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Gondore
Regular Member


Date Joined Jan 2014
Total Posts : 119
   Posted 1/25/2014 4:04 PM (GMT -6)   
So, I am new to the asthma world and wanted to get the opinion of all the experts here. This week I was diagnosed with reflux induced asthma. I have never had issues with asthma in my life and I have no known allergies. The doctor prescribed Advair 45/21 (2 x day) and ProAir when needed. My main symptom is chronic shortness of breath that started about three months ago when my reflux got bad again. I primary have problems inhaling and really no problems exhaling. I monitor my oxygen levels when when the shortness of breath is at it's worst and my levels are usually always around 93%+. The doctor diagnosed my asthma using a spirometry test. I was at around 89-90% normally and around 97% with the inhaler.

I should also mention that I haven't taken any of the inhalers yet besides the one given to me during the testing.

So my questions are:

1. Do you think this will be a short term treatment or will I most likely need the inhalers the rest of my life (assuming I get the reflux under control)?

2. Is Advair overkill for my symptoms/diagnoses. I ask because this seems like a sort of dangerous drug.

3. If I take the Advair short-term will there be any withdrawal issues?

4. Could I just take the ProAir without the Advair?

I definitely want some relief from this constant shortness of breath, but at the same time I don't want to end up making things worse. Some people have suggested that I may have VCD (haven't been diagnosed yet) and I am worried that the Advair could make it worse.

Any input the group can provide would really be appreciated!

almost medfree
Veteran Member


Date Joined Jan 2004
Total Posts : 2570
   Posted 1/26/2014 9:53 AM (GMT -6)   
Hi Gondore,

I've had chronic shortness of breath for many years along with reflux issues. I was tried on several kinds of inhalers over the years and none of them helped, they only gave me the jitters.

I do all that I can to eat healthy to prevent the reflux and I stay away from foods that irritate my reflux. I also don't do dairy products because they produce excess phlegm, something we don't need.

Gondore, are you able to easily take a deep breath? Unfortunately I'm not, I have to really focus on it.

By the way, what is VCD?
Fibromyalgia, CFS, MCS, scoleosis, herniated disks, spinal stenosis, osteoarthritis, sjorgens, sleep apnea, asthma, allergies, headaches. On a regiment of different supplements including sleep supplements. I eat nutritiously and do not eat foods I'm sensitive to and ever since a back injury triggered my fibromyalgia, I have been doing prescribed stretches twice daily.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 4998
   Posted 1/26/2014 1:48 PM (GMT -6)   
Hi.

A number of people on the GERD forum have/had reflux-induced asthma. Getting the reflux under control was key to controlling their symptoms. Most who have posted have had Nissen surgery, but it's entirely possible to try other remedies first.

As medfree said, learning if you have trigger foods might help. I found, by keeping a food journal (look up many posts) I was able to find that I had trigger foods. Avoiding these stopped most of the refluxing that gave me symptoms. PPIs got the refluxing that was left to at least be non-acidic.

Food intolerances may not be found on allergy testing. You can figure it out though, by keeping the food journal. They also can start up at any time. Most of the problem seems to be from foods that are processed. A lot of people acquire wheat intolerance or even allergy, or worse, celiac later in life. I'm reading medical articles now about problems suspected to be from genetically modified wheat and soy, which is about all that is available anymore.

O2 of 93% is not good.

Gondore
Regular Member


Date Joined Jan 2014
Total Posts : 119
   Posted 1/26/2014 2:03 PM (GMT -6)   
Alcie:

Thank you for your reply! Would you mind sharing more details of your condition? I to have started to think this may be food related (at least to some degree). I am on an elimination diet and have been keeping a food journal. Right now I pretty much just least lean meats, carrots, broccoli, lettuce, little rice, melon, and dates. Been doing this for about two weeks. It has seemed to help some. I am on Protonix 40 mg x 2 for awhile. My main problem right now is the breathing. It just feels like I can't fully inhale and I believe it makes me light headed at times. It causes my anxiety to go through the roof and has really been significantly decreasing my quality of life.


almost medfree:
VCD stands for Vocal Cord Disfunction.

almost medfree
Veteran Member


Date Joined Jan 2004
Total Posts : 2570
   Posted 1/26/2014 2:19 PM (GMT -6)   
Gondore,

You mentioned you are on Protonix. I was on it for years until I found out being on it could have caused me to come down with osteopenia. Supposedly Protonix can affect our bones.

Here is some info about a long term effect of Protonix from Drugs.com:

Long-term treatment with Protonix may also make it harder for your body to absorb vitamin B-12, resulting in a deficiency of this vitamin. Symptoms of a vitamin B-12 deficiency may develop slowly and include pale skin, weakness, tired feeling, shortness of breath, and a fast heart rate. Talk with your doctor if you need long-term Protonix treatment and you have concerns about vitamin B-12 deficiency.

I have never looked Protonix's long term effects before: Interesting after being on it for a time I started having weakness, tired feeling, shortness of breath, and I do have a B-12 deficiency.

I try not to rely on meds and do it all on my own when I can.
Fibromyalgia, CFS, MCS, scoleosis, herniated disks, spinal stenosis, osteoarthritis, sjorgens, sleep apnea, asthma, allergies, headaches. On a regiment of different supplements including sleep supplements. I eat nutritiously and do not eat foods I'm sensitive to and ever since a back injury triggered my fibromyalgia, I have been doing prescribed stretches twice daily.

Gondore
Regular Member


Date Joined Jan 2014
Total Posts : 119
   Posted 1/26/2014 2:32 PM (GMT -6)   
almost medfree:

Yeah, I HATE the meds. I try to avoid them like the plague. The problem is that I got so bad recently that I couldn't function. I am married and have two kids and I was having to take of days from work or work from home for months. I had to do something to get back on my feet. I also have some damage to my esophagus that was diagnosed when I had a recent upper endoscopy. I plan to stay on the meds a couple months and then try to wean off. I have weaned off before in the past. I have never had this chronic shortness of breath before though. I need to figure out a way to get it under control because I start screwing with to many other things.

almost medfree
Veteran Member


Date Joined Jan 2004
Total Posts : 2570
   Posted 1/26/2014 2:52 PM (GMT -6)   
Wow, Gondore, sorry to hear how poorly you've been doing. Yes, it is very difficult when you have a family to take care of and responsibilities like getting through work.

Gondore, are you exposed to something that you weren't exposed to before that could be irritating your breathing? I found being around a gas stove irritated my lungs and it even burned my eyes. We now have an electric stove. I can't be around smoking, not even someone who has smoked--which is called third hand smoke.

Have you tried going off of dairy products to see if it might help?

Wishing you all the best.
Fibromyalgia, CFS, MCS, scoleosis, herniated disks, spinal stenosis, osteoarthritis, sjorgens, sleep apnea, asthma, allergies, headaches. On a regiment of different supplements including sleep supplements. I eat nutritiously and do not eat foods I'm sensitive to and ever since a back injury triggered my fibromyalgia, I have been doing prescribed stretches twice daily.

Gondore
Regular Member


Date Joined Jan 2014
Total Posts : 119
   Posted 1/26/2014 3:06 PM (GMT -6)   
almost medfree:

My story is sort of long but I will try to provide the short version. I have had throat clearing issues for about 15 years now. This would come on mainly after eating. I never thought much about. Then about three years ago I was under a descent amount of stress and I started having short periods where it felt like I couldn't breath. They didn't happen very often but sort of worried me. I Googled and found that it might be reflux (though I have only had heart burn a handful of times in my life). So, I scheduled an appointment with a GI. The GI didn't run any tests just gave me a prescription for Protonix. That might my symptoms got MUCH worse. I had acid coming up my throat, I started having sleep apnea type symptoms where I would feel like I stopped breathing right before falling asleep (non-stop), lump in the throat, bad throat pain, acid taste in mouth, all kinds of fun stuff. I tried to hold off on the protonix as long as possible but I was in very poor condition. Eventually I started the protonix and after a couple months I got back to about 80%. Over the last couple years I have just been going at 80% and I have tried different things to hit 100% (i.e. mainly diets and supplements).

about 3-4 months ago I decided to try some additional stuff to get better. I went to several doctors and started on an antibiotic. After three weeks on the antibiotic the GERD/LPR symptoms went through the roof. On top of all the symptoms I had when it was really bad years before I also developed chronic shortness of breath. I felt like I was constantly being suffocated though my oxygen levels never got below 90% (usually in the 93-97% range). I also started having chest pain/tightness and dizziness. All these caused my anxiety to go through the roof. My family doc told me it was all anxiety related and prescribed Zoloft and Xanax. I have been on the Zoloft for about 8-9 weeks now and haven't noticed any differences (working on weaning off this now). I haven't taken the Xanax very often but it does seem to help some when the breathing is really bad. Anyways, I ended up having an upper endoscopy and they found a hiatal hernia (3 cm) and grade 1 damage to my esophagus. Since then I have gone on Protonix 40mg x 2 and have changed up my diet a lot (mentioned this above). The LPR symptoms are pretty minimal now but the shortness of breath is still bad (though the diet has seemed to help some). I am just trying to figure out now if I really want to introduce another drug. The asthma doc wants me to try it for a couple months and said I may be able to reduce the dosage in the future. I don't know much about asthma or the medications involved with it so I was hoping to get some insights here.

almost medfree
Veteran Member


Date Joined Jan 2004
Total Posts : 2570
   Posted 1/26/2014 5:26 PM (GMT -6)   
Thanks for sharing your story. I too was diagnosed with Barrett's but my most recent gastronologist says according to my upper GI, I no longer have it. I asked him if it can go away on its own and he replied no, that the previous gastronologists I had probably put the scope a bit too far past the esophagus into the stomach and it showed some red.

I'm thinking there's a chance that what I was doing helped me get rid of the barretts. I did have at least 3 upper GI's before I was told I didn't have barretts. I'm not saying you might not have it, what I'm trying to say is we really have to do all that we can to help ourselves along with working with our doctors though not always following their every piece of advice.

Do you ever watch Dr. Oz? I've been trying something new for my gerd that was recommended on his show: DGL licorice. I would recommend that you google this. These tablets seem to help my stomach along with the acid and give me some relief for my difficulty breathing.

Also I would recommend that you look at Drugs.com and look into the side effects of some of these meds you're on just so you can stay on top of things.
Fibromyalgia, CFS, MCS, scoleosis, herniated disks, spinal stenosis, osteoarthritis, sjorgens, sleep apnea, asthma, allergies, headaches. On a regiment of different supplements including sleep supplements. I eat nutritiously and do not eat foods I'm sensitive to and ever since a back injury triggered my fibromyalgia, I have been doing prescribed stretches twice daily.

Post Edited (almost medfree) : 1/26/2014 4:32:09 PM (GMT-7)


Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 4998
   Posted 1/26/2014 6:36 PM (GMT -6)   
Protonix didn't agree with me. The only PPIs that helped were Nexium and Aciphex. It's OK to complain to the GI and ask to try something different.

My reflux trigger turned out to be sulfites. I hate to turn everyone on to that because there are lots of other possible triggers. I had a reaction within a half hour most times when I consumed a large enough dose - felt like a bubble in my stomach, then tachycardia. But more people seem to get migraines from it. You have to keep a good diary to see what your own trigger is, if it's food.

I was never one of the people who had asthma from reflux. For their stories check the many threads - see search box. You could post on the GERD forum.

Zoloft raises serotonin. Xanax is a short acting benzo. Very different. those don't have sulfites, but lots of meds do. Supplements can be the worst!

I'm not fond of elimination diet. The one you are doing still has a bunch of sulfite. Pork is high, beef moderate. Broccoli is on the list too, along with all its relatives. Licorice has sulfites too.

If you can drink wine and beer without a problem you might not be sensitive to sulfites. But keeping a log/diary/journal is what my allergist had me do - try a calendar with a page for each day. There are other chemicals that can cause problems: MSG, salicylates and such.

I eventually had to get the dreaded Nissen, but that was because of a bad wreck that pushed my stomach into my chest. I had my reactions under control before that.

Gondore
Regular Member


Date Joined Jan 2014
Total Posts : 119
   Posted 1/26/2014 6:55 PM (GMT -6)   
Alice:

Thank you for the response!

When you say you had the reactions under control can you tell me what your symptoms were like? Before this most recent episode I was probably at 70-80% most days. I still had a good amount of throat clearing, quite a bit of throat pain, and a good number of days with acid taste in mouth/bad breath. Those were the main symptoms I had though I never felt well when exercising either.

What are your thoughts on the Nissen? Should it even be something for me to consider at this point?

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 4998
   Posted 1/31/2014 4:20 PM (GMT -6)   
Gondore,

My reactions were 1. feeling like there was a big gas bubble in my stomach and 2. tachycardia. I did not feel the traditional "heartburn" because I was on PPIs and any actual reflux was non-acid. In addition, I had reflux on lying down if I had eaten within 3 hours or so. That reflux gave me choking which was eased after a lot of coughing.

I was usually able to get rid of the bubble feeling and also the tachycardia by trying to get a burp up, which I found later was similar to Valsalva maneuver. The trigger for the "bubble" was usually my breakfast cereal, which had lovely dried fruit (which is sulfited).

After I followed my allergist's directions in keeping a "food journal" and finding my "trigger foods" were all sulfite-containing, I stopped eating those foods and the bubble feeling and tachycardia stopped.

On barium swallow it was seen that my LES was weak and reflux was happening. Part of that diagnosis was seen because the barium available today is all loaded with flavors and sweetener - which contain sulfite.

I did not need Nissen, only a small hernia, until I was in the bad wreck that shoved my stomach into my chest. I was just fine with getting my symptoms stopped and avoiding surgery. My gastroenterologist didn't believe the sulfite story, but the allergist had seen it all before.

I believe in trying all medically approved remedies before jumping into surgery. Nissen, or varieties thereof, have the best success records, especially when a hernia needs to be closed. But this is major surgery! None of them carry a guarantee and there is mortality and morbidity to be considered. You must go through the testing to see what type is right for you, if it is needed at all.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9661
   Posted 2/1/2014 11:04 PM (GMT -6)   
Seems like Alcie gave you good advise, you need a good asthma/allergy doctor working with you to see if you have some food intolerances, also could be that the protonix has stopped working for you so a medication switch might be in order...or try stopping the protonix and maybe try Zantac to see if that will help, or just stopping the protonix for a few days and then re-starting it sort of like a medication holiday...to reboot your system...
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