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Asthma Control?

What does it mean to have your asthma under control?

im sure there are a number of responses to this question, as we all experience different symptoms and react differently to medications, stimuli, etc!

I ask because this always appears as a goal in asthma management yet there is little definition. 

Im new to asthma, and been taking some medication for a few months along with some lifestyle changes. I have this general consistent tightness and minor SOB, that is annoying yet it does not affect my day to day activities (hopefully it never does lol!). I'm wondering if it's reasonable to aim to feel better or if I should be satisfied with my current status. I ask also, as to wether I should decrease current medication (QVAR and Singulair), or even try new ones!

i know these are all questions I should be discussing with my doctors, but I don't have an appointment for a few more months. They consider me "stable". I just want to be prepared for my next appointment.

Thank you guys!!

 

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  • K8sMom2002

    Hi, RedCoog … I think talking with your doctors about what their goals are for you — in a way that is easily understood — is a great approach, and a good question to ask. It's always good to be on the same page as your medical team!

    A few ways my doctors help me define my goals are for me to answer the following questions:

    • What are am I not able to do because of my asthma? 
    • How often does asthma prevent me from doing the things I like to do?
    • How often am I using my rescue inhaler? (or SHOULD I be using my rescue inhaler but don't?)

    One easy way to help me keep track of this is to log my "yellow days" and my "red days." It's based off AAFA's asthma zones, and I know I need to check in with my doctor and tweak my plan if I'm spending more of my days in the yellow zone.

    Could you take this or an to your doctor and have a heart-to-heart about what is a reasonable definition of your asthma being under control is for you?

  • RedCoog

    K8smom2002,

    Your great. Your feedback around this board is so appreciated!!!

    Like you advices, I think I need to have a serious conversation with my doctor about my plan. As almost everything with this disease, not all scenarios are the same .

    My biggest issue at the moment is the persistent tightness (no issues out side of this as I can function "normally" and have no need for my rescue inhaler). Per the sample plan you posted, I should make modification to my medication in hopes of reaching a green zone. This would be great but it sounds like a very few lucky ones are able to get back to this point!

    im really considering swapping the use of QVAR and giving Breo a chance! 

    If anyone has done this change, I'd love to hear your experience!!!

  • K8sMom2002

    Awwww … thanks, Redcoog! It is absolutely my pleasure!

    A question: did your doctor suggest that, when you have that "tightness," that you try your inhaler? 

    Part of my action plan is to address that tight feeling, where it feels like I can't move air. Sometimes I feel like I can get air in, but it won't go out without a cough (or a series of coughs). It took me a long time to realize that what I was calling "can't get air out" was the time I needed to use the inhaler. My doctor helped me with that. 

    Could you put a call into your doctor's office or nurse and ask, "Hey, what DOES the doctor want me to do when I have this persistent tightness?"

  • Pljohns

    RedCoog-I too use QVAR and have tried BREO-it didn't work for me, but not much does.  I had a reaction to it but that's just me.  You may be able to try a different inhaled steroid-I switched from QVAR to Alvesco and did much better but my insurance didn't cover it so I had to change back.  The "combo" med-:Breo, Adviar etc, have a long acting bronchial dilator in them in addition to the steroid component.  Take a LABA alone without a steroid has some serious warnings (All LABA's carry a black box warning from the FDA that it needs to be used WITH an inhaled steroid). The combo's work great for a lot of people.  If you are considering it, I would ask your doc one thing-what do I do if I try it and it doesn't work THAT DAY?  Most of those meds are once daily use-so if it doesn't work you, what do you do for the rest of the day?  In my case-it was just get through it with albuterol but is something you definitely need to ask about so you are prepared.

    I would say a lot of us are able to be in the green zone-I am some days, but not always and thats probably the case for most everyone here.  We have good days way up in the green and then days that aren't so great but are still green.  Yellow means you need to do something so it doesn't get any worse.

  • RedCoog

    K8smom2002,

     

    thanks for the advice once again. I left a message to my Pulmonologist in regards to what I'm feeling to get some feedback from him! 

     

    PlJohns, 

    thanks for the input. Never thought about asking for a substitute to QVAR, just thought as the combination inhalers. Wing the next logical step! Will absolutely bring this up to my Doc!

    if you don't mind me asking, what side effects did you get from the Breo? All of these drugs are such double edge swords!!! They can be miracle pills or put you in a tailspin!!

  • Pljohns

    REDCOOG-The Breo caused chest pain, bronchial spasms and severe shortness of breath for me-all of the things it's supposed to fix!  Please understand, backwards reactions to meds is the norm for me but this med has worked great for a lot of people I know.  All of the current asthma meds on the market worked backward on me and instead of taking care of asthma symptoms, most sparked severe bronchial spasms and chest tightness and shortness of breath. I had an anaphylactic reaction to symbacort and nearly died. My list of drugs that I can't take is about 25 long-the latest to cause me issues is albuteral-after 6 years of using it without any issues at all, all of a sudden the"quit using and call your doctor' side effects showed up.  I've had to change to levabuterol as a rescue med now.  

    I was accepted to the UAB severe asthma clinic and am waiting for the first appointment the 19th of next month.  Hopefully they can help me make some sense of this mess.

    I would encourage you to do a lot o research and ask a lot of question-there are multiple "flavors" as I call them to almost every type of med-long acting bronchial dilatory, rescue meds, inhaled steroids-everything and you have to ask questions and research them to see what's available and to know what to ask questions about.

  • Pljohns

    Also-I would highly recommend a peak flow meter if you don't already have one.  It allows you to keep up with your numbers and see when you are beginning to have a problem.  Most of us here us an app to log them in-there are several available or a good old fashioned note book works just fine.  It has helped me identify what flares me off by looking at the trends-I know a weather front will cause me problems.

    also, if you don't have an action plan, get one.  It lays out what to do when you have symptoms xyz or when you peak flow number fall below 80% of your personal best-what meds to add etc. 

    With the help of a good doc or a team of docs and some diligence and patience(something I don't have), you will find what works for you.

  • RedCoog

    LPJohns, wow, your situation sounds unique for lack of terms. I really hope you get some solutions during your upcoming UAB visit!!

    I bought a PEF meter about a week before starting Singulair. I noticed a big jump (525 to about +610/625) that brought me almost to my 100% predictable numbers after the singulair. 

    The frustrating thing is that I still feel off with this tightness. On paper, I'm stable and in control, but the tightness is a reminder that I may not be!

    I will talk to my Doc about this! Maybe (hopefully not lol), the way I feel will be the new norm! Either way I'm optimistic!!

    thanks for the reply!!!

  • Pljohns

    I use to go strictly by how I felt and ignored my numbers and pulmo ripped me a new one about it-she said you go by BOTH (either or) if numbers are good and you still have symptoms, treat them and if your numbers are awful but you have no symptoms, treat it.  Unfortunately that has me adding levabuterol almost every day for one reason or another. Yes, I am a bit unique-meds tend to work backwards on me-always have and with my reactions to so many things and not being able to us an inhaler, I'm a challenge. it has presented a problem here-pulmo's don't want to treat asthma patients (all they want is sleep apnea  patients right now) and they want primary care docs to treat asthma, but mine won't touch me.  It's left me with no pulmo right no-I do have one, but he's AWFUL, so I'm holding on for the UAB appointment and hope I get some help there.

  • green881

    >What does it mean to have your asthma under control?

    The simplest reply is that you need albuterol less than 3 times a week.  If you are experiencing symptom that you notice (some kind of tightness) try take 1 puff albuterol and wait 15 minutes.  If it doesn't improve at all then take another puff.

    If two puffs (your limit) has no effect on the symptoms after 15-30 minutes then I am scratching my head, you really ought to discuss that with your doctor.

    Because you said you are new to asthma I think you need to first thoroughly understand when you need albuterol and the effect.  Make sure you are using the inhaler correctly, try a spacer, have a HCP observe you using it.  A lot of these details get lost in the "medical shuffle" in my humble experience.  Once that is resolved you will have a better guide on how to increase and decrease your preventers.

     

  • K8sMom2002

    Green881, it sounds like you've had some really productive conversations with your doctor about your individualized plan!  

    And yes, spacers definitely help if your inhaler requires one. (Some don't.)

    Here's a link to .

    One thing to remember, since each person's asthma is unique, each person's plan and definition of control is unique as well. There's a range, of course, but what is right for one person may not be right for another. That's where good discussions with your doctor is so important.

  • green881

    >Green881, it sounds like you've had some really productive conversations with your doctor about your individualized plan!

    Ha! I wouldn't go that far!

    Just last week I plunked down my completed 1 page asthma action plan in front of a new GP.  Her expression gave away that she thought I was Orson Welles landing from Mars. She admitted she had never seen one before.  Then after reading it a bit she says "Wow, how convenient it has all your allergies nicely listed" 🙂

    I've had this since age 5,  40+ years on and off.  I was well trained in my youth.

  • RedCoog

    LPJohns, I like your comment about taking action if either your numbers or symptoms aren't right!! It makes sense for both to be on check!

    Green881, I'll will bring up your comment about the use of the rescue inhaler to my doctor. It's weird, I don't know if the feeling I have in my chest is worth the use of the rescue, but it may be!!! I kinda have the mental idea that I should absolutely only use medication if it's needed! I hate that I'm already on 2 separate medications at a young age. I hope I can rapper off at some point!

  • green881
    RedCoog posted:

    Green881, I'll will bring up your comment about the use of the rescue inhaler to my doctor. It's weird, I don't know if the feeling I have in my chest is worth the use of the rescue, but it may be!!! I kinda have the mental idea that I should absolutely only use medication if it's needed! I hate that I'm already on 2 separate medications at a young age. I hope I can rapper off at some point!

    From time to time all asthmatics test how far they can go before they take it unfortunately.  As you learn more about asthma you will find out that (a) everyone's is individual (b) for most people where there is smoke there is fire.  The way I think about it, inflammation leads to more inflammation.  Taking your Ventolin early prevents worse episodes.  If you are thinking about it you probably already need it.  

    One puff is not a big deal, experiment a bit and see how you feel.  Only you can do this, you are not going to have the symptom in front of a doctor usually.

  • K8sMom2002

    Green881, glad you had that conversation with your new GP! 

    RedCoog, glad you're going to have what I call the "what if" conversation with your doctor!

    Like Green881 and Lynn (PLJohns) say, when I stick with my plan and implementing it sooner rather than later helps me overall. 

  • Kathy P

    Hah Lynn, I used to go by the peak flow numbers and I'd be feeling like I had an elephant on my chest and my numbers were still fine. Now I use a combination. Now I use PF, O2 saturation and how I feel – and that includes paying attention to things like how dry or wet my cough is.

    At the moment, I have a lot if different, single ingredient meds in my arsenal and decide which to use that day based on the overall picture. I get to make that determination twice a day and add albuterol through the day as needed. I'd love if I could just have a consistent med protocol, but this is what I need to keep things stable right now. And it takes working closely with the doctor to figure things out. 

  • Pljohns

    UAB Kathy-I'm really hoping that's what the UAB doc will help me do.  Right now I have my set meds and I know when I should add levabuterol but that's it-no one has EVER worked with me to help me figure out when to add what and I think that's the missing part to the puzzle.

  • Kathy P

    Fingers crossed! My big wildcard is mucus. And 2 of the meds target that. But if I take them every day at the same dose, I wind up too dry at times or still too mucousy.

  • Shea

    For me, having my asthma under control really came down to knowing my triggers, avoidance of them as much as possible–which for me meant lifestyle change— and finding medications and doctors I was comfortable with. 

    I, personally, am against Singular. And this is why: I have always been allergic to cats. But, I met a guy and started dating and he had 2 cats and a dog and I couldn't ever stay at his house for more than 10 minutes without wheezing and sneezing and being a mess. I talked to my general Dr and he recommended singular. It worked amazingly… At first.. And all of a sudden I could be there no problems at all, I could pet the cats.. I thought it was magical. 2 years later, I developed asthma symptoms (never had asthma before), I started needing prednisone tapers all the time, and going to the hospital for breathing treatments. Finally my doctor and I suspected my allergies were back, no amount of cleaning or separating rooms could prevent my reactions, finally I had to move out. Bteak up with boyfriend who ius now also the father of my newborn btw, yeah that happened during this time period- he would not find a home for his pets and ended up also stealing money from me so it was good to move out. He brought clothes of mine covered in cat and dog hair that I had told him I didn't need and to not bring to my parents home where the baby and i were staying and he brought them anyways and dumped them into our sdmall room, I had a horrible asthma attack went to the er-I ended up having a heart attack from allergic eosinophils surrounding and choking my heart, and I was hospitalized for 20 days, and a lung doctor there was able to diagnose me with a chronic allergic disease called churg-strauss syndrome that used to be very rare but is becoming more common and is starting to be correlated with Singulair (although causation has not been proven). Now I have this lifelong chronic allergic disease. It has been 5 years, and I now live in a dander-free home, and I know my allergies and triggers, and I do not just Medicate them, I actively avoid them. I have learned if a dog just touches me now I break into a rash, and my cat allergies are stronger then ever even to secondhand dander coming in on the clothes of others. I am on nucala injections, and maintenance dose of prednisone, I nebulize 2 times a day and carry ventolin with me. I try not to overdue things and keep my stress level OK. But it started rocky the first few years of symptoms starting and them being "managed" correctly. The pulmonologist that was able to identify and treat my disease during its critical state told me flat out that singular is not a good medication. But it hasn't been proven not to be. I wish someone had warned me, but if you know your allergies, and keep an eye on a thing called eosinophils in your blood work (CBC), and have at least one specialist on top of your general doctor that is a good start to managing and having asthma under control. I think it is something you can discuss with your doctor, maybe find an alternative but if not, just be aware of warning signs.

  • RedCoog

    Shea,

    thanks for sharing your story and your definition of control. I'm still trying to figure out what my triggers are! At the moment I'm just trying to avoid all the common items: smoke, dust, fragrances, etc!

    As far as the singulair, I tried to do a bunch of research before taking it. Even after all that I was 50/50 about taking; the testimonies were either increadible or frightening! One of the things I read is that singulair should not be used as the primary medicine to treat asthma, only as a supplement since it only reduces inflammation rather then treating the cause of inflammation. I can see how long term use could turn south…

    One of the items I plan to discuss with my Doc is the reduction of medications I'm taking, in hope that I can be pore specific on the treatment of this "thing".

  • RedCoog
    Kathy P posted:

    Hah Lynn, I used to go by the peak flow numbers and I'd be feeling like I had an elephant on my chest and my numbers were still fine. Now I use a combination. Now I use PF, O2 saturation and how I feel – and that includes paying attention to things like how dry or wet my cough is.

    At the moment, I have a lot if different, single ingredient meds in my arsenal and decide which to use that day based on the overall picture. I get to make that determination twice a day and add albuterol through the day as needed. I'd love if I could just have a consistent med protocol, but this is what I need to keep things stable right now. And it takes working closely with the doctor to figure things out. 

    Kathy, I too use a O2 meter but I have not been able to correlate my numbers to my symptoms. I'm always 97% or higher (really almost always at 98). Could you share your experience? I saw there is a separate 02 meter post, maybe we could add comments there! 

  • Kathy P

    Mine's often within normal limits too – at least if I'm sitting!If I'm feeling tight or mucusy and I get up and walk around, often my O2 will drop to 93 or even lower. But my PF will still be in my green zone. 

  • Pljohns

    I"m glad to hear others have the same issues I do-my numbers will be green, but o2 sat near 90 and all sorts of symptoms.

  • Shea

    Redcoog, glad it was helpful, and I agreevwith you:, I think it would be safer used on top of avoidance of the triggers of inflammation. I am not an anti-med person at all, but I do like to think of a day I will be able to get my asthma and allergies and disease in general under enough control to be able to get off them. I have learned so much from hearing what triggers other people on this forum, and being more mindful of my own reactions in different environments. 

  • RedCoog

    Guys,

    So I took some of you alls advice over th weekend.

    1)I contacted my Pulmo about my symptoms. I am able to contact him directly via email thru their website portal. His reply was a bit frustrating, he just said we could add a "stronger" med. Although I may need a stronger medication, I would appreciate a tailored medication/plan to my particular situation. I feel this doctor has been average. I live in a big metropolis so I'm wondering if I should find a better doctor for my needs since there are so many options!

    2)I talked to my doctor about taking a puff of my rescue inhaler (ProAir) like you guys mentioned, and he said to go for it. With this inhaler I'm suppose to take 2puff in an emergency. I decided to take 1 puff so see its effect! My tightness reduced, which was great, but my my heart rate jumped up quite a bit for a few hrs (nothing crazy just around 80-90, but still noticeable). Not sure if the trade off was worth it….does anyone also have this side effect?

    hope you all had a great weekend!

     

  • Melanie Carver

    At the Asthma and Allergy Foundation of America, we define "uncontrolled asthma" as this:

    If you respond yes to any of the following, your asthma is "uncontrolled":

    • Do you experience asthma symptoms more than two times per week?
    • Do you use your quick relief (rescue) inhaler more than two times a week?
    • Do you wake up at night due to asthma at least one time per week?
    • Have you needed an oral steroid more than once in the past 12 months?
    • Have you visited the ER for treatment of asthma at least once in the past 12 months?

    A long-term controller med serves the purpose to prevent (or reduce) asthma episodes and get the asthma under control. Finding the right controller medicine for you may take a little bit time as you try one, see how well it works and alter as needed. Initially, you may need a higher dose to get things under control and then you work with your physician to lower the dose until you reach the level that can still maintain your asthma control.

    The quick-reliever inhalers (e.g. albuterol) provide relief to help you breathe, but they do not treat the underlying inflammation. Side effects like feeling jittery are common – but if it is too bothersome, contact your provider. A different type of inhaler may work better for you.

    Best of luck!

  • K8sMom2002

    RedCoog, to what Melanie says above. I think it may be worth it at this point to set up an appointment with your doctor so that you can talk through ALL your options. What your doctor may mean by "stronger" medicine may be different than you think. 

    That will also give you a chance to evaluate your relationship with your doctor and see if you do want to seek a second opinion. 

    Setting aside that time, when you're not super, super sick, might help you in several different ways.

    • your doctor isn't urgently concerned with treating an acute situation
    • you feel somewhat better, so you can focus on what the doctor is saying
    • you've had some time to see how the doctor's recommendations are working for you.
    • you've had some time to figure out the questions you need to ask.
    • if you bring a family member or a friend, that person can listen and form an opinion as well.

    I know that I've had doctors tell me that one of their biggest frustrations is when a patient ISN'T getting better, but they wait until they get super sick to go back and see the doctor — or they go to another doctor. 

    Doctors, I think, assume that if they don't hear from you, their recommendations are working and patients are taking their medications as directed (and stopping them as directed.) The expectation is that if the patient isn't getting better, he'll come back to the doctor and say, "Hey, doc, is this to be expected?"

    Even so, sometimes a person WILL need to seek a second opinion, and that's okay, too. 

    As for medications and treatments and even how things are for me right now, I like to think of things as for NOW and not forEVER. If you DO need to start on a long term controller medication, it could be just until you bring down the underlying inflammation and you identify your triggers. 

  • Pljohns

    REDCOOG-Xopenex inhaler has much less cardio side effects as the other albuterol inhalers.  I use the neb version of it because of other side effects but you may want to check on it.  

    As for finding another doc, that's your call.  If he's so-so, he may be fine for your general needs but you may want to find a pulmo for your asthma.  :They know a lot more about what is out there and-at least in my experience-have been much better to make a med plan more specific to you.

  • green881
    RedCoog posted:

    I decided to take 1 puff so see its effect! My tightness reduced, which was great, but my my heart rate jumped up quite a bit for a few hrs (nothing crazy just around 80-90, but still noticeable). Not sure if the trade off was worth it….does anyone also have this side effect?

     

    Yes a little jittery or racing or palpitation is normal from abluterol, you'll get used to it.  80-90 is no big deal, when I'm on the elliptical it is 130-150+.  I took a puff last night and went about my business without any thought.  Some deep breathing will help.  If you focus on it too much I think you can add to it.

    You do want to address the asthma early.  The way I think about it: Inflammation leads to more inflamation.  1 puff now better than 2 puffs later, or needing nebs.

    Whenever you feel the tightness enough that you are thinking about albuterol, take 1 puff and note in the log approximate time and place.  If it's just handful of puffs a week you can wait to review with doctor at next appointment, but if it is 1+ each day then you should call in.  They will increase the amount of Qvar and or start you on a combination LABA.  You need to give any change in the Qvar about a week.

  • K8sMom2002

    Green881, good point about logging the meds — we tend to forget how often we use something or even what was happening at the time that made us realize we needed it.

    Red Coog, logging the time you use the medication (whether it's on your smart phone or a sheet of paper or a memo pad in your pocket) will help you have some more information to give your doctor. It will also help you — you can add as much detail as is helpful — where you were, what you were doing, what the weather was like, for instance. That can help you identify those triggers!

  • RedCoog
    Jen posted:

    @RedCoog Did you ever end up adding a stronger medication?

    Hi Jen,

    Yes! I'm 1 week into taking Symbicort. I do feel quite a bit better but not "normal". My PEF have gone up quite a bit so I feel it's working much better then just the QVAR. My tightness is down but I'm not back to normal. The past week has been particularly bad air quality were I live (ozone, mold, lost of pollen, etc), so I'm not sure if the results are representative.

    only thing is I've noticed a bit of sore throat/horseness so I'm thinking of trying a spacer to see if this helps!

    i was also prescribed a new rescue inhaler (ipratroium Bromide) which I have yet to need. But I may try a puff as needed!

    some of the discussion point from this thread really helped during my chat with my doctor!

    thanks for asking Jen!

  • K8sMom2002

    Glad it's helping! 

    Did your pharmacist give you a spacer to go along with the inhaler? Could you circle back and talk with your pharmacist and/or your doctor since you're experiencing a sore throat, etc?

  • green881
     

    i was also prescribed a new rescue inhaler (ipratroium Bromide) which I have yet to need. But I may try a puff as needed!

     

    What was the reason for the change from Ventolin (albuterol)?  I have heard of this used more for COPD but I guess it can be used for both. 

  • RedCoog
    green881 posted:
     

    i was also prescribed a new rescue inhaler (ipratroium Bromide) which I have yet to need. But I may try a puff as needed!

     

    What was the reason for the change from Ventolin (albuterol)?  I have heard of this used more for COPD but I guess it can be used for both. 

    I was actually given ProAir. I told my doctor that I would get very giterry and my heart rate would jump up a bit even if I took a puff. He said that This option is a bit less strong as the ProAir and recommended it as an alternative.

    your right tho. I've read that this is also more common for COPD patient. I have yet to need a puff so I'm not sure of its effect. The Symbicort does appear to be helping me a lot better then the QVAR. I'm still taking singular as well.

  • Pljohns

    Green881-A lot of us with asthma use it-it's a normal drug for me and I frequently add it to albuterol in my neb

  • green881

    The jitters with albuterol are common/normal.  I get them a bit, but I get about the same thing from a strong cup of black coffee.  I rarely drink coffee like that anyway 🙂  They go away after a bit either way.

    Another option is levabluterol, I was told often people are less jittery with it, but I've never taken it.

    One thing to be wary of (especially when starting out) is that for many of us inflammation breeds more inflammation.  It's important to take your rescue and stamp it out early especially while you are still working out the dosage and type of preventer. So I would lean towards tolerating a few jitters if albuterol is more effective and you can experiment with both down the road once you are used to the situation. 

    Just my $0.02.

  • Pljohns

    i can attest that levabuterol is much less jitters.  I started having some not great side effects of albuterol and had to change over.  

  • K8sMom2002

    Redcoog, how's the new med working out? Any sore throat still?

    @green881, you sound a lot like my doc when she advised me that using the inhaler SOONER might mean using it LESS. It seemed like a contradiction to me at the time, but it really did turn out to be true. How did you learn that piece of wisdom?

  • RedCoog

    Hi @K8sMom2002,

    im doing ok! The Symbicort appears to be working well. Unfortunately, I had to work a few days in a dusty environment and I feel I might have taken just a few steps back! I did my best to wear masks wile walking around tho; I've my lesson!! I'm hoping that now that I'm done with that I'll get back on track!

     

  • Kathy P

    Glad the Symbicort seems to be working. I masked up while cleaning yesterday…but then I didn't change my clothes right away so I was dragging the dust around with me til I showered and changed. Hope things get back on track for you. 

  • K8sMom2002

    @RedCoog, are you back on track after the dust attack? Is that something you have to do on a regular basis? 

  • RedCoog

    Hi @K8sMom2002,

    So in my line of work I have to go to job sites maybe 2-3 times a yr that are a bit dusty. Up to this past visit I really did not take the right precaution in wearing dust mask, but that will be the norm for me from now on!!! No excuses!

    yes! Thankfully, I feel that I'm getting back on track with my symptoms; not 100%, but at least a bit better then before I went on the job site. Eating cleaner, being around my air filters, and getting better rest has helped!

    Something I've incorporated per the groups recommendation (and approved by my doc), is the use of my ProAir rescue inhaler if I feel any tightness! The rescue dose is 2 puffs, but what I have been doing is if I feel a bit of tightness I only take one puff! I feel some over all improvement and I think this is why I have been able to get back on track so quickly. Inn not going to abuse the use of the rescue inhaler, but if I need it, I will use it! Another interesting development is that I used to get very giterry with this inhaler, but maybe since I'm using the Symbicort, the LABA has made me less succeptible to the cardiovascular effects…just questing!

    thanks for always checking up!

  • K8sMom2002

    Bummer that you have to go to such a dusty environment 2-3 times a year, but now you can plan for it, and it sounds like you'll keep it on your radar for next time.

    And also that's fabulous that we've helped you talk to your doctor about ways to step up your asthma plan so that you don't get so far off track once a flare hits … I know that's been the biggest blessing for me with this group. Finding out how other folks manage their asthma gives me tips on what to ask my doctor and my DD's doctor. And that helps me tremendously!

  • K8sMom2002
    green881 posted:

    One thing to be wary of (especially when starting out) is that for many of us inflammation breeds more inflammation..

    Hey, @green881 reading back over this thread made me think of a question — you had a great point about inflammation. What other ways do you fight inflammation?

  • Shea

    What a good question K8Smom!!! I would love to hear what people use to fight inflammation! 

    For me, there is prednisone, inhaled steroids (I use budesonide nebulizer solution and neb 2x daily with it–doc says it needs to be used 2x daily to work). I use nucala (injected monthly by nurse) and that is supposed to reduce inflammation-producing eosinophils (blood cells caused by allergy, and a marker of my disease CSS).

    And then avoidance of allergens, use of HEPA air purifier, and masks in some environments are great preventatives!

    I have heard omega 3s are good to incorporate into diet as antinflammatory (and less omega 6 oils and fats too). 

  • RedCoog

    Hi @Jen,

    yes!!! No exception!! I got some N95 rated masks with the exhale valves on them and they have worked great. I even concidered getting the high dollar N99 ones! I've had to be at a few sites in the last months and did not feel I took any steps backs during or after my visits!

    only this I had to do was tell our clients and site Rep guys that I had asthma not to freak them out about the mask! 

    Thanks for asking!

  • Teri G

    It seems to be different person-to-person but for us, my granddaughter should be ZERO flare-ups in order to be meeting treatment goals!   Just be a healthy happy 2 year old who can keep up with the other littles!  Thats our goal for management!