Asthma is worse after Pneumonia

I am a 38 y/o woman who was diagnosed with Asthma the fall of 2008.  Until recently my asthma attacks only consisted of coughing and a some S.O.B.  Last fall I had Walking Pneumonia after an upper resp. infection. Last month I had a cold that ended up turning into pneumonia, which was treated with Levaquin.  I started having Asthma attacks with this, which I thought was from being allergic to the Levaquin, but it has been over two weeks since I have been off the antibiotic and I am still having the Asthma attacks.  I get tightness in my chest and I feel like I am breathing through a straw.  My lower chest and back hurt or burn.  These attacks usually last 5-10 minutes.  I have tried taking allergy pills, such as Benadryl or prescription allergy meds, but they don't work.  My doctor put me back on the nebulizer, but that didn't seem to make a difference yet.  I have been on Symbicort 160 since the start of my Asthma treatment.  The only thing that helps is the Albuterol to stop the Asthma attack.  

I have noticed that the Asthma attacks mostly happen at night and that I get a rash on my chest, forearms, and cheeks.  The tip of my tongue is red and it hurts all the time.  I guess I am allergic to something.  But I can't get my Pulmonologist or the ER doctors to listen to me.  

Any advice?

[hava]

This relaxation technique will help get more oxygen into the lungs and heart and help ease the asthma and heart problems.You will be pleased that you can do something yourself.
Build up your timing gradually.If you feel tired or dizzy, stop and resume after one minute.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 10 to 30  minutes twice a day.
Children under 15 years – do 5 to 10 minutes twice a day.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

[caregiver222]

After an infection the lung may become hypersensitive for weeks.

You just have to keep the albuterol handy.

It is also best to avoid steroidal inhalers, if at all possible  after an infection because the degrade the immune response. I have argued this with many physicians who deny this is true, but it is only common sense.

Levaquin is not the best antibiotic to treat pneumonia, and has many side effects.

In any event, it is not unusual for there to be an increase in the severity and incidence of asthmatic attacks after a lung infection.

Asthma attacks that only happen at night suggest a possible cardiac problem. Not necessarily. But a stree test is indicated.

Asthmatic attacks are precipitated because of a super-sensitive immune system, so it is not surprising that some asthmatics also have allergy problems.

You need to find an M.D. who is an allergy specialist to look into your symptoms and provide suggestions.

[whisperwolf]

I do have cardiac problems too. Just recently diagnosed with Tachycardia 2 months ago.  I am taking Verapamil, 120mg tid.  I have had stress test and echo.  Both were normal.  The Holter monitor showed Tachycardia, and the EKG showed borderline abnormal, with the T-waves.  I had an overnight Pulse Oximetry, which my Pulmonologist said was fine, but I know I don't get enough oxygen at night, so I specifically asked him about it and he told me that my stats did drop into the 80's, but told me not to worry because my stats were in the high 90's during the day.  When I see my Cardiologist, I am going to mention that and see if he wants to repeat that test or if he can get a copy of the results.

He mentioned that the virus I had last fall may have affected my heart because the symptoms I started having right after I got the URI.    

[caregiver222]

Many asthmatics have compensatory tachycardia, which should not always be treated. The liklihood the virus affected your heart is about as likely as you having been telaported down here at the age of six months by space aliens.

Presumably you have the two part echo, one part of which involves swallowing a probe. This is a test for endocarditis. A "one part" test is meaningless.

Whenever there is a deficiency of oxygen (low P02) the carotid sensors speed up the heart. This is not necessarily harmful. When medication is given to restrict the heartrate this means that during an asthmatic attack the patient loses the ability to stay alive.

Tachcardia is defined as a heart rate over 100 beats per minute.

I am not sure what your rate was.

Mild tachycardia in an asthmatic or COPD patient is the body's normal way of maintaining a proper oxygen supply to the tissues. Verapamil is often prescribed simply because the heart rate is high. That's the "protocol". Plan stupid.

The differential diagnosis rests upon whether or not the increased heart rate is compensatory or because the atria is malfunctioning and sending inappropriate signals.

As one ages the ability of the heart to deal with increased heart rates declines and the probability of developing what is called ventricular tachcardia increases.

"Borderline abnormal" is a meaningless statement.

Keep the windows open at night. And get some plants in the room. Normal oxygen is twenty one percent of the atmosphere, but in a closed room it can drop to eighteen pervent.

Always ask for all copies of lab results as soon as possible after the test.

[hava]

This relaxation technique will help get more oxygen into the lungs and heart and help ease the asthma and heart problems.You will be pleased that you can do something yourself.
Build up your timing gradually.If you feel tired or dizzy, stop and resume after one minute.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 10 to 30  minutes twice a day.
Children under 15 years – do 5 to 10 minutes twice a day.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

[whisperwolf]

Thanks for your help so far.

I have decided my pulmonologist is an idiot. I refuse to take Symbicort and am coughing a lot less and have less exercise induced asthma.  I just use my rescue inahler as needed.  ( approx. 3 times a week.)
Also discovered I am allergic to Lexapro.  I would break out in a rash 2 hours after taking the drug and have a asthma attack.  So I take Ativan (1mg) as needed for anxiety.

For allergies I find Claritin works the best....:)


As for the SVT ( the official word on my type of Tachy) My average resting heart rate before the medications was in the teens when I was reclining.  It got up into the mid 20's and low 30's just walking around the house.  

Along with the tachy, I was also having SOB, chest pain, palpitations, feeling faint, kept falling down.  

My recent EKG says "T-wave abnormality, consider anterior ischemia"  And it has been that way for the past few months.  

I will say that when they did not have me swallow a probe during the echo.  When they did the stress test my ejection % was 76%.  

They repeated the overnight O2 sat and it didn't drop below 90%.  

So that is my update.  Thanks for your help.  

BTW...I meant to put your answer as the best answer, but accidentally put hava's instead;)

[marieann288]

I'm a bit concerned about Symbicort. I have heard of other having problems. I couldn't take it.I could hardly walk any distance and went into tachicardia. It was 165 when I went to see the doctor who sent me to the cardiologist and said NOT to take it.

[marieann288]

Did you suggest that Verapamil is not a good idea for asthmatics that are having tachi due to their asthma?

I have an idea you may have an understanding of what may have happened. I was over the pond Xmas before last. My son had two birds that flew around the house alot. I can't remember if the tachis came before or after the lung incident, but is sure went on after.

It was a Saturday and I really felt like I should start taking the brown inhaler again. I was in a room with carpets and didn't realize the birds were affecting me. I called the NHS Nurses line to see if I could get the puffer. I had Ventalin on me. After talking with me she made an appointment for me to go to the Emerg. The doctor there said I had pneumonia to take an antibiotic and I was having asthma and he was concerned it was going to get alot worse. He put me on Prednisone which I have never taken before. Within just a few days I felt better.

I went back to the doctor earlier than what the emerg doctor said to do to see if I could go for a long drive to take my daughter back to uni. This other doctor said I never had pneumonia, to stop taking the Prednisone but still take the antibiotics (why? if I never had pneumonia). Within two days I was coughing quite a bit, felt lousy and was stuck away from home. I ended up using the Ventalin quite a bit.

So whether or not I had or did have pneumonia, who knows, but I think the Prednisone helped alot whatever was going on and it was probably allergy based due to the birds.

What I'm concerned about is I started having tachacradia every morning when I first woke up. Not high always, just 120 sometimes 140. Didn't last more than half hour. I would have to sit quietly. On one occasion I went to the doctor, he thought it was SVT because I had a history and put me on Verapamil. It took awhile for my heart to calm down. I don't know if I started to expect it to happen each morning and it did, or now I am wondering if it had something to do with the birds or ashtma or ???

Does this make any sense to you?

Thanks.
ps I was diagnosed just Friday with FMS. Great!

[whisperwolf]

Yeah, I have heard some bad things about Symbicort recently too.  So I am off it as well.  But I am starting to have problems with evening Tachycardia again, similar to what I had before the Verapimil.  I have only been on it for 3 months.  Waiting for my insurance to approve another Holter monitor.  

It seems to start with my BP going up right before bed, then I wake up a couple of hours later, with my pulse racing and feeling really weak. I feel a lot of palpitations and chest pain.  But then it passes after approx. 5 mins.