Worst allergy season change we've ever had. Advice appreciated!
Hi everyone, first time on the forum and really hoping for some support or advice.
My fiance started showing her typical asthma flare ups she gets in mid September through October.
Typically, while not fun, these go away eventually with steroids and inhalers.
This year, things escalated much worse than ever before. Even after a week of ramped up treatment, we had an ER visit followed by another one 2 days later, where she was hospitalized for 4 days.
She has improved, but very slowly, and a week later now we are seeing more mild flare ups as we ween off of steroids. She is on 6 hour duonebs, xopenex as needed, prednisone, all her regular inhalers and allergy meds.
We want to start Xolair but know it won't really give us short term relief.
Our lives are fairly consumed at this point with worry and anxiety, which of course just makes things worse. We don't know if or when we will need to make another scary trip to the hospital, its a terrifying experience and we did it 2 times in 3 days.
Anyone with similar experiences able to share how they were able to get better? Sounds like we are going back up on steroids today. We know we need to be patient but this is really taking its toll on us mentally.
some other details. We've done dramatic changes to the house just in the last 2 weeks. No more bedroom carpet, and we have buckled down to the extreme with our shedding dog (we got him before we were aware of the allergy). Air purifiers, humidifiers galore too.
We were up to 60 mils of prednisone during the worst of it. We weened off back to 20 mil, we may be going back up to 40 but waiting on the allergist.
and for what its worth, our dog was out of the house for the first week back from the hospital. We think the fall season is the driving force, but the dog surely doesn't help. No magic recovery having the dog out of the house though. We've gotten away with very limited control over our home environment in the past without issues. Now we knew we needed to make drastic changes.
Hi nrou, and thanks for your posts here. We appreciate you sharing your fiance's medical condition as it relates to allergies, asthma episodes and treatment. You have been very thorough in your analysis and the way you are managing this condition with her.
To me, it sounds like you have covered pretty much every aspect of what may be triggering these episodes (at home), and seem to have a strong feeling it is all caused by the change in seasons this year.
It also sounds like your fiance is under the care of an allergist.
In my experience, there are any number of patients who don't seem to respond to the various levels of treatment you've shared in this conversation. Often times I have seen the diagnosis and treatment requires an adjustment. I wonder if this is the case with your fiance.
Although we cannot provide medical advice over the internet (for your own safety), I do have a suggestion to make. You did say an allergist is guiding your fiance's care.
With the repetitive therapy (with no real change of outcome), what would the doctor's strategy be moving forward? You certainly don't want to be heading to the emergency department over and over again. This would appear to warrant more immediate evaluation and consistent monitoring on the part of the physician.
Have you considered seeing an additional (or an alternate),
Thank you for your thorough response! I want to clarify, we are mostly living comfortably at home, but always teetering on the brink of worse. She describes it as a 2/10 discomfort level baseline, no wheezing. We've had a pretty good day today after getting a bit nervous this morning, but we are back up to 40 on the prednisone and weening a bit slower.
We really truly saw alot of progress over the last week, to the point we got a little too risky and attended a family dinner, probably wore us out.
In your opinion, what kind of work up would, say, a pulmonologist do with these kind of symptoms, and would it differ much from an allergist?
Hi nrou, and thanks for YOUR response and further explanation - I appreciate it! I see some of the comments I made yesterday, were cut off. I remember I was suggesting an alternate physician (a specialist in diseases of the lung), a pulmonologist. I can see from your response you understood that - I am grateful that my thought process did not escape you!
Sometimes, various specialists approach the evaluation of diseases differently. Some allergists think that everything is precipitated by an extrinsic allergic trigger. Pulmonologists, on the other hand, should understand that allergic triggers can be one cause of asthma - there are many others! Sometimes, the disease can have several causes in the same patient.
I only mention this since it seems your fiance is being treated repetitively with the same approach and yet, there is not necessarily an improvement being seen.
Please remember we cannot provide medical advice or diagnostics over the internet (for your own safety).
My comments are not meant to (over)simplify the approach to diagnosis and treatment. In fact, I would more likely underscore the complexity of arriving at an accurate diagnosis with proper treatment and therapy!
We value your input and feedback in your latest comment. Living on the 'brink' can make this all the more challenging. Ideally, one would like to have this condition under better control.
Perhaps the allergist is doing everything that needs to be done for your fiance. Perhaps a second evaluation by another specialist might be in order. It's difficult to assess this online. That is the role of the diagnosing physician.
What are your thoughts on this?
Wishing you well,
Leon (site moderator asthma.net)
