(no subject)
Dec. 19th, 2008 11:05 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
the_rck::snarls at the world::
Okay, pieces of today so far haven't been awful. Most of the day in fact. The weather's awful, and school's closed, but my doctor called me to take care of my concerns over the phone so that I wouldn't have to try to get downtown. It's one of those things that has made me stay with her for so long even with the other issues I have with her.
I'm even feeling a little better. My doctor strongly suspects, given the timing, that I had the bug that Scott did. She says that antibiotic side effect usually take a couple of days to get started. Given that my issues started no more than twelve hours after my first dose, she thinks it was the bug. I didn't get as sick with it as either Scott or Cordelia. I'm not sure if that's because my immune system was already up in arms fighting the strep or if the bug wasn't as viral as Scott was told when he went to the doctor.
The thing making me snarl is that my doctor called back to say that the pharmacy has informed her that they can't fill my rescue inhaler prescription because nobody's making that medication any more. I use alupent. I've tried albuterol several times in the last twenty years, and it's never been pretty. The side effects aren't as bad as ceasing to breathe, but they are worse than spending an hour or two coughing after being out in the cold or having to walk out of restaurants at the first whiff of smoke or incense.
I'm very frightened of what happens the next time I get asthmatic bronchitis or anything else that sets off a prolonged problem. It's only happened three or four times in my life, but those occasions are all in the last ten years, three of them in the last five. When that happens, I end up using my rescue inhaler fairly constantly for weeks. During those bouts, I use inhaled steroids, too. I need both.
This isn't going to mean big changes in my everyday life. I use my rescue inhaler maybe once a month under normal circumstances. It's just going to mean that there are chances I can't take. For example, my brother-in-law and his family want to try to fly us out to Seattle to visit. They've been telling me that they've kept their cats out of the downstairs of the house and that that area should be 'cat-free' and safe for me to stay in. With a safe rescue inhaler I might consider trying it. (I'm still dubious that space that shares the same heating/cooling ducts and general air circulation is going to be free of an air-born allergen, and I'm allergic enough for it to be a big risk with a good inhaler, even if it's just the risk of having to pay for a hotel room for the whole of the stay.)
Admittedly, I've only tried albuterol a few times. I used it for two days in the 80s. I was given it for a reaction to an allergy shot in the 90s (without being told what it was). I was given it in the ER for asthmatic bronchitis about three years ago. The first two reactions were clearly bad due primarily to the medication. The third...I was sufficiently sick at the time that it's hard to tell what was the medication and what was the illness. It helped me breathe a little better, I think, but the side effects left me feeling quite as bad as I had when I'd come in. They held me overnight in hopes that they could get me to sleep, but they kept putting more albuterol into me (I'd specifically told them not to, too. I only found out after the fact that, after the first treatment which was something else, they went back to albuterol).
Does anybody else out there have problems using albuterol? Do you have advice for alternatives? For decreasing the side effects? (I get a racing heart that feels like it's trying to escape my chest. I shake to the point that talking is hard, 'tremors' in my back and chest basically. My anxiety goes up which is hard to do when the normal level is somewhere in the stratosphere.)
::sighs:: My doctor's referring me to a pulmonologist in hopes that there's a solution. As long as I take Singulair every day, my asthma is mild 99% of the time. I've got time to look for options.
Okay, pieces of today so far haven't been awful. Most of the day in fact. The weather's awful, and school's closed, but my doctor called me to take care of my concerns over the phone so that I wouldn't have to try to get downtown. It's one of those things that has made me stay with her for so long even with the other issues I have with her.
I'm even feeling a little better. My doctor strongly suspects, given the timing, that I had the bug that Scott did. She says that antibiotic side effect usually take a couple of days to get started. Given that my issues started no more than twelve hours after my first dose, she thinks it was the bug. I didn't get as sick with it as either Scott or Cordelia. I'm not sure if that's because my immune system was already up in arms fighting the strep or if the bug wasn't as viral as Scott was told when he went to the doctor.
The thing making me snarl is that my doctor called back to say that the pharmacy has informed her that they can't fill my rescue inhaler prescription because nobody's making that medication any more. I use alupent. I've tried albuterol several times in the last twenty years, and it's never been pretty. The side effects aren't as bad as ceasing to breathe, but they are worse than spending an hour or two coughing after being out in the cold or having to walk out of restaurants at the first whiff of smoke or incense.
I'm very frightened of what happens the next time I get asthmatic bronchitis or anything else that sets off a prolonged problem. It's only happened three or four times in my life, but those occasions are all in the last ten years, three of them in the last five. When that happens, I end up using my rescue inhaler fairly constantly for weeks. During those bouts, I use inhaled steroids, too. I need both.
This isn't going to mean big changes in my everyday life. I use my rescue inhaler maybe once a month under normal circumstances. It's just going to mean that there are chances I can't take. For example, my brother-in-law and his family want to try to fly us out to Seattle to visit. They've been telling me that they've kept their cats out of the downstairs of the house and that that area should be 'cat-free' and safe for me to stay in. With a safe rescue inhaler I might consider trying it. (I'm still dubious that space that shares the same heating/cooling ducts and general air circulation is going to be free of an air-born allergen, and I'm allergic enough for it to be a big risk with a good inhaler, even if it's just the risk of having to pay for a hotel room for the whole of the stay.)
Admittedly, I've only tried albuterol a few times. I used it for two days in the 80s. I was given it for a reaction to an allergy shot in the 90s (without being told what it was). I was given it in the ER for asthmatic bronchitis about three years ago. The first two reactions were clearly bad due primarily to the medication. The third...I was sufficiently sick at the time that it's hard to tell what was the medication and what was the illness. It helped me breathe a little better, I think, but the side effects left me feeling quite as bad as I had when I'd come in. They held me overnight in hopes that they could get me to sleep, but they kept putting more albuterol into me (I'd specifically told them not to, too. I only found out after the fact that, after the first treatment which was something else, they went back to albuterol).
Does anybody else out there have problems using albuterol? Do you have advice for alternatives? For decreasing the side effects? (I get a racing heart that feels like it's trying to escape my chest. I shake to the point that talking is hard, 'tremors' in my back and chest basically. My anxiety goes up which is hard to do when the normal level is somewhere in the stratosphere.)
::sighs:: My doctor's referring me to a pulmonologist in hopes that there's a solution. As long as I take Singulair every day, my asthma is mild 99% of the time. I've got time to look for options.
no subject
Date: 2008-12-19 04:40 pm (UTC)They've also switched to a new propellant in the last couple of years (due to regulation changes in propellants related to global warming/climate stuff.) The new one is pricier (mine was $30, instead of something like $9 previously) as it's not yet a generic.
That said, there's some bonuses: the new propellant hits me differently. With the old one, I couldn't take it in the evening if I wanted to sleep, and I couldn't wake up in the middle of the night and take it and fall back asleep. (I didn't get the jittery issues unless I took it for at least a day or two running) With the new one, I can (though I'm still a little nervous about it.)
Like you, I don't take it often - and the herbalist stuff I've been doing has helped a lot (and kept me off steroids, which I have *miserable* reactions to.)
I'd see if the pulmonologist has a sample you could try or something - see how it affects you.
no subject
Date: 2008-12-24 05:47 pm (UTC)Steroids and I are not a happy combination. They tend, even in inhaled form, to increase my reflux which can make the asthma worse. I also don't seem to lose the steroid weight after I stop taking the steroids.
I expect I will ask for samples. I've had so many weird side effects and difficulties that buying isn't going to be a good idea.
I think that the shift in propellants has driven some marginal medications, things not used by many people, off the market. The manufacturers decided that the expense and hassle of switching propellants wasn't going to yield adequate return. My doctor did some research. Everything she could find available for purchase was albuterol based. Other medications exist in theory, but nobody's selling them in the U.S.
no subject
Date: 2008-12-25 02:37 am (UTC)In my case, my herbalist noted liver and kidney issues which combine to reduce energy circulation to the lungs and lead to stagnation issues. The end result is that if I get a cold, I do some combinations of things (I usually go heavy on the thyme) to kill the infection, and also start taking pleurisy root for the coughing. And we do some other stuff in the fall to help avoid issues at the time I usually have the most problems (fall pollen allergies + mold allergies make the fall the worst for me until the first hard frost or two.)
Pleurisy root is my friend: it's named for exactly the kind of cough I get (moist and gunky in the bottom of the lungs, dry and a bit hacking as it gets up to the throat.) I only take it if I'm getting a cold or if I'm getting over one: I stop adding it in to my regular herbalist blend once I stop coughing. It clears up the cough much faster, and means my lungs never get as miserable and tight and messed up.
(This cold I got in November was nasty - but even with it, I was able to do substantial walking the first week after I got over the bulk of the rest of the cold, and I've been coughing but not miserable since. I'm almost over the coughing, now.)
The other one we've used - mostly to help with allergies - is mullein, which I think helps discourage the allergic response and inflammation, and so can help help sidestep asthma issues that way, too.
The regular herbalist blend I take is mostly focused on boosting the liver and kidney healing, and on fixing some of the hormonal issues. The first part also helps the lungs, though as a sort of secondary effect (less stress on the body = lungs less likely to panic.)
My steroid issues aren't so much the weight (though I'm pretty sure it didn't help other metabolic issues) but the fact I've had psychotropic effects (specifically, fast-cycling mood swings if I'm on them for more than 3-4 weeks) on every one we've tried me on, which is most of the milder ones. My sister has the same problem, and has had good luck on Singulair, but really, I don't want to test it if I don't have to.
no subject
Date: 2009-01-03 02:39 am (UTC)I'd be curious, though, to see if an herbalist would have an opinion on the aspect of my big asthma troubles that has made some doctors think I'm crazy-- Before I started taking Singulair, often my first cold symptom would be my chest getting tight, even for colds that started in my sinuses.
no subject
Date: 2009-01-03 02:57 am (UTC)What I'd look for (and this may be tricky for you, I admit) is a really well stocked natural foods store or herb store (i.e. place that sells lots of dried herbs and related stuff, not just the 40-50 most common ones, but up in the hundreds). And then ask them for recommendations, and ask about training.
The other option would be to see if you can find someone who's trained in Traditional Chinese Medicine - which does have a more useful structure in the US as far as who uses the name, as I understand it. Somewhat different set of approaches, and different herbs in some cases, but the same basic concept of looking at holistic balance and imbalance in the body.
Liz, who I see, is definitely very careful about med interactions (far beyond the point most people might be: whenever we go through stuff in class, she's careful to mention the major interactions to us, even though they're also prominently listed on the jars as well.) Her training is through a distance program, ongoing training with a number of local herbalists, and she did some Traditional Chinese Medicine training a few years ago.
The lung thing doesn't strike me at all weird - I don't quite get that, but I do get some similar stuff that is weird by allopathic standards, but that keeps getting mentioned in my herbalism classes, so I go "Oh, *duh*".
no subject
Date: 2009-01-13 06:16 pm (UTC)I actually remembered to ask the pulmonologist I saw yesterday about the lung thing, and he was utterly unsurprised. He said that any infection in the sinuses affects the large airways in the lungs pretty much instantly and that it's perfectly normal for someone who's used to paying attention to what their lungs are doing to notice that first.
Which kind of underlines my determination not to see the particular doctor who didn't believe me on walk-in ever again. He's not my primary care doctor. His specialty is bone and joint injuries. He just covers a lot of walk-in time because he's willing to work lots of overtime and because the stuff he's best at tends not to easily delayed for a day or four while someone waits for an appointment. (There are several other reasons I don't want to see him again. This was just the final straw because, if he'd started me on preventative measures when I came in asking for them, I might have avoided several weeks of severe illness.)