Getting rid of asthma/chest congestion
June 2, 2010 10:49 PM Subscribe
Why has my asthma returned and how can I get rid of it again?
I'm from a part of Australia with semi-humid summers and dry winters and had suffered mild asthma since a young age - mostly brought on by dust, cat hair, or exercise especially in cold dry weather. About six years ago I moved to Japan and lived in some of the big polluted cities over there. However, during my time there my asthma virtually disappeared - I don't even remember it being a problem during the dry Japanese winters. The same story when I moved to dirty London for two years after Japan - no real asthma dramas, it was as if this pesky ailment had disappeared for good. I moved back to Australia in the middle of summer this year (January), and was not bothered by asthma at all to begin with. However, come April this year when the air becomes a lot drier and cooler I suddenly began suffering from chest congestion. Coincidentially or not, I also moved from an inner city apartment to a near new apartment complex in a leafy area in the burbs just before this time (late March).
When I first noticed it, it sounded really bad, a really loud crackling rattle when breathing out especially, but the strange thing was it was not hindering my ability to breathe. Yes, despite breathing that sounded like one of those Orcs from Lord of the Rings I felt no restriction at all and no need to take my reliever puffer (and even when I did it did not do anything). Also, the crackling was not so bad when sleeping or when waking up in the morning, but by 11am it became shockingly loud.
I went to the doctor about a month ago and was prescribed a preventer (budesonide). Within days of taking it the crackling diminished by about 60%, but that pesky 40% remains to this day. It is still the same situation in that the crackling is near to non-existent in the morning when I wake up and I have no troubles during the night, but by mid-morning it starts up again and lasts until I go to sleep at night. Also, often shallow breathing produces limited or no popping sounds, but when I exert fully and forcefully those final pockets of air deep at the bottom of my lungs make the loudest and thickest sounds of all. Another strange thing is that whenever I go jogging outside (in the cool dry air) or do any sort of physical exertion the crackling disappears and my breathing becomes perfectly clear temporarily! There's no sign of infection - the colour of the mucus when I manage to cough it up is a normal clear/very light yellow colour - that said, it is very difficult to cough up most of the time as the mucus seems very deep down. I also took a spirometry the other day at the docs, at mid-morning when my Orc-like breathing had started up again, but the results were *better* than average for my age/height/weight range in most areas - lung capacity of 117% predicted, FEV1 (the volume of air I can breathe out in the first second) of 108%, and a peak expiratory flow of 121%! The only thing that was down on normal was FEV1/FVC (amount exerted in first second vs total lung capacity) at 77.3% whereas it should be 82% (although looking at the graph I think this was caused by a last second final exertion at the end of the test).
So basically, I have this respiratory problem that is not necessarily hampering my ability to breath, but just sounds awful and occasionally causes me to cough or want to clear my throat. I'm also worried that the amount of mucus in there is creating a system that is ripe for infection come flu season. Expectorants don't seem to do much either. Doubling the dose of budesonide did nothing. As a last resort today I purchased a humidifier to see if recreating a humid Japan/England/Australian summer-like atmosphere while sleeping does anything. Other than that I'm completely perplexed. The doctor just says it's a "symptom of asthma" and to keep taking the same medication. I'd appreciate any ideas, or suggested questions I should ask my doc on next visit.
I'm from a part of Australia with semi-humid summers and dry winters and had suffered mild asthma since a young age - mostly brought on by dust, cat hair, or exercise especially in cold dry weather. About six years ago I moved to Japan and lived in some of the big polluted cities over there. However, during my time there my asthma virtually disappeared - I don't even remember it being a problem during the dry Japanese winters. The same story when I moved to dirty London for two years after Japan - no real asthma dramas, it was as if this pesky ailment had disappeared for good. I moved back to Australia in the middle of summer this year (January), and was not bothered by asthma at all to begin with. However, come April this year when the air becomes a lot drier and cooler I suddenly began suffering from chest congestion. Coincidentially or not, I also moved from an inner city apartment to a near new apartment complex in a leafy area in the burbs just before this time (late March).
When I first noticed it, it sounded really bad, a really loud crackling rattle when breathing out especially, but the strange thing was it was not hindering my ability to breathe. Yes, despite breathing that sounded like one of those Orcs from Lord of the Rings I felt no restriction at all and no need to take my reliever puffer (and even when I did it did not do anything). Also, the crackling was not so bad when sleeping or when waking up in the morning, but by 11am it became shockingly loud.
I went to the doctor about a month ago and was prescribed a preventer (budesonide). Within days of taking it the crackling diminished by about 60%, but that pesky 40% remains to this day. It is still the same situation in that the crackling is near to non-existent in the morning when I wake up and I have no troubles during the night, but by mid-morning it starts up again and lasts until I go to sleep at night. Also, often shallow breathing produces limited or no popping sounds, but when I exert fully and forcefully those final pockets of air deep at the bottom of my lungs make the loudest and thickest sounds of all. Another strange thing is that whenever I go jogging outside (in the cool dry air) or do any sort of physical exertion the crackling disappears and my breathing becomes perfectly clear temporarily! There's no sign of infection - the colour of the mucus when I manage to cough it up is a normal clear/very light yellow colour - that said, it is very difficult to cough up most of the time as the mucus seems very deep down. I also took a spirometry the other day at the docs, at mid-morning when my Orc-like breathing had started up again, but the results were *better* than average for my age/height/weight range in most areas - lung capacity of 117% predicted, FEV1 (the volume of air I can breathe out in the first second) of 108%, and a peak expiratory flow of 121%! The only thing that was down on normal was FEV1/FVC (amount exerted in first second vs total lung capacity) at 77.3% whereas it should be 82% (although looking at the graph I think this was caused by a last second final exertion at the end of the test).
So basically, I have this respiratory problem that is not necessarily hampering my ability to breath, but just sounds awful and occasionally causes me to cough or want to clear my throat. I'm also worried that the amount of mucus in there is creating a system that is ripe for infection come flu season. Expectorants don't seem to do much either. Doubling the dose of budesonide did nothing. As a last resort today I purchased a humidifier to see if recreating a humid Japan/England/Australian summer-like atmosphere while sleeping does anything. Other than that I'm completely perplexed. The doctor just says it's a "symptom of asthma" and to keep taking the same medication. I'd appreciate any ideas, or suggested questions I should ask my doc on next visit.
Do you take allergy medication? How does that affect your asthma management?
I am allergic to virtually everything botanical here (I'm in Georgia, USA). I also have asthma. My asthma was brought on by allergies. Once my doctors and I made that connection and got my allergies under control with first medication (I used Singulair) and later allergy shots (immunotherapy is a 100+ year proven way to treat allergies for anything airborne) I have now gone off my allergy and asthma medication.
posted by FergieBelle at 6:56 AM on June 3, 2010
I am allergic to virtually everything botanical here (I'm in Georgia, USA). I also have asthma. My asthma was brought on by allergies. Once my doctors and I made that connection and got my allergies under control with first medication (I used Singulair) and later allergy shots (immunotherapy is a 100+ year proven way to treat allergies for anything airborne) I have now gone off my allergy and asthma medication.
posted by FergieBelle at 6:56 AM on June 3, 2010
I have the same issue- allergy triggered asthma every spring that takes a long time to go away, even when taking symbacort + albuterol. If my cough gets too bad I have to go on a short course of oral steroids. Is your doctor a specialist? If not, you might want to go to a pulmanologist for a second opinion and possibly more aggressive treatment.
posted by dudeman at 7:16 AM on June 3, 2010
posted by dudeman at 7:16 AM on June 3, 2010
I had asthma till I was about 13. It vanished. It came back again about seven years ago when I moved from a place I'd lived all my life to another place with an unfamiliar climate and a whole new set of pollens. There's not really any satisfactory explanation that I've heard or found why the asthma returned, but it came back much stronger and has not gone away since.
There are theories aplenty, including one that ascribes a general increase in asthma to decreased necessary exposure to allergens because of an increased social obsession with sanitation and hygiene, but that's only one hypothesis.
posted by blucevalo at 9:50 AM on June 3, 2010
There are theories aplenty, including one that ascribes a general increase in asthma to decreased necessary exposure to allergens because of an increased social obsession with sanitation and hygiene, but that's only one hypothesis.
posted by blucevalo at 9:50 AM on June 3, 2010
I wish I had some actual advice, but as a data point, a good friend of mine from Perth found that her asthma all but disappeared when she moved to London—and then reappeared when she went back to Perth for a holiday. She is similarly flummoxed, and her doctors haven't been able to offer any explanation.
posted by hot soup girl at 3:53 PM on June 3, 2010
posted by hot soup girl at 3:53 PM on June 3, 2010
So basically, I have this respiratory problem that is not necessarily hampering my ability to breath, but just sounds awful and occasionally causes me to cough or want to clear my throat. I'm also worried that the amount of mucus in there is creating a system that is ripe for infection come flu season.
Welcome to having Asthma. Doctors don't really know a whole lot about it or what causes it. They do know how to treat it. Most of the time you will be fine. You will get sick more often, and you will sound like a bowl of rice-krispy-lungs occasionally.
Chances are your asthma never really was gone. Asthma (and it's cousins, eczema and allergies) are all related to immune system going-ons. It's possible you were less exposed to some irritant or trigger while you moved around. It's also possible that you didn't have a chance to become allergic to new irritants in your new environment.
Allergies and asthma don't exactly follow logical rules of behavior. They're much more like "whack-a-mole" than a formula. If you remove one irritant, you will probably become allergic to something else, even something you were not previously allergic to. If you are not exposed to something that used to make you allergic, you may loose your allergy to it for a time, as exposure creates immune responses which equals allergy.
If you were looking for a cure to Asthma, sorry, there isn't one. If you're looking for maintenance, sounds like your Dr. has given you sound advice.
posted by fontophilic at 2:53 PM on June 4, 2010
Welcome to having Asthma. Doctors don't really know a whole lot about it or what causes it. They do know how to treat it. Most of the time you will be fine. You will get sick more often, and you will sound like a bowl of rice-krispy-lungs occasionally.
Chances are your asthma never really was gone. Asthma (and it's cousins, eczema and allergies) are all related to immune system going-ons. It's possible you were less exposed to some irritant or trigger while you moved around. It's also possible that you didn't have a chance to become allergic to new irritants in your new environment.
Allergies and asthma don't exactly follow logical rules of behavior. They're much more like "whack-a-mole" than a formula. If you remove one irritant, you will probably become allergic to something else, even something you were not previously allergic to. If you are not exposed to something that used to make you allergic, you may loose your allergy to it for a time, as exposure creates immune responses which equals allergy.
If you were looking for a cure to Asthma, sorry, there isn't one. If you're looking for maintenance, sounds like your Dr. has given you sound advice.
posted by fontophilic at 2:53 PM on June 4, 2010
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posted by Rube R. Nekker at 11:13 PM on June 2, 2010