asthma control and overuse of inhalers

[nebi]

I have repeated problems with asthma that usually start with a sinus infection. I have asthma problems so often, which is usually 4-5 times a year and always after an infection, either sinus or bronchitis. On Sept.13,2005 i had bronchi/asthma and a sinus infection and was put on zpak and given a shot of prednisone.  On 10/21 i had a sinus infection and bronchitis and put on cefaclor for 10 days, 3 xs a day and given another shot of prednisone. at that time i was using albuterol via nebulizer 5 times a day.  To date i still need to use the albuterol via nebulizer 3 - 4 times a day (sometimes waking at night) I am also taking advair 250/50. My asthma has been so much worse (hospitalize once) that using it 3-4 times a day didn't seem like a big deal, but now I am concerned that I am using albuterol too much. Am I worrying too much? My symptoms right now are wheezing and coughing, and some chest tightness. After having 2 bouts of bronchitis so close is it normal to need it that often? I have an appointment with a pulmonary dr. but not until 12/1.  My personal Dr. said I should talk to the pulmonary Dr. because he doesn't know what else to do. Any help or advice would be greatly appreciated. Thank you.

[National Jewish]

It is easy to understand your concern.  It is clear that since September your asthma is not under control.  It is possible that your sinus infection has never been cleared since September and is the source of the continued problems.  A CT scan of the sinuses is probably a good idea to confirm if this is the case or not.  It is a good idea that you are going to see a pulmonologist, but it is unfortunate that you have to wait another month until that occurs.  It is likely that you will continue to have problems until then.  I would call your family doctor and see if you can push up the date for the pulmonologist.

[starion]

Waking at night because of difficulty breathing may be a sign of poorly controlled asthma.  Could you ask your doctor to see if the pulmonary doc could see you sooner than 12/1--that's a long time to wait to improve your breathing.

In the meantime, perhaps you could ask your doctor if you could try using the higher strength Advair (500/50), 2x/day instead of the medium strength 250/50.  Also, sometimes ipatropium bromide (also known as Atrovent) OR tiotropium bromide (also known as Spiriva) m-a-y be a helpful addition.

Two other things to consider are
(1) whether you have any allergies & can possibly reduce your exposure to triggers (allergies can worsen lung function) and
(2) whether you might have gastric reflux (even silently) which may also worsen lung function.

Good luck--hope your docs can help you get better control of your breathing challenges.
Starion

[nebi]

thanks for the comments. My appointment with the pulmonary Doc has been moved up to middle of Nov., and I am on a cancelization list so hopefully sooner. I have a new symptom, (never had this one before).  I have been getting a fluttering noise in my right ear, around 4 times a day.  It doesn't hurt, just anoying.  Anyone ever hear of such a thing?  Could it be related to my other symptoms?  Thanks.

[annt79]

I have asthma since I was 18 months old, now 26... so I've been around the block...

I was hospitalized in August after severe anafalatic (SP?) shock that caused me to stop breathing (they said another 10 minutes and I would be a gonner....) My asthma has not been under control, despite the addition of several meds to my regular regime, and upping to 500/50 Advair.  

About your ear... I have an ear infection now and it caused by a head cold/sinus infection. It felt dirty / wet all of the time with lots of popping.  Sound familiar?  He said once you have so much junk in your head that sits there for days, it's what happens. I'm on a super strong decongestant and anti-biotic for it now.  Seems to help.

Good luck.

[nebi]

Thanks for the input. I saw my pulmonary Doc, he put me on prednisone for 8 days, seemed to help a little but i still think i have a sinus infection which is agravating the asthma.  They seem to go hand in hand with me.  I had them in the past and usually antibiotics, prednisone, inhalers, helped but for some reason this time it is just hanging on.  My 14 year old daughter is having the same sinus problems,  She is on her 3rd round of antibiotics for it and had a x-ray of her sinus today.  I hope you start to fell better.  Maybe short term prednisone would help you.  Good luck.