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Hi klynn1960,

I can totally relate to what you're going through right now. I had very bad asthma for 15 years (1980 to about 1995). I had to be on very high doses of prednisone for LONG periods of time early on because my asthma was so out of control. (I had a life threatening episode in 1985 and was on a respirator for FOUR DAYS!!)

However, things started getting better for me in 1988 when I had to switch pulmonary doctors because the one who saved my life in 1985, quit his practice to go into research instead. My new pulmonary doctor has been WONDERFUL in helping me get into COMPLETE REMISSION the last 15 YEARS, both physically and psychologically!

Though I DO still have to take a small (6 mg/day) dose of Prednisone for the rest of my life due to total adrenal insufficiency, the side effects of the higher doses really did bother me. Prednisone is a double edged sword drug - it really brings your asthma under control with short term "burst doses", but it has a LOT of side effects long term. One, as I say, is total adrenal insufficiency where my adrenal glands no longer put out ANY cortisone on their own which is why I need the low dose every day. (A healthy person's adrenals normally put out 25 mg. of cortisol daily to help fight infections and just keep your body working normally.) Another serious long term effect of taking high doses of Prednisone is the development of osteoporosis in your back and hips. (I have it in both, but cannot take ANY of the drugs to treat osteoporosis because I also have acid reflux disease AND, in 2009, to avoid the oral drugs adversely affecting my esophagus, I tried that new I.V. drug Reclast, but had a severe temporary kidney failure reaction to the Reclast! Thankfully, they caught it in time and there was no permanent kidney damage.) So now, I can no longer take ANY drug that contains components of the drug family called Zoledronic acids. (I could not even try Synvisc for my osteoarthritic knees because it is in the zoleldronic acid family. Besides, my knees were so bad that I had to have total knee replacements in both, one year apart - 4/5/11 and 3/23/12. TKRs have a 90% proven success rate long term. Synvisc doesn't have the proven track record yet and most insurance companies would rather pay for the $50,000 knee replacement surgery for this reason. I'm pretty much done with re-hab for my left TKR from this past March and both new knees feel great and should last me the rest of my life since I'm not an uber athlete!) But, I digress.

I know the side effects of long term high doses of Prednisone can be very uncomfortable, but if you are having asthma symptoms right now, let your doctor put you on a short term "burst" of Prednisone and wean you down over a few weeks time to not having to take it at all. See if it gets your asthma under control again.

Also, ask him to put you on Singulair (10 mg./day) as a maintenance asthma drug with little or no unpleasant side effects. I have been on it since it first came on the market and it's been an absolute Godsend! You might also ask for either Advair or Flovent inhalers (one or the other but not both!). They are also long acting asthma control maintenance drugs. Advair contains a steroid component to reduce the inflammation of an asthma flare-up combined with a beta-agonist component for fast acting results. HOWEVER, if you have any heart problems or have too fast a heart rate, ask the doctor for the Flovent. It works the same as Advair but without the beta-agonist component that can adversely affect your heart rate. Both Advair and Flovent are taken twice a day. The Advair is one puff twice a day and the Flovent is 2 puffs twice daily. There are different dose levels of each so whichever one your doctor puts you on, ask for the LOWEST dose one first to see if it's enough to bring your asthma under good control and KEEP it there!

Hope this info was helpful. Don't lose hope! I'm a walking example of a true asthma success story! As a matter of fact, I participate with one of my pulmonary doctor's group colleagues in a presentation every April for the 2nd year Pharmacology med students at NY Medical College. The doctor and I have a Q & A session first - he asks me certain questions about my asthma history and how the asthma meds I take affect me. Then we open the floor to questions from the medical students. This way, they get a valuable understanding of asthma from a patient's perspective a year before they start their clinical clerkships going on rounds with senior attending physicians, and teaches them how to have compassion for what the patient is going through. I've been doing this (volunteer basis) for about 10 years and really look forward to it. And the students seem to appreciate my being there to answer their questions because they always thank me as we all walk out of the lecture hall. Some even have stayed to privately ask me questions that they might have been too shy to ask out loud with their classmates there.

Hope this info helps and you ask your doctor about the medications I've mentioned here that he could put you on in order to get you off the Prednisone and still keep your asthma under good control.

Let me know what happens. I care because I've "been there, done that" IN SPADES!!

Regards,
CPW2012 (Carol)
Hi klynn1960,

Yeah, it HAS been a very tough roller coaster ride the last 30+ years with first the asthma, then the GERD and finally the osteoarthritis that required the double knee replacement surgeries! But I've learned a lot about health care because as I was going through all these crises, I made it my business to learn everything I could about my conditions.

Matter of fact, a nurse friend of mine suggested I take a program or class to get certified as a Medical Coder/Biller which is much in demand and a recession proof job. (Also, it can be done from home via the internet.) I just got approval from the NY State Dept. of Labor to take this class at my local BOCES school! (Board of Cooperative Educational Services). The Dept. of Labor is paying my way in FULL!!!

Since I've been out of work since January of 2011 due to my knee replacement surgeries a year apart, I realized the corporate world wasn't for me anymore. Been there, done that! So I was thrilled when my friend suggested the medical billing/coding profession for me. (The class starts in Sept. but I am going to start looking for a job in that profession that doesn't require certification right away. Now that I know I will be taking the course, I can mention that in an interview and maybe they'll hire me knowing that I'm pursuing certification.)

I digress.

You are right about the Singulair. For some reason the experts are not sure why, it doesn't work for every asthma patient. I have a high school classmate who lives in Arizona and she tried it a few years ago but said it didn't work for her.

Luckily for me, as I mentioned in my first post to you, Singulair has been one of my Godsend medications to keep my asthma in remission!

I understand how you feel about the Prednisone issue, but if you are REALLY having frequent and bad asthma attacks, don't refuse a short term "burst" course of its use to get you back under control. Your doctor will know how to wean you off it quickly once it does its job of getting you back under control.

The other thing you might ask your doctor to prescribe for you so you can treat your attacks without going to the E.R. is a nebulizer machine and albuterol with saline to use instead of your rescue inhaler when you are at home. (They also have portable nebulizer machines that run on batteries so you can keep it in your car should you need a neb treatment.) I have NEVER had to use the portable one - it's somewhere in a box in the back of my SUV! And I don't remember the last time I had to use the electric one at home since I've been in complete remission for years!

Just another tip for you to try.

Hope this helps.

Regards,
Carol
Hi Titchou,

No problem! I probably AM amongst the few adult onset asthmatics who have managed to achieve full remission and stay that way for as long as I have! (A HUGE part of why I'm in remission is that I take all the "maintenance" drugs to help me STAY that way!!) Just one minor correction regarding children who "outgrow" asthma. They DON'T! Like me, and usually starting in their teens, they start to go into long term remission that may or may not hold for the rest of their lives. Once you have the disease, it doesn't matter at what age you developed asthma. Your lungs will ALWAYS be susceptible to an asthma attack! It's the nature of the disease. Maybe someday, researchers will find out what REALLY CAUSES ASTHMA and find a way to cure it! Right now, we asthmatics have to settle for achieving complete remission for as long as possible like I have. But that doesn't mean I can stop my asthma meds altogether! They are what is keeping me in this complete remission.

I'm actually on the Prednisone now, and for the rest of my life, more for the total adrenal insufficiency than for the asthma. (I was on high doses for such long periods in the early years of my adult onset asthma, that it caused my adrenal glands to completely stop producing my body's normal level of cortisol - the normal putout of cortisol by the adrenals is 25 mg a day. I had an adrenal stimulation test seven years ago and it showed, as my pulmonary doctor and I suspected it would, that my adrenal glands had totally turned off and stopped working. THAT is why I have to be on a small dose EVERY DAY FOR THE REST OF MY LIFE! I belong to Medic-Alert Foundation and wear a bracelet that notes that I have both the asthma AND the adrenal insufficiency. That way, if God forbid I got into a bad accident or got very ill and could not talk for myself, first responders would see the bracelet and know to IMMEDIATELY give me IV steroids! And as I noted in my earlier post, I need IV stress doses of hydrocortisone for any MAJOR surgery, such as the two total knee replacements I had - right one 4/5/11 and left knee 3/23/12!)

I realize this board is for all asthmatics to exchange helpful info and ask questions on how to deal with the disease. As I noted previously, and per your welcoming comments, it's why I joined this message board, (along with the one for knee and hip problems) - to help others to "maybe" someday achieve the kind of long term remission that I currently enjoy.

Again, thank you for your kind welcoming words and I hope I can be of help on this message board too, just like I've been doing with the one regarding knee and hip problems!

My pulmonary doctor and I have this kind of "Abbott & Costello "who's on first" routine. Every time I go for a checkup (every six months, though this time, it will be three months because of my March knee surgery), once we are in the exam room, he will ask me how my asthma is and I respond with a smile, "Asthma? - What's THAT?" He always gets a big kick out of that little routine, especially because I am STILL doing so well that I am able to "forget" that I have the disease!

Regards,
Carol





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