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Here it is (sorry dont know how to attach word doc)
Pulmonologist (DO) stated is asthma. I didnt ask how he came out with that assessment, so I am posting it here for any suggestions? I was already taking: xanax, Advair 250/50 (2 puffs/day), Singulair 10mg and ProAir when necessary. He switched me to Symbicort (4 puffs a day) and i am not liking but i will give it couple of days. I was doing better progress before, didnt get any attacks lately but i am afraid of such attacks like the ones that took me to the ER. I am wondering which nebulizer should i buy. I would like to use it with an adapter during my job road trips or at the airplane. Can i do this?


Spirometry Pre-Dilator Post Dilator
Actual %PRED PRED Actual %PRED%Change
FVC 5.9 126 4.69 6.28 134 6
FEV.5 3.19 4.27 34
FEV1 5.08 131 3.89 5.39 138 6
FEV3 5.84 130 4.49 6.13 137 5
FEFmax 6.38 71 8.95 10.11 113 59
FEF25-75% 5.05 122 4.14 6.55 158 30
FEF25% 4.19 51 8.28 8.74 105 108
FEF50% 5.55 113 4.92 9.05 184 63
FEF75% 4.01 199 2.02 2.91 144 -27
FEV.5/FVC 54.01 67.9 26
FEV1/FVC 86.08 104 82.8 85.71 104 0
FIF50% 2.31 3.72 61
FEF50/FIF50 239.86 243.29 1
TET 4.1 5.65 38

LUNG VOLUMES pre-dilator
Actual %PRED PRED
VC 5.68 121 4.69
IC 4.08 138 2.97
ERV 1.6 94 1.7
RV 2.22 121 1.84
TLC 7.91 121 6.51
RV/TLC 28.15 96 29.39
FRC 3.82 108 3.55

DIFFUSION
Actual %PRED PRED
Dsb 34.52 114 30.37
VAsb 6.96 107 6.51
D/VAsb 4.96 106 4.66

Computer Impression

Normal Spirometric values indicate the absence of any significant degree of obstructive pulmonary impairment and/or restrictive ventilator defect.
Lung volume testing was performed by helium dilution
The increased residual volume (RV) and total lung capacity (TLC) indicate the possibility of a mild degree of hyperinflation.
Normal diffusing capacity. This is indicated by the finding of normal values for both the diffusing capacity (Dsb) and the diffusing capacity in relation to the lung volumes (D/VAsb)
Bronchodilator therapy was administered followed by repeat spirometric testing.
The FEF25-75% is significantly increased indicating that this patient would most likely benefit from
Continued bronchodilator therapy.
Well i skipped work today, i didnt feel like driving 40miles. Even though a lot people swear by Symbicort 160/4.5, I feel like is not stronger than Advair 250/50. Though i have only used one day. 2 puffs twice a day is what i was told, kind of extreme.
Symbicort=160mcg/4.5mcg
Advair= 250mcg/50 mcg

I also hear Advair is more expensive which doesnt necessarily mean is better. I need something quick to get me through the days. I regret switching to symbicort at this point. I already taken 5 days out of work the last 2 wks. Plus Albuterol doesnt do jack for me. I am so afraid of getting stuck in the highway.
Getting your asthma under control when first diagnosed and you haven't been on any meds can take several weeks. Advair nor Symbicort work immediately. Are you having actual attacks or are you simply having trouble getting it totally controlled? I'm not sure I understand exactly what's going on. Also, you could switch to a nebulizer for a while as that sometimes helps more in the beginning before things get under control.
[QUOTE=Titchou;4037921]Getting your asthma under control when first diagnosed and you haven't been on any meds can take several weeks. Advair nor Symbicort work immediately. Are you having actual attacks or are you simply having trouble getting it totally controlled? I'm not sure I understand exactly what's going on. Also, you could switch to a nebulizer for a while as that sometimes helps more in the beginning before things get under control.[/QUOTE]

I been on Advair for just 1.5 wk but it was already working. Then just yesterday i switched to symbicort (less side effects) but my attacks are back again. Plus albuterol doesnt work much when needed. I asked my doc and he said to switch back to Advair but the 500/50 dose. So should i stick with advair even though i want to give symbicort a try? right now, i think if something is working then keep doing it.
Which at home nebulizer should i buy? is there a portable nebulizer where you can plug it in the car?
Whether you go with the Symbicort or Advair, you need to choose based on your Pulmonologist's advice, you need to stick with one for a bit before trying the other.

I've done various dosages of Advair and found it useful. When I have extremely bad asthma that needs to be brought under control, a couple weeks on a tapering dosage of oral steroids, like Prednisone, helps tons. (It is part of my asthma action plan.) I do that in addition to the Advair 500/50, Singulair and Albuterol. I'm finally to the point that after a while on that, I can cut down to the Advair 250/50 until the 500/50 is needed again.

Did your Pulmonologist tell you that you need a nebulizer? I have bad asthma and don't use one. My Pulmonologist told me that as long as I'm using the Albuterol well, the nebulizer wasn't necessarily the way to go.
Thanks gals.

I am new to all of this. When i asked the pulmonologist about a nebulizer, he said the albuterol will do and he is more confident with the symbicort than with the advair. As a matter of fact, it appears to me the symbicort w/ spacer will target/reach the lungs better than the advair. I am not sure whether to change back to the symbicort. Right now i am jittery with advair 500/50 hoping to kick again, the bad side effect is the hoarseness, sore throat irritation. The symbicort seems gentler even after one dose. I am trying to get my asthma under control but i am afraid of the sudden attacks which the albuterol doesnt do much. If anyone wants the pulmonary report, i can email you. I want to know the FEV1/FVC normal range should be.Is there any other pills i should i ask for besides singulair?

Besides the verdict is that a nebulizer will work better than the albuterol. They also sell portable that plugs into a cigarrette adapter. I always believe to plan ahead specially how incompetent ER staff in this country are. Last visit they only checked the oxygen level and concluded i was fine and is in my head. Some are not equipped with nebulizer, peak flow meter or else. Anyone bought a good portable nebulizer? please which brand?





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