Asthma - Page 2

Doc · 05-30-2006, 05:41

Quote:

Originally Posted by jasonglh

An acute episode of asthma called status asthmaticus is a life threatening event. It often does not respond to prn home meds like Proventil inhalers. People like me are stubborn and do not want to go to the ER if they can get out of it. If an attack does not respond to your normal PRN meds trying to wait it out is a bad idea. Respiratory arrest can occur causing death.

The only way I can describe it would be one minute your wheezing wondering why your damn inhaler is not working then suddenly the wheezing stops. Its not because you suddenly got better but because you are no longer moving enough air to wheeze. Next thing you know someone is coming at you with a laryngoscope.

Having 2 episodes from gradeschool mentioned in my medical record derailed any chance of me getting a waiver to enlist.

I control mine with Accolate and Allegra D for allergies twice a day plus a Proventil inhaler when it hits the fan. Cigarette smoke and felines really set mine off in particular.

Two terms that come to mind are "controllers" and "relievers".

Michelle · 05-30-2006, 08:54

Great thread... great information. My father died from an asthma attack at the age of 62. Even though I poured over the autopsy report and learned it was from cardiac arrest, I didn't quite understand the mechanism of how/why until now.

Quick question: Although not an asthmatic myself, I have twice in my life had "asthma-like" symptoms, both times were when I was in very hot, dry temps (triple digits, no humidity). Is that abnormal? I see someone else here posting cold weather as a trigger.

Thanks,

m1

medicerik · 05-30-2006, 13:14

Michelle,
any extreme in temperature, either hot or cold, can trigger asthma. What were you doing when you had the "Asthma like symptoms"?
Erik

05-30-2006, 14:33

Peregrino and sf-doc,

trust me I would. I have worn a few M17A2's and recently an Avon S-10 around for a few hours in the hot sun for "Civil Disorder" training and didn't have a problem. Same goes for the SCBA. Not sure whether there is any simularity at all between the three and if the two are any "indicator" on how I'd do underwater?

Michelle · 05-30-2006, 15:06

Quote:

Originally Posted by medicerik

Michelle,
any extreme in temperature, either hot or cold, can trigger asthma. What were you doing when you had the "Asthma like symptoms"?
Erik

Erik,

First time it happened I was hiking in extremely hot, dry conditions. Second time I was just sitting in my Jeep... in the desert... stuck in traffic.... with a broken AC. It was 106 outside and I know it was a lot hotter than that in the vehicle. The situation in the car really freaked me out because I wasn't exerting myself at all.... just sitting there at the wheel when it hit.

m1

Doc · 05-30-2006, 19:01

Do any of the asthma patients reading this thread or HCP's treating patients with asthma know what an asthma medicine holiday is and what are your thoughts on this practice?

medicerik · 05-30-2006, 19:20

There are specific reccommendations available about asthma and diving published by the Undersea and Hyperbaric Medical Society. They are summarized as:

1). Exercise or cold induced asthmatics should not dive
2)Asthmatics requiring 'rescue or reliever' medication should not dive. Asthmatics on chronic maintenance bronchodilation ('controller') and inhaled steroids are thought to be able to dive.
3) Mild to moderate asthmatics with normal screening spirometry can be considered candidates for diving.
4). If an asthmatic has an attack, screening spirometry should be done and the individual should not dive until his airway function returns to normal.

It really is a decision that needs to be made between each indivudal patient and a QUALIFIED physician.

For anyone else reading in the Northeast Ohio area looking for physicians specializing in dive medicine, there are two hyperbaric chambers in that area. The chamber than can handle multiple patients is at Cleveland Clinic Huron Road Hospital in East Cleveland. In downtown Cleveland, St. Vincent's Charity Hospital has a single patient hyperbaric chamber. Both of these hospitals have physicians specializing in dive medicine. For those in other areas, the list of hyperbaric chambers and the physicians running those chambers can be found at: http://www.scuba-doc.com/listchmbr.htm

05-30-2006, 19:41

Doc,

I have no idea what that is but you have my undivided attention.

By the way, I am a very nice guy! Just ask anybody!.

medicerik · 05-30-2006, 21:03

Asthma Holiday -- Taking asthma patients off meds for a short period when they are less likely to be exposed to a trigger so they aren't stuck taking meds 365 days a year. My biggest concern is doing this in an asthma patient who then decides they were able to go a week/ten days without meds, why not longer? Then they choose not to restart the meds and then become uncontrolled again.

We see epileptics all the time who've gone "20 years without a seizure so I decided to stop taking my dilantin." Then all of a sudden they are having break through seizues they can't explain.

Erik

jasonglh · 05-30-2006, 21:47

I could probably stop taking my Accolate in the winter but I dont have any trouble with side effects so I just stick with it. I have been on it since the day it hit the shelves as I had been waiting for it to be approved. Asthma meds have certainly come a long way since I was a kid in the 70's. Most of my troubles are allergy related and I live in KY where all the bad things grow. When harvest time gets here it overwhelms my allergy meds so I get a shot of decadron to get me through.

My last attack where I needed my "rescue" inhaler was over 2 years ago when I caught a face full of Camel non-filtered walking out of the hospital of all places. It had been so long between attacks when I made it to my truck I realized the inhaler in my glove compartment had been expired for over 2 years. I hate to spend the $25 on one just to keep it current but it beats taking a chance on an ER visit.

Doc · 05-31-2006, 05:07

Quote:

Originally Posted by medicerik

Asthma Holiday -- Taking asthma patients off meds for a short period when they are less likely to be exposed to a trigger so they aren't stuck taking meds 365 days a year. My biggest concern is doing this in an asthma patient who then decides they were able to go a week/ten days without meds, why not longer? Then they choose not to restart the meds and then become uncontrolled again.

We see epileptics all the time who've gone "20 years without a seizure so I decided to stop taking my dilantin." Then all of a sudden they are having break through seizues they can't explain.

Erik

Good answer.

Is an asthma medicine holiday a good thing?

Doc · 05-31-2006, 05:13

Quote:

Originally Posted by jasonglh

I could probably stop taking my Accolate in the winter but I dont have any trouble with side effects so I just stick with it. I have been on it since the day it hit the shelves as I had been waiting for it to be approved. Asthma meds have certainly come a long way since I was a kid in the 70's. Most of my troubles are allergy related and I live in KY where all the bad things grow. When harvest time gets here it overwhelms my allergy meds so I get a shot of decadron to get me through.

My last attack where I needed my "rescue" inhaler was over 2 years ago when I caught a face full of Camel non-filtered walking out of the hospital of all places. It had been so long between attacks when I made it to my truck I realized the inhaler in my glove compartment had been expired for over 2 years. I hate to spend the $25 on one just to keep it current but it beats taking a chance on an ER visit.

http://www.professionalsoldiers.com/...ad.php?t=10638

Check out the one airway one disease theory located lower down in the thread.

Doc · 05-31-2006, 05:15

Quote:

Originally Posted by medicerik

There are specific reccommendations available about asthma and diving published by the Undersea and Hyperbaric Medical Society. They are summarized as:

1). Exercise or cold induced asthmatics should not dive
2)Asthmatics requiring 'rescue or reliever' medication should not dive. Asthmatics on chronic maintenance bronchodilation ('controller') and inhaled steroids are thought to be able to dive.
3) Mild to moderate asthmatics with normal screening spirometry can be considered candidates for diving.
4). If an asthmatic has an attack, screening spirometry should be done and the individual should not dive until his airway function returns to normal.

It really is a decision that needs to be made between each indivudal patient and a QUALIFIED physician.

For anyone else reading in the Northeast Ohio area looking for physicians specializing in dive medicine, there are two hyperbaric chambers in that area. The chamber than can handle multiple patients is at Cleveland Clinic Huron Road Hospital in East Cleveland. In downtown Cleveland, St. Vincent's Charity Hospital has a single patient hyperbaric chamber. Both of these hospitals have physicians specializing in dive medicine. For those in other areas, the list of hyperbaric chambers and the physicians running those chambers can be found at: http://www.scuba-doc.com/listchmbr.htm

Thank you.

06-04-2006, 12:54

jasonglh,

Thanks for correcting me on that one. I also will not be learning a new sport/hobby! Thanks all for saving my life and money!

Doc · 06-10-2006, 09:33

I guess since no one is going to chime in on asthma medicine holidays I will simply state that there is no documentation that I can find that supports such a practice.

Asthma patients IMHO should stay on their meds 24/7, 365 days a year. Taking an asthma patient off their meds is like taking insulin from a diabetic patient.

Thoughts???