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Consistent flares with preventative meds

I have been having serious flares the last four months. I take advair, have an in home nebulizer, take a rescience inhaler, and acid reducer and several orc allergy meds. I am consistent contact with my allergist/asthma specialist. Any recommendation to help would be great, it's affecting my work and home life. I have been in the hospital at least 4 times. 

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  • Pljohns

    Mariaoct-I can sympathize-the weather affects my asthma badly.  Do you keep a journal of any type?  I found early in my asthma that keeping a journal or app on my phone helped me track things and figure out triggers-I have non-allergic asthma so I knew I wasn't allergic to anything but figuring out triggers has helped tremendously.  The weather is a biggie for me, stress, sinus infections/respiratory infections and strong smells of any type.  I was able to log what the weather was like, what was going on in my life etc.  It really helped a lot-  Also, do you use any type of air purifier?  I use HEPA filters in our AC/heat and here at work, have a air purifier specifically for smells.  With the flu season being what it is, I'm also wearing a mask all day, every day until it settles down some.

    I was hospitalized 4 times in less than a year for 5-6 days each time, followed by a month or more of nebs every 3-4 hours and a LARGE prednisone taper.  I made lifestyle changes that eliminated most of the stress in my life and all of the 60 hr work weeks and that made the biggest difference.

  • K8sMom2002

    Hi and hugs, @Mariaoct … that sounds like you're trying to do everything right, and yet you're still having flares and problems with asthma! Extremely frustrating, I know!

    I love @Pljohns' suggestions! One thing that has definitely helped me (and this community is a big part of how I found out about this strategy) is keeping a symptom diary so that I can figure out my triggers. 

    For instance, I had NO idea that weather changes had such a huge impact on me. I live in the South, where the temperature or air pressure would do those famous wild swings. Having it down on paper (or on a phone app or just noting it on a calendar either on the fridge or on your phone) can really help clear up mysteries.

    Another thing that helped me: realizing that upper respiratory infections could quickly trigger my asthma. Having a "sick plan" (what to do when I first get sick) and getting a every year and a seems to have REALLY made a difference.

    And I also agree that managing your indoor air quality is really important as well. AAFA has a great resource on .

    Sometimes it's not just ONE thing, but a whole bunch of little things that create a tipping point. It sounds like you're doing a great many (if not all) the right things, and I know how frustrating it is to keep getting sick and landing in the hospital.

  • MMKB

    Mariaoct – I can sympathize with you. My asthma has also been out of control despite taking several medications. My asthma is like a ticking time bomb and I never know when it is going to explode. As it was mentioned in previous posts, I also find it helpful to keep a log/journal. I keep an asthma/allergy log to keep track of my medications, symptoms and asthma/allergy triggers. Has your doctor tried changing any of your medications or adding additional medication? Do you have a mask that you can wear to help reduce your exposure to your triggers? Are you exposed to any asthma triggers at your workplace, if so have you asked for accommodations? 

  • Pljohns

    Mariaoct-when I was first diagnosed, we tried more meds than I want to even remember.  I kept a log of when we tried what, did it work, did I have problems on it, the dosage and if i couldn't take it, why and when we dropped it.  by consistently keeping that, I've been able to go to new docs and tell them what we tried, what happened and is it worth trying again or not.  It also helped me see what meds I was able to drop and not even tell I had so I knew they weren't helping me-no need to take meds that are doing no good. I was also able to tell if a med worked just as good once a day as it did twice a day.  It helped fine tune my meds and even today-7 years late, I still am OCD about keeping it up. Eventually, we found what worked and have had to tweak it some but it works for now.

  • LK

    Hi @Mariaoct,  That is very frustrating when things don't seem to be getting any better and you've been dealing with it for some time. 

    I second everything mentioned above!  I was diagnosed with asthma five years ago and every so often something will trigger my asthma and even after managing the major flare, it takes my lungs months to get anywhere near normal again.  I had an upper respiratory infection last fall which triggered a flare.  I was on antibiotics and prednisone two times.  I would get worse again after the pred would wear off.  My pulmonary doctor then put me on another longer term dosage of prednisone, added different asthma maintenance med and increased the dosage of another of my asthma maintenance meds.  Finally after about two months I could take a fairly deeper breath. 

    Did you say you were on any maintenance asthma medicines?  Maybe something to ask your pulmonary doctor to see if it would be right for you? 

  • Kathy P

    @Mariaoct - sorry you're still having issues. I got a viral infection just after Thanksgiving and I've been having issues since! I've been dillegent with my meds and even done prednisone. I just can't seem to turn things around. I get close and think I'm over the hump, but then something triggers and I'm back to square one.

    Has the doc checked for secondary infection? That's usually what keeps me inflammed. I get over the virus, but then wind up with a bacterial infection that is asymptomatic and lingers until at some point, it takes over and I get really really bad!

  • Shea

    Hi Maria… That is frustrating to have so many hospitalizations after all you are doing. I nebulize with budesonide and albuterol-ipatroprium bromide 2 x day and thats been a big part of my asthma management because I kept having bad reactions or no success with other inhalers, and nebulizer seems to really get into my lungs better. 

    Do you have allergic asthma/any known allergies? Avoidance measures have helped me a lot.  I am severely allergic to cat/dog dander so I dont have cats/dogs and dont visit homes in which they reside (this was a difficult thing for me,  but one of the most effective things, as it lowered my eosinophils significantly (eosinophils were the blood cells that were causing most of the inflammation in my body when I was at my worst).

    Molds and dust mites are also triggers, so I use zipper mattress and pillow encasements and wash all linens weekly in hot water–and honestly if it goes longer than a week, I do notice my symptoms getting worse. 

    I have a HEPA air purifier in my room, and about a year ago I purchased a Hyla air cleaner/vacuum as well, and I breathe best in my home where I spend most my time, and it has a lot to do with minimizing triggers. And it helps to have a safe space.

    Gosh, I hope some of these things might be helpful… And hopefully you can work with your specialist to get the asthma under better control and reduce the hospitalizations! And, Im sure youll get some good info from the folks here too!–(I like the info already given about symptom-diary, minimizing stressers and taking time to dedicate to solving this issue, whether that means working less, or taking time outs to check in with yourself and your breathing. 

     

  • Marie E Natzke

    Maria, try to keep your bedroom as clean as possible and limit the clutter. Wash any blankets, covverlets,bed spreads  once a week. Try to wash your hair before bedtime. If you have pets keep them out of the bedroom. Try to keep your bedroom a safe place for you to go to. Have you tried an air purifier for your bedroom? If you do Have one or get one keep the door closed when it's on .You'll notice a big difference when you walk into the room.

  • Tiffany F.

    I second keeping a journal of where you were, what you were doing, even if you changed clothes, at something (fine details!) because it could be something as little as laundry detergent or your vehicles cabin air filter needs changed.  So many things, so its important to journal as much as you can to start to see patterns.

    Also, invest in a TRUE HEPA air cleaner for your home. Germ Guardian and Dyson are the best names.