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   silent asthma frustrations (Asthma board)

27th January 2008
I am 23 years old...

I have had asthma since I was a kid. I had a few older teen years when it seemed to 'go away...' but in the last two years it has reared it's ugly head once more.

I also (had?) severe GERD due to some premature birth defects...I've had 2 corrective surgeries and have been symptom-free since.

I've been on advair for awhile, with the usual albuterol rescue inhaler.

I caught the seasonal 'junk' just before thanksgiving...as is my wont, it settled into my chest and turned into bronchitis. I was on biaxin & prednisone for a couple of weeks..with no change. We tried dioxycycline and more prednisone, as well as increasing the advair dose. Again, no change. My doc decided the bronchitis had moved on, but that my lungs/passages were inflamed from a combo of the cold weather, bronchitis and coughing in general. He upped the advair again to the 50/500, started a 3rd prednisone taper (this one a 5-week deal), added singulair and zantac just for kicks. they also ran some labs to see if they could find an allergy...with no luck. Apparently I tolerate everything...but of course, I'd been on prednisone for over a month at this point, so who knows? Anyway, a few days later I ended up in the ER for one of those uncontrollable coughing spells...they gave me two albuterol treatments neb which did nothing, some lidocaine in the neb (which is wonderful, fyi), and finally an epi neb treatment. This did relieve most of the coughing...for the evening. They also gave me IV solumedrol. The day after I went back to the doc, who gave me more solumedrol and changed my alubterol inhaler to neb xopenenx. The xopenex gives me more relief than the albuterol (which was seemingly ineffective.)

Currently, I'm using the xopenex neb every four hours. I'm like clockwork...I start coughing more about 3.5 hours in. I get worse at night, and have trouble sleeping...I almost always wake up 2 and 5 hours after going to bed....typically, midnight and 3am. I finally sleep from 3 or 4 until I wake up at 6/7 for classes and work.

My chest is ALWAYS tight. The xopenex relives this somewhat..but only for an hour or maybe two. I never wheeze, frustrating the ER docs and RT's ... who all swear that asthma requires wheezing. My primary rolls his eyes and tells me they're wrong...but this does NOT help me during those ER visits! I actually had an RT last night tell me that, if I was going to cough I should cough like I mean it...that my short, very barky (deep) cough wasnt doing me any good and I needed to cough longer and harder. This was after a severe attack...I'd been coughing non-stop for over an hour, my pulse was in the 200's, my heart beat was tachy and my fingers/face were tingling from hyperventilation. Of course...my O2 sats are always 99/100...further stumping the practicers of medicine we call doctors...

I've been referred to an allergy/asthma specialist...who is apparently supposed to call me for an appointment. To say the least, I am exhausted. I have been coughing for over two months, with frequent paroxysms and attacks that leave me coughing and gagging. I am sore and bruised...on my last visit my primary said even my throat was bruised from coughing! I can't lay flat...my bed is a pile of pillows... and going outside, laughing or crying makes it worse. I get lots worse at night...

Anyone have any tips? I'm thinking of asking to try something other than the xopenex...while it is more effective than the albuterol, it's not totally effective. I'm exhaused and bruised...and I don't feel like the docs are listening anymore. Except to tell me that my O2 sats are fine and they dont hear any wheezing...and to cough like I mean it. Ugh.
29th January 2008
to gcsmithjr... (and others)

I received a call from the specialist office today...my appointment is May 14th! I want to call someone else in the area...who do you reccomend? I cannot wait anymore!

I started to panic after that phone call...I have been coughing since thanksgiving, and I am very discouraged. A couple of doctor appointments ago, my primary was saying things like "this is the last thing we can do with you as an outpatient, and you know what that means." Well, here I am two ER visits, two boxes of xopenex and innumerable phone calls to doctors later...still coughing. I feel like they're doing nothing. They're not ruling other things out, or testing lung function...the ER tells me my O2 sats are fine and there is no wheezing, so go see the specialist...who cant see me for three months. My chest hurts every second, my BACK hurts from coughing...sleeping flat is something I dream about if I sleep at all...I'm up two or three times a night. the xopenex neb is only bringing temporary relief...may two hours before I start watching the clock for the that four hour mark! I'm anxious and jittery all the time from the meds (started my 4th prednisone "taper" this week). I guess I'm just venting here...but what do I do? I got an email from the head of my department (I'm in grad school) suggesting I take a break to get well, or try to work out a way to keep up while resting! My gosh! The messages are so conflicting...help!
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