Question:
I think your allergist needs to read the NIH report.
: :Readings :last winter were then 400-450, with very wild swings, but apparently :OK because they were near the expected range : :I think you should discuss these wild swings with your MD. If they are more :than 20% I think that is unacceptable. : :Since adding Serevent, the swings are no longer a problem. :) : :My regular doctor :had me double the Vanceril dose, and take my rescue inhaler every 4 :hours, and said if I had problems over the weekend to call the doctor 
n call. His response Saturday evening was that if I could talk to :him on the phone there wasn’t really a problem, and I should be ok : :I think you should leave asthma management to a specialist. General MD’s are :know if you were ok? He didn’t see you, he couldn’t jump into your body!!!!! : :My allergist’s office is closed on Fridays. I knew I was in trouble, :so I went to my primary doctor. She is very helpful, and converses :with my allergist regularly. The problem was with the idiot on call :that weekend. : :I also think you need to learn some relaxation techniques. Guided imagery is :good. It helps you to calm dowm and take slow deep breaths. I find that this :is essential to managing asthma. : :Already done – mostly to keep the migraines away, but it does help :most "minor" problems I have with asthma. : :Ok, next problem – went to my allergist Wednesday. She did the :spirometry (sp?) again, and said basically that it seemed good, I :seemed to be doing just fine on these meds, did I have any questions r problems. At which point I asked about all of the above stuff – :classes, exactly when I should increase the Flovent, and when to call :the office. Her respose was "most asthmatics would love to have peak :flow readings like yours, so I really wouldn’t worry about it too :much. Do you know when you start having trouble?" (yes, anything :below about 470 I am out of breath if I walk more than 1 1/2 blocks) :"Well, Flovent is a pretty potent steroid, so we really don’t want to :get too much of it – I guess if you have numbers that low for 3 or 4 :days, then you could add another 2 puffs in the middle of the day for :about 2 weeks, but if you do, definitely call me so we can see what :the problem is." She said that with the medicines I had, I shouldn’t :have to miss class if I got a cold, but if I did to let her know. I’m :getting a bit frustrated. What she seems to be saying doesn’t seem to :match all of the info that shows up on this newsgroup all the time. :Her office is the only allergist’s office within 100 miles, and to go :anywhere else, I’d have to miss class (which is what I’m trying to :avoid). Arghh! : :janet : : : Barry Landy Computer Laboratory:+44 1223 334600 Head of Systems and Development Direct line: +44 1223 334713 University of Cambridge Computing Service Pembroke Street, Cambridge CB2 3QG
Response:
Didn’t anyone tell you that the lack of wheezing sound could also mean that the air movement in the lungs is so restricked that it can’t make that "Wheezing" sound. Lack of that sound in my son is a BIG RED FLAG.
I am not nearly as concerned with when I am wheezing than I am when I am not wheezing and not feeling well. My doctor HATES for me to come in and her not be able to hear a wheeze–that usually means I am in BIG trouble. Best of luck to you and your son. Angela Remember: That which doesn’t break us makes us stronger.
Response:
I usually don’t wheeze You don’t have to wheeze to have asthma.
Didn’t anyone tell you that the lack of wheezing sound could also mean that the air movement in the lungs is so restricked that it can’t make that "Wheezing" sound. Lack of that sound in my son is a BIG RED FLAG.
Response:
Readings last winter were then 400-450, with very wild swings, but apparently OK because they were near the expected range I think you should discuss these wild swings with your MD. If they are more than 20% I think that is unacceptable.
Since adding Serevent, the swings are no longer a problem. :) My regular doctor had me double the Vanceril dose, and take my rescue inhaler every 4 hours, and said if I had problems over the weekend to call the doctor on call. His response Saturday evening was that if I could talk to him on the phone there wasn’t really a problem, and I should be ok I think you should leave asthma management to a specialist. General MD’s are know if you were ok? He didn’t see you, he couldn’t jump into your body!!!!!
My allergist’s office is closed on Fridays. I knew I was in trouble, so I went to my primary doctor. She is very helpful, and converses with my allergist regularly. The problem was with the idiot on call that weekend. I also think you need to learn some relaxation techniques. Guided imagery is good. It helps you to calm dowm and take slow deep breaths. I find that this is essential to managing asthma.
Already done – mostly to keep the migraines away, but it does help most "minor" problems I have with asthma. Ok, next problem – went to my allergist Wednesday. She did the spirometry (sp?) again, and said basically that it seemed good, I seemed to be doing just fine on these meds, did I have any questions or problems. At which point I asked about all of the above stuff – classes, exactly when I should increase the Flovent, and when to call the office. Her respose was "most asthmatics would love to have peak flow readings like yours, so I really wouldn’t worry about it too much. Do you know when you start having trouble?" (yes, anything below about 470 I am out of breath if I walk more than 1 1/2 blocks) "Well, Flovent is a pretty potent steroid, so we really don’t want to get too much of it – I guess if you have numbers that low for 3 or 4 days, then you could add another 2 puffs in the middle of the day for about 2 weeks, but if you do, definitely call me so we can see what the problem is." She said that with the medicines I had, I shouldn’t have to miss class if I got a cold, but if I did to let her know. I’m getting a bit frustrated. What she seems to be saying doesn’t seem to match all of the info that shows up on this newsgroup all the time. Her office is the only allergist’s office within 100 miles, and to go anywhere else, I’d have to miss class (which is what I’m trying to avoid). Arghh! janet
Response:
Readings last winter were then 400-450, with very wild swings, but apparently OK because they were near the expected range
I think you should discuss these wild swings with your MD. If they are more than 20% I think that is unacceptable.My regular doctor had me double the Vanceril dose, and take my rescue inhaler every 4 hours, and said if I had problems over the weekend to call the doctor on call. His response Saturday evening was that if I could talk to him on the phone there wasn’t really a problem, and I should be ok
I think you should leave asthma management to a specialist. General MD’s are know if you were ok? He didn’t see you, he couldn’t jump into your body!!!!! My lung function tests are also above normal for my age. However, I am very sensitive to changes in my lungs. I know immediately, without my PF meter, if there is a problem. had a lot of difficulties getting any doctors to listen to me.
Find one that will listen. There’s go to be one out there! I usually don’t wheeze
You don’t have to wheeze to have asthma. I also think you need to learn some relaxation techniques. Guided imagery is good. It helps you to calm dowm and take slow deep breaths. I find that this is essential to managing asthma. Nice speaking with you Janet. Hope you get in control. Sindee
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Anyhow, it sure makes it more difficult to not have some of the typical symptoms, but I’ve read that it is possible to have asthma but not wheeze.
I have cough-variant asthma. I don’t begin to wheeze until I am in serious trouble.
Response:
: :I think what you may need is a better asthma plan. I think you should speak to :your physician about the problem. Not just about the notes, but about haw to :better manage yourself if you come down with a cold. If a cold always triggers :abn asthma attack then maybe at the first sign of a cold you should take a :"run" of oral steroids. My question to you is: what are the medications you :are on now? Are they managing your asthma well between "colds?" And, of :course, what do you do for your asthma once you have a cold. [much material snipped for brevity] Just to support other excellent posts:- As another sufferer from late onset asthma (last 5 years) I have learned a lot about self management in that period, and believe the following to be the case. There are three critical factors in good (self) management of asthma symptoms: 1) Patient’s understanding of his/her own symptoms, what triggers them, and what are danger situations. This is partly observation and partly reading – the NIH Asthma workshop report cited by others is a critically important resource 2) Medical assistance (Doctor, Nurse, Clinic) which is knowledgable and helpful, and which has the goal (again, as advised by the NIH report) of making the patient understand what is going on and learn to cope with his/her own symptoms 3) Putting the above into practice and not getting into "denial" ("It isnt really happening, so I wont do anything"). Item 1: Know your normal Peak Flow, and where your own danger levels are. Guideline is that below 80% of maximum is the first step, and 50% the second, but this is very personal. Item 2: Whenever PF is below the first level **and** whenever a known trigger is encountered double the "preventer" medicine (Beclamethasone or other corticosteroid). Cold or other infection is a standard trigger, so at the onset of cold/flu double up (and dont wait for the PF to tell you the bad news). Take reliever if necessary. Item 3. If the initial doubling does not prevent asthma symptoms, double up again and again, up to whatever maximum the doctor has advised. Meanwhile contact your doctor/clinic for advice and reassurance. Item 4. If the maximum level is reached and still no stability (as show by PF), medical assistance is necessary, and will probably involve oral steroids. Item 5. Once stable, maintain dosage until the trigger has gone and the PF shows consistently high readings; then slowly drop the dosage (the NIH report recommends going down in smaller steps that going up, but it is a matter of experience; I reduce by 25% steps, roughly); say 2 weeks for each level down provided the PF stays OK. Sticking to this type of regime should anticipate the stress placed on the lungs by the trigger, and also, by generating confidence (each well managed episode gives you more confidence in your ability to manage the next one) enables you to stay calm during the initial stages which in itself helps to reduce the asthma symptoms. Denial: It is all too easy (I know, I have done it!) to say "My PF is still high, this is not really a cold/allergen/whatever so I dont need to start doubling my dose" and to fail to get the dosage doubled early enough. This usually then means that the preventer dose needed to get the attack under control is eventually higher. Deny denial! Barry Landy Computer Laboratory:+44 1223 334600 University of Cambridge Computing Service Pembroke Street, Cambridge CB2 3QG
Response:
Hi Janet, Just diagnosed asthmatic here. For me too, they never hear wheezing, although last night in the middle of the night I think I did. But it does cause problems in being taken seriously. After a severe attack yesterday where the peak flow got down to 350, maybe lower, the doc said I could call and come in for breathing treatments. So today I felt like I did yesterday when it all started and wanted to get in before it got as bad as yesterday – because I was not able to function at all yesterday. The doc came in and listened to my breathing and said, "You’re not very bad, normally we don’t give breathing treatments, but we will since you are here." Don’t know if he was using wheezing or what as a criteria, but I told him I hate to wait for it to get as bad as it did yesterday before I come in. And it felt the same etc. He said he’s hoping the new inhaler will make this not happen anymore. Anyhow, it sure makes it more difficult to not have some of the typical symptoms, but I’ve read that it is possible to have asthma but not wheeze. Good luck, Kirloga – Hide quoted text — Show quoted text – So at least there is hope that I don’t have to go through this whole mess over and over again. Because my lung fuction tests always come out higher than average, even when I’m not feeling too good, I have had a lot of difficulties getting any doctors to listen to me. I usually don’t wheeze (the nurses in Student Health are well aware of this, since when I’m sick I stop by to have them listen, because I don’t know what it sounds like, and they haven’t heard any wheezing yet in over a year). So I’m stuck. Even at a peak flow of 400, feeling terrible, there is no wheezing, and often no apparent symptoms other than the fact that I’m always out of breath, and often cough uncontrolably. That was part of why I missed so much class – I couldn’t stop coughing for more than about 2 minutes at a time, and it made walking to class, sitting though class, even thinking difficult. And I’m sure my classmates and professors would have been equally annoyed with me. :) janet
Response:
I think what you may need is a better asthma plan. I think you should speak to your physician about the problem. Not just about the notes, but about haw to better manage yourself if you come down with a cold. If a cold always triggers abn asthma attack then maybe at the first sign of a cold you should take a "run" of oral steroids. My question to you is: what are the medications you are on now? Are they managing your asthma well between "colds?" And, of course, what do you do for your asthma once you have a cold. Last winter, when I was diagnosed, the doctor put me on 4 puffs of Vanceril twice a day (took an ER visit to get the diagnosis). No peak flow meter or anything. Switched doctors (primary and allergist) in January, got a peak flow meter, readings were around 420-460, expected for my height was 450, so new allergist did base line pulmonary function test and reduced Vanceril to 2 puffs twice a day.
Personal Best Peak Flow should be established by measuring Peak Flow under best conditions; middle of day after using Ventolin with asthma completely controlled–somtimes this requires a short regiment of prednisone. Typical peak flows based on height, age, sex are notariously inaccurate and the new asthma guidelines don’t even include the tables. Readings last winter were then 400-450, with very wild swings, but apparently OK because they were near the expected range. I still was out of breath pretty often, but doctors both insisted there wasn’t a problem.
Well controlled asthma does not have wild swings. You shouldn’t be out of breath. Lasst summer, I was pretty stable at the low end of my green range on 2 puffs of Vanceril twice a day. When I got sick last fall, my allergist switched it to 2 puffs of Flovent 110 twice a day. Then when it got cold and I couldn’t walk 2 blocks without a serious bout of coughing, we added Serevent, 2 puffs twice a day.
Flovent 110 and Serevent are good meds. 4pf/day of Flovent 110 is a Moderate Dose. Your previous use of Vanceril 4pf/day is a very Low Dose. Serevent is good at controlling nocturnal and exercise symptoms. All that medicine even though my last pulmonary function test (with breathing treatment in between 2 sets of readings) said I might possibly have mild asthma (just barely enough change for the doctor to say I have asthma). When it was warm last week, my peak flow readings were consistently between 580 and 620. This week it is cold, and my readings are 520-550. When I got sick last semester my readings were 390-450, with lowest readings at night, lots of couging, and very little relief from my rescue inhaler (my mother has voiced the opinion that I should have gone the ER several of those nights).
So your Personal Best Peak Flow appears to be 620. It sounds like cough variant asthma; coughing instead of wheezing. If the asthma diagnosis is really in doubt, it could be repeated or a more definitive test administered–the methacholine challenge test. Since asthma meds like inhaled steroids seem to help your asthma this tends to confirm the asthma diagnosis. See: http://www.ama-assn.org/special/asthma/library/scan/interp.htm Interpretation of Positive Results of a Methacholine Inhalation Challenge and 1 Week of Inhaled Bronchodilator use in Diagnosing and Treating Cough-Variant Asthma Ironically, I already had an appointment scheduled with my allergist for tomorrow for a pulmonary function test. So I can discuss all off this stuff with her then. Last semeter was the first really bad cold I’d had since being diagnosed with asthma. I’d had the sniffles a few times, a couple of bouts of coughing, but nothing like that…..my peak flow dropped from 560 one night (a Thursday) to 490 the next morning, and was 470 when I came home for lunch and decided to call my doctor. My regular doctor had me double the Vanceril dose, and take my rescue inhaler every 4 hours, and said if I had problems over the weekend to call the doctor on call. His response Saturday evening was that if I could talk to him on the phone there wasn’t really a problem, and I should be ok until Monday without further treatment.
One of the ways used to diagnose severity of asthma is how you talk. Talking in sentences indicates Mild asthma. Talking in phrases indicates Moderate asthma. Talking in words indicates Severe asthma. Monday morning I called the allergist’s office when they opened (I was actually feeling worse by then.) She saw me that morning, decided to switch inhalers, and told me to call back if I had any problems. Two days later, she put me on antibiotics for bronchitis. It was the next weekend before I started really feeling better. Asthma is very manageable even if you come down with a cold there is no reason to miss so much school! I was a moderately severe asthmatic before I was able to get it under control. Now even if I have a cold, I am still able to teach.
Janet, the key here may to get the asthma under control using a Peak Flow Meter to monitor lung function and a doctor approved Action Plan to increase meds when Peak Flow drops below 80% of Personal Best; in your case appears to be .8 x 560 = 448. The usual Action Plan is to double inhaled steroids (Flovent 110) and use your Ventolin as needed. Most asthmatics can cope with asthma in the yellow zone (50-80% of personal best). Symptoms also need to be taken into account in the Action Plan. Its best if you find one asthma doctor who is familiar with your case and stay with him/her. When you use multiple doctors/nurses it can get too confusing. However if Peak Flow drops below 50% of PB it may be time to go to ER after calling doctor. Even below 50% PB home management is possible, depending on patient. This may require doubling the inhaled steroids again or/and starting a short course of prednisone. Most of the things they do in urgent care or ER can be done at home, unless its a life-threatening situation. See Action Plan links: ACTION PLAN http://www.arbon.com/njc/APAMF.htm Action Plan to Manage Asthma http://www.arbon.com/njc/APFMF.htm ADULT PEAK FLOW MONITORING http://www.ama-assn.org/special/asthma/treatmnt/updates/patient.htm Patient Asthma Action Plans http://www.pedipress.com/articles/htp/htpadpf.html PEAK FLOW BASED HOME TREATMENT PLAN I went up to Lake Tahoe, 6700 ft elevation and cold, last weekend. My Peak Flow dropped to 55% PB the nite I arrived; so I jacked up my dose of Vanceril Double Strength. (I made the mistake of not monitoring my peak flow on the way up, we took the long way thru 3 bird refuges, over Donner Summit with chain control on and thru Nevada around Lake Tahoe & back to Calif, took 12 hours.) I went snowshoeing for 30 min the next day and an hour the day after that, but decided not to push it as my peak flow was running 75% of personal best–decided to stay near the warm cabin rather than venturing out too far into the wild. Came back Mon from the Heavenly Valley area (where Sonny Bono had his fatal ski accident) I have had a virus this past week and have increased the Vanceril DS to control the symptoms. Peak flows around 85-90%PB Ellis – Hide quoted text — Show quoted text – So at least there is hope that I don’t have to go through this whole mess over and over again. Because my lung fuction tests always come out higher than average, even when I’m not feeling too good, I have had a lot of difficulties getting any doctors to listen to me. I usually don’t wheeze (the nurses in Student Health are well aware of this, since when I’m sick I stop by to have them listen, because I don’t know what it sounds like, and they haven’t heard any wheezing yet in over a year). So I’m stuck. Even at a peak flow of 400, feeling terrible, there is no wheezing, and often no apparent symptoms other than the fact that I’m always out of breath, and often cough uncontrolably. That was part of why I missed so much class – I couldn’t stop coughing for more than about 2 minutes at a time, and it made walking to class, sitting though class, even thinking difficult. And I’m sure my classmates and professors would have been equally annoyed with me. :) janet
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Do I go talk to my professors ahead of time (like in the next couple of weeks), or do I wait until I get sick, and then try to bail myself out? Winter is always the worst for me because I’m very sensitive to the cold air. Do I tak to my doctor and explain that if I get sick, at least one of my professors is going to want a note? I understand that he’s trying to teach us to be professional, but most places I’ve done internships have sick days, and if you call in and explain what’s going on, there isn’t a problem, so this seems a bit overboard. Suggestions, anyone? janet
As a former college professor, I would strongly advise you to speak with your professors ahead of time. In fact, the best time would be between registering for the class and the first class meeting. You might take along a "to whom it might concern" letter from your doctor explaining the situation. During my college teaching years, I had a number of students with various health problems that needed accommondation, and it was always possible to work out something with them. Alternatively — or in addition — you might speak with the adacemic dean and perhaps ask to have a note placed in your student record. Good luck
Response:
First of all. I understand where your professors are coming from, since I am one. However, I am also an asthmatic and I understand your concern about missing your classes. I think what you may need is a better asthma plan. I think you should speak to your physician about the problem. Not just about the notes, but about haw to better manage yourself if you come down with a cold. If a cold always triggers abn asthma attack then maybe at the first sign of a cold you should take a "run" of oral steroids. My question to you is: what are the medications you are on now? Are they managing your asthma well between "colds?" And, of course, what do you do for your asthma once you have a cold. Asthma is very manageable even if you come down with a cold there is no reason to miss so much school! I was a moderately severe asthmatic before I was able to get it under control. Now even if I have a cold, I am still able to teach.
Response:
I think what you may need is a better asthma plan. I think you should speak to your physician about the problem. Not just about the notes, but about haw to better manage yourself if you come down with a cold. If a cold always triggers abn asthma attack then maybe at the first sign of a cold you should take a "run" of oral steroids. My question to you is: what are the medications you are on now? Are they managing your asthma well between "colds?" And, of course, what do you do for your asthma once you have a cold.
Last winter, when I was diagnosed, the doctor put me on 4 puffs of Vanceril twice a day (took an ER visit to get the diagnosis). No peak flow meter or anything. Switched doctors (primary and allergist) in January, got a peak flow meter, readings were around 420-460, expected for my height was 450, so new allergist did base line pulmonary function test and reduced Vanceril to 2 puffs twice a day. Readings last winter were then 400-450, with very wild swings, but apparently OK because they were near the expected range. I still was out of breath pretty often, but doctors both insisted there wasn’t a problem. Lasst summer, I was pretty stable at the low end of my green range on 2 puffs of Vanceril twice a day. When I got sick last fall, my allergist switched it to 2 puffs of Flovent 110 twice a day. Then when it got cold and I couldn’t walk 2 blocks without a serious bout of coughing, we added Serevent, 2 puffs twice a day. All that medicine even though my last pulmonary function test (with breathing treatment in between 2 sets of readings) said I might possibly have mild asthma (just barely enough change for the doctor to say I have asthma). When it was warm last week, my peak flow readings were consistently between 580 and 620. This week it is cold, and my readings are 520-550. When I got sick last semester my readings were 390-450, with lowest readings at night, lots of couging, and very little relief from my rescue inhaler (my mother has voiced the opinion that I should have gone the ER several of those nights). Ironically, I already had an appointment scheduled with my allergist for tomorrow for a pulmonary function test. So I can discuss all off this stuff with her then. Last semeter was the first really bad cold I’d had since being diagnosed with asthma. I’d had the sniffles a few times, a couple of bouts of coughing, but nothing like that…..my peak flow dropped from 560 one night (a Thursday) to 490 the next morning, and was 470 when I came home for lunch and decided to call my doctor. My regular doctor had me double the Vanceril dose, and take my rescue inhaler every 4 hours, and said if I had problems over the weekend to call the doctor on call. His response Saturday evening was that if I could talk to him on the phone there wasn’t really a problem, and I should be ok until Monday without further treatment. Monday morning I called the allergist’s office when they opened (I was actually feeling worse by then.) She saw me that morning, decided to switch inhalers, and told me to call back if I had any problems. Two days later, she put me on antibiotics for bronchitis. It was the next weekend before I started really feeling better. Asthma is very manageable even if you come down with a cold there is no reason to miss so much school! I was a moderately severe asthmatic before I was able to get it under control. Now even if I have a cold, I am still able to teach.
So at least there is hope that I don’t have to go through this whole mess over and over again. Because my lung fuction tests always come out higher than average, even when I’m not feeling too good, I have had a lot of difficulties getting any doctors to listen to me. I usually don’t wheeze (the nurses in Student Health are well aware of this, since when I’m sick I stop by to have them listen, because I don’t know what it sounds like, and they haven’t heard any wheezing yet in over a year). So I’m stuck. Even at a peak flow of 400, feeling terrible, there is no wheezing, and often no apparent symptoms other than the fact that I’m always out of breath, and often cough uncontrolably. That was part of why I missed so much class – I couldn’t stop coughing for more than about 2 minutes at a time, and it made walking to class, sitting though class, even thinking difficult. And I’m sure my classmates and professors would have been equally annoyed with me. :) janet
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coughing long enough to get more than a few hours sleep at a time. If that happens again, I’m going to have a serious problem this semester.
If you can, try not to worry about what might happen as that will may make the situation worse. Most things your worry about don’t happen anyway. A better approach is to take the necessary steps to prevent the problems academically then rest easy knowing you did everything you could. Do I go talk to my professors ahead of time (like in the next couple of weeks), or do I wait until I get sick, and then try to bail myself
I am a graduate student myself so my first suggestion is if you can approach your professor, explain your circumstances and see if it may be possible to make alternate arrangements in the event you become ill. Most professors can be quite understanding especially if they are aware that you have a medical problem and are not just trying to find a way out of your academic obligations. If you feel that you cannot talk to the professor about this talk to the head of the department or someone else who may be able to approach your professor on your behalf (ie. academic counsellor). Perhaps your doctor could provide you with a written statement to be kept with your academic file to prevent problems in the future. At any rate, you should have some type of documentation should be attached to your academic record since you have an ongoing medical problem. If you cannot arrange something suitable between yourself and your professor is it possible to either find another professor who is teaching the same course or find an alternative course? Hope this helps. — Janine
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Ok. I have one class where we have an exam every other week, and if you miss an exam you must write a paper explaining, in detail, why you missed the exam. The professor has already stated that if your excuse is that you are sick, you must have a letter from your doctor verifying that you were sick enough to skip class. Then he gets to decide whether to let you make up the test or not. Just from my first three classes, I have a test of some sort every week.
Ouch!…they’re keeping you on your toes The last time I got sick, I missed between 2 and 4 classes out of 6 for each class I had over a 2 week period. I had a cold, and bronchitis, which cause an asthma flare-up. My peak flows hovered around 70% for most of that 2 week period, and I couldn’t stop coughing long enough to get more than a few hours sleep at a time. If that happens again, I’m going to have a serious problem this semester.
that happened to me in my second year at College Do I go talk to my professors ahead of time (like in the next couple of weeks), or do I wait until I get sick, and then try to bail myself out? Winter is always the worst for me because I’m very sensitive to the cold air. Do I tak to my doctor and explain that if I get sick, at least one of my professors is going to want a note? I understand that he’s trying to teach us to be professional, but most places I’ve done internships have sick days, and if you call in and explain what’s going on, there isn’t a problem, so this seems a bit overboard. Suggestions, anyone? janet
stage1…no one can complain about good preparation…if there’s a health centre on campus ask them for advice…check with your academic departments who you need to inform about your asthma…best to do stuff in advance…because stage2…if you’ve prepared the ground well the chances of you having problems are decreased because you’ll feel less stressed about it good luck eric
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Ok. My classes just started today, I’ve been to 3 of 5 classes, and already, I think I’m detecting a potential problem. I have one class where we have an exam every other week, and if you miss an exam you must write a paper explaining, in detail, why you missed the exam. The professor has already stated that if your excuse is that you are sick, you must have a letter from your doctor verifying that you were sick enough to skip class. Then he gets to decide whether to let you make up the test or not. Just from my first three classes, I have a test of some sort every week. The last time I got sick, I missed between 2 and 4 classes out of 6 for each class I had over a 2 week period. I had a cold, and bronchitis, which cause an asthma flare-up. My peak flows hovered around 70% for most of that 2 week period, and I couldn’t stop coughing long enough to get more than a few hours sleep at a time. If that happens again, I’m going to have a serious problem this semester. Do I go talk to my professors ahead of time (like in the next couple of weeks), or do I wait until I get sick, and then try to bail myself out? Winter is always the worst for me because I’m very sensitive to the cold air. Do I tak to my doctor and explain that if I get sick, at least one of my professors is going to want a note? I understand that he’s trying to teach us to be professional, but most places I’ve done internships have sick days, and if you call in and explain what’s going on, there isn’t a problem, so this seems a bit overboard. Suggestions, anyone? janet
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I’ve heard of some doctors providing the steroid via injection. IMHO that would be my very last resort — as if oral steroids weren’t bad enough systemically, sheesh, let’s just mainline it, eh? I would also ask the doctor about inhaled steroids and a spacing chamber with mask (Aerochamber, for example) if you find your son repeating his prednisolone bursts. HTH Jeanne Ed’s Asthma Track http://asthmatrack.com/ 
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Glad to hear you getting better. bill 
) and four hourly nebs of Atrovent/Ventolin. Boy after 24 hours of that I was in ‘jitter city’ I have had a flu shot and pnuemovax but this virus really had teeth. Just starting to be able to move about again. Phew!! Remove the spam from address if replying by email 