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Moderate Persistent Asthma

So I was diagnosed with this about a year ago. Last week I went to the doctors and was informed that it was still out of control despite my constant use of my controller inhaler (Dulera), my rescue inhaler (Proair) and my singulair. I have been to the ER multiple times from attacks. I either wind up on prednisone or stuck on a nebulizer. The doctor is thinking of getting me a nebulizer. What are your opinions on using one of those?

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  • Kathy P

    Welcome Emillee. That sounds very frustrating.

    I have a nebulizer and I have inhalers. I usually only break out the nebulizer when things are really bad. But it does help – the meds seem to get in "deeper". It's definitely worth a try.

    What type of doc are you seeing? Is it someone who specializes in asthma? 

  • Emilee R Ashline

    No. It's a family doctor. There isn't much for doctors that specialize in this particular condition. I use dulera twice a day and I've been using my albuterol around the clock every four hours. Plus I am on singulair. And I also have a spacer for my inhalers

  • Kathy P

    Using a spacer is good – that will increase the effectiveness of the medication. Trying a nebulizer may increase that even more.

    Are there any pulmonologists in the area? Or an allergist who specializes in asthma? That who I see for my asthma and allergies.

  • Emilee R Ashline

    I would have to ask my physician when I go back next month. I know he said if I am still wheezing then, then he is definitely going to get me a nebulizer. But we have a big medical center about thirty minutes away from this hospital and they can probably help. Only trouble is is that I might need a referral

  • GigiGibson

    Emilee you need a specialist or at least a review of your meds because your asthma is uncontrolled. I feel your pain. I am out of control too on several meds, a nebulizer and prednisone. I only got diagnosed in March. Please consider asking for a referral to pulmonary even if it's an hour away. We don't want long term damage from being like this. I'm in the same boat, it's taking over a month to see one. 

  • Emilee R Ashline

    You are right. I go back to my doctor next month because that's the soonest he can get me in, I will definitely be asking for a nebulizer and a referral. When all this started, the doctors blamed it on bronchitis. But I kept going back to the hospital for having bad spells with my breathing and finally one doctor said he didn't know what the others were thinking but you've had asthma all along

  • GigiGibson

    If you can get your doctor to go ahead and order your nebulizer meds you can buy a nebulizer online like $50

  • Allison

    I also recommend seeing a specialist.

    also that kind of office will likely have a respiratory therapist or asthma education specialist who can watch your technique with any inhalers….

  • K8sMom2002

    Emilee, and I, too, was diagnosed with asthma after a lovely (not) bout with bronchitis. I'm yes to Kathy P's suggestion about using a spacer — we think that spacers are for little kids, but actually adults with adult onset asthma have been shown to . I posted a link to an in another topic.

    Another option is to look at using an inhaler that doesn't require a spacer — some of the dry powder inhalers don't, I believe.

    Another thing is to — you may not even realize what all your triggers are, but keeping a journal of each time you have to use your inhaler and what you were doing in the time leading up to it can help you and your doctor figure things out. Also, sometimes environmental allergies can trigger attacks. So you can check that by:

    • noting the time and day of the asthma attack
    • checking with sites like Weather.com about the pollen levels
    • noting what's blooming in your area.

    Then you'll have a better idea of what environmental allergens you could test for. Avoiding triggers or managing triggers can mean the difference in how often you have to use your inhaler. 

    I say to getting a pulmo or at least a board certified allergist on your team, and it would be worth it to at least get a more experienced set of eyes on this. So if your medical center is only 30 minutes away, then that's a good place to start. 

    That's not to say that if you do everything right, you'll never have another asthma attack — we have folks on here who attack their triggers head on, take their meds, stick with their action plan, see their doctor, and their asthma just doesn't seem to let go. 

    Still, it's a place to start. Do keep us posted on what you decide to do! We are here for you no matter what!

  • Jen

    Emilee – is there any chance you can get in with your family dr sooner than a month from now?  If not, perhaps you can call them to get the ball rolling on a referral to a specialist.

  • Emilee R Ashline

    Thank you guys for all the great advice! today isn't as bad as yesterday. Although I did have one mild episode when I was raking the lawn

  • Kathy P

    I would call the doc and tell him you need a referral. Often getting in to see specialists can take time – sometimes a month or more. You need to start the process now. Uncontrolled asthma can cause permanent lung damage.

    Waiting a month for your next appointment, when it's clear that things are not well controlled, is not OK. When you call, also push for getting the RX for the nebulizer now.

    I know it can be difficult to push back with doctors – they are "authority" figures and we've been taught to respect authority figures. But you have balance that with advocating for your own health. Some docs are quick to refer out when they realize that a case is beyond their expertise and the patient will be best served w/ a specialist…other docs are not as quick to do that. 

  • Emilee R Ashline

    It is better today. I woke up late so I ended up taking my meds late, But it's ok. It's hot and muggy so I am staying in where it is cool

  • Kathy P

    It's been quite toasty here all week – it always seems to get hot again right when the kids go back to school! I just checked and it's supposed to cool down over the weekend.

    Glad the mowing is done!

  • K8sMom2002

    Oh, yay, Emilee! Now for a good rain to wash all the pollen down!

    What's your go-to-strategies for handling things like that? And did you ever circle back and see if the doctor could fit you in any earlier? You could try to get added to their cancellation list. That has worked for me in the past, although it means I have to be ready to go at a moment's notice. Still, it's better than waiting a month.

  • Emilee R Ashline

    We got a good rain last night and today my allergies aren't even acting up. No stuffy nose, no runny nose, no sneezing. And yes I tried but my appointment next month is lathe soonest they can see me or so they say. I usually just stay indoors if they are mowing or if my allergies are really bad, then at night ill sit out on the deck. My asthma isn't acting up either!!

  • K8sMom2002

    Glad you're doing better and you had some rain — hopefully it isn't muggy! 

    The polite but squeaky wheel approach has worked for me and others: I've heard of folks picking a particular day and time of the week and once a week calling and asking for any cancellations. 

    And by all means, if things go downhill again or you wind up needing your inhaler more than the doctor has indicated, call back and tell the nurse that. Even if you don't get the appointment, you'll have let them know your asthma isn't under control. 

  • Emilee R Ashline

    Well I have been lucky, I have had no problems with allergies and my asthma for two whole days now. That's a long stretch for me. I've only had to use my dulera twice a day and haven't had to use my albuterol inhaler!!!

  • Emilee R Ashline

    I think the rain helped get some of the pollen out of the air. For me, if allergies act up, my asthma acts up most of the time of vice versa. I haven't done a lot of strenuous activities either that would trigger an asthma attack

  • Jen

    Emilee – hope it stays that way and your allergies/asthma stay in check.

  • K8sMom2002

    Rain does that for me, too, as long as it doesn't get too muggy. I'm glad the rain helped wash things away and that you're taking advantage of good days!

    Have you talked to your doctor about how to avoid attacks after doing strenuous activities? What sort of activities do you find makes things worse?