Posts belonging to Category 'signs of severe asthma'

Asthma and sleep apnoea yet again – getting desperate here

Question:

I’mnot sure if they’re available overseas yet, but there’s a company here in australia thatmake extra fine filters for use with cpap…..this may well be something that  will help you……in addition to a heated humidifier. the website for the filters is http://www.jonbirdmedical.com.au/SpiroFilter.htm (these filters won’t work if you have a combined CPAP/humidifer like the F&P 200 series – you need to be able to place the filter before the humidifer, after the CPAP) — Beth in Australia =================== FAQ for alt.support.sleep-disorder can be found here http://www.anchorweb.com.au/sleepdisorders this site is a work in progress – feel free to submit info/articles "chrissie" <chris…@btinternet.com> wrote in message

news:bddac50e.0206251317.63292add@posting.google.com… – Hide quoted text — Show quoted text -> After my wonderful start on CPAP things seem to be going horrible > downhill.  My asthma is appalling bad…..I’m 8 days into a course of > oral steroids and really breathless and tight-chested (peak flows > still only 55% of normal, for those in the know.)  I’m not well enough > to work which is costing me a fortune since I’m self-employed. > I am stuck between two specialties.  The sleep people say CPAP doesn’t > affect asthma unless it’s uncontrolled;  the GPs say that they don’t > really know anything about CPAP. > The whole pattern of this asthma is different…normally I have a very > chesty bronchitic asthma with lots of coughing.  Now I am just > breathless…like I’m hyperventilating.  Is there there any > possibility that this might be due the the drying effect of the CPAP? > Would a humidifier make a difference? > I can’t bear the idea of giving up the CPAP and going back to that > awful chronic exhaustion. > Is there no-one out there using CPAP who has severe asthma who can > help???? > Best wishes > Chrissie

Response:

- Hide quoted text — Show quoted text -chrissie wrote: > After my wonderful start on CPAP things seem to be going horrible > downhill.  My asthma is appalling bad…..I’m 8 days into a course of > oral steroids and really breathless and tight-chested (peak flows > still only 55% of normal, for those in the know.)  I’m not well enough > to work which is costing me a fortune since I’m self-employed. > I am stuck between two specialties.  The sleep people say CPAP doesn’t > affect asthma unless it’s uncontrolled;  the GPs say that they don’t > really know anything about CPAP. > The whole pattern of this asthma is different…normally I have a very > chesty bronchitic asthma with lots of coughing.  Now I am just > breathless…like I’m hyperventilating.  Is there there any > possibility that this might be due the the drying effect of the CPAP? > Would a humidifier make a difference? > I can’t bear the idea of giving up the CPAP and going back to that > awful chronic exhaustion. > Is there no-one out there using CPAP who has severe asthma who can > help???? > Best wishes > Chrissie

Chrissie…… you called? I have severe asthma and allergies and have found that CPAP use has reduced my symptoms by about two thirds.  However,  I use the ultra fine filter and change it every couple of months. Now, are you really sure that it is your asthma that is the problem? Your description sounds more like the ‘drowning’ caused by congestive heart failure.  This is caused by untreated OSA which causes one side of the heart to enlarge.   Talk to your doctor about this possibility and have them do a high definition echogram of the heart.  The regular is NOT good enough. If enlarged you should be on BP medications and a heart regulator like Verapamil.  With proper treatment, you can repair the damage.  They might also want you to wear a Holter monitor for a couple of days to track stresses to the heart. Are you breathless on even minor exertion? Are you more comfortable laying propped up as against flat on your back. Does this happen more often/worse in hot humid weather? Do you sometime sweat a clammy sweat over most of your body rather than the usual places? All above are signs of a stressed heart. you can find all kinds of information on the net by using google and typing- congestive apnea apnoea I hope this helps Let us know what happens Regards Lee in Toronto —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–==  Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

After my wonderful start on CPAP things seem to be going horrible downhill.  My asthma is appalling bad…..I’m 8 days into a course of oral steroids and really breathless and tight-chested (peak flows still only 55% of normal, for those in the know.)  I’m not well enough to work which is costing me a fortune since I’m self-employed. I am stuck between two specialties.  The sleep people say CPAP doesn’t affect asthma unless it’s uncontrolled;  the GPs say that they don’t really know anything about CPAP. The whole pattern of this asthma is different…normally I have a very chesty bronchitic asthma with lots of coughing.  Now I am just breathless…like I’m hyperventilating.  Is there there any possibility that this might be due the the drying effect of the CPAP? Would a humidifier make a difference? I can’t bear the idea of giving up the CPAP and going back to that awful chronic exhaustion. Is there no-one out there using CPAP who has severe asthma who can help???? Best wishes Chrissie

Response:

Holy crow!  You’ve got major asthma and you’re not using a heated humidifier?  What are they _thinking_! YES.  GET A HEATED HUMIDIFIER.  NOW. On your own dime, if you have to and if you can afford it. If not, jump up and down and scream at your pulmonologist. [When I went to my pulmonologist to see if she would sign off  on the physical for scuba diving, she wouldn't.  All that  cold, dry air, she said, is the very worst thing.  Now your  CPAP air probably isn't very cold, but the dry isn't doing  you any good.] [I don't have severe asthma.  In fact, mine is subclinical  almost all the time.  But she told me that having my first  major paroxysmal attack at 80 ft below the surface would  be tacky.  So I snorkel.] – Hide quoted text — Show quoted text -chrissie wrote: > After my wonderful start on CPAP things seem to be going horrible > downhill.  My asthma is appalling bad…..I’m 8 days into a course of > oral steroids and really breathless and tight-chested (peak flows > still only 55% of normal, for those in the know.)  I’m not well enough > to work which is costing me a fortune since I’m self-employed. > I am stuck between two specialties.  The sleep people say CPAP doesn’t > affect asthma unless it’s uncontrolled;  the GPs say that they don’t > really know anything about CPAP. > The whole pattern of this asthma is different…normally I have a very > chesty bronchitic asthma with lots of coughing.  Now I am just > breathless…like I’m hyperventilating.  Is there there any > possibility that this might be due the the drying effect of the CPAP? > Would a humidifier make a difference? > I can’t bear the idea of giving up the CPAP and going back to that > awful chronic exhaustion. > Is there no-one out there using CPAP who has severe asthma who can > help???? > Best wishes > Chrissie

Response:

Update on this walking wounded

Question:

…just wondering. Lotte "Ash Boland" <lu…@shaw.ca> skrev i meddelandet news:3C16B100.F789FCB4@shaw.ca… – Hide quoted text — Show quoted text -> BaliKris wrote: > > >It’s okay, but hard to get used to.  That’s why I was asking how to handle > > this stuff. > > Ash, I sure do wish that the answer was here but I’m afraid it doesn’t seem to > > be since there haven’t been posts from others who have experienced the same > > thing (none that I recall – and if there were then I hope you got it and have > > hooked up in private mail with anyone that has or is going thru this too.) > > A good professional is going to be the best source of support and help in > > understanding why these things are happening to you and what they mean. > > Therapists are a wide range and it may take a trial with one or many, hopefully > > not, but I honestly believe that learning ways to handle the stuff will come > > from opening up to an experienced psychotherapist that is familiar with this > > difficult pain and more able to help you manage the situation.  Are you doing > > that? > > balikris > Yeah my therapist is cool.  She is a psychologist, hypnotherapist, as well as an > accredeted Shaman of Celtic background. > Ash

Response:

Dear Ash, after some more thinking: If I’m right in my hypothesis, that we (and possibly others in this ng) are trying not to lose control (subconsciously), and fall into the deep sleep we need, we need to look at others who don’t get enough sleep. There have been experiments made on students and soldiers, and reports from places where sleep deprivation has been used as torture.  The result is the same. After 2 -9 nights without deep sleep, anyone hallucinates. This points toward the conclusion that what we need -no matter what else is going on- is to rest. My own experience tells me that sleeping pills only makes the "dream inside a dream" thing worse. Waking up becomes impossible, and you need to get away from the fear. What you need then is Valium, I used something called Sobril (in Sweden): A strong medication to calm you down, if only for one night, to give your subconscious a chance to catch up and rest. I hate the stuff, and am terrified of getting dependant – but I use them -very carefully!- when I need to "snap out of it". Your visions may stem from lack of deep sleep. Hugs, Lotte "sis" <lowies.pbr…@spray.se> skrev i meddelandet news:m19S7.173$O5.546@nntpserver.swip.net… – Hide quoted text — Show quoted text -> P.S.: I forgot to mention the obvious two: Good psychotherapy and good > medication, in my cas Zoloft. > Lotte > I hope you’re OK? > "sis" <lowies.pbr…@spray.se> skrev i meddelandet > news:gzTR7.56$O5.268@nntpserver.swip.net… > > Dear Ash, > > It seems I have to tell you my whole story. > > My "hallies" (my own private nickname, they’re *not* hallucinations!) > > started in 1978, when I was 18. They consist of: > > 1. A *very vivid nightmare*, highly symbolic, the kind that C. G. Jung > would > > have called a "Big Dream"; > > 2.A deep note, which begins at the point where the dream starts to become > > intolerable. This note comes in pulses, fills my consciousness and my > ears, > > and rises in volume until I can’t stand it anymore. (Anything in real life > > that reminds me of it triggers me: Ferryboat engines, escalating sounds of > > any kind, such as ambulances, feedbacks, particularly bass frequency ones, > > and, funnily: Cockchafers. > > We’ve got lots of them at my summer house, and lovely Nordic summer > > evenings, they and I fight for our right to be there. They win.) > > 3. The struggle to get out of the intolerable place I’m in. This *was* > > diagnosed as "sleep paralysis", and for many years, I’ve experienced this > as > > waking up, knowing precisely where I am, still hearing the sound, and > being > > paralyzed. > > 4.The fight to wake up. I wake up after an incredible struggle: My body is > > *so* heavy, and sometimes some furry thing is lying on my chest. I reach > for > > the light switch, but it or my hand won’t work: It slides, turns into > jello, > > or just won’t go "click". When I thought all this really happened, I > would, > > after the fifth or sixth time start screaming with all my might: Nowadays, > > discouragingly, I have proof that I’m sleeping all the time. > > Lovers have been looking at me while this happened: All they can see is > that > > I’m unusually pale and still, and my breathing very shallow. > > I think the sounds are muscle tonus from turning my eyeballs up as I > sleep. > > You know how we can interpret a phone signal as a scream when we’re half > > asleep: Muscular tonus in the head has a fluttering sound, which you can > > hear under water, for instance. Just like when you hear your own > breathing. > > My understanding of what happens, physiologically, is that fear drives me > > into hypnosis. I’m between being asleep and awake. I can observe my > > thoughts, analyze my dreams, and think pretty coherently: > > AMOF I believe my thinking is sharper in this situation, than in any other > > I’ve experienced. I’ve nearly drowned, I’ve had severe asthma attacks, > I’ve > > been raped, I’ve been beaten up: But in none of those situations have I > ever > > been as close to death as in these ones. This is a "life or death" > > situation, > > and my thinking is rational, creative, ice-cold and focused on *getting > the > > hell out of there as fast as f***ing possible*. At any cost. > > I don’t know if you appreciate advice, Ash, but I’ve learnt this: Think! > > It’s the only thing I can do. > > So: What did I do today? What triggered me? Who made me angry, and I crept > > away? Am I pissed off with myself for being lazy? > > Stupid little things like that get me going. And: Full moon, half moon, > > period (might n

Kenalog Re: Hayfever and steroid injections (kenalog)

Question:

x-posted to alt.support.asthma – Hide quoted text — Show quoted text – I suffer from chronic hayfever in the UK and this last week has been the worst week ever.  I take pills (Telfast 180), eye drops (Rapitil), nasal spray (Flixonase) and an inhaler (Beclazone 100) but the symptoms are still very severe. I few years back I had a steroid injection and was fine all summer. When I asked the doctor for the injection the next year he said they didn’t give people it more than once as they don’t know what the long term side effects are. I saw the doctor again yesterday and asked again about the injection. The long term risk apparently are unknown and the short term side effects are your imune system not working so you could catch anything. BUT he did say if the latest set of drugs don’t work I could get the injection again. Has anybody else had more than one steroid injection for severe hayfever?  Any comments on the risks and opinions on what I should do? Jason

The corticosteroid Kenalog (triamcinolone acetonide) can be given in the form of a long-acting intramuscular injection to treat severe allergies. The potential side effects of steroids are well known. I was taking the inhaled triamcinolone (Azmacort) (2400 ug/day) for asthma and ended getting facial edema (moon face) after 3 months. This was a minor side effect compared to those experienced by patients taking the much higher dose oral or injected forms long term. Once an intramuscular shot of long-acting Kenalog has been given, it’s impossible to reduce the dose since it’s already in your body, gradually releasing over a period of weeks. If used at all, a short-acting oral or injected form could be considered, so if symptoms develop, the dose can be reduced or stopped. Also, when your symptoms stop due to the allergy season being over, you can stop the steroids immediately. [Side effects are dose dependent and time dependent.] One poster on alt.support.asthma reported experiencing necrosis of the hip, requiring a hip replacement, after using steroids for a short while. If long-acting Kenalog injections were really considered a safe treatment, all the asthmatics with Severe asthma would be using it, instead of inhalers or oral tablets of prednisone. Info on Kenalog: http://www.rxlist.com/scripts/patient/piumore.pl?mononum=469&order=3&… Excerpt: "What does triamcinolone injection do? TRIAMCINOLONE (Aristocort

Albuterol almost killed me

Question:

Frankly, I don’t understand why everyone seems to think that all asthmatics need one.  The MIDI can be used to increase albuterol dosage until you can get to an ER.  I agree that some folks may have severe enough asthma that one is required, but in my case the asthma is actually mild except for times of exertion (exercise) or illness.  It was extremely difficult to control for some reason though.

For some of us having to go to the ER just to get nebulized does not make sense. Many of us will sometimes fall into the position where the MDI is not enough, but the situation does not warrant an ER visit.  For us a nebulizer is a real helpful tool. "Usenet is like a herd of performing elephants with diarrhea — massive, diffucult to redirect, awe-inspiring, entertaining, and a source of mind boggling amounts of excrement when you least expect it." Gene Spafford 1992

Response:

I have said it before…..and I’ll say it again, "They are YOUR lungs and YOUR breath, make your decisions wisely. You can’t live without either, and it’s a helluva way to die!" Scooby RCP, EMT-P Perinatal-Pediatric Respiratory Specialist

Response:

– Hide quoted text — Show quoted text – It is used in lieu of the trip to the ER.  During the times I have had severe asthma attacks, my treatment at the ER has been the nebulizer.  That, except for one ocassion, has resolved the problem.  The point, in my case, is to avoid that trip to the ER.  If my peak flow does not increase and I continue to experience shortness of breath, then I go to the hospital.  I’ve been in the ER when it was packed with asthmatics that only required the nebulizer treatment.  Responsible asthmatics could very well do this themselves, without the burden on their bodies and the health system. I have to disagree with this in part….yes, these asthmatics could probably nebulize themselves at home, and some people in the ER really do not need to be there.  However, responsible asthmatics also know that they MUST follow treatment plans that their doctors have provided to them (i.e. their peak flow reaches a certain point and their meds are not working as well as they usually do)….so they are instructed to go to hospital when this happens.

Amber, PART of some asthmatics’ treatment plan IS the use of a nebulizer.  In certain situations, I will have an attack that isn’t responsive to the inhaler.  However, given my PF readings [and nigh unto five decades of asthma], I know that a neb treatment is likely to be all I need to be OK again.  Why should I have to tra-la-la off to the ER, and go through all that stress, when I can treat myself at home?  Being sure, of course, to keep track of my vital signs, so that, if the neb doesn’t work, the NEXT stop is the ER. Yes, they could take nebulized treatments at home, but what happens if they don’t realize they are getting into trouble.  

That is why God invented PFMs.  You don’t just nebulize and go about your life; you nebulize, and monitor your PF. Chris Owens

Response:

Niasha. It is used in lieu of the trip to the ER.  During the times I have had severe asthma attacks, my treatment at the ER has been the nebulizer.  That, except for one ocassion, has resolved the problem.  The point, in my case, is to avoid that trip to the ER.  If my peak flow does not increase and I continue to experience shortness of breath, then I go to the hospital.  I’ve been in the ER when it was packed with asthmatics that only required the nebulizer treatment.  Responsible asthmatics could very well do this themselves, without the burden on their bodies and the health system.

I have to disagree with this in part….yes, these asthmatics could probably nebulize themselves at home, and some people in the ER really do not need to be there.  However, responsible asthmatics also know that they MUST follow treatment plans that their doctors have provided to them (i.e. their peak flow reaches a certain point and their meds are not working as well as they usually do)….so they are instructed to go to hospital when this happens. Yes, they could take nebulized treatments at home, but what happens if they don’t realize they are getting into trouble.  There are many documented cases of paramedics showing up to a call to find an asthmatic collapsed with an inhaler clutched in their  hand or lying on the floor barely breathing (if at all) with a neb mask on them. I think that would be a much bigger burden to deal with. Amber Robinson

Response:

The increase in heart rate is not why I do not use a nebulizer.  I agree it is an acceptable tradeoff. I have discussed it with m doctor and we both feel that one is not necessary for me. Frankly, I don’t understand why everyone seems to think that all asthmatics need one.  The MIDI can be used to increase albuterol dosage until you can get to an ER.  I agree that some folks may have severe enough asthma that one is required, but in my case the asthma is actually mild except for times of exertion (exercise) or illness.  It was extremely difficult to control for some reason though. Besides, in the three years I’ve been diagnosed with asthma, I’ve only been in the ER *once* and that was because I was traveling on business and my doctor wanted an x-ray to be sure I didn’t have pneumonia.  It wasn’t for the asthma itself though I did get two nebulizer treatments at the time. Loki – Hide quoted text — Show quoted text – Loki, the use of the nebulizer is part of the treatment plan that my doctor and I worked out.  I use it when my asthma becomes labored and require a trip to the emergency room.  A prescription is required to purchase a nebulizer, as well as the medication used in the machine.  It does not increase my heart rate but if it did, it would be seem an acceptable tradeoff to not breathing.  As a responsible asthmatic,  my doctor knows that I will faithfully follow the treatment plan and call him/go to the ER when the plan calls for it rather than relying on the nebulizer.  I recently had severe shortness of breath, knew it was more than an asthma attack and went directly to the doctor’s office for a diagnosis.  At other times, when my inhaled abuterol is not working, I just wait.  I know that during a severe thunder storm I develop shortness of breath.  If the inhaled abuterol doesn’t work, I don’t automatically use the nebulizer.  I try to wait until the storm passes, which usually resolves the attack.  Perhaps you should discuss the pros and cons, uses and abuses  of a nebulizer with your

doctor.

Response:

Loki, I agree that the nebulizer may not be appropriate for everyone. You have to be responsible, stay on top of monitoring your condition, know what works for you, know when you are past the point when the nebulizer will be effective and be willing to call it quits and go to the ER if necessary.  In my action plan, the nebulizer is not part of my standard medication.  It is used in lieu of the trip to the ER.  During the times I have had severe asthma attacks, my treatment at the ER has been the nebulizer.  That, except for one ocassion, has resolved the problem.  The point, in my case, is to avoid that trip to the ER.  If my peak flow does not increase and I continue to experience shortness of breath, then I go to the hospital.  I’ve been in the ER when it was packed with asthmatics that only required the nebulizer treatment.  Responsible asthmatics could very well do this themselves, without the burden on their bodies and the health system.

Response:

Loki, the use of the nebulizer is part of the treatment plan that my doctor and I worked out.  I use it when my asthma becomes labored and require a trip to the emergency room.  A prescription is required to purchase a nebulizer, as well as the medication used in the machine.  It does not increase my heart rate but if it did, it would be seem an acceptable tradeoff to not breathing.  As a responsible asthmatic,  my doctor knows that I will faithfully follow the treatment plan and call him/go to the ER when the plan calls for it rather than relying on the nebulizer.  I recently had severe shortness of breath, knew it was more than an asthma attack and went directly to the doctor’s office for a diagnosis.  At other times,  when my inhaled abuterol is not working, I just wait.  I know that during a severe thunder storm I develop shortness of breath.  If the inhaled abuterol doesn’t work, I don’t automatically use the nebulizer.  I try to wait until the storm passes, which usually resolves the attack.  Perhaps you should discuss the pros and cons, uses and abuses  of a nebulizer with your doctor. – Hide quoted text — Show quoted text – Oh good grief.  Folks using nebulizers get more albuterol in a normal treatment than you’d get if you took 4 puffs from a MIDI. I take 2 puffs, 5 minutes apart for a max of 6 puffs before I exercise. It’s the only way to get past my exercise induced asthma. Yes, it does mess with my heart rate a tad, but not all that much.  The albuterol neb I received in the ER did that a whole lot more. Talk to your doctor.  That’s the only way you can really know what to do. Loki

Response:

Status asthmaticus

Question:

I would like to now if any one can explain how and if Status asthmaticus can be a cause of death with reguards to an autopsy report. John

Response:

I would like to now if any one can explain how and if Status asthmaticus can be a cause of death with reguards to an autopsy report. John

Here’s a link on status asthmaticus (Poland): http://www.nil.org.pl/gazeta/gl97/03-97-1e.htm   Excerpt: "Status asthmaticus Status asthmaticus is an exacerbation of bronchial asthma or chronic obstructive pulmonary disease (COPD) that may threaten the patient’s life. It can be compared to coronary heart disease beginning as angina pectoris and suddenly developing into myocardial infarction. Hospitalisation is mandatory with status asthmaticus. In rare instances, several hours’ confinement to an acute care unit at the admission room of a hospital or ambulance station is sufficient, but much more often the patient has to be referred to an intensive care unit. There are a number of definitions of status asthmaticus: in Britain this condition has been termed acute severe asthma, and status asthmaticus is therefore never diagnosed. Some physicians do not realise that these two designations mean the same and diagnose status asthmaticus as a sequel of acute severe asthma. Not infrequently it is difficult to decide whether a patient is suffering from asthma or COPD as some patients present with features of both disorders. Therefore the definition of status asthmaticus does not make it clear whether it is the result of asthma or COPD. The underlying pathology is a sudden and severe bronchial stenosis that is largely reversible and the treatment is nearly always the same. "Status asthmaticus is a severe and diffuse bronchial stenosis which does not subside transiently with conventional treatment." (-) W. Droszcz Conventional treatment should be understood to include the administration of intravenous aminophylline or b-adrenergic stimulants by parenteral or inhalational routes. If the patient still shows signs of marked bronchospasm, they should be referred to hospital. Various patient observation intervals have been proposed, but one can  afely assume that 1-hour observation is sufficient. The above is a practical definition: if a doctor is unable to control an attack of asthma using conventional procedures, they should not abandon the patient but ensure that the patient is taken to hospital. Status asthmaticus may lead to death. Statistics vary, but a figure of 1-2% mortality during in-hospital intensive care seems a reasonable estimate. Deaths are certainly more frequent outside the hospital setting. 75% of all status asthmaticus-related deaths occur in the home, while the patient is being transported to hospital and, sadly, also in admission rooms and at ambulance stations. Death in status asthmaticus may be attributed to two different mechanisms. In about 70% of the patients, the symptoms deteriorate quickly and an autopsy finds diffuse inflammation, overproduction of mucus and the presence of mucous "plugs" that block small bronchi and bronchioles. The other 30% are often young people in whom a fulminant attack of asthma produces extensive bronchospasm without mucous "plugs" ("empty" bronchi). Clinically, death often occurs before the patient reaches a hospital. When such patients are admitted they have often been resuscitated. Patients with status asthmaticus should best be treated at intensive care centres (particularly pulmonary disease centres). A number of years ago a study of status asthmaticus treatment efficacy over a 10-year period carried out in Edinburgh revealed that there had been 4 times more deaths at internal medicine departments than at intensive care units at specialist pulmonary disease centres. Those results were a stimulus that led to the establishment of a Status Asthmaticus Management Centre (SAMC) at the Pneumology Clinic of Warsaw Medical Academy in the autumn of 1990. Over the 6 years the centre has handled 579 patients with status asthmaticus (314 with a diagnosis of bronchial asthma and 265 with a diagnosis of COPD). We have therefore gained considerable experience in the management of status asthmaticus, which we would now like to share with our Readers." Andrzej D

Help please: have I got asthma?

Question:

Hi, over the last few months I have noticed that after any strenuous exercise I invariably start wheezing. I am pretty unfit and don’t often exercise. I am also slightly overweight and an occasional smoker (usually when I’ve had a drink). Since my mid teens I’ve suffered from nasal problems: blocked nose and catarah especially in the morning. For a while (1 year) I used beconaze(?), sniffed up nose to alleviate this but stopped this when I was about 19. It did help. I’m 26 now. So have I got asthma? And what can I do about it? I really don’t know anything about it. I did mention my concerns to my doctor, who listened to my chest with a stethoscope for about 2 seconds and said ‘You’re fine’. Any help much appreciated. Thanks in advance Nick

Response:

So have I got asthma? And what can I do about it? I really don’t know anything about it. I did mention my concerns to my doctor, who listened to my chest with a stethoscope for about 2 seconds and said ‘You’re fine’.

I suggest that you find another doctor.  Just because you are not wheezing at the moment does not mean that everything is fine. A wheeze can be caused by other things than asthma.  A good doctor will  some checking to try to identify exactly what the problem is.   ‘Reply to’ address changed to foil email spammers.

Response:

Nick, Unless your physician is an asthma specialist or pulmonologist, he/she may not be aware of the many aspects of asthma. Ask for a referral to a physician specializing in Pulmonary Diseases. What you describe could be exercise induced asthma, but the only way to know for sure is to have an evaluation done by a knowledgeable physician in this specialty, most G.P.s are not trained sufficiently in this area, and are not up to date on the latest information available for asthma. John Rhoades, RRT Asthma Guide http://asthma.miningco.com Asthma – The Mining Company – Hide quoted text — Show quoted text – Hi, over the last few months I have noticed that after any strenuous exercise I invariably start wheezing. I am pretty unfit and don’t often exercise. I am also slightly overweight and an occasional smoker (usually when I’ve had a drink). Since my mid teens I’ve suffered from nasal problems: blocked nose and catarah especially in the morning. For a while (1 year) I used beconaze(?), sniffed up nose to alleviate this but stopped this when I was about 19. It did help. I’m 26 now. So have I got asthma? And what can I do about it? I really don’t know anything about it. I did mention my concerns to my doctor, who listened to my chest with a stethoscope for about 2 seconds and said ‘You’re fine’. Any help much appreciated. Thanks in advance Nick

Response:

- Hide quoted text — Show quoted text – over the last few months I have noticed that after any strenuous exercise I invariably start wheezing. I am pretty unfit and don’t often exercise. I am also slightly overweight and an occasional smoker (usually when I’ve had a drink). Since my mid teens I’ve suffered from nasal problems: blocked nose and catarah especially in the morning. For a while (1 year) I used beconaze(?), sniffed up nose to alleviate this but stopped this when I was about 19. It did help. I’m 26 now. So have I got asthma? And what can I do about it? I really don’t know anything about it. I did mention my concerns to my doctor, who listened to my chest with a stethoscope for about 2 seconds and said ‘You’re fine’. Any help much appreciated. Nick

There is a web page on Recognizing Asthma Signs and Symptoms at http://www.njc.org/MFhtml/RAS_MF.html Excerpt "Early warning signs are experienced before the start of an  asthma episode. By discovering these clues that occur before actual asthma symptoms, early treatment can be started. These signs are unique to each person. Early warning signs may be the same, similar or entirely  different with each episode. Some early warning signs may be noticed only by the individual, while other early  warning signs are more likely to be noticed by other persons. In addition, persistent changes in peak flow numbers  can be a reliable early warning sign. Some examples of early warning signs are:       Feeling tired, fatigue       Itchy throat       Runny nose       Funny feeling in the chest       Headache       A change in the color, amount or thickness of sputum (mucus)       Peak flow numbers may be in the acceptable range, but are  dropping closer to the caution range       (usually 80% of personal best) Asthma symptoms indicate that an asthma episode is occurring.  Changes have taken place in the airways and airflow is obstructed. Individuals with asthma experience  some or all of these during an asthma episode. Action should be taken to treat these symptoms before they become worse.       Wheezing       Coughing       Shortness of breath       Tightness in the chest       Peak flow numbers may be in the caution or danger range  (usually 50% to 80% of personal best) Severe asthma symptoms are a life-threatening emergency. These  symptoms indicate respiratory distress. Examples of severe asthma symptoms include:       Severe coughing, wheezing, shortness of breath or tightness in the chest       Concentrating or talking may become difficult       Walking causes shortness of breath       Breathing may be shallow and fast or breathing may be slower than usual       Posturing (hunched shoulders)       Nasal flaring (nostril size increases with breathing)       Retractions (the neck area and between or below the ribs moves inward with breathing)       Cyanosis (gray or bluish tint to skin, beginning around the mouth)       Peak flow numbers may be in the danger zone (usually below 50% of personal best) If any of these symptoms occur, seek emergency medical treatment  immediately. Have an action plan for getting emergency care quickly in the event of severe asthma symptoms.  Inform family members and those who are close to you or your child of this emergency action plan."

mind and body in asthma

Question:

- Hide quoted text — Show quoted text – Note to Moderator of Alt. Suport.Asthma:  I posted this on Nov. 27, but never saw it come through on news group postings. Perhaps you never got it or ???? Please let me know what is happening.. Thanks Re: mind and body in asthma To make the facts clear—ASTHMA IS NOT A PSYCHOSOMATIC OR A PSYCHOLOGICAL DISEASE.  It has been proven and known for many years that asthma is a physical disease involving        As a long time allergic asthmatic and serious student of the subject, I am quite certain that asthma is not primarily a psychosomatic disease. I too, doubt that asthma can be "wished" away. That said, I am saddened to see such an antagonistic response from cruisingmrw to a sensible and interesting posting from epetee.        Epetee did not claim that asthma is psychosomatic. In fact there are many studies that show the strong influence of mental or emotional factors on physiological processes. The key to this is that the mind and the body are not separate. They are connected by the nervous system and the immune system. The scientific study of these interrelations is called psycho- neuro-immunology. The flip side of this discipline is the placebo effect, of which we have much scientific data, not just isolated reports. Spontaneous Healing, a fine book by Dr. Andrew Weil explores this.        A basic example of the interelation of mind and body in asthma is that stress has very specific physiological effects, sometimes called the general adaptive syndrome. This involves the secretion of hormones from the adrenal glands, especially catecholamines (mainly adrenaline) and glucocorticoids (like cortisol). These two classes of hormones are the conceptual basis for most of the pharmacological attempts to develop drugs to control asthma. (This is because the body’s own adrenal hormones have ability to control, to varying extents, the asthmatic condition. In asthmatics, this system- the hypothalamic-pituitary-adrenal axis- and its receptors are not always up to the task.)        When stress is chronic, the adrenal glands are liable to become weakened from overuse. (There are many other unhappy effects from these hormones constantly coursing thru our bodies.) If our rest and nutrition is insufficient, the result will be a worsening of asthma, since even in asthmatics, our own adrenal hormones provide some basal level of protection. (see Asthma and Rhinitis, 1995, section by Undem and Myers, pp707-8)        Glucocorticoids in the body are derived mainly from cholesterol; and adrenaline and its sisters from the amino acid tyrosine. But they cannot be made by the body, nor will they work effectively without adequate amounts of nutritional co-factors such as zinc, magnesium, vitamin C, vitamin B5 and others. Nutritional studies (e.g. NHANES II) show that many Americans are deficient to some extent in these nutrients.        Thus the emotional state of stress can be mitigated by simple biochemistry. Taking lots of vitamin pills does not guarantee optimal function of any system but I think a strong multivitamin is good insurance.        This is an explanation for the fact that many asthma authorities believe that "there is an emotional factor" in asthma. Most believe that stress is detrimental to asthmatics. Of course the best "cure" for stress is to resolve it, not vitamin pills, but excellent nutrition can be very helpful..          I am not a doctor. Anything I write should not be taken as medical advice. I live a rich and active life with the very rare use of drugs, although I have severe (by IgE skin test) allergies and asthma.                                             John Hepler

Your original message (which, by the way is worded QUITE different from the one you are now posting) certainly was posted and I replied.   Several other people also replied and had some interesting comments about your theory.  Its rather interesting that you missed them all.  It was on the newsgroup for about a week. I can’t imagine how you missed it if you were checking the newsgroup.  The posting that you originally replied to was about my response to someone else’s claim that healing emotions can cure asthma. Again, I reiterate that this implies that emotions are the cause of asthma, and the entire posting implied that emotions were the root of asthma.  And I stated that I did think it could be dangerous for someone with asthma to try this approach as a cure for asthma, since asthma cannot be cured, but rather controlled.  Some of the objections I had to the logic used (which by the way I do not think were sensible approaches)were:1)using neurological signs and symptoms of Vitamin B12 deficiency to somehow show that this supports the theory that asthma’s cause is psychological and 2) implying that because it involved the immune system it was caused by the emotions. Several other diseases are also immunological diseases. I will ask you the same question I asked you in my original response.  AIDS is an immune system disease.  Would you say that it is has a psychological cause because it involves the immune system?    I’ve copied another recent response I made to someone else about this issue. I will repeat one more time that I believe it is prejudicial (or at the very best ignorant) to continue to blame psychological issues as a cause of asthma in the 1990’s when the research has clearly shown that asthma is a physical disease with a physical cause. That said, her is my posting to someone who stated that sometimes asthma is caused by psychosomatic causes: I differ with you on this, or at least with the way you said it. NO asthma is psychosomatic.  Asthma’s cause is physical.  However, in some people (a small portion I might add), psychological issues can aggravate, BUT NOT CAUSE asthma. BTW, psychosomatic means a physical symptom that is psychologiclly caused.  Again, psychological OR psychosomatic issues DO NOT cause asthma, though they may aggravate asthma symptoms for a select few asthma patients.  I think it is very important to make this distinction, as asthmatics have already had to suffer too many years in the past with this false premise and don’t deserve to have to endure this any more now that science has PROVEN that asthma is a physical disease, not a psychological one. I hope we can finally lay this issue to rest, and move on to more productive discussions.

Response:

- Hide quoted text — Show quoted text – Note to Moderator of Alt. Suport.Asthma:  I posted this on Nov. 27, but never saw it come through on news group postings. Perhaps you never got it or ???? Please let me know what is happening.. Thanks Re: mind and body in asthma To make the facts clear—ASTHMA IS NOT A PSYCHOSOMATIC OR A PSYCHOLOGICAL DISEASE.  It has been proven and known for many years that asthma is a physical disease involving        As a long time allergic asthmatic and serious student of the subject, I am quite certain that asthma is not primarily a psychosomatic disease. I too, doubt that asthma can be "wished" away. That said, I am saddened to see such an antagonistic response from cruisingmrw to a sensible and interesting posting from epetee.        Epetee did not claim that asthma is psychosomatic. In fact there are many studies that show the strong influence of mental or emotional factors on physiological processes. The key to this is that the mind and the body are not separate. They are connected by the nervous system and the immune system. The scientific study of these interrelations is called psycho- neuro-immunology. The flip side of this discipline is the placebo effect, of which we have much scientific data, not just isolated reports. Spontaneous Healing, a fine book by Dr. Andrew Weil explores this.        A basic example of the interelation of mind and body in asthma is that stress has very specific physiological effects, sometimes called the general adaptive syndrome. This involves the secretion of hormones from the adrenal glands, especially catecholamines (mainly adrenaline) and glucocorticoids (like cortisol). These two classes of hormones are the conceptual basis for most of the pharmacological attempts to develop drugs to control asthma. (This is because the body’s own adrenal hormones have ability to control, to varying extents, the asthmatic condition. In asthmatics, this system- the hypothalamic-pituitary-adrenal axis- and its receptors are not always up to the task.)        When stress is chronic, the adrenal glands are liable to become weakened from overuse. (There are many other unhappy effects from these hormones constantly coursing thru our bodies.) If our rest and nutrition is insufficient, the result will be a worsening of asthma, since even in asthmatics, our own adrenal hormones provide some basal level of protection. (see Asthma and Rhinitis, 1995, section by Undem and Myers, pp707-8)        Glucocorticoids in the body are derived mainly from cholesterol; and adrenaline and its sisters from the amino acid tyrosine. But they cannot be made by the body, nor will they work effectively without adequate amounts of nutritional co-factors such as zinc, magnesium, vitamin C, vitamin B5 and others. Nutritional studies (e.g. NHANES II) show that many Americans are deficient to some extent in these nutrients.        Thus the emotional state of stress can be mitigated by simple biochemistry. Taking lots of vitamin pills does not guarantee optimal function of any system but I think a strong multivitamin is good insurance.        This is an explanation for the fact that many asthma authorities believe that "there is an emotional factor" in asthma. Most believe that stress is detrimental to asthmatics. Of course the best "cure" for stress is to resolve it, not vitamin pills, but excellent nutrition can be very helpful..          I am not a doctor. Anything I write should not be taken as medical advice. I live a rich and active life with the very rare use of drugs, although I have severe (by IgE skin test) allergies and asthma.                                             John Hepler

Hi John, Thanks for the info. I personally have had an improvement in my asthma by getting enough rest, exercise 5 days/week, and having adjustments by a chiropractor once a week. All of this has helped me deal with stress, and therefore I have been much healthier in the last 2 years.

Response:

Note to Moderator of Alt. Suport.Asthma:  I posted this on Nov. 27, but never saw it come through on news group postings. Perhaps you never got it or ???? Please let me know what is happening.. Thanks                         Re: mind and body in asthma To make the facts clear—ASTHMA IS NOT A PSYCHOSOMATIC OR A PSYCHOLOGICAL DISEASE.  It has been proven and known for many years that

asthma is a physical disease involving        As a long time allergic asthmatic and serious student of the subject, I am quite certain that asthma is not primarily a psychosomatic disease. I too, doubt that asthma can be "wished" away. That said, I am saddened to see such an antagonistic response from cruisingmrw to a sensible and interesting posting from epetee.        Epetee did not claim that asthma is psychosomatic. In fact there are many studies that show the strong influence of mental or emotional factors on physiological processes. The key to this is that the mind and the body are not separate. They are connected by the nervous system and the immune system. The scientific study of these interrelations is called psycho- neuro-immunology. The flip side of this discipline is the placebo effect, of which we have much scientific data, not just isolated reports. Spontaneous Healing, a fine book by Dr. Andrew Weil explores this.        A basic example of the interelation of mind and body in asthma is that stress has very specific physiological effects, sometimes called the general adaptive syndrome. This involves the secretion of hormones from the adrenal glands, especially catecholamines (mainly adrenaline) and glucocorticoids (like cortisol). These two classes of hormones are the conceptual basis for most of the pharmacological attempts to develop drugs to control asthma. (This is because the body’s own adrenal hormones have ability to control, to varying extents, the asthmatic condition. In asthmatics, this system- the hypothalamic-pituitary-adrenal axis- and its receptors are not always up to the task.)        When stress is chronic, the adrenal glands are liable to become weakened from overuse. (There are many other unhappy effects from these hormones constantly coursing thru our bodies.) If our rest and nutrition is insufficient, the result will be a worsening of asthma, since even in asthmatics, our own adrenal hormones provide some basal level of protection. (see Asthma and Rhinitis, 1995, section by Undem and Myers, pp707-8)        Glucocorticoids in the body are derived mainly from cholesterol; and adrenaline and its sisters from the amino acid tyrosine. But they cannot be made by the body, nor will they work effectively without adequate amounts of nutritional co-factors such as zinc, magnesium, vitamin C, vitamin B5 and others. Nutritional studies (e.g. NHANES II) show that many Americans are deficient to some extent in these nutrients.        Thus the emotional state of stress can be mitigated by simple biochemistry. Taking lots of vitamin pills does not guarantee optimal function of any system but I think a strong multivitamin is good insurance.        This is an explanation for the fact that many asthma authorities believe that "there is an emotional factor" in asthma. Most believe that stress is detrimental to asthmatics. Of course the best "cure" for stress is to resolve it, not vitamin pills, but excellent nutrition can be very helpful..          I am not a doctor. Anything I write should not be taken as medical advice. I live a rich and active life with the very rare use of drugs, although I have severe (by IgE skin test) allergies and asthma.                                             John Hepler

Response:

- Hide quoted text — Show quoted text – To make the facts clear—ASTHMA IS NOT A PSYCHOSOMATIC OR A PSYCHOLOGICAL DISEASE.  It has been proven and known for many years that asthma is a physical disease involving        As a long time allergic asthmatic and a very serious student of the subject, I am quite certain that asthma is not primarily a psychosomatic disease. I too, doubt that asthma can be "wished" away. That said, I am saddened to see such an antagonistic response from cruisingmrw to a sensible and interesting posting from epetee.        Epetee did not claim that asthma is psychosomatic. In fact there are many studies that show the strong influence of mental or emotional factors on physiological processes. The key to this is that the mind and the body are not separate. They are connected by the nervous system and the immune system. The scientific study of these interrelations is called psycho- neuro-immunology. The flip side of this discipline is the placebo effect, of which we have much scientific data, not just isolated reports. Spontaneous Healing, a fine book by Dr. Andrew Weil explores this.        A basic example of the interelation of mind and body in asthma is that stress has very specific physiological effects, sometimes called the general adaptive syndrome. This involves the secretion of hormones from the adrenal glands, especially catecholamines (mainly adrenaline) and glucocorticoids (like cortisol). These two classes of hormones are the conceptual basis for most of the pharmacological attempts to develop drugs to control asthma. (This is because the body’s own adrenal hormones have ability to control, to varying extents, the asthmatic condition. In asthmatics, this system- the hypothalamic-pituitary-adrenal axis- and its receptors are not always up to the task.)        When stress is chronic, the adrenal glands are liable to become weakened from overuse. (There are many other unhappy effects from these hormones constantly coursing thru our bodies.) If our rest and nutrition is insufficient, the result will be a worsening of asthma, since even in asthmatics, our own adrenal hormones provide some basal level of protection. (see Asthma and Rhinitis, 1995, Busse and Holgate, pp707-8)        Glucocorticoids in the body are derived mainly from cholesterol; and adrenaline and its sisters from the amino acid tyrosine. But they cannot be made by the body, nor will they work effectively without adequate amounts of nutritional co-factors such as zinc, magnesium, vitamin C, vitamin B5 and others. Nutritional studies (e.g. NHANES II) show that many Americans are deficient to some extent in these nutrients.        Thus the emotional state of stress can be mitigated by simple biochemistry. Taking lots of vitamin pills does not guarantee optimal function of any system but I think a strong multivitamin is good insurance.        This is an explanation for the fact that many asthma authorities believe that "there is an emotional factor" in asthma. Most believe that stress is detrimental to asthmatics. Of course the best "cure" for stress is to resolve it, not vitamin pills.         I hope that those critical of this posting will respond in the spirit of illumination rather than attack. I am not a doctor. Anything I write should not be taken as medical advice. I live a rich and active life with the very rare use of drugs, although I have severe (by IgE skin test) allergies and asthma.  John Hepler

With the "very rare use" of drugs to control asthma or allergies, I doubt if you currently have severe asthma and allergies.  The real discussion was not about vitamins, so I’m not quite sure why you or the other poster are bringing that up.  To compare B12 deficiency, which results in neurological signs and symptoms, to asthma and somehow make a correlations that this shows asthma can be psychosomatic is like trying to say football and bowling are the same thing because they both use balls. I repeat, the truth is that asthma is a physical disease, and attempts to display it as psychological or psychosomatic IS prejudical.   Emotional and psychological issues after every person’s life.  The real issue here is if a person has a psychological or psychosomatic problem,and that person also happens to have asthma, can that affect their ALREADY EXISTING PHSYCIALLY CAUSED ASTHMA.  And in some cases, it can.  However, ASTHMA is not a psychological or psychosomatic disease. And many (most) people with asthma DO NOT have psychological or psychosomatic problems.  Asthmatics have had to live with the false conecept of psychosomatic cause and been stereoyped for years because of this myth until science proved that it is not a psychological or psychosomatic disease.   In the statements of the original posting you are referring to, I do not believe they were sensible statements, and in fact, could be dangerous for an asthmatic to attempt these approaches as a CURE.  Here’s the main part I am referring to:  "Some people may be able to heal by working on emotional issues. Others may heal or reduce symptoms from medicinal approaches or other means. Whatever works, works, and that is all that is important." I repeat, healing emotional isues won"t heal asthma.  This implies that emotions are the cause of asthma.  The entire message implies that emotions are the ROOT of the issue.  This is what I STRONGLY object to, and I repeat, is prejudical.  AIDS involves the immune system.  Would you imply that is a psychological disease also because it involves the immune system?  You are taking giant leaps between body systems and jumping to conclusions that really don’t paint the true picture.

Response:

To make the facts clear—ASTHMA IS NOT A PSYCHOSOMATIC OR A PSYCHOLOGICAL DISEASE.  It has been proven and known for many years that

asthma is a physical disease involving        As a long time allergic asthmatic and a very serious student of the subject, I am quite certain that asthma is not primarily a psychosomatic disease. I too, doubt that asthma can be "wished" away. That said, I am saddened to see such an antagonistic response from cruisingmrw to a sensible and interesting posting from epetee.        Epetee did not claim that asthma is psychosomatic. In fact there are many studies that show the strong influence of mental or emotional factors on physiological processes. The key to this is that the mind and the body are not separate. They are connected by the nervous system and the immune system. The scientific study of these interrelations is called psycho- neuro-immunology. The flip side of this discipline is the placebo effect, of which we have much scientific data, not just isolated reports. Spontaneous Healing, a fine book by Dr. Andrew Weil explores this.        A basic example of the interelation of mind and body in asthma is that stress has very specific physiological effects, sometimes called the general adaptive syndrome. This involves the secretion of hormones from the adrenal glands, especially catecholamines (mainly adrenaline) and glucocorticoids (like cortisol). These two classes of hormones are the conceptual basis for most of the pharmacological attempts to develop drugs to control asthma. (This is because the body’s own adrenal hormones have ability to control, to varying extents, the asthmatic condition. In asthmatics, this system- the hypothalamic-pituitary-adrenal axis- and its receptors are not always up to the task.)        When stress is chronic, the adrenal glands are liable to become weakened from overuse. (There are many other unhappy effects from these hormones constantly coursing thru our bodies.) If our rest and nutrition is insufficient, the result will be a worsening of asthma, since even in asthmatics, our own adrenal hormones provide some basal level of protection. (see Asthma and Rhinitis, 1995, Busse and Holgate, pp707-8)        Glucocorticoids in the body are derived mainly from cholesterol; and adrenaline and its sisters from the amino acid tyrosine. But they cannot be made by the body, nor will they work effectively without adequate amounts of nutritional co-factors such as zinc, magnesium, vitamin C, vitamin B5 and others. Nutritional studies (e.g. NHANES II) show that many Americans are deficient to some extent in these nutrients.        Thus the emotional state of stress can be mitigated by simple biochemistry. Taking lots of vitamin pills does not guarantee optimal function of any system but I think a strong multivitamin is good insurance.        This is an explanation for the fact that many asthma authorities believe that "there is an emotional factor" in asthma. Most believe that stress is detrimental to asthmatics. Of course the best "cure" for stress is to resolve it, not vitamin pills.         I hope that those critical of this posting will respond in the spirit of illumination rather than attack. I am not a doctor. Anything I write should not be taken as medical advice. I live a rich and active life with the very rare use of drugs, although I have severe (by IgE skin test) allergies and asthma.  John Hepler

Response:

Dilantin and pregnancy?

Question:

I suggest that you go to your neurologist some months before you wish to become pregnant & discuss your situation.If he/she thinks it OK to give you new medication to try,start it as directed (ie whilst weaning yourself off of Dilantin very slowly),and continue on it for a while to ensure you are going OK before getting pregnant.Remember that any controlling medication is better than suffering grand mal seizures during pregnancy.Also that any possible adverse effects  for pregnancies with anti- convulsant medication are only slightly higher than for the general population. You may also have noticed in your previous pregnancy(as I did in my  previous 2 pregnancies) that any petit mal/absence seizures are likely to increase- and so an increase in medication may be recommended by your neurologist. Only your neurologist will know your situation sufficiently to be able to give you the best advice. Stay in consultation with him/her throughout and do not be afraid to ask questions! For your info, Ihave been on several medications over 20-odd years, and went on to Tegretol a feww months before the birth of my 1st daughter in 1993. My name is Brenda and my internet address is wal…@ocean.com.au. Please ask me anything you like-I know how scary it all is too. I personally would never stop taking medication during pregnancy (I once kidded myself that my epilepsy was mild and infrequent,and this had pretty bad results-back in my younger years)-but only your neurologist will be able to advise you properly on this.Apologies if this is all obvious stuff. Good luck.      

Response:

It looks like I have just accidentally posted on some info to you re Dilantin and pregnancy. Sorry for the mistake.

Response:

- Hide quoted text — Show quoted text -dwal…@news.ucs.ubc.ca (Dan Walker) wrote: >Ann Maloney (szmal…@dale.ucdavis.edu) wrote: >: Hi Everyone: >:   I have a mild case of epilepsy (up to 4 years between seizures); >: I was diagnosed in 1992 and have been taking 300mg/day of Dilantin since >: then. In 1994, I disovered I was not only pregnant, but already in my >: 17th week. I agonized over the possible effects the Dilantin I took in >: the first trimester would have  on my baby through the remainder of the >: pregnancy, reading everything I could about it. On 22 Aug 94, I gave >: birth to a healthy 8 lb 9 oz girl, much to everyone’s relief. I want to >: have another child soon, and am undecided as to what to do about my >: medication during those first 3 months – switch to something else, tempt >: fate and stop altogether, just continue to take Dilantin and hope… >:   I would love to hear about how others have dealt with this – you >: can respond here or at my address – :               Thank You! >:                   >:                   Ann Maloney >:                   acmalo…@ucdavis.edu >Just don’t stop cold turkey…you have to wean yourself off the >Dilantin slowly. (Apologies if this is common knowledge.) >Dan Walker dwal…@geology.ubc.ca

Response:

Go to your doctor in the months before you wish to become pregnant and discuss your situation.He/she may say it’s Ok to continue, or recommend a gradual change of medication, which should take place well before you become pregnant, to ensure all is working fine for you.You may need an increase in dosage during pregnancy. Your neurologist wil give you the best advice,but dont’t be afraid to ask lots of questions. I have been on many sorts of medication over the years, but went back on to Tegretol, very gradually, a few months before my 1st pregnancy, in 1992. This is brief- sorry Ann- but I sent a longer message to the wrong person and what I’m telling you may be blindingly obvious. Please feel free to contact me – Brenda- at wal…@ocean.com.au-if you want to know more. I think any neurologist would tell you not to take chances in your 1st 3 months by cutting out your medication, no matter what its type, and risk having grand mal seizures, even if  you consider your epilepsy to be "mild". But I’m not a neurologist, so talk to someone who is, as soon as you can. Good luck.    

Response:

In article <4kmamt$…@mark.ucdavis.edu>, szmal…@dale.ucdavis.edu (Ann Maloney) wrote: > Hi Everyone: >         I have a mild case of epilepsy (up to 4 years between seizures); > I was diagnosed in 1992 and have been taking 300mg/day of Dilantin since > then. In 1994,……………..(text deleted)…….. I want to > have another child soon, and am undecided as to what to do about my > medication during those first 3 months – switch to something else, tempt > fate and stop altogether, just continue to take Dilantin and hope… >         I would love to hear about how others have dealt with this – you > can respond here or at my address –

I’m taking 350mg Dilantin (up from the regular 300) and now 21 weeks pregnant with our first, thus far healthly and normal daughter (according to ultasounds, amnio). I’ve had epilepsy for 20 years, medicated, and hardly ever had seizures.  When considering getting pregnant, I tried going off meds and was fine—for a couple of months and then…………Ya never know. Having researched this to the max, we decided to remain on medication, and, in fact, carefully monitor *free phenytoin* levels at least every 4 weeks and adjust dosage as necessary to maintain what for me is appropriate therapeutic levels. (Beware: The "standard" Dilantin level used by most neurologists in the USA is almost useless in monitoring levels in pregnant women!) Some women appear to have increased seizure potential during pregnancy. And some a decreased, with most experiencing no change.  Seizure during pregnancy is clearly dangerous to both the mom-to-be and the fetus and the risks of taking medication (at least Dilantin monotherapy) appear to be minimal to non-existant. I wouldn’t even consider switching to another drug if Dilantin works for you!  But you are also in the unique situation of having long seizure free periods. Tough one! Personally, I wouldn’t risk it. Folic acid supplementation *may* prove to be the key in mitigating potential epilespy medication fetal defects, as well as using monotherapy (one med, not combos). So make sure you are taking AT LEAST 800mcg (I take 4mg—5 times that dose) beginning at least a month prior to conception. There is no official protocol for folate supplementation–but 4-5mg appears to be the increasingly accepted standard—not the 800mcg level, which is recommended for all pregnant women. The old 50’s scare of Dilantin birth defects appears to be completely unfounded. We checked with two extemely knowlegable OBs who have experience (or direct knowledge) of delivering a total of a couple of thousand babies to moms on Dilantin and *not one* major defect and but two extremely minor (like not detectable unless you look for it! and maybe not even related to meds) "anomolies".  Based on *that* data, it would appear that women taking Dilantin monotherapy have *a lower* incidence of birth defects than the "normal" population—and in fact one rather large study a few years back likewise seems to support that finding.  The rationale appears to be that: 1. the meds might not matter and  2. medicated women have better access to prenatal care and pay better attention to their health in general. (PS: Monotherapy mean just that: no other drugs, including alcohol, nicotine, caffeine, etc. No one really knows how this stuff interacts.) And of course you did it once and have a healthy child! There are no guarantees, you know. And sadly this whole thing with meds and pregnancy is not very well studied.  What else is new? So best of luck and stay healthy and may you remain seizure free! Regards, Jamie ########################## Larry Bickford, OD Adult and Pediatric Vision Care Santa Barbara, Ca. e-mail: eyec…@west.net ————————– The EyeCare Connection & CyberLens http://www.west.net/~eyecare

Response:

Ann Maloney (szmal…@dale.ucdavis.edu) wrote:

: Hi Everyone: :       I have a mild case of epilepsy (up to 4 years between seizures); : I was diagnosed in 1992 and have been taking 300mg/day of Dilantin since : then. In 1994, I disovered I was not only pregnant, but already in my : 17th week. I agonized over the possible effects the Dilantin I took in : the first trimester would have  on my baby through the remainder of the : pregnancy, reading everything I could about it. On 22 Aug 94, I gave : birth to a healthy 8 lb 9 oz girl, much to everyone’s relief. I want to : have another child soon, and am undecided as to what to do about my : medication during those first 3 months – switch to something else, tempt : fate and stop altogether, just continue to take Dilantin and hope… :       I would love to hear about how others have dealt with this – you : can respond here or at my address – :               Thank You! :                       :                       Ann Maloney :                       acmalo…@ucdavis.edu Just don’t stop cold turkey…you have to wean yourself off the Dilantin slowly. (Apologies if this is common knowledge.) Dan Walker dwal…@geology.ubc.ca

Response:

Dear Ann  I have epilepsy, severe asthma and cp. I am the mother of 3 young children. While pregnant with my first born, who is now 9, I was on dilantin. I went into statis epilepticus at 6 months and phenobrabital was added. I was also on medications for my asthma. We all worried about my baby, doctors included. Would she have my medicine in her, would she be ok, etc. You know all those nice questions, including questions that all new parents ask.   She was born early but not considered a premie. They tested her and found she had no trace of my medicines in her system. I had a strong healthy baby girl 6lbs. 7ozs.   About 26 months later her brother was born, early but not premie. I had been taken off the dilantin but not the other medicines. I was able to nurse him until he cut his first tooth at 10 months. A healthy 6lbs.8ozs. boy. No trace of my medicine in his system and he picked up none of it in my milk. My last born will be two May 6th. He is a premie and was slightly anemic but basically a strong healthy baby. I am still on phenabrabital and my other medications at doses that they thought would cause problems with the pregnancys and the babies. My last one I was able to nurse as long as he wanted. He was on iron suppliment for most of his first year. He weaned himself at about 16 months. All three of my children are small for their ages, but they are strong and healthy.  My medicines though they are in my bloodstream and from all known knowledge should have been in the children and come to them through the milk seemed to never cross the placenta and none of my children had any signs to show that I was even on medication during that time. They are strong, healthy children and smart.   With the first born I was on both dilantin and phenabrabital. But for the last 8 years I have been on the same dosage of phenabrital and my asthma medications I am still on. The doctors always moniter me very closely but they do not take me off my medication and my children are fine.   Rebecca

Response:

Hi Everyone:         I have a mild case of epilepsy (up to 4 years between seizures); I was diagnosed in 1992 and have been taking 300mg/day of Dilantin since then. In 1994, I disovered I was not only pregnant, but already in my 17th week. I agonized over the possible effects the Dilantin I took in the first trimester would have  on my baby through the remainder of the pregnancy, reading everything I could about it. On 22 Aug 94, I gave birth to a healthy 8 lb 9 oz girl, much to everyone’s relief. I want to have another child soon, and am undecided as to what to do about my medication during those first 3 months – switch to something else, tempt fate and stop altogether, just continue to take Dilantin and hope…         I would love to hear about how others have dealt with this – you can respond here or at my address –                 Thank You!                         Ann Maloney                         acmalo…@ucdavis.edu

Response:

Ann Maloney wrote: >         I have a mild case of epilepsy (up to 4 years between seizures); > I was diagnosed in 1992 and have been taking 300mg/day of Dilantin since > then.

I am curious as to why you take the medication. I have just been diagnosed myself, but it seems to me at the moment that my epilepsy is so mild that I am better off risking seizures than risking the side effects of the medication. Do you have any thoughts? My neurologist has prescribed Dilantin. I need to make an intelligent decision on what to do soon. — =-=-=-=-=-=-=-=-=-=-=-= Gary Evesson KCS Australia Pty. Ltd. http://www.kcs.com.au =-=-=-=-=-=-=-=-=-=-=-=

Response: