Spice_Weasel. Are you sure that your heart is operating, beating, functional as it is supposed to? Your alergy doctors have probably ruled that out. Had an EKG? maybe an Echo cardiagram? Any edema or swelling of your ankles? If you are overweight that can be hard to determine. Easily winded? Water retention can cause all of your symptoms, including difficulty breathing.
Don’t remain fixated on an alergy or immune reponse when I may be something unrelated. Something to ask your doctor about next visit.
Very much this. It took 20 years for my occasional heart murmur to show up on an echocardiogram, despite stress tests, weakness, and occasional chest pains.
I don’t know about the asthma and hives (that may have other causes that you should look into), but what I CAN tell you is that every mother (*) of a preschool child I know has gone through basically being CONSTANTLY sick (basically nonstop, lots and lots of fatigue) for 2-3 years. Preschool kids are just a cesspool of germs.
Around year 2 I was complaining to another preschool mom about this, and she said, “Yeah, we were sick constantly for two years and then in year 3 it started letting up.” And the next year I was very very pleased to find out that it got much better. Hang in there.
(*) I know this isn’t true in all families, but in almost all the het families I know, the mother is the one who spends vastly more time with the kid and also vastly more time with the kid literally breathing in her face. My husband gets sick much more frequently than he did before we had kids, but he doesn’t get sick as much or as long as I do, because he doesn’t have the kid BREATHING IN HIS FACE. I mean, don’t get me wrong, I love it, I adore that my kids love to be close to me, but I do get sick a lot more.
You might want to see about getting a nebulizer for home use. When my asthma is flared up and I experience similar coughing fits that can go on for days or my breathing is impacting my sleep, etc., one or two breathing treatments is often enough to calm things back down.
Having the ability to do breathing treatments at home has saved me from several middle-of-the-night ER trips.
Yes I’m seriously considering contacting my immunologist next week because things were really bad last night, like maybe I should go to ER bad. I used the emergency inhaler but generally it was a pretty miserable night and I’m not doing great today either. That’s after taking steroids for three days. I can’t sustain being a functional human when I can’t breathe like this.
So obviously the first line treatment has not been effective.
Please consider urgent care TODAY at least, where you could get an albuterol or combivent nebulization or two, get your pre and post treatment peak flows checked, and make sure you’re not teetering on the edge of respiratory compromise. Back when I saw patients, I was big on very close follow up for folks that had a bad flare and were NOT doing significantly better by the next day.
Please listen to Qadop - as someone that’s had asthma my entire life, there are multiple red flags. You are on preventatives and yet your rescue inhaler is not enough to alleviate your symptoms, your sleep and quality of life have been impacted, AND you’ve already been on steroids for several days. Please go to urgent care or an ER to be evaluated and treated today.
And be on the phone to your immunologist at 8am on Monday. Someone that has needed urgent care for their asthma twice in less than a week needs to be seen ASAP.
Joining the pile on. I hope you recognize that I am not one of those posters who knee jerk posts see a doctor.
Not improving on steroid, still bad with frequent use of rescue inhaler? No question go in now AND GET A BETTER BASELINE PREVENTION PLAN!
You may need a revisit to be sure this IS asthma and not actually something else. The coincidence of this at the same time as your joints acting up raises an eyebrow too.
ETA that I now see you are. GOOD. YES I AM YELLING.
I haven’t read every post (though I did do a keyword search), so forgive me if this is repetitive, and … IANAD:
You’re using steroids to treat the asthma/upper respiratory issue(s)?
Steroids can inherently suppress the immune system:
Which may put you into that ‘delicate balance’ group where allergy/immunology – apart from comprehensively testing your immune function – may have to strike a ‘delicate balance’ to determine what’s helping, what’s hurting, and what alternatives may improve the risk/reward equation.
Meaning: you may want to consider reaching out to a tertiary care center. IIRC, you’re a Michigander. Something like University of Michigan may be worth talking with.
But they’re far more likely to save the lives and reduce the severity of the chronic disease than not. I successfully prescribed a LOT of oral steroid bursts for poorly controlled asthma exacerbations along with chronic inhaled steroid maintenance therapy over the decades.
And the OP has seen her allergist/immunologist exactly once so far, during a time when she apparently had mild intermittent well controlled asthma. Seeing that specialist again (after she has acute treatment for her ongoing exacerbation) seems to me to be the next best step, based on posted info.
I walked into my office one 6:30 AM only to have my nurses grab me and drag me to the treatment room where there sat a 20-something guy with a history of asthma who’d been complaining of shortness of breath unresponsive to albuterol for the previous 6 hours.
The on-call doc had been ordering nebulizer treatments to keep him stable until I showed up. Problem was, the guy was saying he was no better, and this didn’t feel like his asthma.
One thing I learned in med school that did stick with me is that one can see a whole lot just by looking. So I looked and listened and found a guy struggling to breath, with his Adam’s Apple a bit off center, and absent lung sounds only on the right, with diminished but non-wheezy sounds on the left. O2 sats were upper 80’s too. Ugh
So I upped the oxygen, got a nice long 16 gauge needle ready just in case, and summoned a hot ambulance to take him to the nearest ER (<1 mile away) and let them know we were sending a guy with a collapsed lung. They saw him, confirmed the diagnosis, stuck a chest tube in, and everyone breathed easier.
If one’s presumptive diagnosis doesn’t explain all the critical findings, it’s key to consider other diagnoses. I always have to remember that, despite past similar experiences.
I’m back. They did a chest x-ray and found nothing remarkable. Apparently I only feel like I’m dying. They prescribed a stronger steroid. They think there’s maybe some bronchitis going on.
I will definitely call my doctor Monday.
So am I contagious? I was gonna see a little baby tomorrow, but I’m thinking I better not.
No. I feel like I have this general issue with doctors where they think I just have a lingering cough and don’t compute the asthma part. He did ask if I’d done a nebulizer and I said no, I don’t know what that is and he left it at that.
I was also there right at close so maybe they didn’t want to bother.
Yeah using a steroid burst every so often is fine. Needing it more than infrequently however is a serious indication that there is highly likely baseline inflammation not being adequately addressed.
The big move in the newish (2022) guidelines (GINA, previously linked) is to caution about using short acting bronchodilator agents (SABA) alone. Hence the relative push to the combined steroid long acting bronchodilator agent, brand name Symbiocort for the one preferred, as the safer approach.
But accurate diagnosis is important. And follow up.
IF the diagnosis is accurate then maintenance is required. Symbiocort used for maintenance ramping up frequency for episodes is the guideline’s preferred option for many but other approaches are fine as well.
Again, being sure there is no additional trigger other than the viral exposures, and that the diagnosis is accurate, is job two, after controlling this episode.
That makes me sad. In private practice, and later in public practice I helped lead a campaign to see that ALL patients with a history of asthma who presented with shortness of breath and/or respiratory symptoms (cough, congestion) needed to have peak flow measurements done as a part of their intake vital signs, in our systems. It is standard of care, really.
I’m sad for how that falls through the cracks too often.
I would stay away from optional little kid exposure.
You don’t want an additional virus first of all. And socially even if you are not contagious, and you very likely are NOT at this point, you are the visible coughing person. You will be blamed when the kiddo gets something from somewhere else!
I have Alvesco for the maintenance twice a day. And Albuterol for the emergency inhaler I’m only supposed to use twice a week at most. The Albuterol seems to help for a minute but it can’t really stop this crazy chain reaction of coughing once it gets going.
