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Doctors prohibit the use of lidocaine in asthma through a nebulizer.

I’m frustrated, so bear with me. I know some of you have experienced this so this is why I am venting here… 

Once again a doctor has refused my request for Lidocaine Nebulizer solutions, citing it being “quasi-dangerous.” I have done the research and research performed my UW Medicine, NCIB – NIH, and countless others have stated it not only is safe, but actually is shown to help those with Steroidal Resistant Asthma (SRA) in reducing asthma flare symptoms and cough severity.

It is EXTREMELY frustrating when my own Doctors refuse to do the same research and read the SAME sources that have taken me TEN MINUTES to find, read, and understand. So once again I am SOL for a treatment that was proven to stunt the length of my asthma attacks when I had access to it five years ago. Its disheartening and depressing…

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  • Help

    Matthew, it’s really frustrating to feel like you haven’t been heard. What are your doctors suggesting instead?

  • Matthew

    Nothing. Staying the course basically. Because that’s been an effective approach to this point (sarcasm)

  • kira

    Matthew, that is frustrating when you feel a doctor isn’t willing to discuss new things, research with you, and venture into new territory (especually when you feel stuck in your treatment plan).

    I like immunologists (as opposed to pulmonologists alone because they seem used to dealing with new treatments and complex diseases in a whole-body manner)– AND I like doctors that work at universities–They tend to be more comfortable doing research and continuing education, and are often teaching or former teachers so they are comfortable both educating and becoming educated.

    Don’t give up! Your doctor might just not excel in this particular area but I bet there is one out there who does! I went through something similar looking fir a dictor who was comfortable treating me for my rare disease AND who would talk tbrough treatments with me. It was mt 3rd try and it was the charm thank goodness. Eventually I had to leave due to insurance purposes but he got me through some difficult times with my disease. Anyways I remember it being a pain and feeling rustrated and I have seen others go thpugh it on here but totally worth it when you find a good foctor… So feel free to vent here because we definitelt can empathize.

  • miri

    Hi Matthew, I just stumbled across this post. One of my doctors suggested that I try lidocaine nebs for breaking the pesky refractory cough and I love them. Perhaps you could ask your doctor to call their clinic or hospital pharmacist for assistance with dosing? Maybe he/she is unnecessarily worried about hitting the systemic toxic dose? Or she/he had a bad experience in the past which has colored their perception of the drug? Do you use 2% or 4% solution? If you have a very nervous doctor, you could try to get him/her to prescribe the lower percent … or, even consider switching physicians like Shea suggested until you find one that matches and will listen to your research and what treatment works for you! I did a rough back of the envelope calculation with a pharmacist and i’d Have to neb q4-6 hours to get close to a toxic dose.

  • Matthew

    I would love to, but none of my local clinic, hospital, or compound pharmacies actually offer the lidocane nebs anymore. In fact, my pulmonologist said its getting harder and harder to find doctors who’ll look at lidocane nebs. He also told me its getting harder for insurances to cover Bronchial Theromoplasty, one of the treatments we considered for me 5 years ago to reduce the severity of my asthma.

    But I’m glad you found a doctor who will prescribe them and a pharmacy to get them at. They really helped me out and I’m glad they help someone else out.

  • Matthew

    The Lidocane nebs are still a no go. But, I have overcome the asthma flare that sparked this post.

    On the flip side, I have mixed news. Xolair may no longer be proving to be a viable treatment for me. My pulmonologist says I may have built up enough of a tolerance, considering I’ve been on it for nearly 13 years. Good news is he’s seeing if I’m eligible for some similar treatments that interact in other ways.

    I also got him to note that I need the 60 mg taper of prednisone for all asthma flares… but there is a flip side: I have early stages osteopenia from the prednisone use. I’m now on Vitamin D and Calcium suppliments daily as a result.

    So like I said mixed good and bad news.

  • Aaliyah

    Glad the current flare is under control. That stinks that Xolair may no longer be helping. I hoping that switching things up will improve things.

    My doc started tracking bone density a few years ago and I was already in osteopenia territory. I recently had my 2-year check and things had declined more than they wanted to see [hopmad] Since I need steroids to breathe, we are focusing on all the other ways I can try to stop/reduce bone loss.

    I’ve been doing calcium and Vit D for several years. Did your doc do a Vit D level to see how much supplementation you need?

    Weight-bearing exercise is also important – but can be really hard when you can’t breathe! I’m still working on my plan to increase, but it’s a struggle! My exercise of choice – cycling – doesn’t count as weight bearing. So I’m trying to alternate with hiking more. Did the doc give you the recommendations for exercise?

  • Matthew

    I had my levels drawn. No surprise I’m Vitamin S deficient. I’m on 4k or 8k mg a day, I can’t remember which exactly at this moment.

    I walk a substantial distance to work and at work, averaging 20k steps in the 1 hour commute to and 1 hour from, plus 8 hours on duty. So about 2k steps an hour. Which isn’t bad. I also hike, and do kendo-like activities. So yeah.

  • Help

    Matthew, glad to hear you are feeling better! Wow, you are able to get a lot of steps in! That’s great!

  • kira

    Matthew, yikes, that’s a tough mixed bag of updates from your pulmo regarding the xolair, but good news about standardizing the approach when you get a flare. For whatever reason 40 mg usually doesn’t touch me and like you we have to go higher. When I talked to my docs about biologics it was pretty exciting to hear about the new drugs out there like nucala and dupixent. I hope you find one that works for ya!

    One thought, if insurance is being a stinker about paying for BT, have you and your pulmo thought about looking into seeing if there are any trials available at the bigger centers like UW, Colorado, NJH? The doc that I saw at NJH, Dr Wechsler, performs BT. Perhaps there might be ongoing studies on severe asthma and BT that you could get into?

    Holy cow! That’s awesome how active you are! I’m lucky to get in 8-10k per day. I tip my hat to you!