Breathe easier

September 11, 2007 1:24 PM

Hive mind: Help me kick my asthma's ass (if that's what the problem is), get off the puffer, and regain my energy!

Cold and flu season is coming, and it's not looking good for me. I've just spent the last hour hooked to a nebulizer, because my asthma is on the rampage. Enough's enough, says I - inhalers don't cut the mustard, and steroids are not really an option.

Stuff you should know:

- I never had breathing problems until I got pneumonia 2 years ago. Since then, I wheeze, cough and have trouble breathing. However, I have excellent lung capacity and am getting enough oxygen.

- I was told I had asthma, but I was also told I had chronic fatigue syndrome. No one is quite sure what the problem is. I also gained about 45 pounds during the course of the pneumonia (over about 60 days), which no one can quite explain, and will not leave, despite a strictly monitored diet and exercise program (I do have statistics on this). I have a normal thyroid.

- I have tried dietary modifications (more organic, less dairy, more oily fish, less sugar, less wheat), which has helped some. No processed food to speak of.

- I exercise vigorously when the asthma is not flaring up.

- I have a really high 'oh my god you're going to keel over' BMI. (Of course, if I could exercise more often, my weight might be under better control - I'm working on it)

- I've got HEPA filters at home to keep out the dust, and have my house cleaned regularly.

What have you tried? Acupuncture? Weird diets? Yoga?

I'll try anything to get back to being the active, energetic person I was.

posted by beezy to health (26 comments total)

Asthma sucks. I ended up with it after a long stretch of bronchitis.

For me, allergies would stir up trouble, and allergy immunotherapy has been a big help there.

My wife has been on various inhalers her whole life, but has needed them much less since going on Singular about a decade ago.
posted by Good Brain at 1:35 PM on September 11, 2007

IANAD, but I have been dealing with my own asthma for 30+ years.

First, exercise doesn't make asthma better. It helps your cardio, but no benefit to asthma.

The are several major inducers of an asthma attack, mainly allergies, exercise, and cold. The majority of people have allergy induced asthma.

There are many great treatments that help prevent attacks. You can ask your doctor about them. Some of them work by reducing inflammation in the lungs directly and others work by preventing the allergic reaction that causes inflammation. Everyone is different on what works for them.

What is clear is that if are having chronic problems, you need to be on a preventative course of treatment. That should knock the use of a bronchodilator inhaler/nebulizer way down.

Personally, I take Allegra for anti-allergy and Accolate for anti-asthma daily and have few problems.

For me the trigger of an attack is almost always dust, grasses, and pollens. I have to wear a dust mask when working outdoors or I have problems. YMMV.

Again, you need to talk to a doctor about finding a preventative treatment that works. You mention that steroids 'are not an option'. Obviously, it's your call, but the type of inhaled steroids used to prevent asthma are not similar 'evil' steroids that athletes get caught using. Inhaled steroids are more like cortisone cream for your lungs...

Good luck.
posted by Argyle at 1:36 PM on September 11, 2007

Thanks for that - FWIW, I've tried steroidal treatment for asthma, but it just made me hyper & sleepless and didn't actually improve my breathing.
posted by beezy at 1:47 PM on September 11, 2007

First, exercise doesn't make asthma better. It helps your cardio, but no benefit to asthma.

Actually, it depends on your type of athsma. I had allergy/exercise induced athsma where I had some REALLY thick phlegm in my lungs, and the only thing that did clear it out was doing an hour of intense cardio a day for a couple of months. Haven't had a problem since.
posted by SpecialK at 1:48 PM on September 11, 2007

I feel you. I never had asthma or breathing problems until I ended up with pneumonia either, and then for a couple of years afterwards I couldn't do any exercising at all, and I was doing inhalers 2x a day and taking meds, and was still wheezing and had rattling lungs. I didn't want to be a slave to the daily meds so I tried no dairy. I stopped taking the meds and doing the inhalers after about 3 days of no dairy. I see you said less dairy, but have you tried no dairy?

After about a week after I stopped all the dairy, stuff just started pouring out of my nose. It ran all day, although I had no cold and no allergies. It was like all the gunk was draining out of my lungs and sinuses and it was actually kind of cool. Since then my breathing's been fine and I can do pretty much anything without getting winded.

If you're addicted to real cheese it might be hard to give up, but as far as milk and ice cream and yougurt go, there are soy subs that are just as good if not better than the real thing, if you'd like to give it a shot.
posted by iconomy at 1:48 PM on September 11, 2007 [1 favorite]

Have you had an actual allergy test? You haven't really said what you're allergic to - dust, pollen, dander, certain types of food - it'll help you devise a better plan of attack if you know.

I've had amazing results treating my allergies with Quercetin. I buy mine from the Pro Health Store.

Best of luck. I hope you're feeling better soon.
posted by LuckySeven~ at 1:52 PM on September 11, 2007

Both Accolate & Singulair are non-steroidal drugs designed to combat asthma. Years ago I used Cromolyn Sodium, also non-steroidal, and it worked OK.

Hopefully you have some new options to try.
posted by Argyle at 1:52 PM on September 11, 2007

this is in left field but... make sure it's not the byproduct of burning gas that is bothering you. some people can't be around gas cooking stoves or gas heaters. in your home, but don't forget restaurants, etc.

avoiding gas appliances worked for my son.
posted by cda at 1:56 PM on September 11, 2007

Seconding allergy immunotherapy. I don't know your particulars, but once my allergies were correctly identified (through a blood test) and treated, my asthma hasn't bothered me much at all. Now, I do use a preventative inhaler (Advair) every day because my allergies are so severe and the asthma is triggered by the allergens but I haven't had to use my rescue inhaler or a nebulizer in over three years.

Have you seen an allergist or a pulmonologist? Go see them if you haven't already. My GP is fantastic, but he would never treat these specific conditions because they're not his specialty.

Good luck.
posted by cooker girl at 2:02 PM on September 11, 2007

If you're in DC, Dr. Daniel Ein at GW is the guy you want to see:

http://gwumc.photobooks.com/Profile.asp?numrecs=10&last=ein&specialty=&gender=&keywords=&pict_id=9353312

http://www.yelp.com/biz/Y1-p9zvbPl0SbC7VtY9DBA

As the Yelp review (which i didn't write) says, he actually talks to you, which is remarkable in a doctor.
posted by RandlePatrickMcMurphy at 2:24 PM on September 11, 2007 [1 favorite]

If you want to try something completely "outside the box" and "out of left field," I'm going to go ahead and point out marijuana. This is not medical advice and I'm not a doctor... although I do know a few doctors that smoke weed (not that that's an endorsement either).

I've had asthma since I was young. It was pretty bad. For around 8 years, I would find myself hospitalized at least twice a year due to attacks, sometimes for several days. It's mostly gone now, but I still have bouts with it before, during, and after sickness, whenever my allergies are acting up, when there's a lot of vog (volcanic fog) in the air, etc. No more hospital stays, but I don't think I've ever cut the cord on my Albuterol inhaler.

Back to the marijuana: I jog frequently. Some time ago, I noticed that on the days after I smoked, I could jog much further and sustain my pace for longer periods of time. It was a large enough energy increase to warrant attention. Ditto for gym sessions - I could detect a major difference in performance on days after I smoked the night before vs. the days after I hadn't for a while. It defied logic. So I looked around, and found other anecdotes, as well as the study I linked to above. Again, I'm not endorsing this as it is, well, illegal (for now). And largely untested. But it is another idea, and if you aren't a stranger to MJ, this may not be a big deal for you to try.
posted by krippledkonscious at 3:15 PM on September 11, 2007

infect yourself with hookworm? (warning: a very nasty story)
posted by Mach5 at 3:28 PM on September 11, 2007

I second iconomy's suggestion. In order to give the dietary modifications a fair shot, you need to cut out all dairy. None, zip, zilch. And you should really try it for at least 2-3 weeks. Then, if that doesn't help, cut out all wheat/grains. Yes, this significantly affects most people's diet. If you find that these changes don't do anything or it's not worth it, you can return to your normal diet, no harm done.
posted by Durin's Bane at 3:29 PM on September 11, 2007

Gawd, I hate to plug the pharmaceutical industry, but Advair changed my life. Way, way for the better.

I've had asthma all my life (no attacks after about 8 years old, but wheezing aplenty, and without regular inhaler use my lung capacity was down to 50%!) Symptoms compounded by allergies, humidity, temperature, having a cold, etc. I tried Advair on the advice of the doctor in a research study I participated in, and it's been great.

I take a dose twice a day. IANAD, but from what I remember being told, Advair contains two drugs: a little bit of the same stuff that's in a regular asthma inhaler, but mostly this other stuff that is not a "reliever" like an inhaler but more of a "maintainer" that keeps your lungs, um... not wheezy. Within a week I could breathe nice and deeply, I've gotten more active with more energy and less shortness of breath, and I haven't looked back.

So depending on what kind of asthma you have, you might want to ask about Advair.
posted by Rykey at 3:38 PM on September 11, 2007

Seconding Advair. Truly a life-changing drug. This is coming from someone who has gone to the ER and almost died from attacks at least 30 times in my life (since childhood), a few times literally to the point of having to be jump started with the defrib paddles.

I am distrustful of so-called "wonder drugs" and often wonder whether I will get some crazy cancer from this one someday, but after being on at the least 20 different asthma drugs and combos, plus allergy meds, I think the worst's been done.

Here's what's worked for me. 1) get those allergies under control. See a reputable allergist and for the love of god don't waste your money on homeopathic treatments BEFORE going the traditional route. Get tested before you quit any foods, they can blood test for food allergies and tell you right away the results. Cutting back on the dairy does help but I think cutting it out altogether for anything less than a lifestyle change (ie veganism) is not the way to go. Make changes where acceptable.
2) See a pulmonary specialist who can help you work out your triggers and give you the best drug combo for your asthma.
3) Exercise for sure but be careful about your level of exertion until your asthma is fully in control. So, if you can walk comfortably, do that and don't take up jogging just yet. I have allergy and exercise induced asthma but find that if the ol' lungs and allergies are under control through meds that the exercise is fine and quite beneficial.
4) Avoid your triggers like your life depends on it (it may). Get a HEPA filter for the house and a de/humidifier depending on your climate and triggers.
5) If you have traveled and noticed your allergies have improved, consider moving (seriously!). I have discovered I *only* have seasonal allergies in certain parts of the world and when I do they are debilitating.

As for the weight gain, when you had pneumonia, did they put you on serious steroids like prednisone? Those things will make you experience water- and permanent weight gain, on top of tons of other fun side effects. My specialist told me that they don't often tell people this for fear that the patients vanity will take precedence over living (they prescribe them to heart patients as well). Your face gets a very recognizable round "moon" shape. My already round face + prednisone made my head look like a beach ball for a while.

Hope my long response is helpful, this has obviously been a big part of my life for some time. Just remember that even the most crazy terrible chronic asthma can be managed eventually. Email's in the profile if you (or anyone else for that matter) want to ask anything else. :)
posted by SassHat at 4:11 PM on September 11, 2007

Please, please, please, ask your doctor for a BNP test. (B-type natriuretic peptide). BNP rises when the heart is overloaded and is going into heart failure. Your symptoms sound very similar to mine (sudden unexplained weight gain, "asthma" that doesn't respond, fatigue) and heart failure can be caused (as mine was) by a virus that then infects the heart.
I hope to God that it's just asthma, but the test is a simple blood test and only costs about $15. I spent 6 months being incorrectly diagnosed and it wasn't until I was near death that anyone bothered to get that test and determine what the real problem was.
Other diagnostic tests include echocardiogram, which is expensive and involved, but will be necessary if your BNP is elevated, and a chest x-ray, which shows cardiomegaly. Unfortunately, enlarged heart is sometimes missed on review of the x ray. BNP is the gold standard.
posted by katemonster at 5:23 PM on September 11, 2007 [1 favorite]

Oh, is your cough a dry cough? Is it worse when you lay down? If so, don't bother with the BNP -- go to a cardiologist or an ER right away. At an ER, they won't take you seriously about heart failure if you're young (under 50), but refuse all efforts to give you IV fluids. That's if and only if you're having orthopnea -- more fluid = more pressure on lungs = greater feeling of drowning/being unable to breathe.
I don't want to be all panicky, but this hits very close to home. As I said, it may not be anything remotely cardiac related -- but if it is, it's very easy to go un- or mis-diagnosed, especially in a young person.
posted by katemonster at 5:30 PM on September 11, 2007

I was diagnosed with asthma when I was 24, living in an old house with a dog (allergic to dogs no less).

Pulled out all the carpets, went with wooden floors, asthma gone. Not used an inhaler, or any other asthma related things in 10 years.

YMMV.
posted by lundman at 8:41 PM on September 11, 2007

I had asthma since childhood. When you normally row out of it, it improved, but never went away. Mid-twenties, I moved to the other side of the world and BAM, asthma completely gone. WTF?


I then heard that
1. That this is not uncommon - the asthma is related to an ongoing immune response that was triggered by something in the environment.
2. Apparently, if you stay in that different environment for 5-6 years, your body loses all the antibodies (the same reason you need vaccine booster shots), and then the asthma can be gone for good - even if you return to the triggering environment.

This seems consistent with my own experience that when I move back to the triggering side of the world after a year or two away, I remain asthma-free for 3-6 weeks, then return to normal. 4-6 weeks is about how long you'd expect your body to take to rebuild its "immunity".

So take a vacation to a far hemisphere, and see if it helps. If it does, that gives you some options, and some food for thought.


Another promising area scientists are looking into is hookworms, again for their influence on the immune system. At least one guy online was desperate enough to self-medicated this way and reported incredible night&day difference, but asthma is so different person to person that anecdotes, even if true, are of limited meaningfulness.
posted by -harlequin- at 9:42 PM on September 11, 2007

I had pretty severe asthma until I turned 16 when my godmother suggested no dairy at all. My asthma REALLY improved after that. I still get it occasionally, but not anything like when I was younger. Also, keeping pet dander to a minimum (vacuuming rugs everyday etc) really works for me.
posted by gt2 at 9:42 PM on September 11, 2007

Ipratropium bromide (Atrovent in the UK) is a non-steroid preventative inhaler you can ask your doctor about.

I'd also advise you to get a peak flow meter and actually track your lung capacity, morning and night. I use a freeware program called Asthma Assistant, and the best thing about it is that I can see a downturn in the numbers before I can feel it.
posted by happyturtle at 10:48 PM on September 11, 2007

Get a Chihuahua.
posted by edmz at 10:50 PM on September 11, 2007

I have to third the Advair. My life is not recognizable to the way I lived it before (sucking on ventolin, trips to the ER, sucking on the nebulizer). I feel great, I run now, I can even run outside.
My allergies also improved when I moved to DC from Massachusetts - something about the climate here, or maybe different pollens in the air. Anyway where do you live? might be worth considering a move.
posted by chickaboo at 12:42 PM on September 12, 2007

My husband had a pretty bad six months with the on-set of asthma out of the blue. Asthma medications did not help, and the asthma was not cleared up until the root cause was diagnosed as a hiatal hernia.
posted by Squeak Attack at 12:56 PM on September 12, 2007

Do the following:

1. Go to doctor and make them test for ALL allergies. Most allergy tests are confined to the usual things people in cities come in contact with. Also make them test for horses and so on.

2. Make sure you take worm medicine. There is a link between asthma and worms, so though hookworm will cure asthma according to some people, as the larvae pass through your lungs, they do a lot of damage that leads to asthma. And worms live in you for years (which would also explain your secondary symptoms)

3. Use the daily lung local asthma spray. They work preventive

4. As a last resort, switch your climate for a few weeks. If you live in wooded damp areas, go live in a dry desert for a while. It helps.

Asthma and fatigue are caused by something that your body is constantly fighting. You have to discover what it is and remove it from your life.
posted by markovich at 7:47 PM on September 12, 2007 [1 favorite]

Do you have any medicine for the asthma besides the emergency "puffer" (albuterol, xopenex and the like)? If you really have asthma, you should be on a maintenance/preventative medicine like Advair. You really should. Advair (before that I had two inhalers plus my rescue, but the Advair combines the two meds that were on the two inhalers) seemed like a miracle drug to me. After just a couple weeks of taking it I noticed some improvement, and after a while it was like I didn't have asthma at all.

Now, I only take Advair 3 times a week, more when my allergies are really bad (this is at a doctor's advice, btw). I also still have my rescue inhaler, but that's "just in case". I haven't used it in a really long time.

Now, you might not even have asthma. It could be really bad allergies. Have you been tested for allergies? Are you on allergy meds? This is something you should definitely look into. If there is something in your environment that is constantly irritating your lungs you need to know about it so you can take care of it, and thus take care of the "asthma".

You say that you're overweight, and obesity is often a cause of asthma. But skinny people have asthma too, and there are lots of fat people who don't. If you have a doctor who's telling you fat=asthma and who isn't delving any deeper into the problem, you need to find a new doctor. Yes, your obesity may be contributing to the asthma, but it is (almost certainly) not the only reason for it.

People up thread also have lots of great advice.

Asthma sucks. I am terrified of getting it again as badly as I had it for about a year (triggered by the horribly moldy conditions I was living at at the time in Ireland). I couldn't get enough air to even walk up a flight of stairs without stopping a few times. I thought I was dying. I really hope you can get the help you need.
posted by misanthropicsarah at 8:49 AM on September 13, 2007 [1 favorite]