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Monday, June 29, 2009

Random asthma questions

Every day at we get lots of asthma related questions. Below are some questions I thought my readers at the RT Cave would enjoy.

(I normally try to shorten questions to make them pithy, and I made an exception for this one because it's simply a great question as worded.)

Question: I just had a question about this because I think it's odd. My asthma doctor sent me to the ER on Thursday because I called her for the second time that week. I wasn't wheezing or anything, my chest just felt really funny and was starting to hurt. I was trying to be good about calling early too, so it didn't get too bad. So she sent me to the ER.

I just find it odd that after a nebulizer treatment and 60m of prednisone, I started wheezing for the first time that day. I also find it a bit disconcerting because in some ways I didn't realize it was that bad until after I had taken the extra medications. I'm now on 50m of prednisone along with advair, alvesco, singulair, and about 4 other
allergy medications. I do feel much better today (Sat.)

The other thing is they're always asking me how low my peakflow is. It drops, but not that much, so I've learned to base what I do on my symptoms. So although I feel better my peakflow was actually lower this morning than when I went to the ER. I'm just grateful they listened to me anyways.

My humble answer:
The first thing I want to say to you is based on what you describe here you seem to be a Gallant Asthmatic like Jake Gallant, and a true role model for other asthmatics. I'm very impressed that you called your physician as soon as you observed your early warning signs so your asthma could be treated right away to prevent it from getting worse.

To answer your question, not all asthmatics wheeze during asthma attacks, which is why it is essentially important that you follow your Asthma Action Plan, of which you did. Even while your peak flows barely decreased, and you did not wheeze, your body gave you other signs that it was time to call your physician.

Likewise, it can be normal to not wheeze during an asthma attack, which can also be a sign of worsening asthma. Often times when I give bronchodilator breathing treatments to an asthmatic in the hospital I hear more wheezes after the treatments than before, in which case wheezes can be a sign that your air passages are opening up and air is flowing more freely through them. So, for you, wheezing may be a sign that your asthma is improving.

Monitoring peak flows is a great way for most asthmatics to monitor their asthma, but for some reason peak flows do not drop for some asthmatics. This is all the more reason for you to be aware of YOUR other early warning signs and to work with your doctor on creating an Asthma Action Plan that works best for you. It appears you have one and followed it to a tee. Great job.

Question: love your blog. You've recently posted about Singulair and I'm needing opinions on my Xopenex. My copay is 50 bucks and will be increasing to 60 in July. I rarely need it. I've got an appointment with my Dr in August. What would you (as an asthmatic and RT) recommend that may be less expensive than the Xopenex? I've tried straight albuterol and it made me too jittery.

My humble answer: Xopenex and Albuterol and really the only bronchodilators on the market that are safe for home rescue use. Some people seem to note fewer side effects with Xopenex, yet since Xopenex is not available as a generic it is way more expensive than Albuterol. Sorry to say this, but there really is no alternative to Xopenex unless you want to go back to Albuterol. Obviously you don't want to stay short of breath, so for the time being you have to decide between a drug that makes you shaky or a drug that costs a lot.

Wish I had a better answer for you.

Question: everytime i have asthma attack, i have irregular heart beat. why?

My humble answer: An irregular heart beat is not normally associated with asthma, and is definitely something you should talk to your doctor about.

Question: I'm 15 years old and I find it hard to take deep breathes in, do you know what it could be? It has happened for ages but my parents haven't done anything about it, I don't know what to do and I sometimes get panic attacks.

My humble Answer: Based on what you describe here I think it's time you sit down with your parents and have a discussion about your health. If you need to print this off and show it to your parents. As you know, it is not a good feeling when you are having trouble breathing, and being short of breath is something you should NEVER ignore.

Yes, it is possible what you have is asthma, but unfortunately we cannot diagnose you over the Internet. I would highly recommend your parents take you to your physician so you can get checked out, because only your doctor can tell you what is wrong with you and what you can do to treat it.

Likewise, if he diagnoses you with asthma, there are great controller medicines to prevent asthma attacks so you should be able to live a normal active life.

You should tell your parents that most asthma experts agree that if asthma is diagnosed immediately and treated aggressively it can be prevented from getting worse, and can therefore be easier to control now and down the road.

On the other hand, if you do have asthma and it is left untreated, it is possible that lung scarring can occur that can make your asthma more of a challenge to control down the road.

If you have a question you would like to ask you may inquire at


Steve said...

To the person who asked the first question; you asked a very good question.

Like you, I rarely wheeze during a really really bad flare-up. It's usually during the recovery phase When I'm on steroids ,that I'll start wheezing up a storm. Sometimes I'll wheeze so loud, it will keep me awake. As backwards as it sounds, wheezing ( especially during exhalation) is usually a sign that you're moving more air.

Anonymous said...


I found my way to your blog a while ago when I was looking for other people who have asthma like I seem to. I wrote that first question. It's good to know I'm doing the right thing in a world of mostly non-asthmatics, and that it makes sense (not just in my own little world :). I've been learning mostly through trial and error, and in trying to make things as best as I can. It does really help to have an understanding doctor though.

I'm looking forward to your continued asthma saga as a kid....


Anonymous said...


Huh...that makes sense. I didn't know that. I usually start wheezing when I exhale too.

It's nice to know more too, because I wonder this whenever I get sick...and now I don't have to...thanks


Freadom said...

Melissa: You are right, learning about your own asthma is quite often a game of trial and error. It really helps having a good support team and a good asthma doctor. Likewise, the Internet now grants us access to other asthmatics which is nice because we learn we are no alone.