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So I have had an asthma flare-up for the last 8 days. Typically I have major asthma problems in the winter. In the past, I have only had asthma problems in the summer when the air quality was bad from wildfires. Right now, our air quality is OK- no fires. I know humidity can play a role, but we have only been averaging around 18-20% humidity here.

I am frustrated right now because I am not sure what my triggers are for this attack so I can help get it under control.

Here are my suspects- either individually or in some combination:

Allergens: I do have year-round and seasonal allergies, but I have never had allergy induced asthma. So far this spring and summer, my allergy meds and immunotherapy have kept me from really having severe allergies. I've actually felt better this allergy season than I have for many many years.

Dry hot air: We haven't had rain for over a month. My doc thinks this flare-up may be as a result of particulates that may be hanging low in the air because there hasn't been any rain to clear it out.

Acid reflux: I do have reflux. I was on Prevacid 2x/day for years. In May, I went to the Pulmonologist for my asthma. He ran some tests and found I still have some acid coming up and aggrevating my asthma. I have been working with my GI doc to find a new medication to help control the acid. My problem here is that I don't feel any acid symptoms so it is hard to know if it is causing problems at any given point and time. (My acid symptom is typically a cough.) I tried Nexium a month ago and it was horrible. I have been on Aciphex for the last couple weeks.

Current treatment regimine for this flare-up: Asthma- Advair 500/50, Singulair, Albuterol, Prednisone; Allergies- Allegra, Flonase, Astelin, immunotherapy, Saline rinses; Reflux- Aciphex 2x/day, Gaviscon. I'm also beginning Avelox for the next 5 days, just for the heck of it to see if I have some sort of infection.

Anyone out there have any thoughts on what I may be able to help get my asthma back under control? If so, they would be much appreciated.
My asthma cough has gotten worse instead of better this week. I finished a round of Prednisone yesterday and I am already loaded down with the other meds I am taking for this. I have been relying on my Albuterol every 4 hours for the last 9 days. My voice has really gotten hoarse. The doctor put me on antibiotics in case I have some sort of infection that is aggrevating my asthma, but I'm not sure it is doing much. I just don't know what else I should be doing.

To make matters worse, our air quality changed today. We are under red air quality alerts for the near future and our humidity is 9%. I just don't see any relief in sight.

Aside from just hoping I don't have a serious attack that needs emergency care, I feel like my options are limited. This is really wearing me out.
So, I am 5 days into a 9 day burst of Prednisone and my cough is already back. (Sigh!) This is with frequent use of Albuterol and daily doses of Advair 500/50 and Singulair.

I had another follow-up with my GI doc today. I just know it is my acid that is flaring up my asthma cough this summer. He verified that my EGD I had two weeks ago was just fine. I have been on Aciphex 2x/day for the last 5 weeks and I have had to go to my PCP 3 times for my chronic cough. He is switching me to Zegrid. Basically this is my last hope since I haven't had luck with Prilosec, Protonix, Nexium, Prevacid or Aciphex and all of my other tests verify that I have "serious" acid. I know it has the same medicine as the Prilosec, but it is supposed to be a bit more effective. I also have to go back for another Manometry and 24 hr PH. My last ones were 2 years ago. Depending on how the Zegrid and test results are, I think I am seriously looking at having the Nissen Fundoplication surgery for my reflux. They are running out of other medical interventions to help. I can't continue forever with my asthma out of control. I am getting scared for fall and winter that are fast approaching. In past years, the summer has been my "safe" time from my asthma since the cold air & winter inversions are my worst triggers. I can't imagine my asthma worse than what it has been this summer.

By the way, my Prednisone "flush" on my face, neck and chest just lasted 2 days. I found on a website that it is a "lesser" side effect. I will definitely let my PCP know next time I go in.





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