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Newly inducted into the Asthmatics Club
January 25, 2012 2:17 PM   Subscribe

I was just diagnosed with asthma. Doctor developed a treatment plan (to start off, prednisone, Qvar and Atrovent inhalers, and narcotic cough syrup so that I can start sleeping again), so I hope that the symptoms -- the violent, persistent cough, mainly -- will soon abate. But, going forward, what do I need to know about having and living with asthma?

Any lifestyle or diet tips? Things I should know or avoid? I've also recently joined a gym, though I haven't been able to go much because I caught the cold that triggered the asthma shortly after signing up. So, any tips on exercising with asthma?

It seems to be activated most by colds/viruses (I personally think it was actually caused by a bad cold I had this time last year), but I also have seasonal allergies that should come along again in the springtime.

All tips and experiences appreciated. Oh, and I'm not a smoker, so that's not an issue.

Bonus question: I was also supposed to ask the doctor (i.e., was threatened by my partner if I didn't) about the possibility of doing a sleep study since my snoring has gotten so bad over the past few months. She seems to think that it's asthma-induced as well. Has anyone had the experience of their snoring improving after beginning asthma treatment?
posted by mudpuppie to Health & Fitness (24 answers total) 7 users marked this as a favorite
 
My own asthma is pretty mild -- I have an inhaler that I use as needed -- but it's definitely exacerbated by seasonal allergies and exercise. Obviously, this is something to talk to your doctor about, in terms of how this would fit into your own treatment, but I find that I can avoid having it flare up during/after exercise if I take a preventative swig from my inhaler BEFORE I start working out, even if I feel fine. (This is all on the thumbs up from my own doc.) This has been REALLY successful for me. It has really, really improved my quality of life.
posted by Countess Sandwich at 2:35 PM on January 25, 2012 [1 favorite]


There are so many different possible triggers for asthma, and everyone's are different. My own is triggered primarily from perfumes/scents, or from cold weather. But randomly I'll have attacks/tightness/coughing for no damned good reason other than my body hates me as far as I can tell.

The real key is discovering what triggers your asthma, and avoiding those things as best you can.
posted by strixus at 2:43 PM on January 25, 2012


I thought snoring was a sinus and throat thing where asthma is a lung thing, but maybe I'm wrong. It wouldn't be a bad idea to get a second opinion. I was treated for asthma until it almost killed me. And by that I mean it wasn't asthma, it was an embolism. I wasn't a typical embolism candidate, so everyone was convinced it was asthma. I know that's just one person's anecdote, not data, but it wouldn't be a bad idea to also see a pulminologist for another opinion, if you can swing it. By the way, if the doctor hasn't already told you, the Prednisone may make you a little bit crazy. Make sure your partner knows that. Good luck.
posted by 0BloodyHell at 2:45 PM on January 25, 2012


I actually have recent experience with prednisone due to a nasty case of poison oak, so I know its effects well. (It actually makes me really dopey and mellow. Go figure.)
posted by mudpuppie at 3:18 PM on January 25, 2012


it's easier to manage the triggers than the asthma - by which i mean, if i keep my allergies in check, have a scarf over my face in cold weather, wash my hands if i've touched anything dusty, and stay on my allergy medicines, my asthma is mostly invisible. figure out your triggers and how to best manage them. weird things can be triggers, like red wine, so don't rule anything out.

i also take a hit of my inhaler before exercise and i try to concentrate on my breathing. sometimes i accidentally cause my asthma attacks by not breathing properly while exercising.

after you use any of the inhalers, rinse your mouth out. also, keep your inhalers clean - pop out the canister and wash them out with hot water once a week. make sure they fully dry before you put he canister back in, because a spray of water to the back of your throat is unpleasant.

it seems counter intuitive, but if you start having an asthma attack, breath steady and shallow, don't try to take deep breaths - you make your attacks worse. sometimes i know an attack is coming on because my chin itches. learn what your early warning signs are - it's a lot easier to come down from an almost asthma attack rather than a full blown asthma attack.

get a humidifier if you don't already have one. stay hydrated.

if you're dreaming about it being hard to breathe or wheezing or anything like that, try to train yourself to wake up - you're probably having an attack.
posted by nadawi at 4:22 PM on January 25, 2012


I used to have very serious asthma caused by allergies, but as I've gotten older it only comes on with certain triggers, and is managed by occasional use of a rescue inhaler.

Winter will suck. If you live somewhere that gets cold, try to always wear a scarf or something to cover your nose and mouth when you go outside, just to cut down a little on that cold dry air wreaking havoc on your lungs.

Chest colds will take much longer to get over and you might want to go to the doctor and get a steroid inhaler at the onset just to save you from three weeks of barely breathing.

DON'T SMOKE. Anything. You will regret it. (I know this because about every six months I go 'hey, let's go to the hookah bar!' LATER '*wheeeze* I'm never doing that again!' Lather rinse repeat.)

Any over-the-counter inhalers are utter garbage. I think they might have even taken them off the market.
posted by whitneyarner at 4:37 PM on January 25, 2012 [2 favorites]


you can still get the OTC inhalers, but they're kept with the pseudoephedrine behind the counter. they do indeed suck, and they're far more speedy (as in the drug, not how fast they work), and they cause me to have horrible coughing fits. i don't recommend them, but if you don't have a prescription inhaler, they will work in a pinch.
posted by nadawi at 4:43 PM on January 25, 2012 [1 favorite]


I found sleeping in an air conditioned room during my allergy season makes my asthma much less likely to flare up, at least as caused by allergens. Something about filtering the air, but then, I'm mostly allergic to tree pollen and it mostly floats around at night. I get it after being sick, too, and I haven't found a way to avoid that yet but I've found if I start treating it as asthma as soon as I have the slightest hint of a cough, it will go away slightly faster. Other than that, recognizing when I'm having an episode that my inhaler and nebulizer aren't controlling and going straight to the doctor, do not pass go, to get on prednisone is pretty much all I can do.

I don't know if a nebulizer would be helpful for you or not, but it might be worth asking the doctor about - it's a machine that is more effective at delivering asthma medication to your lungs because you have 10 - 15 minutes to breath it in. It's been pretty instrumental in getting me through the day when my inhaler just doesn't seem to be doing the job.
posted by rosethorn at 4:57 PM on January 25, 2012


I was diagnosed with asthma after moving to NZ after 2 years or so. Lived with it for about 3 years, inhalers and all that. Then we pulled out all the wall-to-wall carpets and just had wooden floors. Not had asthma, or even an inhaler, for the last 15 years. (including another 3 in NZ).

But everyone is different.
posted by lundman at 5:42 PM on January 25, 2012


A lot of good info here, but......if you feel short of breath, ever, concentrate on breathing OUT. Purse your lips and gently and slowly empty your lungs. The air will come in on its own.

Get a peak flow meter
This will provide you with an objective reading on what is happening to you--sometimes you will indeed only feel short of breath, sometimes you will be in more serious trouble than you might realize. Having one has made a huge difference to me.

Also: The National Jewish Health Organization is a gold mine of solid information on asthma.
posted by uans at 5:46 PM on January 25, 2012


I have "maybe" asthma (intermittent, but long-lasting, horrific coughs for months and months that show up out of the blue and vanish just as suddenly; the doctors are undecided about the formal diagnosis but totally prescribed me albuterol, so) and I find the inhaler-before-exertion thing very effective. Waiting to actually being gasping for breath and such is not worth it for me; it always happens if I don't pre-treat, so.

Also, for me, making sure I am really well-hydrated is helpful: the wheezing and gasping combined with the dry hacking is self-reinforcing. Sadly, the serious anti-cough stuff doesn't help me at all (I have some marvelously dangerous narcotics sitting in a plastic tub, waiting for the next turn-in event, that I couldn't even tell I'd taken.) Apple juice helps, but it's not very good for you in anything like the quantities that'll make your throat feel nice (sigh.)

Focusing on being emotionally calm is also really important: I hyperventilate when I'm very anxious. The pain from coughing makes me anxious, sadly, as does the wheezing and not being able to fill my lungs. Just having the darned inhaler on my person is reassuring.
posted by SMPA at 6:23 PM on January 25, 2012


I've had asthma since I was an infant. Determine what your triggers are, whether it's cold weather, exercise-induced, dust, dust mites, animals (esp dogs and cats), pollen (esp grass, trees), all of the above. Your treatment will depend on the severity of your exposure to triggers. In San Francisco, my attacks were quite rare (fostering kittens was a horrible idea as was using a reverse leaf blower). In Houston, my asthma is off the charts but I got a dog, live in a carpeted home and it's hot and humid.

My drug of choice is Advair. I'm settling for Asmanex (no insurance), an inhaled steroid that's only barely adequate til I get insurance. If you can, keep prednisone on hand for those occasions when your rescue inhaler doesn't work after several uses. That has made a tremendous difference for me and kept me out of emergency rooms.

I can't have feather pillows and feather comforters and I try not to have wall-to-wall carpeting. My last allergy tests showed I was allergic to grass, dust mites and some tree pollens. My dog is bathed regularly and I vacuum regularly. The more I exercise, the less I tend to need my inhaler beforehand but I always have it with me. A cup of black coffee and being quiet can head off a mild attack for me. Always keeps a backup rescue inhaler on hand and if you travel, be sure one is on your person not in checked luggage. I used to always keep one in my glove box, purse and pocket.

And effective 12/31/11, OTC inhalers can no longer be sold and are no longer manufactured. There is no replacement.
posted by shoesietart at 7:54 PM on January 25, 2012


If you don't have a spacer for your inhaler, you might want to think about getting one. They are bulky, but can be very helpful in using your inhaler.

Also, make sure to have your inhaler on you when you leave the house. I've found that a good rule of thumb is if you have your keys on you, you should have your inhaler on you.
posted by wiskunde at 8:09 PM on January 25, 2012


I have severe asthma.

The best defense against it, for me, is to deal with the triggers. For me, that's pretty much everything in the world ever, but I mitigate that by keeping a very clean house, bathing the dog often, taking my allergy/asthma meds religiously, and washing my hands almost obsessively (especially during cold and flu season).

When that doesn't work and I can feel difficult breathing coming on, I start myself on nebulizer treatments (with albuterol). If I don't do this, I will end up in the hospital. I don't like being in the hospital.

I'm never, ever without my rescue inhaler. Ever.

As far as exercise goes, I can do pretty much anything, except for flat-out running. I do cardio, yoga, and brisk walking. I have done the elliptical machine and bikes but not currently, and not because of my asthma.

The best thing you can do is to make sure you know exactly what your triggers are. You say you have seasonal allergies - are you sure about that? Do you know exactly what you're allergic to? The answer to that could change your treatment course, so perhaps an allergy test is next on your list.
posted by cooker girl at 8:11 PM on January 25, 2012


oh damn. good to know about the OTC inhalers. i would have bought a couple if i had known that.
posted by nadawi at 8:11 PM on January 25, 2012


As a side note, if you have what's known as cough variant asthma (which I think might be the case, since you say here that your main complaint is a hacking cough), a peak flow meter may not be helpful for you. Often people with cough variant asthma will have normal peak flow readings even during a bad episode of asthma. This is the case for me, but YMMV, and of course peak flow readings are very helpful for those with the traditional wheezing and shortness of breath type of asthma.
posted by rosethorn at 8:24 PM on January 25, 2012


I hope you've been diagnosed correctly. Are the meds helping? If not, it could be something other than asthma. I say this because I was incorrectly told by a lung specialist that my coughing was due to asthma. It was in fact due to acid reflux. The lung specialist wanted to believe it was asthma because I had bad asthma as a child, and he kept insisting despite the fact that I said I could breathe fine and it didn't feel like asthma, and even despite the results of the breathing test post-inhaler NOT being significantly better. I also often have residual coughs after colds, which have nothing to do with asthma and which eventually get better.
posted by parrot_person at 9:24 PM on January 25, 2012 [1 favorite]


As other people have mentioned, know your triggers and avoid them. If your asthma gets bad, try to figure out why. From the ages of about 8 years old until 20 years old I used to go through one rescue inhaler/month. When I moved away from home I ended up moving away from SO many triggers, I barely use my inhaler anymore.

I also recommend allergy treatment. :-)
posted by Lt. Bunny Wigglesworth at 9:25 PM on January 25, 2012


My partner has asthma and has used Qvar to successfully control it by varying the amount used daily depending on the symptoms experienced, the time of the year (more in allergy seasons) and the use of a cheap flow meter. Keeping a record of twice daily flow meter measurements for several months when first diagnosed and treated for asthma helped establish warning levels for varying the amount of Qvar to be used. This practice enables the use of as little steroids as needed to maintain good breathing. An inexpensive spacer helps produce the best use of each dose of Qvar taken and rinsing out the mouth and brushing the teeth after each use prevents thrush infections in the mouth. My partner has had more energy since treatment started several years ago after annual months long "coughing colds" every winter for the prior decade. Always keep your rescue inhaler available with you so you can be confident that you will be safe. And as unas says above, remember to breath out steadily through pursed lips if you are in trouble. Thankfully, in this decade, most asthma sufferers can control their asthma by careful self observation of their triggers and their medication.
posted by sevenstars at 9:28 PM on January 25, 2012


Deal with the triggers (food habits, dry air, cold air, allergies, exercise). Pretreat when you can't or don't want to avoid the trigger (I do this for cats, mostly, but also exercise during heavy allergy seasons).

When you know what your triggers are, you might find some of them require more intense treatment- e.g. you might need to restart a course of steroids during tree pollen season.

I found having a peak flow meter to be really useful especially at first; I wasn't diagnosed until my early twenties so I just wasn't used to it and didn't know when I was off enough to need the inhaler (I had a tendency to wait too long and be pretty miserable as a result). Also if for some reason your healthy peak flow isn't normal for your size and age, you'll be able to warn docs about it.

Strongly consider getting a flu shot. It won't protect you completely, of course, but you're now in a higher risk group. I didn't take this seriously until I ended up with walking pneumonia last year after I had the flu. (If you do get the flu, take care of yourself, and make sure your asthma is managed until you are well over it.)

Lastly-- it is possible to have both sleep apnea and asthma! I have both (fortunately for me, mildly). They aren't necessarily related. If your sleep issues *don't* resolve in several weeks, do be aggressive about getting evaluated. It's not just for your partner; if you do have apnea, you aren't getting good sleep either.
posted by nat at 10:31 PM on January 25, 2012


I have a diagnosis severe, chronic asthma. I've had it since I was 5 and I am now 43.

When I grew to my adult size, my symptoms reduced but didn't go away.

Agreed with everyone else that the first literacy to develop is what your triggers are and then learn to manage or cope with those triggers. Know that a lot of folks with asthma also have allergies and it is not uncommon for allergic reactions to trigger asthmatic ones.

Know also that Gastric Reflux/Heartburn is strongly correlated with asthma, and both are in turn strongly correlated with stress levels.

Also spend some time developing two other vocabularies/literacies:
1) The specialized vocabulary your medical professionals use to describe asthmatic symptoms. Don't settle with just "wheezing", but talk about where the wheezing is coming from in your body. Don't just say "asthma attack", but specify what kinds of wheezing, coughing and other symptoms you suffer during your attack. Be similarly particular when talking about your triggers. There are lot of qualities and some are very important to diagnosis, medication and the like.
2) A literacy of your body and reactions to different stimuli. If you have allergic reactions that are not anaphalactic (just avoid these entirely, please), you may wish to try to plumb the depths of the allergies, especially now that you have medication to help you deal with asthmatic effects. This is also something you'll develop as you just learn to deal with your diagnosis and condition. The other way to help develop this literacy is to exercise and get an idea of your thresholds. I didn't know, for instance, that one of my triggers is a heart rate of higher than about 145 until I did regular exercise. If exercise is a trigger for you, just keep your as needed inhaler (mine's albuterol) handy. Or your doctor may tell you to use it proactively before you exercise.

A lot of folks I know have reported strong results with exploring holistic medicine (especially acupuncture) and/or Cognitive or other psychological therapies as a method to reduce overall stress in life which in turn seems to help control or even obliterate both asthma and allergic reactions (or perhaps just drastically reducing allergic or asthmatic reactions to their triggers).

I am personally exploring these connections with my own studies of Traditional Chinese Medicine (TCM) and my own experience as a patient of both western medicine and acupuncture (and related methods). The exploration is going well, but either my asthma is more severe than the folks I know have or my acupuncture/TCM hasn't gotten around to being as totally effective as some of the experiences folks I know have.

You should also know that there are two interesting emerging medical therapies in asthma and allergy treatment. I will leave it to you to decide whether you find them helpful or not, but I will give you some feedback I've gotten from my acupuncturist about one of them:
1) Hookworms. The conceit here is that a parasitic infection of hookworms (made medically safe regarding other side effects) would suppress the immune response commonly associated with asthma and allergies because that's what hookworms do to promote their own parasitic agenda. Unfortunately, it sounds like this treatment is not establishing a better than placebo effect. Also, my acupuncturist had severe reservations about utilizing a parasite to try to defray automimmune response.
2) Bitterness. In February 2010, Nature (a very well regarded scientific journal) published a paper about how there are (a) bitter taste receptors in the body's airways and (b) how they appear to be very effective in dilating the airways if exposed to bitter taste compounds. In Fall of 2010, a lot of geeky blogs and also weird medical conspiracist blogs posted about the study (to find them, Google "bitter asthma"). I haven't heard of it since, but was interested in it at the time. The study suggests (but again, getting followup work and results from it would be needed before moving forward with it) that (a) an additional reason inhaled asthma medications work is that they're bitter (b) we may not need to seek out other pharmaceutical properties if bitterness is the primary mechanism here. Again, this requires further research into the medical literature (by laypeople such as ourselves) as well as further clinical study. But it's interesting.
posted by kalessin at 7:38 AM on January 26, 2012


Thanks for all the tips, folks. Helps muchly with the info-gathering, since I'm only just learning about this.
posted by mudpuppie at 9:45 AM on January 26, 2012


In case you haven't seen it yet, Medline Plus: Asthma has a good summary of patient information available.
posted by SarahbytheSea at 7:58 PM on January 26, 2012


1) I'll be more pushy than wiskunde. Go get a spacer. It will help make the medicine from your rescue inhaler more effective.

2) Get multiple rescue inhalers, and keep them in several places (home, backpack, etc). That way you won't be without one, even if you forget.

3) Learn about your illness, and how to take care of it. Learn how it works, what it does, how it feels, and understand it. I think it's probably easier on adults, but asthma is scary shit, and the more you know the more comfortable you'll be during attacks.

4) Someone upthread said something about coffee...hot water works, too (really hot). It can help relax the muscles in/around your chest. Similarly, hot showers can help with symptoms. Not as well as an inhaler, but they can help in a pinch.

5) Find an asthma support group. If you can't find a support group, feel free to memail me, and I'll be glad to support you however I can.

6) Check out triad asthma. If you have it, you might have problems with your sinuses (snoring could be a symptom), and you might avoid aspirin.
posted by Gorgik at 8:12 PM on January 26, 2012


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