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Respiratory Disorders Community
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Avatar universal

Sinus and respiratory

Sorry - if this is the incorrect section, I'm unsure where to put this. This is a sinus and respiratory related question.

I am a male, I am currently 24, and am at around 265 lbs.

For a good history of all my recent problems, I'll start about two or three years ago:

Around three years ago, I got lyme disease. The hospital put me on Doxycycline, then because that started ripping up my stomach they put me on Nexium. After I had finished with the Doxy, it turned out that the combination of nexium and doxy caused a bacterial growth in my stomach. I went to a Gastroenterologist for a while before they came to that conclusion because they had to do other tests to see why I had constant nausea and stomach pains for about three months straight. Finally they treated me with a medicine I don't recall the name of, and I assume it got rid of it completely even though I had to stop early because of the insomnia that it caused me to have - did not sleep for 72+ hours straight while taking it. After taking that, I still have had bad acid reflux and GERD, so the Gastro doctor put me on a few medicines for acid - finally resulting in ranitidine which worked the best. I was around 220lbs at the time, for reference.

After that I was healthy for a while so long as I took the ranitidine, only having minor nausea. I was only needing 75mg at the time. Around two years ago, though, I started having very frequent sinus infections - nearly one after the other, with maybe a month or so in between. At first my doctor would treat them with a Z-pac (amoxicillin?), then ceftin started to be needed. As you can imagine, none of these were very good on my stomach.

At about the middle of last year, I went to an allergy specialist who did an allergy test which showed I'm allergic to all of the environmental factors. He recommended I take two nasal sprays, and that I begin allergy shots. After the first few they were already giving me breathing troubles, so they dropped me to an even lower dose to start and built up slowly over time.

At the beginning of this year/end of last year, however, I ended up with pneumonia/atelactasis, after starting to be treated with ceftin for a sinus infection. The hospital ended up putting me on Augmentin, but after a week that was making no progress (sorry, I don't recall the mg for the z-pac, ceftin, or augmentin). My primary doctor put me on Levofloxacin 500mg once a day for 10 days. After one round of it I still was having trouble and ended up in the hospital again being unable to breath, even with taking albuterol nebulizer treatments 4x a day. The hospital put me on prednisone 60mg for a week, and my primary doctor had initially planned for me to be on 60mg 3 days, then taper down by 10mg every 3 days until being done, as well as another round of levofloxacin. I ended up needing 3 rounds of the levofloxacin, and ended up needing to do a week of each for the prednisone, so it was more like 60mg for 7 days, 50mg 7 days, 40 for 7 days, etc. until I was finally able to come off of it and was no longer having breathing issues. She also had me on advair 250/50 for this time period to get me off the prednisone faster. With all that prednisone, I went up to about 250lbs.

After the pneumonia being cured and finally having my asthma under control, I tried very hard for about a month and a half to lose some of the weight. I was logging calories, taking only 1,500-1,700 in a day, as well as adding as much exercise as I could handle which increased over time as I built up more stamina with breathing. All of it was for naught, though, because I was still gaining weight. My primary doctor said prednisone can make it very difficult to lose weight, and she ended up checking me for thyroid and testosterone issues. I ended up being fine in terms of my thyroid, but my testosterone was at 188, while mentioning the lowest a male should have is 250. She recommended me to a pulmonologist and endocrinologist, which I only recently just saw last week due to long wait times for appointments.

However, because of prednisone also lowering my immune system, about three months ago I once again got a sinus infection which turned into bronchitis this time. I took two z-pacs this time, and when neither of those fully got rid of the problems, I was put in Levofloxacin 500mg again for another 10 days. I was also put on prednisone again because of how well it worked with the pneumonia and was having very bad breathing troubles, and was also prescribed duoneb, a nebulizer solution that I guess is a combination of incruse and albuterol. She also switched me to breo and incruse, rather than the advair. I am now around 265 lbs.

Over the past weeks I've worked my way down to being on 5mg of the prednisone a day, almost done with it. I am once again trying to exercise and work toward losing weight, because I know that all of my weight is causing the troubles with asthma and reflux/gerd. My doctor even prescribed metformin, a diabetes medication, to attempt to help me get some of this weight off because it is unbearable and causing more problems for me. However... in the past couple days my chest has started getting tight again when I wake up, and I have been having increasingly bad sinus pressure and headaches in the past few days as well. I am so unbelievably scared I'm getting sick once again, I honestly do not know what to do, but I know that it is coming. My stomach has also been particularly terrible for the past two days, burning like hell even after I take my ranitidine and causing lots of pain. I've even been bringing up some vomit into my mouth randomly because it is just so damn acidic in my stomach. It's..honestly horrible and degrading. I am on the edge of giving up at this point because I just do not see any route to being healthy or anything I can do differently because I am taking so many medications.

For the current meds I'm taking:

For stomach:
Ranitidine 300mg - 2x daily

For allergies:
Azelastine HCI nasal spray, 0.15% - 2x daily
Flonase (OTC) - 2x daily
Zyrtec - 1x daily
Montelukast - 1x daily
Sudafed PE 10mg - 1x daily (new addition, just bought tonight)

For asthma:
Incruse 62.5mcg - 1x daily
Breo 200/25mcg - 1x daily
Duoneb (Ipratroium Bromide + Albuterol Sulfate inhalation solution) - 4x daily
Prednisone, finally down to 5mg - 1x daily

Other/Sometimes:
Metformin HCL 500mg - 1x daily
Mucinex 600mg - when needed for chest congestion/phlegm
Probiotic - 1x daily
Ester C 500mg - 1x daily (to attempt to up my immune system)

As you can see, I am on almost everything my doctor has told me she can think of to help with my allergies and asthma without just keeping me in a locked and sterile room. Even with that, for some reason I am somehow starting to get sick again, and to make things worse my stomach is just being absurdly painful. I've been suicidal for quite some time now as you could imagine, but at this point I am honestly ready to give up. I am miserable daily, I try so hard to move forward then fall ten steps back. I'm sorry to be so frank, but it's just getting worse and worse, and I'm really seeing no way to get better and it is genuinely killing me. I can't handle it any more. I need to get better and I don't know how. I can't lose weight because of low T and prednisone so I can't make the stomach and asthma symptoms better, and my biggest goal is to be taking less ranitidine too because I've read that can cause more mucus, but I need to be less heavy in order to have less reflux so I could take less than 600mg a day of the ranitidine. With all of these meds for allergies and everything else, I'm still going back toward a sinus infection once again, and I just don't know what to do.

Please, if there are any alternative methods or any other things you think could be wrong please let me know. I need something to change or give me hope.
3 Responses
Avatar universal
Please look into Chinese medicine. Look for a Chinese medicine practitioner in your area. Yelp is a good start. Meditation is a fantastic help for health as well.
Avatar universal
If not tapered properly your symptoms will continue to flare up. I had to taper in 10mg a week then every other day 10 and 7.5 then 7.5 a week so on and so forth. Going too rapidly will cause your body to react poorly. I went all the way up to 230 after being on 60 mgs of prednisone about 6 months. They kept tapering improperly so I kept getting sick. Also, you might try a different reflux med. I used that one with no luck. I currently use pantaprazole which I am not a huge fan of but it works much better. Dexilant works amazing if you can get a low cost prescription for it.
Avatar universal
you certainly need to be on testosterone therapy ! you have the T level of a 95 year old man. you also need Estrogen levels and prolactin levels checked. what is your A1C?
the stomach acid blockers change the stomach normal PH, which in turn allows the growth of certain unwanted bacteria, which you've sadly found out.
don't blame all your weight on the GERD and allergies.
I had severe GERD at age 23 and only weighed about 135-140 lbs.
and stayed that way until I hit my 50's.
low T has bad repercussions especially at your age.
you need to google low T symptoms but remember google it as age appropriate.
you mention you had an appointment with an Endo, yet you failed to state the results ? remember all Endo's aren't necessarily schooled in Male hormone replacement therapy.
best of luck at this rate you have a hard path ahead of you unless you take more charge of your health.
1 Comments
Weight gain he discussed is caused by long term use of prednisone. A few lose weight while others gain. That is why it gives people "moon face." GERD and allergies have nothing to do with the actual weight. Some can drop the weight while others it throws out of whack and doctors give the same suck it up response you did. I spent years trying to drop weight with my conditions. Nothing worked well because of unaddressed health issues.  Recently I started dropping weight without trying. I weighed more than you as a female Marine in regulations. Think builds and muscle etc different body types. Without the proper information it is difficult to find a solution. My doctors response was exercise and diet. Neither worked. Hormones are definitely a possibility because they won't check mine because my thyroid is fine. Weight gain isn't always about self control but how to go about making the proper lifestyle change. I.e. mine will require a balance with GERD, Allergies, Lupus, mixed IBS, a new found lactose intolerance, and medication mixes. At his age I was just gaining issues and progressive symptoms.
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