Question:
Remember me, I wrote the article "Bad Cough + Great Lungs = Asthma?".
Well, on my last visit to my doc, I was told I had a " mild asthma" that
is tickled by viral infections ( I get the nasty cough after a cold ). I
went away with a flovent inhaler to replace my aerobid (yechh) and
supplement my ventolin, claritin-D and rhinocort plus another 10 day
course of prednisone.
Okay, I have asthma but so far all I get are awful coughing episodes.
Exactly what is a full fledged asthma attack? Should I worry about
getting one? If I get one, what should I do?
As I said in my earlier article, though still in my prime, I won't be
there much longer as, like cars, the older we get the more the parts
wear out and I am concerned that what I have will get worse. If I can
cough till I puke or get really dizzy now, what happens later?
Answer:
Asrthma attacks can vary in people. Symptoms can include:
Shortness of breath
Chest tightness
Chest pain
Wheezing
Coughing
Difficulty breathing
and in the case of a severe attack diziness and loss of consiousness.
People generally know when they're having an asthma "attack" and the use
of a rescue inhaler, like your ventolin, generally relieves the
symptoms. However, it is possible to have breathing problems and not be
keenly aware of it. That's where a peak flow meter helps. Using a peak
flow meter helps to track your asthma treatment as well as alert you
when you might be having problems. If you were given one, make sure to
follow your doctor's instructions.
There could be several reasons for your cough, but I think the
prednisone will help take care of that, as well as the flovent in the
long run. Be sure to take your meds as your doctor prescribed. Part of
the reason for agressive initial treatment is to get your lungs under
control now, so that maintaining them will be easier later. That and to
keep major attacks from occurring. People generally have asthma for
life... which means medications for life. How well you treat yourself
and this condition now will help determine how well you do later. It sounds like you have cough-variant asthma. That means that the
coughing IS the asthma attack. Get a peak flow meter. Keep track of
your PFs, and if you drop to 50% of your personal best, head for the ER.
Other than that, you and your doctor need to work out a program of
prevention and interim treatment. It sounds like cough variant asthma, coughing but near normal peak flow
readings. This is often caused by post nasal drip from sinus disease
(or allergic rhinitis). Sometimes an infection occurs and antibiotics
are needed. Sinusitis is diagnosed with a CAT scan. If this is what
you have, it will have to be brought under control before the asthma
is under control. The Rhinocort (steroid nasal spray) and Claritin D
(antihistamine with decongestant) help treat sinusitis and allergic
rhinitis. But sinusitis may require more extensive treatments
including daily saline washes and antibiotics; sometimes surgery is
recommended. If your asthma 'progresses' its possible you could have a Severe
asthma attack at some point (Status Asthmaticus). This can happen
if peak flow readings drop below 50% of personal best. A description
of symptoms is contained in The Expert Panel Report 2: Asthma, Fig 3-9,
Classifying Severity of Asthma Exacerbatons.
http://www.ama-assn.org/special/asthma/treatmnt/guide/guidelin/guidel...
The treatment for asthma exacerbations includes using albuterol inhaler
as needed; if peak flow drops below 80% of personal best, steroid
inhaler is increased, usually doubled; if peak flows drop below 50%
usually you call your doctor or go to Urgent Care or ER; some Action
Plans call for doubling the inhaled steroids again or starting a pulse
dose of prednisone.
Here are some links on Cough and Sinusitis:
COUGH
http://www.ummed.edu/dept/pulmonary/irwin/pitfalls.htm Common Pitfalls in Managing
Patients with Chronic Cough
http://www.vh.org/Providers/TeachingFiles/PulmonaryCoreCurric/Chronic...
http://www.mayo.ivi.com/mayo/9411/htm/cough.htm Cough
http://www.scl.ncal.kaiperm.org/medadvice/cough/index.html Cough/Nasal Congestion
http://medicine.ucsd.edu/faculty/davidson/Pathway/Cough.htm COUGH
http://www.ama-assn.org/special/asthma/library/scan/interp.htm Interpretation of
Positive Results of a Methacholine Inhalation Challenge and 1 Week of Inhaled
Bronchodilator use in Diagnosing and Treating Cough-Variant Asthma
http://www.mayo.ivi.com/en/sbin/iarecord.bln?NS-search-set=/34690/aaa... Treating Coughs
SINUSITIS
http://www.ama-assn.org/special/asthma/treatmnt/updates/sinus.htm Asthma and Sinusitis
11-97
http://www.vh.org/Beyond/PeerReviews/50Sinusitis.html Virtual Hospital, Sinusitis Links
http://www.vh.org/Beyond/PeerReviews/14URI.html Virtual Hospital, Upper Resp Infect
http://www.aaaai.org/patpub/resource/publicat/tips/tip23.html SINUSITIS
http://www.njc.org/MFhtml/SIN_MF.html Sinusitis, 1993
http://www.niaid.nih.gov/factsheets/sinusitis.htm Sinusitis
http://www.entnet.org/sinusitis.html Sinusitis
http://www.wdn.com/mirkin/6712.html Sinusitis
http://www.aaaai.org/profinfo/publicat/paramete/treatmen/nasal.html
Nasal and sinus disease and asthma
