have been unable to control consistently.

But, I also have acid reflux, which my ENT says is the main cause of these infections, and he believes I aspirate the acid and that's how I get bronchitiis. No meds or sleep accommodations or air filters have improved this. I am overweight and he wants me to lose weight. The thing is, every time I exercise, I get sick. I mean I get bronchitis, and I am out for 10 days to 2 weeks. I want to exercise, but without fail, 6 weeks in, I come down with bronchitis. At that point, when I was exercising, I got bronchitis every 3 months. I stopped exercising and managed to get bronchitis only every 6 months. So, I can honestly say the exercise makes it worse. HOWEVER, I absolutely believe, if I lost 30 pounds, these problems would be fixed. The thing is the EXERCISE triggers the infections. Just to give full info; I also have asthma, which I'm being treated for, and 62% lung capacity. I have lived in LA many years. BUT, I never had these problems until 3-5 years ago. I moved inland from Santa Monica to Pasadena 5 years ago when I got married to my gay partner. My ENT does not believe the move is responsible for my condition getting worse. He has been treating me for 10 years for my allergies and acid reflux, I did swell for 5 years then I started to deteriorate after the move. Moving to Santa Monica is not an option right now. No money and the market sucks. I wouldn't rule it out altogether, but I would need a way to absolutely prove that it's the move to Pasadena before we could even begin to consider such an expensive proposition.

And here's my question: I feel like what I need is like an old fashioned sanitarium. A place I could go where I could get a thorough exam, a retreat where I would get fed foods that would help me get healthy and get properly monitored exercise under a medical person's care so that, if I start to get sick, they can observe it and act quickly and at least observe and come to some conclusion as to what's triggering it.

Does such a place exist? Is there like a place I could go for 6 weeks to recover, lose weight, have medical personnel who are part of it so I'm not at the mercy of some weird, unapproved "Eat kelp and have your auras repaired" hippie place. I don't mind some hippie influence, just, I've had my auras repaired, and had a fairly bizarre "air massage"--"We don't touch your body or any of your aching muscles, we just massage the air around you and it's the same thing only better." Also, I don't want crystals placed on my chakras and it shouldn't be in Mexico and involve coffee enemas.

I need a top to bottom, full blood work-up, and a controlled environment in healthy air where I can do yoga, pilates, walk, and eat healthy. Does such a place exist? Has anyone here ever been to one or can they vouch for such a place?

I desperately need to get well. I am about to get to run my own TV show for the 2nd time in 17 years, and if I can't stay well, I won't be able to achieve this career dream.

posted by generic230 to health & fitness (29 comments total)

If you want to pursue weight loss but can't exercise there are programs for doing so. I'm sure your GP can recommend one.
posted by le morte de bea arthur at 12:18 PM on February 12

Exercise is important for health, but not necessary for weight loss. Reduce your caloric intake and you'll start to drop the pounds.
posted by chrisamiller at 12:20 PM on February 12 [2 favorites]

Canyon Ranch comes to mind. The Tucson location is closest to you and has medical facilities. It's hella expensive, but does offer the combined food/movement/medical experience you're seeking, and it's relatively light on the woo-woo stuff unless you pay extra for that.

What you're going through sounds awful. I hope you find some relief, and an answer, so you can knock your show out of the park.
posted by catlet at 12:22 PM on February 12

Sorry, I can't directly answer your question in terms of a place to go, but it sounds like you could at least benefit from a carefully monitored and restricted diet: that is, controlled portions and calorie intake. This will help to at least jump start some weight loss. Could you acquire the services of a dietitian, at least while/if you have to wait until you find just the place you're looking for? Your physician should be able to help you find one.
posted by penchant at 12:24 PM on February 12 [1 favorite]

An endocrinologist told me that "unless you work in a coal mine, exercise is not going make you lose weight." He instead said focusing on caloric intact - counting calories - would work better instead, and that exercise is useful mainly for building strength and endurance, assisting with regulating metabolism, and controlling appetite.
posted by KokuRyu at 12:26 PM on February 12 [1 favorite]

I'm not one who usually jumps on the environmental mold-mildew-chemical bandwagon, but...

Have you had your new house tested for mold, mildew, and chemicals? When you moved, did you replace the carpet or repaint the walls? Did you bring a new pet into the house? It could very well be coincidence, but if I started having chronic respiratory problems after moving to a new location then I'd start looking for environmental factors.
posted by sbutler at 12:34 PM on February 12 [2 favorites]

To control your diet and lose weight, could you sign up for one of those programs where all your meals for x number of days/weeks are provided? I can't say how healthy they are, but a several relatives of mine have had good luck losing weight with them, and it serves the long term purpose of helping you get used to actual portion sizes.
posted by MadamM at 12:42 PM on February 12 [1 favorite]

Get thee a new pulmonologist. Explain to him/her what you told us.

Seconding exercise is optional for weight loss. The big weight loss periods of my life had little to no exercise in them. At the end of the day, its all about the food you choose to put in your pie hole.
posted by damn dirty ape at 12:45 PM on February 12

Is there any chance you've been living in the same place? I lived in a sick building once and found myself catching cold after cold, even leading to bronchitis. I had the sweetest apartment ever and it pained me to leave it .. gas fireplace! Floor to ceiling windows right in the heart of the city! Awesome landlord, etc... but when I realized the colds and such weren't just random bad luck, I knew I had to move - immediately. That was ten months ago. I haven't even caught a real cold since.
posted by 2oh1 at 12:45 PM on February 12

I have a close family member who went through something similar -- really long times of non-specifically diagnosed bronchitis type diseases.

Eventually, she went to the Mayo clinic, where they did the full battery of testing that you describe. She was there a week. Now, she didn't have the food/exercise help you're talking about, but what they were able to do was 1) diagnose the type of infection she was getting, and find antibiotics that helped it; 2) diagnose sleep apnea and provide a machine which helps her sleep, and therefore keeps her from getting exhausted; 3) diagnose something (I forget what) related to the acid (I think this was somewhat related to the apnea) and give her a diet and medicine to help that.

As a result, she hasn't been coughing herself/waking herself up to exhaustion, which means she has been able to focus on things like exercise and eating. You might think about that type of second opinion -- it seems that the Mayo clinic was different than other hospitals in that they just kept sending her every kind of doctor you can imagine until they actually figured out and agreed what was wrong. Anyone can get an appointment there, although she got hers really quickly because she was nearly dead by the end.
posted by dpx.mfx at 12:46 PM on February 12 [2 favorites]

I had a buddy who couldn't exercise due to a bad back, and instead decided to walk EVERYWHERE instead of taking the bus or driving. A couple months in you could see the difference in his frame and now he looks like he did in high school. He really didn't change any other aspects of his life style (though getting in shape and losing weight did cause changes in appetite, etc...)

I'd also check out the house you live in for mold. Another friend of mine moved into what we now call "The Mold Apartment" and proceeded to get a cough and bronchitis that took a long time to go away, even after she moved out.
posted by bottlebrushtree at 12:49 PM on February 12

Yeah, if you can afford it, Canyon Ranch would be a great place for that.
posted by judith at 1:07 PM on February 12

Might the Mayo Clinic be the kind of place that would be helpful?
posted by jasper411 at 1:10 PM on February 12

if your docs are correct that acid reflux is provoking your other complaints, ask them if altering your sleep position may help. Some acid reflux sufferers sleep "propped up" in a quasi-sitting position, which prevents acid from easing its way back up the esophagus during the night.

Also, consider consulting with an internist and rheumatologist if you've not already done so. Both specialties (particularly rheumatology) frequently address cases whose diagnoses and solutions have eluded other docs.

Best wishes to you.
posted by terranova at 1:21 PM on February 12

I have also heard good things about the Mayo Clinic's program. I searched their site for chronic bronchitis and found myself redirected to the chronic obstructive pulmonary disease page. There it describes a six to ten week treatment program which can "can improve exercise capacity, reduce the hospitalization rate and improve overall quality of life for patients." I don't know if that is the kind of thing you are looking for or not or whether it applies to your health troubles, but it looks like the kind of place that would be able to accurately diagnose and treat you for however long it takes. Best of luck - I hope you find a way to feel better.
posted by bristolcat at 1:24 PM on February 12

I have acid reflux and it gave me chronic bronchitis for about six months last year. Third most common cause of an ongoing cough is reflux, after smoking and asthma (I see you have the second as well). And yes, exercise can make the reflux worse which can then trigger a new infection. So what your doctor is telling you makes total sense from a biological point of view (I've read quite a bit of scientific literature about this too, my background is digestive physiology).

Gastroesophageal reflux disease (GERD) doesn't just lead to chronic bronchitis btw, the changes in your oesophagus caused by the acid burn can lead to oesophageal cancer.

So you need to address the reflux. Losing weight may or may not help. I'm not overweight at all, makes no difference. Clean air may or may not help. My reflux and bronchitis was just the same when I was living in the dirty city or a (clean air) smaller town (although this may help your asthma I guess?). My reflux is triggered by stress and diet, although sometimes it's just there anyway, and your triggers may vary of course.

I find it odd that no medication has helped you with this, there are several very good options available to you. You're not trying to stop refluxing, just trying to stop it being acidic and therefore damaging. First line of defence is proton pump inhibitors, e.g. omeprazole (Losec) (there are others). They can have side effects in a small number of people (me, unfortunately) although these are generally mild and may be worth while for you to kick your infections. PPIs cut acid production 100% and give excellent relief from reflux.

Second line of defence if those aren't tolerated is H2 receptor antagonists, e.g. famitodine (Pepcid) (again, there are others). These don't have side effects and are widely tolerated. They don't cut acid production 100% but it's possible to take a high dose often if necessary (40 mg 2x/day is the highest 'standard' dose). There are case studies where very high doses (like 10x as high) have been given for long periods without problem. There are several versions of both PPIs and H2ras that you can try if side effects cause problems and the literature at least suggests that most people should get relief.

Dietary intervention can also help. Keep a food diary and see what your triggers are (mine are overly acid foods such as citrus and tomato plus saturated fat, but spicy food or caffeine are also common). I'm not talking about buying stuff like cider vinegar treatments, just things you may be able cut out of your diet that are triggering the reflux. There's a lot of pseudoscience around GERD that should be ignored.

Once I started taking medication the reflux stopping being acidic and my bronchial symptoms have gone. They took about three months to heal and fully disappear. I also find that low impact exercise such as walking does not trigger my reflux, while it is triggered by anything bouncy (running) or anything that causes me to lie or bend down (e.g. swimming, yoga), so there may still be options there for gentle exercise to help you lose weight.

So the acid is what you need to chase up, not staying in a fancy spa or sanatorium or whatever. I assume your asthma is as well controlled as it can be but that's worth keeping on top of too as it's likely contributing. Remove the cause of the bronchitis and give your tissues time to heal.
posted by shelleycat at 1:45 PM on February 12 [3 favorites]

I also think you need to investigate mold and other allergy problems. What you describe is classic.

Have you tried sleeping upright in a recliner? Recline slightly and elevate your feet. This can help with reflux.

You do not need to exercise to lose weight. Just consume less calories. By use of the word "just" I am in no way implying that reducing caloric intake is at all easy. Considering your health issues though you might be more motivated than the average person.
posted by caddis at 2:08 PM on February 12

Nthing "exercise doesn't make you lose weight; eating less does." Exercise makes you look and feel better (when it's not giving you bronchitis), but is totally nonessential for weight loss.
posted by HotToddy at 2:13 PM on February 12 [1 favorite]

A friend of mine who had sleeping problems due to acid reflux found that sleeping in a half-sitting up position helped. This might also help prevent you aspirating the reflux.
posted by 5_13_23_42_69_666 at 2:19 PM on February 12

Listen to shellycat, get the acid sorted (an ENT is not the best person for this!) if only to avoid more long-term problems. It should help with the excercise part too.
get investigated for a hiatus hernia also.
in an extreme case, if nothing else works, consider gastric banding.
posted by Wilder at 3:42 PM on February 12

I second a test for sleep apnea. It's particularly prevalent if you're overweight. I use a CPAP, and it's made all the difference in the world. There have been tremendous improvements lately, so don't believe what you may read about problems getting used to it.

Acid reflux can be silent. If your voice is scratchy voice and you get tired quickly when you sing, you may well have it.

Good luck.
posted by KRS at 3:47 PM on February 12

And by the way, air filters don't help. In particular, avoid those that add negative ions. It creates ozone, which irritates your throat.
posted by KRS at 3:50 PM on February 12

1. Do you smoke? If you do, stop. Do whatever it takes to quit.
2. Go to a pulmonologist and be evaluated for COPD. Chronic bronchitis is a component of COPD. Most people get COPD from smoking but it can happen other ways.
3. You don't need a new place to live or hang out for a while. Any good doctor will tell you that--you should be able to manage your condition regardless of where you live. That's why people with asthma are still able to live in bad air capitals like Atlanta and Bakersfield (I have lived in both places with asthma and have done very well). You need the right combination of therapies to make it comfortable for you. This may include medication for your GERD, COPD meds (if you have COPD), losing weight and other things. Not moving 40 miles west to the coast.
4. The cutting calories advice is going to help you lose weight the fastest.

Good luck.
posted by FergieBelle at 4:58 PM on February 12

You should consider getting accupuncture treatments, especially since Western medicine seems to be failing you. Emperor's College of Oriental Medicine in Santa Monica is great and you can get $20 treatments if you're willing to have your treatments conducted by a doctor with a small group of accupunture students standing around you. I have doctors I'd recommend if you're interested.
posted by HotPatatta at 6:13 PM on February 12

I'd also suggest the Mayo Clinic. And have you considered sinus surgery? A friend of mine had it and it fixed her chronic sinus infections and dramatically improved her quality of life.
posted by fshgrl at 9:53 PM on February 12

I'm so sorry. I know exactly how you feel. I went through it for about four years. The worst it got was when I was on mega doses of prednisolone for about four months straight last Winter. It was that, or go into the hospital because the bronchitis was so bad. Without a doubt, it would start around late November that I would get sick, and by Spring, I felt like I was ready to drop dead from being sick for so long.

All I wanted was for somebody to come take care of me, tell me what to do, feed me and tell me what to do (Basically have Oprah's chef and trainer, but that wasn't going to happen). I was going to an ENT, Pulmonologist and PCP weekly.

The only thing that finally changed was that I had lap band surgery last April. I lost about 35lbs on my own before the surgery and another 45 since then for a total of 80lbs. Oddest thing is, this is the FIRST winter that I haven't gotten more than a mild cold. I was honestly waiting for the other shoe to drop and develop the major asthmatic bronchitis with it. But I never needed more than a few hits of my Asmanex and I was good to go. I never needed the antibiotics (was on three rounds during one bought of bronchitis last year), never needed bronchosteroids. Oh, and I've not needed the Nexium I was taking since the day before the lap band surgery.

I know you wrote you need to drop the 30lbs, and that's awesome if that's all you need to do, but seriously consider the impact it has. I was shocked at how much of a difference it made in my pulmonologic health.

Please, please, please, please know that this isn't some obnoxious lecture about weight loss. That's the last thing I want you to think in reading this. It's just that I *know* how you're feeling right now and it just sucks so badly and I wish I could help you feel better. It's so hard to be in that situation and not know how to get better and not have the energy to even really want to start thinking about how to get out of the hole when you're feeling that shitty. Just know that it *can* get better. Memail me if you want to talk.

Feel better soon! Hugs to you.
posted by dancinglamb at 7:56 AM on February 14

I don't have any specific recommendations, but I definately have the same sort of urge to find a 'sanitarium', 'spa' or 'retreat'. You may try googling on those last two terms, specifically, to find something in line with what you're looking for.

Medical workups aside, it sounds as if you could use a few weeks dedicated to taking care of yourself. You sound exausted, worn out, and just ready to give up. If you can't find something that addresses all of the things you're looking for, it may be worth looking into taking a vacation where there are no demands on you whatsoever. Ask yourself where the most relaxing place you can think of is - cabin in the woods? High rise hotel in Manhatten? Camping in a National Park? Take two weeks. Go there. Bring a stack of books or a laptop with a newer game.

If nothing else, it may give you the rest you need to come back refreshed and ready to address the other issues.
posted by waxlight at 1:39 PM on February 14

My dad went to the Pritikin Longevity Center in Florida 9 months after his triple bypass so he could lose weight in a controlled environment. He came back to California after 3 weeks having lost over 10 lbs and looking really relaxed and rejuvenated. Looks like they have a pretty comprehensive weight loss program with doctors to evaluate your nutrition and exercise needs.

They don't list prices on their website, so I'm imagining that it's pretty spendy.
posted by Orrorin at 7:49 PM on February 14

There are easier ways to drop weight than Pritikin, but it works well, very, very well. If results matter over pain, it is the way to go for health. I am not tough enough. Probably neither are you. The clientele is for the most part folks who obtain their toughness through surviving a first heart attack. That focuses the mind. Breathing beats butter.
posted by caddis at 1:37 AM on February 15