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Severe Asthma Flare
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Severe Asthma Flare

So, yes, I'm a newbie. 27 yr old female with asthma and allergies since I was little. In the last 2 years, my asthma has gotten progressively worse. This year, I started fresh with a brand new asthma/allergy specialist and we finally started to get my asthma under control. I went from a peak flow of 450 to 575 in just a couple months with medication changes! This was all great until 2 1/2 weeks ago when I got a cold and I quickly spiraled downhill and now I'm struggling to get back to where I was.

Two Questions/Situations:

1. This past year, I have had two very severe asthma flares which have resulted in multiple ED visits and a hospitalization. Never been intubated. During this current flare, I haven't been responding as well or as quickly to the typical treatments that we've used in the past. For the most part, per my asthma specialist, I was maxed out on medications. Two weeks ago when I felt myself going downhill, I went to Urgent Care (regular doctor was closed, avoiding ED) and had a chest xray done which showed "nipple shadows project over the lower lung fields". I'm curious to know if this could be pneumonia or something else....I periodically still have a low grade fever and I'm totally exhausted. Been on Augmentin for the past 10 days. Per asthma specialist, I am a "labile asthmatic" and I don't wheeze hardly at all. I either start coughing and then quickly my lungs become tight or just go straight to being super tight.

2. Thoughts on Xolair? Too labile to be considered for traditional immunotherapy and maxed out on oral/inhaled medications to maintain asthma control. If you've been on it, has it been helpful? Side Effects? My IgE level was around 11, not high enough to qualify but that was when I was on oral and inhaled steroids for the previous 2 months. MD is going to re-check it in 6 weeks or so to see if I qualify.   I appreciate your feedback....
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2 Comments Post a Comment
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942934_tn?1268111982
Welcome to the asthma community!

I too suffer the same way you do. Been an asthmatic for most of my life and during this past year my asthma decided to go for the worse. I also don't have a high enough IgE level in my blood and I was also on oral steroids at the time it was taken. I am on the maximum allowable amount for on a long term basis for inhaled steroids.

However, one thing I have noted is that the faster I can treat a flare up the easier it is to treat. A couple of weeks ago I felt a bronchitis type thing affecting my lungs, so the next day I took some prednisone that I had left over. Which was only 20mg/day for three days, but it did the charm. My airways loosened up and I spent the next week coughing up all sorts of excess mucous. My plan is to ask my doctor for more to keep on hand for when I really need it. I shall what she says.

I understand that Xolair is supposed to be quite affective for those with a high IgE count. I'm not certain if it would be beneficial for those who don't have a severe allergy component. I too have a lot of mild allergies, but not enough for Xolair. My specialist also tested me out for GERD to see if that was contributing to my asthma, but that wasn't the case either. Oh and sinusitis can certainly offset asthma quite a bit too. In the end she just declared that it's straight up asthma and that I had to live with some daily symptoms (as they weren't detrimental), because I'm already on a very high inhaled steroid dose. She said that there had to be a balance achieved between drug dosage and actual benefit. For the small gain you receive from the steroids, you end up with more damaging side effects from the drug itself.

Anyone else with ideas, please feel free to comment.
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Avatar_m_tn
That's what is most fustrating for me! I actually started treating this flare right away. I started to feel crummy the Wednesday before New Years so I stayed home and rested. Went back to work on Thursday but stayed home Friday, Saturday, and Sunday. Immediately started using my nebulizer with Pulmicort treatments. By Sunday, I noticed that I was coughing up yellow/green mucus so I went to Urgent Care, thinking it was more than just an asthma flare - maybe pnuemonia (pneumonia). MD there stated it was just asthma, xray was clear except for the shadow in the lower lung fields.

My allergies severely impact my asthma. Severely allergic to pollen, trees, and cats. My allergist is guessing that my IgE level was so low because I was on pred for 2 months (just had weaned off) and also on high doses of inhaled steriods. Dealt with sinusitis and currently treated with allergy meds.

I'm concerned being on so much steroids. Not only just the unpleasant side effects such as weight gain and always being hungry, but the bone loss, etc.

Thanks for the warm welcome! I'm eager to learn how to deal with this better. This asthma action plan is new to me so we're adjusting it as needed. Now, I know to pay attention to the symptoms and not worry so much about the peak flow numbers.
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