I have RAD and can't get off Prednisone. Help

[AmyPBM]

I have always had asthma, and it has been under control.  Then, a year ago I breathed in some glue that was pretty toxic, my throat and airway swelled and it was hard to breathe, I was prescribed flovent and prednisone and it calmed down in about a week.  Since then I have had bronchitus twice, pneumonia once and been on prednisone 9 times. About 2 weeks ago I was in a store and breathed in a body spray that made my tongue swell 3 times its size and my throat swelled.  My quality of life has tanked because I never know what I might breathe in that will cause a reaction.  And each reaction seems to be worse than the one before.  Currently, I have been on prednisone (40-60mg) for 20 days.  I have not worked for a week and am trying to get the twitchy feeling in my airway to settle down, but it won't.  I feel like my immune system is attacking me and my primary care and allergist are at a loss as to what else to do.  I currently use: Advair 500, Flovent, Singulair, Nasonex, Allegra, Xopenex for the nebulizer and benadryl.  Any advice would be welcome and deeply appreciated.

[hava]

You want to reduce your dependency on medicine.This yog pranayam will help you build up your immune system, and then you will notice the need for medication will reduce gradually.
Do the anulom vilom first for two weeks, and than do kapalbhati as well.
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 15 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.

Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 20 to 30 minutes twice a day. Children under 15 years – do 5 to 10 minutes twice a day.
Not for pregnant women. Seriously ill people do it gently.

[bsmsl]

Yes, I have been tested for reflux (barium swallow first) and had a GI scope done.  I have mild barrett's eosphagus from the reflux and I am treating it agressively as well.  Usually my shots don't hurt, but ocassionally they catch a nerve.  That is really not fun.  Does your doctor have lidocaine available?

[AmyPBM]

I will ask about the bronchoscopy.  I am having a lung and sinus CT Scan week after next.  When I am off the prednisone.  I swear I can feel exactly where the problem is at the base of the airway where the tubes branch off into the lungs.  I am hoping that when I get the CT results and see the pulmonologist I can get the test you recommend.  Have you been checked for reflux?  I know that was a contributing factor for me.  I do think allergy shots work because I can eat and be around stuff that I could not when I was younger.  They just hurt (if the nurse uses you as a bulls eye) .  Hope the shots help you.  

[bsmsl]

Hello again.

You may want to request a bronchoscopy since your dr suspects mold in your lungs.  That can be treated with anti-fungals like diflucan.  This procedure would also help to diagnose possible chronic infections that don't cause you to "feel sick", but just keep the lungs inflamed and a constant asthma flare.  Two ideas hear are Neutrophilic asthma and bronchiecstasis.  Neutrophilic asthma has many causes, but they can check biopsies from the scope for a high neutrophil level and then treat from there.  Bronchiecstais is really a pretty common form of lung damage that can allow for the collection of fluid which then becomes infected.  That can be diagnosed by a chest CT scan, but the bronchoscopy is necessary to determine if you have infection from the condition.

I am trying to decide if I need a bronchoscopy.  I was recently treated for the neutrophilic asthma as I do have a history of one of the causes.  I felt great for about two weeks, but I am starting to go down again.  I do have bronchiecstasis lung damage, so I might need the scope to determine if that is the source of infection.  

I was also tested for a type of pneumonia that is caused from exposure to birds.  It is similar to legionaire's disease, but not the same.  I can't remember what it was.  I would have ot get my records out to look that up if you want the information.

Take care and keep me posted.

[AmyPBM]

Thanks for your comment.  I do take Allegra so I will try Zrytec.  I use Nasonex and have had 4 sets of allergy shots in my life.  From when I was 5 to when I was in my 30's.  My allergiest told me that she thinks I may have an issue with mold and she has already ruled out doing shots again.  She thinks the mold may be in my airway.  I have a high white blood cell count, but do not have symptoms of being sick (chills, fever) my only symptom is my airway swelling.  I did get my IgE level tested just for Xolair and it was above 60 so I will call my Dr. today because she totally forgot about that part of the test.  Thanks so much for your insights every piece of information gives me a bit more confidence that I will get better.  

[bsmsl]

Hi.  So sorry for your reactions.  I am in a similar situation, only I do have a very agressive allergist who is working very closely with my very agressive primary.  

You may want to try a different oral antihistamine.  No medicine works well for everyone.  I tried allegra and it did nothing for me.  I now am taking 3 Zyrtec a day, and I am feeling much better.  You may also want to discus a nasal antihistamine with your allergist (Astepro or Patanase).  Are you in immunotherapy treatment (allergy shots)?  Those can greatly reduce your overall allergic reactions as you become less reactive to the treatment allergens your overall level of inflamation and reactiveness declines as well.

Another thought is have you had your IgE level tested?  IgE is a allergic response chemical that triggers reactions.  If you have IgE mediated allergies and have a level over 33 you qualify for Xolair treatment provided your asthma is classified as severe, which it sounds like yours should be.  The  idea is the the Xolair reduces the amount of allergic reaction, thus reducing the overall over ractiveness of the airways.  It is helping me considerably.  

Good luck and keep us posted.