Asthma Exacerbation or is it?
I apologize in advance if this is long but I have been going around in circles for over 6 weeks, and I'm very frustrated. I plan to call my dr and see her yet again next week but wanted to get some possible insight as to where "to go" from here.
My symptoms initially started back in late August with the sensation of of not being able to take a full deep breath. The following week I had some mild head allergies that subsided, though the sinus pressure remains till this day. Around that time the wheezing began, never to subside. I immediately started the budesonide and levalbuterol on my nebulizer. With no relief after a week I was sent for a chest xray, which was clear. I have been put on zpac, completed two rounds of prednisone, tested negative for Covid 4x...tried home remedies, eliminated basically any inflammatory foods, bought an air purifier, used the humidifier...you name it, I've done it. The issue is, I feel exactly the same today, as I did on day one. In fact, I feel worse because I am dealing with prednisone withdrawal from the 2nd course of it. Prednisone provided little relief at 40 mgs, and only on day 6 of 40 mgs before I was to taper down did I notice some improvement. When not on prednisone my rescue inhaler is absolutely useless, and I get little benefit from it. I'm wheezing 24/7, no matter what I do. My one question is, because I can't find ANYTHING on this, is I only feel like I am wheezing on my left side. My right side feels fine. This is very perplexing to me and I'm wondering if this is something that happens with asthma, as my doctor sort of dismissed it. It's a major concern of mine, and making me question if it's something other than asthma.
I'm really at a point where I am feeling helpless, and I'm getting deeper and deeper into a depression over feeling like this 24/7 for going on 7 weeks. Any input or advice as to what I should be asking my doctor at this point? What steps should be taken at this point? Tests? Meds? I'm very worn out and quite frankly, my body can't tolerate any more prednisone, so that's really not an option for me right now. Any advice would be appreciated.
HI.
Thank you for posting your story and concerns here. And no need to apologize. The concerns you have are similar to what other asthmatics have experienced, including me at times. From my own personal experience, I can say that sometimes it takes time to get to the bottom of your symptoms and to find the best treatment. I am also wondering if your doctor is an asthma specialist such as a pulmonologist or allergist (https://asthma.net/living/pulmonologist-or-allergy-specialist). One of these doctors might be better equipped with the knowledge to get your asthma under control (if you are not seeing one already). You note wheezing on one side. Asthma is a strange disease in that it may not affect all of your airways in the same way. By this, some of your airways may be obstructed while others will not be. So, it may be possible that your asthma may be occurring on one side of your chest or the other. So, that may explain why your doctor may have "dismissed it" as you say. Although, the only way to understand what your doctor was thinking is to ask him or her, perhaps at your next appointment. What do you think? John. asthma.net community moderator. I had typed a long reply and it disappeared. Sorry about that. Just wanted to thank you for your response. While my pcp is not a pulmonary dr, the practice a pulmonary practice. So I do have a pulmonologist within reach. Just having a rough time the past few days because I've never gone this length of time completely resistant to any treatment.
You may want to ask your Pulmo for a CT scan simply to rule out any other issues. I struggled through symptoms and treatments very similar to yours and the CT scan provided peace-of-mind as both my Pulmo and a Radiologist saw no other issues. However, they did note that my upper right lobe is the asthmatic one … so I guess it’s quite possible to be isolated to one area. Who knew? did they ever find treatment that helped or worked? I'm very much struggling today.
Mostly the basics; Singulair and Symbicort. Though I have recently switched to Trelegy for asthma because of convenience. And patience … it took a long time for these symptoms to settle for me, but it did happen, slowly, over time. Pulmo wants to taper me off the meds at year’s end to see how I do (he thinks I may not need them any longer). I still have daily mucus though.
Hi helene - and thanks for continuing the conversation here. I see my colleague,, and community member , have already commented with their own suggestions as well as sharing their own personal experiences.
Everything they have written (and to which you have responded), is good work on the road to determining what exactly your case is all about.
I also had a thought - in my experience sometimes, in a case such as this, the physician will suggest getting a first-hand look at the airway to actually visualize anything that may not be revealed via x-ray, CAT scan or auscultation. You may want to inquire of your (pulmonary) physician if a fluoroscopic-guided bronchoscopy might be considered in your case. It's just a thought and one that comes from many years experience in this profession.
Of course you and the physician would make this determination together following a thorough discussion of your present medical condition.
What do you think?
Leon (site moderator asthma.net)Thank you for your response. I appreciate your input. Just out of curiosity, what kind of issues would the test you mention find? I had my first exacerbation around this time.of year in 2019, which lasted approximately 3 weeks. During that time, my dr did order a CTScan which turned up nothing (which I thought to be odd considering I was struggling to breathe).
Hi Helene - thanks for your response - I appreciate it! A bronchoscopy alone, can assist the physician in visualizing the lung first-hand. It is possible the trained physician might see something that is not showing up through any other radiologic diagnostic procedure. If need be, using a fluoroscope would then make it easier for the physician to obtain a biopsy but, only if that was determined to be necessary. I only mentioned this since, nothing else seems to be revealing anything in your particular case.
You may want to discuss this further with your physician. The two of you will then be able to determine if this is a procedure that is indicated in your situation.
Based on the conversation we've all had here, we're trying to think of something that may be of help to you.
Wishing you well,
Leon (site moderator asthma.net)
