At about age four my daughter was diagnosed by our family doctor with asthma and given an inhaler. Several days later our family cat licked her skin and she broke out in hives. I recognized that she was allergic to the cat. We found the cat a good home and all of her respiratory problems disappeared. No asthma.
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On low dose Advair for 17 yrs for asthma/copd shown by spirometry. No symptom decrease. Ended up with huge hiatal hernia. Couldn't tolerate side effects of PPIs. Had Toupet fundiplocation to repair partially hiatal hernia. Haven't taken Advair since operation. Feel so much better.
Can't understand why pulmonologists and gastroenterologists do not talk to one another. Would greatly help the patient.
Can't understand why pulmonologists and gastroenterologists do not talk to one another. Would greatly help the patient.
1
Doctors talking to each other to help the patient? Sorry, not billable.
So....for the last 40 years I've had non-productive cough. No-one has been able to diagnose the cause. Allergist negative over those 40 years. ENT.... negative. Taken off BP medication x 2 months....a number of times as meds changed.
Respirologist...after x-rays, spirology, strangely at that time hadn't coughed from the day I made that appointment. 6 week wait until appointment after interview with MD. The respirologist gave me a puffer with no real regimen. "Use it if you need it"
Complicating all of this is my profession as a health professional...not proper to cough in my patients' faces while I worked on them as a dentist.
Some suggested 'nervous cough' as it sometimes disappeared on holidays.
Recently a close family member who is a MD suggested 'silent acid reflux' although I haven't suffered from 'heartburn' ever or very rarely.
Just saw a 'gastrointestinal' MD last month.
She put me on PPI... seems to have done the trick.
Who knew?????
Respirologist...after x-rays, spirology, strangely at that time hadn't coughed from the day I made that appointment. 6 week wait until appointment after interview with MD. The respirologist gave me a puffer with no real regimen. "Use it if you need it"
Complicating all of this is my profession as a health professional...not proper to cough in my patients' faces while I worked on them as a dentist.
Some suggested 'nervous cough' as it sometimes disappeared on holidays.
Recently a close family member who is a MD suggested 'silent acid reflux' although I haven't suffered from 'heartburn' ever or very rarely.
Just saw a 'gastrointestinal' MD last month.
She put me on PPI... seems to have done the trick.
Who knew?????
3
Ppi: Please explain?
Proton pump inhibitor. Got it. Too bad about that last 40 years though… It may not be proper to cough and your patients face but it sure is not polite!
Who knew? Lots of doctors know! I had a similar problem, and my GP at the time almost immediately put me on a one month trial of PPI.
Spirometry will only identify certain cases of asthma and other breathing issues; I have consistently had normal spirometry even when the feeling is of getting too little air. Fortunately I have a pulmonologist who listens well to the full range of symptoms and tailors treatment precisely and reminds me to keep ahead of the symptoms where I can. And then I figure out what makes things worse and better (e.g., on winter walks, breathing cold air through multiple layers of a fleece scarf warms and humidifies, and considerably lessens the wheezy aftermath).
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Carolyn, I have consistently had less than normal spirometry results. Took inhaled corticosteroids/laba for 17 years for "symptoms" I never had. Ended up on PPIs for a huge hiatal hernia likely caused by the corticosteroid/laba. Post operation on hiatal hernia, got off pulmonary meds, don't need them, feel much better without them, probably didn't need them for the 17 yrs I took them. Spirometry still bad but no asthma nor shortness of breath. Go figure.
Most physicians I've had experience with, when presented with something they can't put a name to or prescribe something for, get irritated if it's ever brought up again.
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My (then) 17 year old son was diagnosed with asthma by our pediatrician when he was feeling like he could not always get enough air, as he described it, and given a rescue inhaler. His symptoms did not improve, a visit and testing with our local asthma and allergy doctor made her doubtful about the diagnosis. We were able to get a referral to a pediatric pulmonologist at the state university who did much more intensive testing and she said 'yes, it's a very subtle asthma'. More inhalers, but still no improvement for my trombone-playing son. We were fortunate that the other specialist at the university was the next to see my son. His verdict , no asthma, but a case of hyperventilation that had probably resulted from damage that occurred when my son inhaled some vomitus when we all had a really nasty gastrointestinal virus months earlier. The low-tech and low-cost cure? Regular breathing into a brown paper bag several times a day for a couple of months. Now symptom free and auditioning for music school!
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I agree with the hyperventilation. I was on inhaled steroids and rescue inhalers and was able to give them up after I started focusing on the hyperventilation with the buteyco method of breathing exercises. I am now
Working hard at the exercises to improve my breathing. It's a commitment but better than medication dependent that can actually make the asthma worse causing the dependence. The medical world never considered hyperventilation or for me to consider breathing exercises.
Working hard at the exercises to improve my breathing. It's a commitment but better than medication dependent that can actually make the asthma worse causing the dependence. The medical world never considered hyperventilation or for me to consider breathing exercises.
1
I had to go to several doctors before one actually realized that my difficulty was not from asthma ( bronchiectasis was the problem), and treat me for what I had. Even at that, I still had to go farther afield (i.e., to a university hospital) until I found one that would give me meds that would not exacerbate (by for example,allowing my immune system to run riot) other ailments. I pity people who do not have the means or wherewithal or insurance to find a doctor who listens to them and comes up with a diagnosis and treatment plan that helps them.
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That asthma is commonly misdiagnosed and over diagnosed is common knowledge. This same high rate of asthma misdiagnosis, an about 33% over diagnosis rate, was also noted in 2004, https://www.ncbi.nlm.nih.gov/pubmed/15962880. This recent JAMA article by Aaron and coworkers and the article noted above both stress the importance of confirming asthma by measuring reversible air flow obstruction before having a person take long term inhaled steroids. All that wheezes is not asthma.
3
I have a 17 or so year old cat, (similar to the age of a woman's son, mentioned above, no trombone though) that though healthy, He sometimes wheezes, coughs and pukes up something, especially after he goes down into the yard and eat s some green grass shoots. Without using any five cent paper bags ($.25 in calif.), I treat him by thumping him with both hands… Kind of like squeezing an accordion.
So the moral of the story is: he doesn't need any meds or (especially) my "thumping", and he doesn't need some Shylock veterinarian to try to prescribe him any… Same goes for humans, although it is hard to "country diagnose" even with a country doctor at hand. And example is my own crusty ears; for years I've had this condition probably called swimmers ear, And one day I went against my general practitioners advice and asked him to refer me to a dermal specialist and found out a simple medication, clobesterol propionate cured this flaky ear problem (Teenie flies would flock to my ears, something in the middle rotten I used to think!)
I had a girlfriend, ages ago, that used to have panic attacks; shortness of breath, Hyperventilation, etc. Thank God she never got diagnosed with asthma. "It's Nerves" she told me.
What-she-said!
So the moral of the story is: he doesn't need any meds or (especially) my "thumping", and he doesn't need some Shylock veterinarian to try to prescribe him any… Same goes for humans, although it is hard to "country diagnose" even with a country doctor at hand. And example is my own crusty ears; for years I've had this condition probably called swimmers ear, And one day I went against my general practitioners advice and asked him to refer me to a dermal specialist and found out a simple medication, clobesterol propionate cured this flaky ear problem (Teenie flies would flock to my ears, something in the middle rotten I used to think!)
I had a girlfriend, ages ago, that used to have panic attacks; shortness of breath, Hyperventilation, etc. Thank God she never got diagnosed with asthma. "It's Nerves" she told me.
What-she-said!
As a retired Registered Respiratory Therapist that worked in a Pulmonary Clinic you should see a board certified Pulmonologist to verify your diagnosis. They are very thorough and very knowledgeable and have the resources to diagnose and treat this disease. In my years of working with a wonderful group of Physicians, they were precise, objective and undeniably an advocate for all of their patients.
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It seems that every component of the American health care process demands a name for any medical event. From the first 911 call, to the admitting desk, the brief conversation with a physicians' assistant, the fast exam by a doctor, right through to the Diagnosis Related Group (drg) that Medicare and other insurance requires for billing, there's a compelling need to name that affliction. And so we do. All subsequent medical records start with a history, usually given by the patient, and that first snap diagnosis just keeps coming back, even though it truly may never have existed.
For my entire professional career I evaluated claims of disability. Over and over again I saw this sort of situation, and the often very severe consequences of chronic and unneeded medication. Many children are diagnosed with asthma after showing respiratory distress, and begin a course of treatment that includes powerful chemicals that can cause or aggravate behavior disorders. They become unruly in school, and are then medicated to restore some form of emotional and mood stability. Instead of going through childhood normally they are immersed in a chemical stew that leaves them confused, under educated and maladjusted, perhaps all because of our need to quickly slap a label on an illness.
The research cited in this article is very important, and needs to be continued.
For my entire professional career I evaluated claims of disability. Over and over again I saw this sort of situation, and the often very severe consequences of chronic and unneeded medication. Many children are diagnosed with asthma after showing respiratory distress, and begin a course of treatment that includes powerful chemicals that can cause or aggravate behavior disorders. They become unruly in school, and are then medicated to restore some form of emotional and mood stability. Instead of going through childhood normally they are immersed in a chemical stew that leaves them confused, under educated and maladjusted, perhaps all because of our need to quickly slap a label on an illness.
The research cited in this article is very important, and needs to be continued.
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