Question:

- Hide quoted text — Show quoted text -Paul wrote: > If you haven’t done it already, consider getting him checked out > for asthma.  I went to my GP with complaints of feeling run-down > and needing a moderately strenuous bike ride in the morning > before I could wake up adequately.  He gave me Albuterol which > helped a lot and clued us in to the fact that I have asthma. > After using the Albuterol inhaler, I realized how restricted my > lung capacity could get.  I’m now taking Flovent and needing my > Albuterol less and less. > I never experienced acute asthma attacks.  In retrospect, I think > that I’ve had asthma for a long time. > It wasn’t until after the Albuterol that I felt like I got > satisfactory results from my BiPAP, even at pressures of 19/11. > — > Paul

Paul, Albuterol is fast acting, that’s why you notice a big difference. You shouldn’t use it anymore than 2 puffs every 6 hours. Normally they put you on a longer lasting one like Serevent, Flovent or Advair (12 hour) and you just use the Albuterol if you start having a breathing problem. Ever use Advair? The damn thing looks like a toy flying saucer. http://gsk.ibreathe.com/advair/consumer/2_2_2_taking_advair_animation… Move this, slide this, spin this, what a laugh. — Bob Gootee Yesterday it worked, today it is not working. Windows is like that. news.newusers.questions Moderation Team Worker news:news.newusers.questions

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Hi All, My brother was dx’d w/severe apnea 18 months ago.  He’s on a self-adjusting (pressure) CPAP since.  Started around pressure 11 or 12.  He’s been getting worse and worse, having to sleep longer and longer and falling asleep on a dime. His self-adjusting pressure is running at 20 (the maximum) and his sleep oxygen levels remain very low. What is disturbing is a doctor ordered a daytime oxygen level test and it’s 62 % (around the same as when he sleeps on CPAP). He’s gaining weight instead of getting better, presumably because he’s barely able to manage self-care, with sleeping so long trying to make up for poor sleep.  (History:  We now realize that he’s had the severe sleep apnea for perhaps 10-20 years, undiagnosed). It is my understanding that once a person is awake and moving about and breathing normally, the oxygen levels in his blood should reset themselves to a more reasonable level, yet that’s not what is happening.  He is getting severe abdominal "charley-horse type" cramps in his torso, presumably from lack of oxygen to his muscles. He’s 51, 6′, 270 pounds, doesn’t smoke nor drink and leads a "clean" outdoorsy type of life. Anyone else have these low daytime oxygen levels? Any ideas what his doc should be looking for/at? (seems to me there has got to be something else going on causing the low daytime oxygen levels). I’m very concerned that some real damage has been done/is happening to his body. Thanks J

Response:

>Any ideas what his doc should be looking for/at? (seems to me there >has got to be something else going on causing the low daytime oxygen >levels).

If you haven’t done it already, consider getting him checked out for asthma.  I went to my GP with complaints of feeling run-down and needing a moderately strenuous bike ride in the morning before I could wake up adequately.  He gave me Albuterol which helped a lot and clued us in to the fact that I have asthma. After using the Albuterol inhaler, I realized how restricted my lung capacity could get.  I’m now taking Flovent and needing my Albuterol less and less.   I never experienced acute asthma attacks.  In retrospect, I think that I’ve had asthma for a long time. It wasn’t until after the Albuterol that I felt like I got satisfactory results from my BiPAP, even at pressures of 19/11. — Paul

Response:

On Fri, 15 Mar 2002 17:01:22 GMT, Paul <p…@noreply.com> wrote: >If you haven’t done it already, consider getting him checked out >for asthma.  I went to my GP with complaints of feeling run-down >and needing a moderately strenuous bike ride in the morning >before I could wake up adequately.  He gave me Albuterol which >helped a lot and clued us in to the fact that I have asthma. >After using the Albuterol inhaler, I realized how restricted my >lung capacity could get.  I’m now taking Flovent and needing my >Albuterol less and less.   >I never experienced acute asthma attacks.  In retrospect, I think >that I’ve had asthma for a long time. >It wasn’t until after the Albuterol that I felt like I got >satisfactory results from my BiPAP, even at pressures of 19/11.

Interesting.  Thanks.  I have had a lung test done several or four years ago but this could be a possibility.  I’ll mention it to my GP. Your posting is cut and pasted into my Palm <smile> Tony

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On Fri, 15 Mar 2002 17:01:22 GMT, Paul <p…@noreply.com> wrote: >If you haven’t done it already, consider getting him checked out >for asthma.  I went to my GP with complaints of feeling run-down >and needing a moderately strenuous bike ride in the morning >before I could wake up adequately.  He gave me Albuterol which >helped a lot and clued us in to the fact that I have asthma. >After using the Albuterol inhaler, I realized how restricted my >lung capacity could get.  I’m now taking Flovent and needing my >Albuterol less and less.  

Hmm, I have an Novo Salmol Inhaler from four years ago.  Wonder if I should try it! <chuckle>  I’ll phone the pharmacist first and see if its date expired.  Which it likely is for safety reasons. Tony

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On Fri, 15 Mar 2002 05:03:52 -0500, J <jwoot…@execulink.com> wrote: >What is disturbing is a doctor ordered a daytime oxygen level test and >it’s 62 % (around the same as when he sleeps on CPAP). >It is my understanding that once a person is awake and moving about >and breathing normally, the oxygen levels in his blood should reset >themselves to a more reasonable level, yet that’s not what is >happening.  

In some patients, there is a condition where their brain doesn’t respond correctly to the carbon dioxide levels; not sure what they do about it, however. – Hide quoted text — Show quoted text ->Any ideas what his doc should be looking for/at? (seems to me there >has got to be something else going on causing the low daytime oxygen >levels).

Response:

In article <2bb59ukpgdai7337sqtkhmv99f8uale…@4ax.com>, Charles L. – Hide quoted text — Show quoted text -Perrin <c.l.per…@worldnet.att.net> wrote: > On Fri, 15 Mar 2002 05:03:52 -0500, J <jwoot…@execulink.com> wrote: > >What is disturbing is a doctor ordered a daytime oxygen level test and > >it’s 62 % (around the same as when he sleeps on CPAP). > >It is my understanding that once a person is awake and moving about > >and breathing normally, the oxygen levels in his blood should reset > >themselves to a more reasonable level, yet that’s not what is > >happening.   > In some patients, there is a condition where their brain doesn’t > respond correctly to the carbon dioxide levels; not sure what they do > about it, however. > >Any ideas what his doc should be looking for/at? (seems to me there > >has got to be something else going on causing the low daytime oxygen > >levels).

Are you thinking about COPD, Chronic Obstructive Pulmonary Disease, where the patient cannot exchange O2 and CO2 as a normal healthy person can. The body then gets confused and begins to shut down the respiratory system when the O2 level is increased to where a normal person’s would be. Treatment is low level of O2 on a continuous level depending on the severity of their COPD. Each patient would have to be evaluated and treated individually. Along with the COPD many other health problems arise and manifest themselves because of the strain upon their physical health. C.   (EMT since ‘78)

Response:

Regarding asthma……I used to be a full time asthma suffer.  After CPAP, I am off inhalers, albuterol, everything.  I only have asthma attacks when I get a cold and bronchitis now.  ?????????????/ Nettie

Response:

Wait a minute…..let me qualify that asthma statement I made!!  I also have RA and Fibromylagia.  I take Prednisone for RA so this could be the reason I do not have asthma problems as well.  ???????  Don’t want anybody to think that CPAP IS ABSOLUTE problem solver for asthma suffers.  Although with my last asthma series along with pneumonia, I used my CPAP constantly and I was able to get through the problem in far less time than ever before. Nettie

Response:

"Charles L. Perrin" wrote: > On Fri, 15 Mar 2002 05:03:52 -0500, J <jwoot…@execulink.com> wrote: > >What is disturbing is a doctor ordered a daytime oxygen level test and > >it’s 62 % (around the same as when he sleeps on CPAP). > >It is my understanding that once a person is awake and moving about > >and breathing normally, the oxygen levels in his blood should reset > >themselves to a more reasonable level, yet that’s not what is > >happening. > In some patients, there is a condition where their brain doesn’t > respond correctly to the carbon dioxide levels; not sure what they do > about it, however.

Wonder if the wrong combo of meds can do that to the brain?  He’s on a tricyclic and they’ve increased it, whereas I’d been pleading with him to decrease it.  Also taking immovane. http://www.nlm.nih.gov/medlineplus/druginfo/zopiclonesystemic500133.html which carries warnings of: Sleep apnea (temporary stopping of breathing during sleep)–Zopiclone may make these conditions worse When you are taking zopiclone, it is especially important that your doctor and pharmacist know if you are taking any of the following: Tricyclic antidepressants (medicines for depression)–The CNS depressant effects of either these medicines or zopiclone may be increased, possibly leading to unwanted effects <snip> J

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Question:

This is from Medscape: WASHINGTON (Reuters Health) Dec 15 – Ascent Pediatrics announced on Friday that it has received approval from the US Food and Drug Administration (FDA) to market Orapred (prednisolone sodium phosphate 20.2 mg/5 mL) to treat children with asthma and other inflammatory conditions. Orapred is a liquid corticosteroid with a "pleasant grape flavor" designed to make it easier for parents to get children to take their medication, the company noted in a news release. While clinical studies have shown that liquid corticosteroids work better in treating acute asthma attacks in children than inhaled corticosteroids, the traditionally bitter taste of liquid formulations has long been a problem in terms of patient compliance, Ascent noted. The FDA’s approval of a more palatable liquid asthma medicine means that pediatricians do not have to prescribe liquid corticosteroid to children at a weaker strength to compensate for its bitter taste "knowing the patient would have to take a lot more of it," noted Dr. Elliot Ellis, former president of the American Academy of Allergy, Asthma and Immunology. Orapred is not recommended for patients with systemic fungal infections and its potential side effects include "dermatologic and gastrointestinal disturbances," the company noted. Asthma is the most common chronic disease in children and the leading reason that children under the age of 14 are hospitalized, representing 12% to 17% of all discharge diagnoses, Ascent said. According to the National Institute of Allergy and Infectious Diseases, about 5 million children in the US have asthma. Pediatric asthma cases have more than doubled in the US in the past 15 years and have reached "epidemic" proportions among preschoolers, rising 160% in that time period, according to the Asthma and Allergy Foundation of America.

Response:

What a great idea for a meganasty medicine! If it isn’t just another lie.  The kids’ll tell.  And what about us big folk?  This stuff is state of the art nasty.  When I was a kid, I thought there was nothing nastier tasting than fresh peote buttons. Comes the big surprise.  And here and there little improvements. Thanks.

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Question:

I have been taking inhaled steroids like aerobid  for about 15 years.The doctor has started me on singular yesterday and he told me not to take aerobid anymore.Is is all right to stop like that suddenly?

Yes.  Inhaled steroids are very low dosages and typically below the threshold for side effects. "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

Well, it’s four days after your post, so you may already have your answer.  I made the mistake of not weening myself off Zamacort and had major problems.  I went to Flixotide because the smaller required dosage causes fewer side effects (grouchiness, water retention, weight gain, compulsion to eat).  There is a recent article (on Medscape, I think) that indicates that some individuals, at least, have some problems with abrupt cessation of steroid MDIs; my experience seems to bear this out. Hope you saved your inhaler, if not, and you begin having problems, don’t wait to go back; I thought I could tough it out–big mistake!  Even with my alternate meds I had some pretty nasty nights and bad coughing spells. Of course, your experience may vary.  I hope so.  Good luck.

Response:

I have been taking inhaled steroids like aerobid  for about 15 years.The doctor has started me on singular yesterday and he told me not to take aerobid anymore.Is is all right to stop like that suddenly?

Response:

I have been taking inhaled steroids like aerobid  for about 15 years.The doctor has started me on singular yesterday and he told me not to take aerobid anymore.Is is all right to stop like that suddenly?

In general inhaled steroids should not be abruptly stopped when Singulair is started; rather tapered down. Note that Singulair is only effective a little over half of cases, and is not effective for exacerbations.  See PI for Singulair [montelukast]: http://www.rxlist.com/cgi/generic3/monteluk_wcp.htm montelukast – Precautions "Montelukast is not indicated for use in the reversal of bronchospasm in acute asthma attacks, including status  asthmaticus.  Patients should be advised to have appropriate rescue  medication available. Therapy with montelukast can be  continued during acute exacerbations of asthma.  While the dose of inhaled corticosteroid may be reduced  gradually under medical supervision, montelukast should  not be abruptly substituted for inhaled or oral  corticosteroids." Ellis

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Question:

well, i gotta put my two cents worth in :go away     Most people here want actual help from people who have been there and survived.  We don’t want to hear about some "technique" that is not scientifically backed up.  All you do is send the posters off onto a tangent that acomplishes nothing.

– Hide quoted text — Show quoted text – I’ve had great success with the Buteyko technique. Fine.  You said your piece – now go away. Odd how your type only surface when the ‘b’ word is mentioned, but never take part in any of the other discussions. Make your mind up Colin. Do you want me to go away or take part in other discussions? It depends, will you actually take part, or will you push the ‘b’ word? "Being responsible sometimes means pissing people off."    General Colin Powell

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this is an open forum Bob…

Nope. It is frankly censorship via intimidation. that means that if you can’t argue logically from facts then your posts will get ripped to shreds by people like Colin (and myself on a good day)

I’m outta here. No open exchange of ideas or thoughts can get past closed minds with big egos who feel they have to cut down anyone that presents a different viewpoint. Maybe that is why I never see anything interesting in this newsgroup. Beam me up Scotty.

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- Hide quoted text — Show quoted text – this is an open forum Bob… Nope. It is frankly censorship via intimidation. that means that if you can’t argue logically from facts then your posts will get ripped to shreds by people like Colin (and myself on a good day) I’m outta here. No open exchange of ideas or thoughts can get past closed minds with big egos who feel they have to cut down anyone that presents a different viewpoint. Maybe that is why I never see anything interesting in this newsgroup. Beam me up Scotty.

I suspect your inability to understand logical argument might be the major factor — eric "if God had intended men to post to usenet, he would have made them intelligent"

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– Hide quoted text — Show quoted text – I’ve had great success with the Buteyko technique. Fine.  You said your piece – now go away. Odd how your type only surface when the ‘b’ word is mentioned, but never take part in any of the other discussions. Make your mind up Colin. Do you want me to go away or take part in other discussions?

It depends, will you actually take part, or will you push the ‘b’ word? "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

I suggest you might read the book you are putting down. It is an excellent sourcebook of all kinds of information about asthma. It is straightforward, no-nonsense, and comprehensive. It looks at drugs and beyond them. the author does not deny a drugs usefulness, but acknowledges their futility in that they do little or nothing to combat the underlying condition.

Then explain the part where the author claims that you can become allergic to somebody’s ‘energy field’.   How can you become allergic to something that does not exist? "Being responsible sometimes means pissing people off."    General Colin Powell

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– Hide quoted text — Show quoted text – I suggest you might read the book you are putting down. It is an excellent sourcebook of all kinds of information about asthma. It is straightforward, no-nonsense, and comprehensive. It looks at drugs and beyond them. the author does not deny a drugs usefulness, but acknowledges their futility in that they do little or nothing to combat the underlying condition. Then explain the part where the author claims that you can become allergic to somebody’s ‘energy field’. How can you become allergic to something that does not exist? "Being responsible sometimes means pissing people off." General Colin Powell

please site the page number please.

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– Hide quoted text — Show quoted text – I suggest you might read the book you are putting down. It is an excellent sourcebook of all kinds of information about asthma. It is straightforward, no-nonsense, and comprehensive. It looks at drugs and beyond them. the author does not deny a drugs usefulness, but acknowledges their futility in that they do little or nothing to combat the underlying condition. Then explain the part where the author claims that you can become allergic to somebody’s ‘energy field’. How can you become allergic to something that does not exist? "Being responsible sometimes means pissing people off." General Colin Powell please site the page number please.

Since I do not own the book in question, a page number citation will have to wait my next visit to a bookstore.  (And this is assuming that I remember to look it up.) "Being responsible sometimes means pissing people off."    General Colin Powell

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Make your mind up Colin. Do you want me to go away or take part in other discussions?

Thanks for asking, I agree with Randy: Go away. pavane

Response:

– Hide quoted text — Show quoted text – For alternative methods, I highly recommend the book "Reversing Asthma" by Richard N. Firshein, D.O. It talks a lot about cleaning up your environment, causes of asthma, medications, nutrients, exercises, etc. A better book would be: The Asthma Sourcebook, by Richard Adams M.D. Or The Family Guide to Asthma and Allergy, by the American Lung Association None of the wacky ‘you can be allergic to somebody’s energy field’ (which does not exist) nonsense. The big problem with books (and people) supporting ‘alternative’ medicine is that they tend to mix fact and fantasy together. "Being responsible sometimes means pissing people off." General Colin Powell

Colin- I suggest you might read the book you are putting down. It is an excellent sourcebook of all kinds of information about asthma. It is straightforward, no-nonsense, and comprehensive. It looks at drugs and beyond them. the author does not deny a drugs usefulness, but acknowledges their futility in that they do little or nothing to combat the underlying condition. The fact is, drugs are only a piece of the puzzle. Things like your environment plays an even larger role. I have had mild to moderate asthma since childhood. I am in my mid 40s now and I can tell you with certainty that my condition deteriorated progressively after seeking help over 10 years ago. Yes, drugs kept my condition in check. But I went from not having any to needing them daily. I suggest that drugs have their place, but there are other things one can do and take for their asthma. I will also suggest that it is the drugs themselves that are the "alternative". And we are at the mercy of the drug companies. Everyone is looking for the quick and easy solution and hoping this drug or that one will work. It ain’t that easy. Almost none of these drugs are void of side effects. And we are the ones who pay. We pay and pay and pay for the drugs we come to depend upon, and pay again with our side effects and deteriorating condition, while waiting for the next new drug to come out. Well, I’ve been there, done that. The fact is, there are common nutrients, minerals, and herbs or spices, that have truly helped me. Some act as broncoldailators, some as anti-inflammatories, some as anti-oxidants, which help repair damage done. Why should this be as a surprise? People have been using herbs as medicine for thousands of years. Why is this so "alternative"??? As a personal note Colin, after reading your responses for some time, you sound like a pawn of the drug companies. If anyone has a different opinion, you are there to throw water on it. Is this newsgroup sponsored by the drug companies? I thought this was an open forum , to disseminate information on what works for us individually, your mileage may vary, thank you very much. I am only saying that I found something that works for me, works very well, works without drugs, has no side effects, and has made me feel better than I have ever felt. Is it wrong to say that in an open forum??? I have nothing to gain, have no connection to the author of the book in question, and yet expose myself to ridicule by you. Excuse me, but what is wrong with this picture? As for your quote from the General….I only submitted my message to an individual asking for advice. He asked for alternatives. I told him what works for me. I felt I was being responsible. You have obviously never even seen the book in question, much less read or god forbid, even tried anything in it. Yet you are the one claiming to be "responsible"??? Give me a break! -Bob

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just two statements fist…please reconcile their apparent incompatibility  It looks at drugs and beyond them. the author does not deny a drugs usefulness, but acknowledges their futility in that they do little or nothing to combat the underlying condition.

and The fact is, there are common nutrients, minerals, and herbs or spices, that have truly helped me. Some act as broncoldailators, some as anti-inflammatories, some as anti-oxidants, which help repair damage done.

so what’s the deal here? bronchodilators and anti-inflammatory drugs do nothing to combat the underlying condition and hence selling them is bad(tm) some nutrients, minerals and herbs act as bronchodilators and anti- inflammatories and hence paying for them is good(tm) and a bit of paranoid fantasy As a personal note Colin, after reading your responses for some time, you sound like a pawn of the drug companies. If anyone has a different opinion, you are there to throw water on it. Is this newsgroup sponsored by the drug companies? I thought this was an open forum , to disseminate information on what works for us individually, your mileage may vary, thank you very much.

as I always say in such circumstances…most people’s first reaction when they try to attack somebody is to reach for an accusation that could in fact be applied to themselves funny how so many of the alt med advocates think nobody would post to usenet unless they had a financial incentive isn’t it? this is an open forum Bob…that means that if you can’t argue logically from facts then your posts will get ripped to shreds by people like Colin (and myself on a good day)…that’s the nature of open debate…people who disagree with you will have their say…if you can’t hack it then either learn fast or shut up there’s plenty of posts here that criticise conventional medicine…when it deserves it…the difference is that since it’s regulated there aren’t very many opportunities to do so when herbal remedies, nutritional supplements and the like are only sold after they have been thoroughly tested and the producers and retailers are under the same level of regulation as the pharmaceutical industry, then there would possibly be as little criticism of them…because, for a start, there would be less outright fraud and charlatanry until then, and whilst this remains a place where NO claim is taken at face value, then anyone posting absurd and unsubstantiated claims for an alternative remedy will get ripped into — eric "the alternative to seeing things in black and white is to see them in full colour"

Response:

– Hide quoted text — Show quoted text – I’ve had great success with the Buteyko technique. Fine.  You said your piece – now go away. Odd how your type only surface when the ‘b’ word is mentioned, but never take part in any of the other discussions. Make your mind up Colin. Do you want me to go away or take part in other discussions? Norman

I can’t speak for anyone else but as far as I’m concerned you can go away.

Response:

I’ve had great success with the Buteyko technique. Fine.  You said your piece – now go away. Odd how your type only surface when the ‘b’ word is mentioned, but never take part in any of the other discussions.

Make your mind up Colin. Do you want me to go away or take part in other discussions? "Being responsible sometimes means pissing people off."    General Colin Powell

Norman

Response:

For alternative methods, I highly recommend the book "Reversing Asthma" by Richard N. Firshein, D.O. It talks a lot about cleaning up your environment, causes of asthma, medications, nutrients, exercises, etc.

A better book would be: The Asthma Sourcebook, by Richard Adams M.D. Or The Family Guide to Asthma and Allergy, by the American Lung Association None of the wacky ‘you can be allergic to somebody’s energy field’ (which does not exist) nonsense. The big problem with books (and people) supporting ‘alternative’ medicine is that they tend to mix fact and fantasy together. "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

there seem to be a very small group of people who do all the online promotion of B*teyko…the number does not seem to increase…that says all I need to know about how many grateful successes they are actually managing…ie next to none If I recall correctly a couple of years ago Norman Back had a website marketing buteyko.

I’m afraid your recall has let you down badly. I’ve never had a website marketing buteyko. "Being responsible sometimes means pissing people off."    General Colin Powell

Norman

Response:

there seem to be a very small group of people who do all the online promotion of B*teyko…the number does not seem to increase…that says all I need to know about how many grateful successes they are actually managing…ie next to none

If I recall correctly a couple of years ago Norman Back had a website marketing buteyko. "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

– Hide quoted text — Show quoted text – Hi there. This is my first posting, so please forgive me if this has been asked before. I’m wandering if there are any suggestions of alternative methods to controling exercise induced asthma, other than salbutamol? Are there any herbal treatments? I am getting fed up of relying on my salbutamol (400mcg) every time I go the gym. I have heard about the Buteyko technique, but it seems rather expensive for something that seems quite controversial. Thanks in advance. Ian

No free lunch here. It does take some work to control asthma. For exercise induced asthma and for cold air, I have always relied on Intal. I switched to a nebulizer in recent years, because I do react somewhat to the propellant in the inhaler. For alternative methods, I highly recommend the book "Reversing Asthma" by Richard N. Firshein, D.O. It talks a lot about cleaning up your environment, causes of asthma, medications, nutrients, exercises, etc. I have been able to reduce my medications down to zero by introducing some supplements. Even in Missoula, which got choking smoke from forest fires this summer, I used only a little Intal and even less albuterol and had no asthma. I will test how well this works when I go skate-skiing this winter. But so far….well, I never felt better….and it is sure nice to get off the meds. I was getting heart palpitations every time I used albuterol. Good Luck. Bob

Response:

I’m wandering if there are any suggestions of alternative methods to controling exercise induced asthma, other than salbutamol? Are there any herbal treatments? I am getting fed up of relying on my salbutamol (400mcg) every time I go the gym.

Salbutamol was developed because the drug found in the herbals (ephedrine) has far to many side effects, and a short duration of action. Using herbals to treat asthma is like giving up indoor plumbing in favor of an outhouse. "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

I’ve had great success with the Buteyko technique.

Fine.  You said your piece – now go away. Odd how your type only surface when the ‘b’ word is mentioned, but never take part in any of the other discussions. "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

– Hide quoted text — Show quoted text – Hi there. This is my first posting, so please forgive me if this has been asked before. I’m wandering if there are any suggestions of alternative methods to controling exercise induced asthma, other than salbutamol? Are there any herbal treatments? I am getting fed up of relying on my salbutamol (400mcg) every time I go the gym. I have heard about the Buteyko technique, but it seems rather expensive for something that seems quite controversial. Thanks in advance. Ian

Somehow this strikes me as a plant.  It seems we get this type of message about once every two weeks or so and then we get the but**** plug.  If a person can find the ASA NG surely they also see that there is an ASAB group as well and would want to post there message there.

Response:

Hi Ian I have heard about the B*teyko technique, but it seems rather expensive for something that seems quite controversial. I’ve had great success with the B*teyko technique.

by this he probably means he’s one of the people that get paid rather than somebody who is gulled into wasting their money on it B*teyko is a controversial subject on this newsgroup where only conventional, medically approved, remedies are considered to be acceptable. However I found these medically approved remedies lacking and supplemented them with Buteyko.

it’s not controversial…it’s simply lost all credibility due to its proponents inability to tell the truth on any sort of consistent basis…and their habit of quoting medical references incompletely or out of context there seem to be a very small group of people who do all the online promotion of B*teyko…the number does not seem to increase…that says all I need to know about how many grateful successes they are actually managing…ie next to none — eric "in some places the digital revolution is still a case of giving the President the finger"

Response:

Hi Ian

Hi there. This is my first posting, so please forgive me if this has been asked before. I’m wandering if there are any suggestions of alternative methods to controling exercise induced asthma, other than salbutamol? Are there any herbal treatments? I am getting fed up of relying on my salbutamol (400mcg) every time I go the gym. I have heard about the Buteyko technique, but it seems rather expensive for something that seems quite controversial.

I’ve had great success with the Buteyko technique. For a good introducing and more information on Buteyko try http://www.wt.com.au/~pkolb/buteyko.htm. It is best viewed by using the option to download the whole site and then read at leisure. There is quite a lot of it. See the ‘Get Started Now’ section, to get you started. For more information, search for Buteyko using one of the search engines. These will give you other sites of interest. Buteyko is a controversial subject on this newsgroup where only conventional, medically approved, remedies are considered to be acceptable. However I found these medically approved remedies lacking and supplemented them with Buteyko. Two years ago my asthma was slowly worsening and my medications becoming less effective. Then I started to supplement my medication with Buteyko. It is now  2 years since I started to use Buteyko.  My Ventolin use has reduced from 730 – 1460 puffs a year to 18 a year and my Becotide use from 800 to 200 mcg per day. I now no longer need to use Ventolin before exercise. I still keep a record of my peakflows which compare well with my pre Buteyko records. My capability for physical exertion is greatly improved and is now comparable with other non asthmatic people. As I took the DIY approach to Buteyko, the cost has not been an issue (total expenditure about

Question:

My 16 yr old is back in the hosp. with asthma (just in in May).  Her Dr. is considering taking her off serevent because he says it gives some people breathing problems.  Anyone heard of this? She has only been on it since June1.

Response:

My doctor says quite the opposite. I asked if my serevent is the thing giving me the bad leg cramps (or maybe it is my flovent or proventil) and he said there really are no side effects from any of them. He said that my legs cramps at night are because I am pulling a muscle somehow. Sounds weird eh? Well I would check around… your doctor may be right. I wish there these doctors would have one uniformed answer… and the correct one. *sigh* Shannon

My 16 yr old is back in the hosp. with asthma (just in in May).  Her Dr. is considering taking her off serevent because he says it gives some people breathing problems.  Anyone heard of this? She has only been on it since

June1.

Response:

I guess he changed his mind.  The Dr. sent her home this a.m. and she is to stay on serevent, along with numerous other meds.  I didn’t question it or bring it up. But the day before he said that some of his patients had experienced breathing problems from the serevent.

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I asked the doctor the same thing regarding leg cramps and serevent. Doc says no but I believe I saw muscle cramps as a side effect listed informational sheet put into the box. I had them bad the first 6 months. I rarely have them now. Could be because I take an over-the-counter potassium supplement before bed? I dunno. Lynda – Hide quoted text — Show quoted text – My doctor says quite the opposite. I asked if my serevent is the thing giving me the bad leg cramps (or maybe it is my flovent or proventil) and he said there really are no side effects from any of them. He said that my legs cramps at night are because I am pulling a muscle somehow. Sounds weird eh? Well I would check around… your doctor may be right. I wish there these doctors would have one uniformed answer… and the correct one. *sigh*

Response:

My doctor says quite the opposite. I asked if my serevent is the thing giving me the bad leg cramps (or maybe it is my flovent or proventil) and he said there really are no side effects from any of them. He said that my legs cramps at night are because I am pulling a muscle somehow. Sounds weird eh? Well I would check around… your doctor may be right. I wish there these doctors would have one uniformed answer… and the correct one. *sigh*

I’m sorry, but your doctor is an idiot. Serevent has many OTHER side effects as well (very serious, like heart palpatations), a lot of flovent CAN have systemic steriod effects, albuterol has side effects…etc etc. A recent look at flonase..has the same steriod as flovent, but less, used for the nose, says it has a strong *progesterone* effect. This may add to women’s getting leg cramps or inhibiting absorption of calcium or what have you. Any doctor that says those medicines, that need to be used carefully, don’t have side effects, is WRONG and is not up on the literature. I’d get another doctor, pronto. Ditto for the original message with the 16 year old. Get an asthma specialist. -j   Shannon JGause23 My 16 yr old is back in the hosp. with asthma (just in in May).  Her Dr. is considering taking her off serevent because he says it gives some people breathing problems.  Anyone heard of this? She has only been on it since June1.

Jennifer Gerbi                          http://www.students.uiuc.edu/~gerbi Univ. of Illinois at Urbana-Champaign   1-113 ESB             (217)244-0332

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I had unbelievable thigh and hip pain. Couldn’t sleep. Couldn’t walk too well and had a difficult time getting in and out of my car. Changed shoes and sneakers. No improvement. Very little help from pain killers. Started to get sore throats. Decided to check out medications. Stopped taking flovent 220 and switched back to old standby vanceril. Pain and sore throat stopped in 3 days. Side effects from serevent showed up in about a month after use. Found increasing amounts of bronchial phlegm causing breathing distress. It increased to the point where it was comparable to an asthma attack. Discontinued use and condition disappeared. Point to case histories: You must be very careful as asthmatics/allergics when  starting or modifying medications or treatments. It may be impossible at times to predict your body’s reaction. Because of my personal sensitivities I start all new medications at roughly half dose for the first day to check my response.   — Posted via Talkway – http://www.talkway.com Exchange ideas on practically anything ™.

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My daughter’s Dr. is an asthma specialist. He admitted the serevent caused problems in some of his patients, just isn’t able to pinpoint the specific reason she can’t clear up completely(always has a wheeze) without major flareups upon reduction of steroids.  Thanx

Response:

My daughter’s Dr. is an asthma specialist. He admitted the serevent caused problems in some of his patients, just isn’t able to pinpoint the specific reason she can’t clear up completely(always has a wheeze) without major flareups upon reduction of steroids.  Thanx

Here’s a link to the PI for Serevent. Note it shouldn’t be used for severely deteriotating asthma, see WARNINGS: http://www.rxlist.com/cgi/generic/salmet.htm salmeterol (Serevent) I use Serevent along with other inhalers; I notice it knocks my peak flow down a little immediately after using; it recovers within 5 minutes as the Serevent kicks in; I think it may be the propellant or additives. A Dry Powder version is available [without propellant]. Difficult to control asthma is often linked to either sinusitis or GE reflux. Ellis

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Ellis, you are right on target. I have sinusitis and reflux and it does create additional problems with asthma. Bill

Response:

My doctor says quite the opposite. I asked if my serevent is the thing giving me the bad leg cramps (or maybe it is my flovent or proventil) and he said there really are no side effects from any of them. He said that my legs cramps at night are because I am pulling a muscle somehow. Sounds weird eh? Well I would check around… your doctor may be right. I wish there these doctors would have one uniformed answer… and the correct one. *sigh* Shannon

I get cramps and always assumed they were from Serevent. The leaflet that comes with the med mentions muscle cramps as a side effect. Perhaps you should send one to your Dr — Robin Muskett ‘When I cannot sing my heart, I can only speak my mind’ (Lennon)

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I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is                               Laura I get this cramp in the back once in a while myself. I have found that a small dose of potassium helps.  I am not a dr. but I do know that taking prednisone or using steriodal inhalers can use up your potassium pretty fast.  The small amount in a regular mulitpul vitamin

serevent is not a steroid, so that has nothing to do with it. I had to discontinue serevent because I had terrible heart palpatations, diziness, and other problems. Possibly muscle spasms can be triggered by it? it is worth going off of it (talking to your doctor of course) and seeing if it gets any better. I think quite a few people have had problems with serevent. -j *Jennifer E. Gerbi  Grad RA Materials Science* *1-113 ESB                                   * *University of Illinois at Urbana-Champaign  * *Office Phone: 217-244-0332                  * *http://www.students.uiuc.edu/~gerbi         *

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- Hide quoted text — Show quoted text – I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                               Laura I get this cramp in the back once in a while myself. I have found that a small dose of potassium helps.  I am not a dr. but I do know that taking prednisone or using steriodal inhalers can use up your potassium pretty fast.  The small amount in a regular mulitpul vitamin isn’t enough for me.  I take a 50 mg tablet once a day for a while when I start feeling that "cramp thing" happening to me.  After 6 to 10 days I don’t feel the cramping sensation any more.  I already take lots of meds and the potassium is just one more to take every day and I try to limit that.  Taking the potassium every day wouldn’t hurt you, but I WOULD ask my dr. Bill

  Hi, First, I have a sure cure for the "Hiccups"…a VERY Small amount of sugar..I know, I thought my friend was crazy, but it really does work. Second, Serevent is NOT a steriod inhalor, I ought to know…been on it and a steriod inhalor(Aerobid) for a couple years now. Learn what each med is and does and learn how to use them for best control of your asthma. Gina

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I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                                Laura

You might try mineral supplements, especially potassium.  OTOH, I use Serevent too, and have fewer problems with it than with daily use of Ventolin or Proventil, so you just may be one of the unlucky ones with this drug. also- Laura

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I have been on Vanceril, which I believe is same drug as serevent (Beclomethasone) for a few months, 3 puffs in evening. I also get cramps in shoulders. If I pulled a few weeds in the garden with my left hand, I’d get a spasm in my left shoulder/neck area. I had no idea that it was related to the drug until I read of someone else who was getting leg cramps after starting on this drug. I stopped drug for a few weeks and problem went away. Now I’m back on it, and my shoulders are both tight, but I’m not getting spasms. Conclusion, drug causes cramps. No problem with hiccups or digestion though.

Vanceril and Serevent(salmrtrol xinafoate) are not in any way the same drugs. Vanceril is an inhaled steroid and serevent is a bronchodilator.Two totally differnt action modes. Colleen the Respiratory Therapist and fellow asthmatic.

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Because I don’t have health insurance, I have been bouncing from one drug study to another for my asthma.   A few years ago I was in clinical trials for Serevent, and I had nightly cramps in my legs, but never connected it to the drug til now!!  Just stretching in the morning would give me cramps in my back and legs, even my feet!!!  I mentioned this to the study people, but I don’t know if they connected it, I assume they recorded it as part of the study…  I was told to take vitamin E suppliments to help the cramps. I am on completely other drugs now, and almost never have these kinds of cramps. says… I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                                Laura

– rls, naked in san diego http://www.concentric.net/~adnohr

Response:

… Vanceril, which I believe is same drug as serevent (Beclomethasone) for a few months

No.  This is incorrect.  "Vanceril" is beclomethasone dipropionate, while "Serevent" is salmetrol xinafoate.  These drugs are completely different from each other, and have different functions. "Vanceril" is an anti-inflammatory steroid.  It is not a bronchodilator and is not useful for the immediate treatment of acute asthma attacks.  It is useful for asthmatics who require chronic treatment with corticosteroids, but it avoids the serious side-effects of oral steroids (e.g., prednisone). OTOH, "Serevent" is a bronchodilator, but compared to others (e.g., albuterol), it is slow-acting, so it ought not to be used for the immediate relief of an acute attack. The package insert that comes with "Serevent" says that in clinical trials, about 1-3% of the patients using it complained about "…pain in joint, back pain, muscle cramp/contraction, mysalgia/myostis, muscular soreness."  Judging by the number of reports in this support group of "Serevent" causing muscle cramping, etc, perhaps 3% is too low a figure. DISCLAIMER:  I am not a physician.  This posting is for information only and does not constitute medical advice. , 3 puffs in evening. I also get cramps – Hide quoted text — Show quoted text – in shoulders. If I pulled a few weeds in the garden with my left hand, I’d get a spasm in my left shoulder/neck area. I had no idea that it was related to the drug until I read of someone else who was getting leg cramps after starting on this drug. I stopped drug for a few weeks and problem went away. Now I’m back on it, and my shoulders are both tight, but I’m not getting spasms. Conclusion, drug causes cramps. No problem with hiccups or digestion though.

Response:

I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                                Laura

Response:

I have been on Vanceril, which I believe is same drug as serevent (Beclomethasone) for a few months, 3 puffs in evening. I also get cramps in shoulders. If I pulled a few weeds in the garden with my left hand, I’d get a spasm in my left shoulder/neck area. I had no idea that it was related to the drug until I read of someone else who was getting leg cramps after starting on this drug. I stopped drug for a few weeks and problem went away. Now I’m back on it, and my shoulders are both tight, but I’m not getting spasms. Conclusion, drug causes cramps. No problem with hiccups or digestion though.

Response:

Potassium is very important to keep up when taking steroid inhalers.  My pulmologist makes me take potassium daily.

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Yes, if you use a spacer with Flovent and combine that with rinsing and spitting out after therapy you can eliminate up to 95% of the larger particles that deposit in your oropharynx. anton – Hide quoted text — Show quoted text -Hi, I’ve been using an aero-chamber for my combivent.  I need to start using Flovent and am wondering if it’s okay to use it with the aero-chamber.   Thanks much, Speedy

Response:

absolutely! We give 10 mg Ventolin neb in ER to people with high potassiums while awaiting other therapeutics anton says… – Hide quoted text — Show quoted text -High doses of beta agonists, like albuterol and Serevent, can cause potassium wasting. — CBI, M.D. Please note: It is impossible to accurately diagnose medical problems without seeing the patient and reviewing the entire history. These posts are intended to be helpful and informative. Always check with your doctor before following any advice given. I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                               Laura I get this cramp in the back once in a while myself. I have found that a small dose of potassium helps.  I am not a dr. but I do know that taking prednisone or using steriodal inhalers can use up your potassium pretty fast.  The small amount in a regular mulitpul vitamin isn’t enough for me.  I take a 50 mg tablet once a day for a while when I start feeling that "cramp thing" happening to me.  After 6 to 10 days I don’t feel the cramping sensation any more.  I already take lots of meds and the potassium is just one more to take every day and I try to limit that.  Taking the potassium every day wouldn’t hurt you, but I WOULD ask my dr. Bill You state taking steroid inhalers can use up potassium.  I have not heard of this before and wonder if this is a fact.  I take serevent, Flovent, Flonase, regularly.  I frequently suffer leg cramps at night and assume it has something to do with potassium loss but never thought of a connection to the use of steroid type inhalers.  Anyone have any comment on this?  I plan to ask my doctor on my next visit. LinC

Response:

"I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                               Laura"

I take serevent, predisilone, albuterol etc and get a lot of cramp – legs, feet , hands, I take quinine tablets and drink tonic water also, it seems to help. Noel

Response:

High doses of beta agonists, like albuterol and Serevent, can cause potassium wasting. — CBI, M.D. Please note: It is impossible to accurately diagnose medical problems without seeing the patient and reviewing the entire history. These posts are intended to be helpful and informative. Always check with your doctor before following any advice given.

– Hide quoted text — Show quoted text – I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                               Laura I get this cramp in the back once in a while myself. I have found that a small dose of potassium helps.  I am not a dr. but I do know that taking prednisone or using steriodal inhalers can use up your potassium pretty fast.  The small amount in a regular mulitpul vitamin isn’t enough for me.  I take a 50 mg tablet once a day for a while when I start feeling that "cramp thing" happening to me.  After 6 to 10 days I don’t feel the cramping sensation any more.  I already take lots of meds and the potassium is just one more to take every day and I try to limit that.  Taking the potassium every day wouldn’t hurt you, but I WOULD ask my dr. Bill You state taking steroid inhalers can use up potassium.  I have not heard of this before and wonder if this is a fact.  I take serevent, Flovent, Flonase, regularly.  I frequently suffer leg cramps at night and assume it has something to do with potassium loss but never thought of a connection to the use of steroid type inhalers.  Anyone have any comment on this?  I plan to ask my doctor on my next visit. LinC

Response:

LinC schrieb: Loss of magnesium?  Sorry to be so dense but are you saying the cramps are magnesium related, and further is the loss of magnesium related to steroid inhaler use? LinC

I wanted to say that by taking magnesium compounds cramps may be avoided. As to me, leg cramps at night usually occur after having lost mineral salts due to sweating during intensive exercises (hiking, sports) the day before. H.Henkler

Response:

Hi, I’ve been using an aero-chamber for my combivent.  I need to start using Flovent and am wondering if it’s okay to use it with the aero-chamber.   Thanks much, Speedy

Response:

Hi, I’ve been using an aero-chamber for my combivent.  I need to start using Flovent and am wondering if it’s okay to use it with the aero-chamber. Thanks much, Speedy

Yes. It is more important to use the aerochamber with the Flovent. With the ombivent it is a good idea because you will get a larger dose into your lungs. The same holds true for the Flovent but in addition it will also help reduce the incidence of sore throat and thrush. It is OK to use the same chamber. You do not need to rinse or wash it between switching meds. — CBI, M.D. Please note: It is impossible to accurately diagnose medical problems without seeing the patient and reviewing the entire history. These posts are intended to be helpful and informative. Always check with your doctor before following any advice given.

Response:

– Hide quoted text — Show quoted text – I have been on Serevent for about 2 weeks now and I have noticed some changes.  I get the hiccups all the time and now, 3 days ago I got the worst "cramp" in my upper back just from stretching.  This has never happened before.  I am in a great deal of pain.  Wondering if there is any connection!!  Any input would help.  Thank you!!                               Laura I get this cramp in the back once in a while myself. I have found that a small dose of potassium helps.  I am not a dr. but I do know that taking prednisone or using steriodal inhalers can use up your potassium pretty fast.  The small amount in a regular mulitpul vitamin isn’t enough for me.  I take a 50 mg tablet once a day for a while when I start feeling that "cramp thing" happening to me.  After 6 to 10 days I don’t feel the cramping sensation any more.  I already take lots of meds and the potassium is just one more to take every day and I try to limit that.  Taking the potassium every day wouldn’t hurt you, but I WOULD ask my dr. Bill You state taking steroid inhalers can use up potassium.  I have not heard of this before and wonder if this is a fact.

Oral steroids [or high dose inhaled steroids] can cause potassium loss. See: http://www.rxlist.com/cgi/generic/pred.htm prednisone Excerpt: "Adverse Reactions: Fluid and Electrolyte Disturbances: Sodium retention; Fluid retention; Congestive heart failure in susceptible patients; Potassium loss; Hypokalemic alkalosis; Hypertension" However inhaled steroids in low dose would be unlikely to cause this. Note that Serevent is a bronchodilator, not a steroid; however Serevent would normally be used in conjunction with inhaled steroids. Ellis  I take serevent, Flovent, Flonase, regularly.  I frequently suffer leg cramps at night and assume it has something to do with potassium loss but never thought of a connection to the use of steroid type inhalers.  Anyone have any comment on this?  I plan to ask my doctor on my next visit. LinC

– Free audio & video emails, greeting cards and forums Talkway – http://www.talkway.com – Talk more ways (sm)

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It

Question:

- Hide quoted text — Show quoted text – I was back in County Hospital ER again Sunday evening through Monday morning. I’ve been there five times this year, and every time they get things under control, my doctor at the local clinic screws things up and I’m back at ER. One time he took me off of Aerobid for some unknown reason. It took about a week after that for me to get into serious asthma trouble, and another week for me to end up back at ER. So Monday morning one of the ER doctors came over to me and told me that he was moving my treatment to County Hospital’s clinic, and I was done with my local doctor and his clinic. I was so glad to hear it! County Hospital has always been on target with my treatment. It’s amazing that they would be so conscientious as to tell me I was not to see my doctor again. (Yes, MDs can be quacks too.) County Hospital even has an asthma clinic. I have an appointment for tomorrow morning. They didn’t waste any time getting me into the program. They also scheduled me with the psych department. (don’t laugh!) They’re going to teach me relaxation techniques and also help me get through this constant medical crisis without losing my remaining marbles. I’m actually impressed. At times I thought none of them paid any attention to what was going on. Evidently they really were paying attention. To give you some idea about how much my old doctor knows about asthma — his clinic doesn’t have a peak flow meter. Think about it.

Martin, I am so glad for you!  Now maybe you can get off the rollercoaster. Chris Owens

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Hi Martin, I so sorry to hear you were back in ER again, but GLAD to hear you’re getting a new doctor and into a program.  I certainly wouldn’t laugh at you about seeing someone in a Psych Dept…I am seeing a therapist for panic due to my "emotional" reaction to my and my son’s asthma and acute asthma attacks.  It’s really helped me and I hope it helps you as much!  :o) Best of luck! Patrice – Hide quoted text — Show quoted text – I was back in County Hospital ER again Sunday evening through Monday morning. I’ve been there five times this year, and every time they get things under control, my doctor at the local clinic screws things up and I’m back at ER. One time he took me off of Aerobid for some unknown reason. It took about a week after that for me to get into serious asthma trouble, and another week for me to end up back at ER. So Monday morning one of the ER doctors came over to me and told me that he was moving my treatment to County Hospital’s clinic, and I was done with my local doctor and his clinic. I was so glad to hear it! County Hospital has always been on target with my treatment. It’s amazing that they would be so conscientious as to tell me I was not to see my doctor again. (Yes, MDs can be quacks too.) County Hospital even has an asthma clinic. I have an appointment for tomorrow morning. They didn’t waste any time getting me into the program. They also scheduled me with the psych department. (don’t laugh!) They’re going to teach me relaxation techniques and also help me get through this constant medical crisis without losing my remaining marbles. I’m actually impressed. At times I thought none of them paid any attention to what was going on. Evidently they really were paying attention. To give you some idea about how much my old doctor knows about asthma — his clinic doesn’t have a peak flow meter. Think about it.

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I’m so happy for you Martin, maybe you can get your asthma under control. He was an idiot, an average of once a month visits to the ER should have denoted something wasn’t right!  Niasha Martin wrote…I was back in County Hospital ER again Sunday evening through

Monday morning.   I’ve been there five times this year, and every time they get things under control, my doctor at the local clinic screws things up and I’m back at ER.

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Question:

people a GP is perfectly capible of treating a person’s asthma – but if your case is more difficult than his level of expertise can handle, he should cheerfully refer you to a specalist.

In a perfect world, maybe. Jo.

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So this year’s tree season rolls around and I’m coughing like a bandit since March.  Nose dripping the whole bit.  I wake up at night and and coughing so bad I can’t breathe.  My chest feels tight, but it’s hard to tell the difference between that and panic.  So, I go see an allergist. He tests me for all kinds of things (the scratch test on your back) and I come up negative.  But I fail the peak flow test and all my other symptoms lead him to believe I have an asthma situation.  I came home today with samples of MaxAir, Pulmicort and Nasalcort.  I’m supposed to use the MaxAir 3-4 times a day as needed and the Pulmicort 2x/day.  I dont’ know how long I’m supposed to use the MaxAir, but I have a follow up appt. next week.  It doesn’t seem to make me as jittery as the Proventil did, but the Nasalcort makes me feel very jittery.

(snip explanation on meds–figured everyone here knows that already!) These do sound like a reasonable treatment program.  One medication to relieve acute asthma attacks; one medication to prevent asthma attacks; and another medication to relieve your nasal symptoms (rhinitus?).  Note that rhinitus/sinusitus can aggravite asthma so doctors like to get it under control also.

Thanks for the advice.  I already answered Bill Ellis by email as he also emailed his comments directly to me.  One point I’d like to make is that, as a panic disorder sufferer, benzos are much more effective than anti-depressants.  There are many panic sufferers who also have asthma and have had no problems with their drug interactions.  The med journals cite CNS depression and possible breathing problems as side effects.  They also recommend that people with severe chronic respiratory problems not take the drug.  First of all, I wouldn’t catergorize myself as having severe chronic respiratory problems.  I have seasonal allergies, which seem to trigger asthmatic conditions and possibly, exercise induced asthma. Secondly, I’ve been on Klonopin for a few months now and have not had that problem.   Now, I have wondered whether or not I truly had some asthma episodes and thought they were panic, but I’d have to categorize my panic as more a racing of the heart and feelings of pure terror. I did hyperventilate and got very dizzy, but  I never felt that I was choking or couldn’t breathe. So, I think I could differentiate the two. One thing to remember is that there is no one ‘best’ asthma treatment program for everybody and that you may have to expirement a bit before you find the program that works best for you.  I know from first-hand expirence how frustrating this is but stick with it and never be satisfied with anything other than well-controlled asthma (asthma symptoms 3 or fewer times a week and _no_ nightime symptoms).  In fact tell your doctor that you expect well-controlled asthma and that you want him to get it under control – and if he cannot, refer you to an asthma specalist.  (For many people a GP is perfectly capible of treating a person’s asthma – but if your case is more difficult than his level of expertise can handle, he should cheerfully refer you to a specalist.

Grrr….it’s the same with panic disorder.  Mess around with meds until you find what’s right for you.  It’s so frustrating and being med-phobic (a common side effect of panic disorder) it’s frightening too.  So far, I’d have to say I like the Maxair better than the Proventil. It makes me less jittery.  Jittery would probably kick off panic for me.  The Pulmicort has no side effects so I’m fine with that.  But the Nasalcort makes me feel like I snorted speed.  So, next week, I’m going to talk with the doc about that. Iris —

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people a GP is perfectly capible of treating a person’s asthma – but if your case is more difficult than his level of expertise can handle, he should cheerfully refer you to a specalist. In a perfect world, maybe.

I am assuming a good doctor of course.  If your doctor is not willing to refer you when he is no longer able to handle the problem then I suggest that you find another doctor.

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I’ve had all the steroid inhalers for nose, chest etc.  My personal favorite for the nose is Flonase. It’s a milky fluid and it helps with the dryness from those steroid inhalers. Helen

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- Hide quoted text — Show quoted text -ing to remember is that there is no one ‘best’ asthma treatment program for everybody and that you may have to expirement a bit before you find the program that works best for you.  I know from first-hand expirence how frustrating this is but stick with it and never be satisfied with anything other than well-controlled asthma (asthma symptoms 3 or fewer times a week and _no_ nightime symptoms).  In fact tell your doctor that you expect well-controlled asthma and that you want him to get it under control – and if he cannot, refer you to an asthma specalist.  (For many people a GP is perfectly capible of treating a person’s asthma – but if your case is more difficult than his level of expertise can handle, he should cheerfully refer you to a specalist. </PRE<

Careful who treats your asthma.  I just had my 11 year old hospitalized because of asthma and the young intern had him on 120 mgm of Prednisone.  I’m 49 years old and 180lbs and I’ve never taken more than 70 mgm, and my asthma is severe. Just be careful….a specialist is your best bet, but first the PCP has to abdicate his throne.  Helen

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Careful who treats your asthma.  I just had my 11 year old hospitalized because of asthma and the young intern had him on 120 mgm of Prednisone.  I’m 49 years old and 180lbs and I’ve never taken more than 70 mgm, and my asthma is severe. Just be careful….a specialist is your best bet, but first the PCP has to abdicate his throne.  Helen

That really got to me. The same thing happened to me once. Because the new young intern didn’t want to bother putting a new IV line in my small vein at 5:00 AM, he decided (all on his own, without asking anybody) to change me over to prednisone. He gave me 120 mg. I can tell you I was strange for a day or two. Later, a nurse who works in intensive care in a different hospital told me that she had never even heard of anyone being given 120 mg of prednisone. Needless to say, my family discussed this problem with both my primary care physician and the intern’s supervisor. Try NEVER to go to the hospital in July. That’s when all the new interns come in thinking they already know more than anybody else. (Some of them never get over it.) Emily

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(HSKARULIS) writes: Just be careful….a specialist is your best bet, but first the PCP has to abdicate his throne.

I have to agree with this completely. My daughter was diagnosed with Asthma when she was 3. (she’s now 6) Last December, we (her Pediatrician and I) couldn’t seem to get her Asthma under control.She was on Intal w/ a nebulizer 3X a day. Still wheezing and coughing all night. They kept on prescribing Ped Pred, one week on, then one week off, blah blah blah. Even worse, she has Exzema. While on the Ped Pred, it would clear it up comepletely. But when she was off it, BAM!! total flare-up! Anyway, I was tired of it and finally had to ask them to give me a referral to a Ped Pulmonologist. She did a whole load of tests, PFT,x-rays,and a sweat test. Then put my daughter on Vanceril DS 3X/day, (now down to 2X/day) and since then, she has had to use her Albuterol "rescue" inhaler maybe 20X. And that’s since December!! She has an appointment next week, and I’m going to inquire about weaning her off the Vanceril to see how she does. Poor thing has a steroid based ointment for her Exzema and I hate pumping all those steroids into her little body! While I’m at it, I may as well make this post a bit longer <g.. She is currently in the 3rd week of a Food Allergy Elimination diet. The Dr seems to think that her Exzema is caused by a food allergy, but so far, it’s not clearing up. It may be wishful thinking on my part, but if it did turn out to be an allergy, it was worth a shot just to try and eliminate some meds!! Donna

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- Hide quoted text — Show quoted text – I went to an allergist today, after suffering my second year of severe seasonal allergies.  I should also mention I am a panic disorder sufferer on Klonopin for that.  But who knows what came first here.  Several years ago, after finishing my stairmaster routine, I found I could barely breathe.  Then when I was running a few months later, it happened again. By this time, the trees had started to bud and my nose started dripping. I went to my doctor who ran lots of tests on my and told me I had asthma and/or severe seasonal allergies.  They gave me Proventil, which I couldn’t take because it drove me up the wall.  So I took Intal instead. Then, we moved and I had a new doc tell me (tree season was over by now) that I probably had bad acid reflux and he took me off the Proventil. So this year’s tree season rolls around and I’m coughing like a bandit since March.  Nose dripping the whole bit.  I wake up at night and and coughing so bad I can’t breathe.  My chest feels tight, but it’s hard to tell the difference between that and panic.  So, I go see an allergist. He tests me for all kinds of things (the scratch test on your back) and I come up negative.  But I fail the peak flow test and all my other symptoms lead him to believe I have an asthma situation.  I came home today with samples of MaxAir, Pulmicort and Nasalcort.  I’m supposed to use the MaxAir 3-4 times a day as needed and the Pulmicort 2x/day.  I dont’ know how long I’m supposed to use the MaxAir, but I have a follow up appt. next week.  It doesn’t seem to make me as jittery as the Proventil did, but the Nasalcort makes me feel very jittery. Any comments or help would be appreciated.  I’m not sure what the hell is going on, but I sure do feel like I’m taking a lot of medication and I’d love toknow if it’s allnecessary. Iris

Asthma and panic disorder can both cause breathing problems. Use of a Peak Flow Meter to monitor lung function at home can help differentiate between the two. Klonopin is clonazepam, a benzodiazepine. See: http://www.rxlist.com/cgi/generic/clonaz.htm Excerpt: "Adverse Reactions: The most frequently occurring side effects of clonazepam are referable  to CNS depression. Respiratory: Chest congestion, rhinorrhea, shortness of breath,  hypersecretion in upper respiratory passages. Cardiovascular: Palpitations. " The Klonopin has a side effect of causing ’shortness of breath’ and heart palpitations. The short-acting bronchodilators used for asthma rescue, like Proventil (albuterol) and Maxair (pirbuterol) can cause heart palpitations and worsen panic attack. So its important to differentiate between them when you have breathing problems, so you take the correct medication. http://www.ama-assn.org/special/asthma/library/readroom/oc4154.htm Asthma and Panic Disorder Excerpt: "Our clinical experience has shown that asthma attacks and panic attacks  may be confused with one another, then mislabeled and mistreated by  patients and caregivers. For example, a 36-year-old white woman with  panic disorder and a history of childhood onset asthma stated, "I know  I have both things, so I make my best guess. I’ll take some Xanax  [alprazolam] and wait a while. If it gets worse, then I figure it must  be my asthma and I’ll take my Proventil [albuterol] then. Or I’ll  decide it’s my asthma and take some Proventil. If it gets worse then  I must be having a panic attack and I’ll take some Xanax." For patients who suffer from both conditions, improved differentiation  may result from increased use of objective measures of airflow  obstruction via peak flow meter and observation of discriminating  symptoms, with wheezing, coughing, and mucous production being more  indicative of asthma. The course of asthma and panic attacks generally  also differs, with the latter being characterized by a more  sudden onset with peaking of symptoms within an average of  10 minutes, and shorter total duration than the former. Panic disorder is effectively treated by cognitive-behavioral therapy(24)  with low relapse and treatment attrition rates.(25) Even a single-session cognitive-behavioral intervention with patients with panic disorder who  visited an emergency department was associated with a decrease in panic  attacks during a 6-month follow-up.(26) High-potency benzodiazepines  (alprazolam or clonazepam) rapidly reduce symptoms of panic attacks but  should be avoided in patients with asthma since these drugs may cause  respiratory depression. Additionally, continued use of these medications  requires careful monitoring to prevent dependence or withdrawal.  Tricyclic antidepressants(27) and selective serotonin reuptake inhibitors  have efficacy similar to that of the benzodiazepines(27) and  fewer contraindications for asthmatic patients. As noted earlier,  beta-agonists may trigger a panic attack. Since it is unlikely that  these medications can be deleted from treatment regimens for patients  with asthma, increasing patients’ knowledge about the anxiogenic side  effects of beta-agonists may make these drugs easier to endure.  Patients can also be coached to make self-calming statements, such  as "I’m feeling more jittery because of my inhaler; this doesn’t mean  I’m having a panic attack, I’ll feel better in a few minutes."

Question:

I have a feeling I’m using my asthma inhaler too much, but how much is too much? I used to use Primatene Mist, but now I use something else I got from my doctor that isn’t supposed to make your heart rate increase (I don’t know what it is, it’s at home <grin) I generally use it once when I get home from work, once again when I go to sleep, and then once more in the middle of the night (around 4am). Is this a lot?  I know some people who watch the time and use their inhalers as frequently as the instructions allow, but these people are senior citizens and I’m only 26.  I do have allergies… A bit of an aside:  I know that tobacco smoking aggravates asthma, but what about marijuana smoking?  The reports I’ve read say that marijuana actually opens up the bronchial tubes, but I notice that I’m a little short of breath after a smoking session.  Perhaps I’m just allergic to marijuana? Any thoughts on this? ML

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I have a feeling I’m using my asthma inhaler too much, but how much is too much? I used to use Primatene Mist, but now I use something else I got from my doctor that isn’t supposed to make your heart rate increase (I don’t know what it is, it’s at home <grin) I generally use it once when I get home from work, once again when I go to sleep, and then once more in the middle of the night (around 4am).

The rule of thumb is that if you use it more than 3 times a week, you should inform your doctor and get placed on preventative medications. Your inhaler is only intended to relieve acute asthma attacks – you probably need something to prevent them. A bit of an aside:  I know that tobacco smoking aggravates asthma, but what about marijuana smoking?  The reports I’ve read say that marijuana actually opens up the bronchial tubes, but I notice that I’m a little short of breath after a smoking session.  Perhaps I’m just allergic to marijuana?

I have yet to see a _real_ medical study that supports the use of marijuana as a bronchiodialator.  What you have read was probably BS put out by the druggies lobby.  Not long ago I had some druggies living in the apartment below mine.  Every time they ‘lit up’ I had to close the windows and turn on the air filter or have an asthma attack. Just as in tobacco smoke, it is the other (mildly toxic) combustion products that irritate the lungs.  You will be better off if you stop using it and avoid the smoke entirely. ‘Reply to’ address changed to foil email spammers.

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– Hide quoted text — Show quoted text – …snipped The rule of thumb is that if you use it more than 3 times a week, you should inform your doctor and get placed on preventative medications. Your inhaler is only intended to relieve acute asthma attacks – you probably need something to prevent them. …snipped Well the information that comes with ventolin here is that it can be used up to 2 puffs four times a day, or as directed by your doctor. Also, my doctor was keen for me to use the ventolin well before an attack became acute. If you feel symptoms you are having an ‘acute’ attack.  If your peakflow suddenly drops – you are having an ‘acute’ attack.  ’Acute’ has nothing to do with severity. And I am aware that albuterol can be used several times a day.  My point is that if you show asthma symptoms more than 3 times a week, you should make your doctor aware of this.

Colin, I agree with your point entirely.  However shouldn’t the instructions on albuterol highlight this?  Considering the overuse of bronchodilators may either a) indicate that your condition is out of control or b) indicate that your asthma conditioning is worsening. I’d also be interested in your opinion on floppy airways. Regards Robert http://www.buteyko.co.nz

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I agree with your point entirely.  However shouldn’t the instructions on albuterol highlight this?  Considering the overuse of bronchodilators may either a) indicate that your condition is out of control or b) indicate that your asthma conditioning is worsening.

I suspect that the manufactuers of medications want to avoid giving anything that may be considered medical advice.  Allthough I think that an paragraph on ‘what to expect from this medication’ would be helpfull.  The bottom line is that your doctor should have briefed you on the medication when he perscribed it. One of my pet peeves is the number of people who come to this newsgroup asking:  "I am being given XYZ medication – what does it do?"  IMO, doctors generally do a terrible job of explaining things to the patient.   I’d also be interested in your opinion on floppy airways.

What are ‘floppy airways’? ‘Reply to’ address changed to foil email spammers.

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wisdom… I have a feeling I’m using my asthma inhaler too much, but how much is too much? I used to use Primatene Mist, but now I use something else I got from my doctor that isn’t supposed to make your heart rate increase (I don’t know what it is, it’s at home <grin)

Did you get instructions with it?  If not, call the doctor and ask about it. I generally use it once when I get home from work, once again when I go to sleep, and then once more in the middle of the night (around 4am). Is this a lot?  I know some people who watch the time and use their inhalers as frequently as the instructions allow, but these people are senior citizens and I’m only 26.  I do have allergies…

;Not so.  People with asthma often need more than the prescribed dosage of Proventil, which is the most common inhaler, I think. And they are not all old people at all.  Before my son went on Serevet, he was going through his inhaler in just a couple of days.  It should last 25 days, at the normal dosage.  He was only in his 30’s.  Now he hardly uses it, but he uses his Serevent twice a day as prescribed. A bit of an aside:  I know that tobacco smoking aggravates asthma, but what about marijuana smoking?  The reports I’ve read say that marijuana actually opens up the bronchial tubes, but I notice that I’m a little short of breath after a smoking session.  Perhaps I’m just allergic to marijuana?

You will need more on your inhaler, if you smoke grass. A better way to get relief is to drink very hot, strong coffee.   —    K3JSZ since 1959 Extra Class   Hazleton, PA  (717) 454 8141

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Question:

I have a friend who has very bad reactions to most asthma meds.  Currently, the only drug that does not cause a reaction  in her is Bronkometer, isoetharine mesylate.  She has only enough meds for one week and she has run out of local resourses. Any ideas that I could pass on to her? I am so glad that Proventil does not cause me problems. — "And if I fail?"                         "I’ll slit you from your guggle to your zatch, and feed you to the Todal."

Response:

- Hide quoted text — Show quoted text – I have a friend who has very bad reactions to most asthma meds.  Currently, the only drug that does not cause a reaction  in her is Bronkometer, isoetharine mesylate.  She has only enough meds for one week and she has run out of local resourses. Any ideas that I could pass on to her? I am so glad that Proventil does not cause me problems. — "And if I fail?"                         "I’ll slit you from your guggle to your zatch, and feed you to the Todal."

Below is a list of drugs containing isoetharine I got from http://www.housecall.com/databases/ami/convert/001782.html (US Pharmocopeia). I think most of these drugs are inhalation solutions for use in a nebulizer, except for the Bronkometer. 25. 6. 16. 0. 0 isoetharine (Bronkometer, Bronkosol, Arm-a-Med Isoetharine, Dey-Dose Isoetharine, Dey-Dose Isoetharine S/F, Dey-Lute Isoetharine, Dey-Lute Isoetharine S/F, Dispos-a-Med Isoetharine, Arm-a-Med, Asthmalitan, Beta-2, Bisorine, Numotac) From the book ‘Reversing Asthma’ by Richard Firshein. D.O., c’96, I got the following info: ‘There are 7 major types of beta-agonists: isoetharine, metaproterenol, terbutaline, perbuterol, albuterol, and bitolterol. The 7th, fenoterol, was never available here and has fallen out of favor because of the deaths associated with its use…A new beta-agonist, salmeterol, has just been approved in this country….. ALBUTEROL is probably the most popular spray in this country….it causes less shakiness than the other sprays……The spray’s effects are ISOETHARINE, known as Bronkosol or Bronkometer, is immediately effective and lasts only about an hour. It has a tendency to cause rapid heartbeat and muscle tremors. It is one of the less popular sprays, but it is still used fairly frequently for children… SALMETEROL, recently approved in this country, is a quick-acting and long-lasting beta-agonist spray. It has shown good results so far in patients with well-controlled asthma, allowing patients to manage their asthma through the night. It is, however inefficient for acute asthma attacks…Because they are long-lasting drugs and take at least half an hour to provide relief, improper use could result in a fatal asthma attack.’ Maybe it is time for your friend to move on to a more effective and more targeted beta2 agonist bronchodilator. I find that Serevent(salmeterol) is very effective, 2 puffs twice a day, in conjunction with Proventil/Ventolin for exercise or rescue(PRN).

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Question:

The following is reprinted from the Townsend Letter for Doctors, by permission.  Those with questions, or interest on the subject may call 360-385-6021 for more information.  If those reading this newsgroup find the information interesting, the editor, Dr. Collin, has agreed to let me post a number of articles each month from his magazine.  Let me know what you think, flame me if you don’t like the stuff. Literature Review & Commentary by Alan R. Gaby, MD 125 NE 61st Street, #198 Seattle, Washington 98115