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Asthma prognosis

Hello I’m a 30 year old male that battled asthma off and on starting from childhood until now. This last year I have undergone a lot of tests at National Jewish to try and figure out what is causing the asthma and nothing except some mild reflux has appeared. My fev1 is around 77-80% on symbicort and my peak flow ranges from 560-670. I have a very physical job that I love but often leaves me a little breathless and a growing family and I’m left concerned about my future because I’m only 30 and I’m currently only around 77% fev1. Where does this put me when I’m 40,50,60 years of age? I have been battling tons of anxiety about this lately and it’s all I think about. I first started going to national Jewish back in 2012 and I was at 60%fev1 with no inhalers. They prescribed me symbicort and it made a world of difference but I never went back because I had no insurance and it cost me $1000 per visit. Then September of last year I had a nasty asthma attack out of nowhere so I went back for testing. My last pft test showed 70% no inhaler and it went to 80% after a neb treatment which showed good response. I’m just a little discouraged because I read about people getting into the 90-100%range but I’m thankful where I’m at. Anyways I’m just rambling now so I’ll end the rant. Sorry for the lengthy post. I look forward to hearing your input, thanks

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  • Kathy P

    Welcome Jeeper52! National Jewish is one if the best places in the country for asthma treatment. I know others who have worked with them to create a payment plan. Not sure if you've looked into that other if it's an option. Do you have another doctor who is managing your asthma?

    Did they tell you what the 80% meant? My understanding is that is the cutoff for "normal". It sounds like you are close to that when on Symbicort. Did they recommend trying a different controller medicine? Did they do any allergy testing? Are you treating the reflux? I've had to try many different meds and combinations over the years to find the one that works best. I've also had to add other meds too – my asthma is mainly allergic and exercise induced. But reflux is big trigger for me as well. I keep thinking I can stop my reflux meds and I always wind up having issues within a month!

    If you are short of breath with exertion, has the doctor recommended pre-treating before you know you will be doing a lot of strenuous work? I have a whole different regimen I use before I exercise. 

    AAFA has a great series of videos – this is the start of the series about asthma basics – There is a link to the next one in there.

  • Jeeper52

    Hello Kathy, yes they have done allergy testing and they said that wasn’t a big factor. Ige was at 41. I’ve tried a couple different meds and all have been about the same so I’m sticking with the symbicort generic from the Canada  pharmacy due to cost. They just told me to also start pre treatment before  exercise and work so I’m going to try that. I’m also treating any heartburn with a diet change and Zantac. My biggest concern is where I’ll be later in life no so much my symptoms now. I’ve started working out again to hopefully improve lung function but it’s hard to do with a physical job. 

  • Jen

    @Jeeper52  Welcome to AAFA's support forums.   I can understand that you're concerned with the future.  That said, if you can get things under pretty good control now, that may bode well for your future.  Have you asked your doctor about what asthma might be like for you down the road?

  • K8sMom2002

    Welcome, @Jeeper52, and I so understand about the worry about the future. 

    My asthma seemed to be really unpredictable and to strike at the worst possible times almost out of the blue until I worked to identify my triggers. Everyone's triggers are different, and not everyone has allergic asthma. 

    I know that @Pljohns has asthma that is not allergic. And other members are similar. My own asthma seems to be triggered more by exposure to things that irritate my lungs than true environmental allergies.

    My doc has suggested that the best way for me to keep my lungs protected was to keep my asthma under control. For me, that means

    • sticking to my
    • avoiding my triggers
      • cigarette secondhand smoke
      • hay and grass
      • perfumes and chemicals
      • upper respiratory infections
      • strenuous exercise without pre-treatment
      • sudden shifts in weather
    • having a good sick plan (what to do if I have an upper respiratory infection)
    • getting the flu and pneumonia shots as needed — flu shot every year.

    As for what the future will hold … I was diagnosed with osteoporosis when I was in my 20s, and my doc told me that I had the hips of a post-menopausal 50+ year-old lady, and that I was in real danger of fractures. I was extremely worried at the time about what the future would hold. 

    But my doc told me NOT to worry about it. Instead, if I followed my treatment plan carefully, I could rebuild that bone. I didn't have a whole lot of faith, but I followed his instructions. What do you know, today (post menopausal, btw, and way too close to the big 5-0 than I want to be!), I have better bone strength than I did at age 25. 

    So ask your doctor what you can do to help rebuild that lung strength. Would pulmonary rehab help? Would pre-treating before you work help, since your job is physical?

    And could you reach out to National Jewish and ask if they have any assistance or grants for people with no insurance? Or ask if they can suggest a doctor close to you who works well with them or who trained with them?

  • Pljohns

    Welcome @Jeeper52!

    I too have severe asthma that is non allergic-and like K8SMOM2002 said, it's all about identifying your triggers.  I was diagnosed 6 years ago-NEVER had problems as a child and no one in my family has any respiratory issues at all.  Me, I got H1N1 flu when it came around the very first time (no vaccine for it and it left a lot of people with lasting respiratory issues), followed by whooping cough and finally pneumonia that lasted 6 weeks and hit both lungs-all of that within about 3 months-totally did my lungs in.  today,I struggle to keep it headed in the right direction.  I know what to do but tend to be stubborn and just don't do it thinking it will get better, but of course, it doesn't until I follow my plan.  For me, that includes :

    • avoiding cigarette smoke/secondhand smoke
    • avoiding strong smells 
    • avoiding Upper respiratory Infections
    • Limiting Serious Stress
    • Trying to figure out how to deal with the weather changes
    • Getting flu shots twice yearly and pneumonia shots when they are due
    • Actually taking my meds off my action plan when I'm supposed to and not waiting

    I'm a good bit like K8SMOM2002-I had osteoporosis early on but after following my doc's recommendations, that is now doing MUCH better and my bones are stronger than they were 10 years ago.

    I think we all worry to some extent what this disease holds for  us as we age (I passed 5-0 a few years back but was over 45 when I was diagnosed).  I think following our doctors plan/suggestions will help us all have better, longer lives and lives that we can live to the fullest-despite the disease.  I would talk to your doc about your concerns and see what he says-can't hurt-and he may have suggestions for building lung volume and easing your worries.  Take some time and make a few brief notes so you know what to ask, talk to your doc about what you write down and then follow his guidelines.  The most important thing is to communicate back to him what is working, what isn't and is there anything else to try.

  • Lemon Harris

    have you read the new research saying people with GERD/Reflux they are finding its directly causing asthma…why because the GERD over time you get it in your lungs and the "asthma" is just chronic lung damage and inflammation caused by irritants.  I am hoping and praying they come out with a drug that reduces inflammation and heals damage in the lungs but all over the body because inflammation is the body's enemy.  Causes many chronic diseases including cancer over time.