Is it normal to still have symptoms despite taking your medications?
Hello, it's Thyme. I'm posting this because lately I've been having worse attacks than usual, which often happens in the summertime, this one giving me pretty bad chest tightness, wheezing, coughing, decreased lung capacity, my throat is closing and blocked, and it is difficult to talk. This time it's happening despite taking my BREO and Singulair and 2 puffs of albuterol and having my air purifier on. I suspect I'm having one of those nighttime attacks since no obvious environmental factors seemed to have triggered it. I also cough and wheeze despite my inhalers daily, throughout the day, sometimes getting to this point, especially in the summer or at night-time.
My pulmonologist previously said have moderate asthma and not to be concerned, but the ENT doesn't seem to agree. At this point, I honestly think I have severe asthma, since I require BREO 200/25 mcg just to keep most of my symptoms at bay on top of one or two doses of Singulair depending on how bad it is, and I still sometimes have attacks like these where I end up needing my rescue inhaler, usually more than once. Up until recently, most of my doctors have been pretty dismissive of my asthma symptoms, either brushing them off as allergies or ignoring the symptom frequencies and only looking at PFT scores. Because of this, I haven't really considered the fact that inhalers are supposed to suppress coughing and wheezing, but I've always coughed and wheezed a lot despite them so I've always considered constantly coughing or labored breathing to be normal.
Maybe it's normal for me, but according to numerous asthma sources, it's abnormal to cough and wheeze despite your medication. I've only had to go to the hospital once for severe asthma attacks, but I've had at least 3 notable severe attacks in my lifetime, well, one very severe attack every 2 years and dealing with difficult symptoms every day. This post is a bit all over the place because I don't know what's normal and what's not anymore. I just know that I probably shouldn't be coughing and wheezing throughout each day no matter what. Thank you for listening, anything helps!
Hi.
Thank YOU for your post here, and for your great question. Sorry that you are still experiencing asthma symptoms despite taking medicines to control it. According to researchers I have talked to, if you take 2 or more medications to control your asthma then it is considered severe asthma. There may be other definitions doctors refer to, but this is the one researchers use. As far as having symptoms despite good asthma control, it can be normal. I certainly still experience symptoms or attacks sometimes when exposed to my asthma triggers -- such as respiratory viruses. Although, good control means you do not experience symptoms on MOST days. For when symptoms do occur, that's what medicines like albuterol are for. However, if you continue to experience symptoms, or find that you are using your rescue inhaler on most days, this may be a sign of poorly controlled asthma. And it may be a good idea to talk to your doctor, who may consider stepping up your asthma treatment. I hope this brief response helps. John. community moderator. 
I sometimes have symptoms (coughing and tightness mostly) certain times of the year, like right now with our hot, humid weather and ozone. I'm usually well controlled with my meds but things do change from time to time. Also on Singulair, Flonase, Breo (Trelegy worked better but became too pricey). I do use my albuterol or nebulizer occasionally and have Budesinide solution for when things get really dicey.
"According to researchers I have talked to, if you take 2 or more medications to control your asthma then it is considered severe asthma." This is very interesting and news to me.Glad you found my comment about severe asthma interesting. I find it interesting too. Some doctors agree with this definition, as it is simple. Although, other doctors may have their own definition of severe asthma, such as is described here (https://asthma.net/living/asthma-subgroups-severe-asthma) It sounds like you have available to you all the best asthma medicines to both control and treat flare-ups when they occur. Sorry you are experiencing symptoms right now. Are you having to use your nebulizer during this time? John. community moderator
Oh, thank you,
, this helps clear some things up. If we go by what researchers say, I definitely have severe asthma. I also have poorly controlled asthma every day, as I still experience symptoms despite medications, even though my symptoms are not usually life-threatening. That would explain why I cannot successfully get a good pft score without taking medications days in advance of the test. This might be why my pulmonologist couldn't find anything concerning with my PFT scores, as I take multiple medicines each day, and the effects lasts for 1 or 2 days afterwards if I were to stop taking them abruptly. My pulmonologist might also have a different definition of severe asthma than other doctors, as some of them measure it by how often you need to go to the hospital or take certain medications such as prednisone, and some of them solely look at your PFT scores without taking your symptoms into consideration. I still get mild to moderate symptoms of asthma every day despite my medications, but for now, this is as controlled as I can get until I can move out of this house and get a job more suitable for my asthma. Hopefully, within a year or two, the allergy shots will kick in as well. Thank you for always listening, it means the world to me. ❤️ Thank you for the update. And you are welcome. Glad to hear that you found my brief response helpful. And yes, if you are taking your asthma medications, this should help keep your PFT results in the normal range. If you want to read further into the topic of asthma control and severity, I offered what I have learned through my studies over the years here (https://asthma.net/living/severity-staging-and-control). Feel free to check it out if you like. Also, like you say, different doctors can certainly have different thoughts on severity and control. That kind of adds to the complexity of this disease, don't you think? Here's hoping your asthma treats you well. All the best. John. community moderator.
Hello
- we appreciate the fact you have posted this. Whether your thoughts are all over the place or not, you've touched on a great topic. As states,
"Although, good control means you do not experience symptoms on MOST days. For when symptoms do occur, that's what medicines like albuterol are for. However, if you continue to experience symptoms, or find that you are using your rescue inhaler on most days, this may be a sign of poorly controlled asthma."
I am sorry your physicians are not taking your symptoms seriously and dismissing them. The fact you are still struggling to breathe throughout the day is frustrating. Do you think it may be time to see a new pulmonologist for a second opinion? If you can't get them to address and help ease the symptoms, might be time for a different approach or new eyes on the situation.
Also, I've not heard of someone taking Singulair when symptoms arise. But do take it as prescribed. I've been on it DAILY for many years for my chronic asthma, which has worked well to ease my symptoms. Do you think maybe it's time to discuss taking it daily for optimal results? This may be just the adjustment you need for better days ahead.
I hope you find answers. Managing asthma is challenging. Stay strong. Rebecca (team member)Thank you. I take the BREO and the Singulair daily, and I take an extra singulair when I have a severe attack and really need to keep my lungs open. Sometimes 1 just isn't enough for some reason.I think at the time I posted this, I had a nighttime attack before I got the chance to take my medicines like I do at night. The BREO and Singulair seem to do really well keeping my lower airways open; I just notice I still tend to struggle with the coughing and my throat being slightly closed on most days. I still noticeably cough and wheeze daily throughout the day, but I don't take my rescue inhaler nearly as often as I used to. My lower airways seem fine, it's my throat that partially closes.
I don't really trust my pulmonologist very much, but I don't think I can realistically change pulmonologists, but the ENT listens to me and is the one who looked at all my symptoms along with the PFT scores and prescribed me the higher dose of BREO along with my Singulair. The pulmonologist also listened to me when I said that this dose helped me significantly better than the last one, and I only see them for a follow up every 6 months. My asthma control is much better than it used to be, so I'm glad. I just need to find some way to keep my throat fully open along with the rest of my airways.
Hey, Thyme! Always good to see you here, even though you're struggling right now. I'm frustrated with the way your pulmonologist isn't taking you seriously, though I also understand that switching doctors isn't always easy or practical at certain times. Hopefully, you'll be in a better position in the future where you can make the choices that feel best to you. Until then, does your doctor work alone, or are there others at the practice (or perhaps a physicians assistant or nurse practitioner)? If it's a practice with multiple docs, that would be an easier way to see someone else without having to go to a different office and start all over again.
Lastly, I just want to clarify about the Singulair ... does your doctor know you're taking an extra one? We want to make sure you're taking your meds safely. <3Thinking about you! -Melissa, team member
