home health nurse here, wanting to pick your brains....
i have spent the past 4 months with a chronic cough. after what seemed like an md appointment or a procedure every other week, it has been determined by my pulmonologist and internist that i have cough variant asthma- i had never even heard of this before now. I'm 41, never smoked, but admittedly about 40 # overweight. and beginning to feel very, very old. i have had my meds adjusted 3 times and still need a rescue inhaler 3-4 times a day. much of my weight gain has come from being on steroids x 3 and getting SOB walking around the block.
i am currently taking :
advair 500 bid
singular 10 at hs
claritin 10 daily
zantac 150 bid
using a portable jet neb (albuterol) that i can plug into cigarette lighter during the day, but usually just using this at hs to help me sleep and relying on the albuter inhaler.
i cover a rural/peach farmer/cotton fields/migrant workers heating with wood burning stove type territory. i know certain patient's always trigger an attack and i just use the albuterol before entering the home, but am getting so frustrated. patient's look at my as if i have some dreaded disease. i always explain my situation to new pt/families to relieve their concerns, but am wearing out. many nights i only get 3-4 hours sleep before waking to take another nebulizer treatment to get through the rest of the night. often have to sleep in a recliner.
shouldn't i have better control than this, or am i just having wishful thinking that i can continue to be in a job that i can't control coming into contact with known triggers- pollen/cigarette smoke/perfumes etc.
my internist says its just a matter of finding the right combination of meds. i feel better for a week or two, then start on a downward decline again. this has been a hard week. south carolina is one big pollenating cloud of blooms right now....
any advise??, would appreciate it. thanks
Mar 28, '05
by NRSKarenRN, BSN, RN Moderator
i've been walking in your shoes this month.
this winter has been trying with a wicked respiratory virus and bacteria going around taking 3 weeks to clear in many patients with asthma.
in addition to the above symptoms, do you snore?? if so, a sleep study to rule out sleep apnea would be indicated.
some people do better with flovent + servent inhaler instead of advair.
time released theophylline helps some people.
what's your peak flow meter reading? need to monitor it regularly pre and post meeds to see if meds working. are you using a space chamber with inhalers--that helps too.
cough variant asthma links:
medscape--free registration, great website: cough-variant asthma
comparison of atopic cough with cough variant asthma: is atopic ...
hope one of these links is helpful.
Last edit by NRSKarenRN on Mar 28, '05