Difficult breathing with pollen - could salbutamol help?

[987931]

Hi all. I have experience a lot of difficulty breathing recently with pollens. It is to the point where each day is a struggle and throughout the day I gasp for a satisfying breath, which often doesn't come. I don't have asthma attacks, as I understand them to occur.

I don't wheeze. I do cough a lot. I have sinus blockage. I take antihistamines (phenergan).

I am thinking of trying salbutamol and wondering whether anyone has any information, experiences or thoughts to share. Anything would be greatly appreciated. It is a horrible time

I should add that I have been mildy anemic and am recovering. This has certainly exacerbated my breathing difficulties -- i.e. I have struggled to breath far more while anemic. However, I have good days and bad days and going by weather patterns, I'm fairly sure these are related to pollen allergy.

Thank you. S

Ohter info: I'm 42, walk every day and do other exercies including weight-training. In good shape. Don't smoke but did for a few years when younger. A bit allergic to aspirin.

[bsmsl]

You are welcome.  Take care and keep us posted.

[987931]

I was given asmol by the pharmacist. It says CFC free and the online information says it contains HFA-134a. So I guess that's not the issue. I looked up frequency of symptoms and see nervousness and shakiness occur in about 14% - 20% of people, depending on the source. I'm always sensitive to such things but I know side effects often decrease over time.

I'll check whethere levabuterol is available. If not, I'll try a short puff/inhalation, judge the effect and work up from there. Thx again.

[bsmsl]

You are very welcome.  I am glad to help when I can.

I am very glad to hear that you are breathing better with that more agressive allergy treatment.

I have found that I get used to the affects of the albuterol when I am using it more frequently.  I don't experience the shaky hands quite as much.  You may experience that as well if you give it a few tries.  If you can purchase Xopenex brand (levabuterol) that does not cause as much shakiness or heart palpitations if you got those as well.  If the allergy treatment doesn't take care of all the problems, you may want to see if the side effects deminish after a few timed doses of the albuterol.  

I think you have generic albuterol available.  In the US we have switched to Hfa propellant instead of the CFC one and consequently lost the generic versions.  I found that CFC propellent made me feel quite ill (heart palpitations, naseous, head ache, shaky...).  I would put off taking that stuff if at all possible or go to bed if I had to take it.  So I know how you feel not wanting to take it.  The newer Hfa propellent doesn't do that to me.  

I hope that helps you more .

Happy New Year.

[987931]

Bsml, I really want to thank you so much. I used a nasal rinse twice today and started rhinocort again for the first time in a while. It seems that after using the rinse, my breathing is much easier. I suspect I am breathing from the chest more than stomach at least partly because my nasal passages are constantly, partly obstructed. It is so great of you to recommend attending to these essential allergy 'hygene' matters.

I actually did try albuterol for exactly that reason -- I gathered a successful trial of albuterol is often relied upon to diagnose asthma. It certainly did allow me to breath easier also, so perhaps I have some obstruction in the airways in addition to allergic rhinitis (I have little doubt the latter is an issue).

Unfortunately, one puff of albuterol made me feel quite nervous and a little shaky (hands) for a while. That part was pretty unpleasant--no great issue one off but I'm not sure I'd want to do it too often. However, at least I can discuss this with my doctor to see if he thinks it enough to try preventative asthma medication.

In the mean time, I will focus on clearing the nasal passages and see just how much difference this makes after a few days. I have also vacuumed couches and used a mask when doing it. The next few days will test me out as there will be strong winds off the land. Lots of pollen.

Again, thank you SO much. This could make an enormous difference to my life: I have really been struggling with breathing and it is affecting my ability to function. I'll come back to give an update.

Is it reasonable to use a small puff of albuterol if the unpleasant effects are too much? ... for example by holding breath for a short time rather than the recommended 10 secs or so? I am inclined to give this a go if clearing the sinuses is not enough, as I really felt on edge for an hour or so.

Thanks bsml, it is really kind of you to give the benefit of your experience and knowledge.

[bsmsl]

You are welcom.

What did the spirometry testing say?  Did your doctor order that test and receive the results?  You may want to request a methylcholine challenge test which is the standard for asthma diagnosis, although the people I know with cough variant asthma may have passed that as well.  Cough variant asthma is harder to diagnose as it doesn't show on standard  testing, especially not on peak flows.

Some doctors will accept a successful trial of albuterol as a reason to give a diagnosis of asthma.  Since you can get it without a prescription and it is generally benign, you should go ahead and try it.  Be careful though if you have high blood pressure or arhythmia as it can make those worse.

Take care.

[987931]

Bsml, thanks also for your advice regarding treating allergies more aggressively. I will get onto a nasal rinse, wash before bed, try Zyrtec, wash bed linen in hot water. I don't have pets. I also need to get off an old couch on which I watch a lot of TV: often feel worse while sitting on it but it's just convenient -- need to take this more seriousy. Again, thx v much. S

[987931]

Hi bsml. Thanks so much for that. It tends to confirm what I suspect: the fact I don't have full blown asthma attacks with wheezing doesn't mean that I don't experience allergic reactions that constrict my airways. I experience a kind of hayfever, characterized by general discomfort, nasal congestion and sometimes itchiness. I have been told my cough is post-nasal drip, which it no doubt is in part. However, that doesn't mean this is the only cause of my persistant cough.

Unfortunately, on the one occasion a few years back that I asked about asthma, he used a peak flow meter and my result was normal. As I understand it, he pretty much ruled out asthma on that basis alone. I had more involved spirometry testing to rule out any serious lung problems for a separate reason. I had chest x-rays at that time also.

Problem is, my doctor accepts I get hayfever symptoms but seems to exclude asthma without what I would expect to be the most basic test: seeing whether there is a change either in resposne to allergin or reliever medication. It may be difficult to get him to take my concerns seriously when he's performed a test before (simple peak flow). Having said that, he is fairly good about discussing concerns most of the time.

I must say that having looked into it, I can't see any serious issue with trying salbutamol when I am symptomatic to see whether it gives any clear relief. It seems to me this kind of test is the least necessary. Given that it's possible to buy salbutamol over the counter here in Australia, I'm inclined just to give it a try. More fierce winds off the land today, and I'm expecting the worst, although the house is all closed up.

Thanks so much, it is hugely appreciated.

Again, thanks.

[bsmsl]

Hello,

First do nothing without consulting a doctor.  You need a doctor's advice and an accurate diagnosis before starting any medication.  Taking an inappropriate medication can be harmful.

I had several thoughts while reading your initial post.  First, what we call the "classic" or "Hollywood" asthma attack" on another board is really a late stage attack.  Many subtle symptoms have been ignored if you experience a "Hollywood depiction" of an asthma attack.  So, just because you haven't experienced a "Hollywood asthma attack", doesn't mean that you aren't experiencing asthma symptoms.  It is my opinion that the Hollywood portrayal of an asthma attack is detrimintal to asthmatics.  People assume that because they aren't experiencing those symptoms they aren't experienceing an asthma attack.  Also, if family or friends do not see the Hollywood symptoms, they act like the patient is over reacting and being dramatic which can cause an asthmatic to not treat in a timely manner.

My thoughts also included the possibility of cough variant asthma and/or exercise induced asthma.  If either of these are the case, salbutamol would be indicated for treatment.

I would however suggest that you become more agressive with allergy treatment.  Some things that would be helpful and not harm you in any way to try would be sinus rinses (netti pot or I prefer the NeilMed bottle) twice a day, washing bedding in HOT water every week to eliminate pollen and dust mite debris, bathing before going to bed so that you are not sleeping with the pollen your hair collected during the day, keeping doors and windows closed as much as possible, and using a air filtration system if possible.  Also, keeping any pets out of your bed room would be helpful.  I would also recommend that you switch to a stronger second generation antihistamine like citirizine (Zyrtec) or fexofenodine.

I hope that helps you.  I would recommend that you print out the information about cough variant asthma, and research exercise induced asthma.  Some doctors are unaware of cough variant asthma and won't diagnose asthma without the "classic" asthma symptoms with wheeze.  

Feel better and
have a blessed New Year.

[987931]

Looking a little further, seems to me the evidence for chronic hyperventilation syndrome is lacking and/or dubious. I wonder whether I have mild(ish) cough-variant asthma. Very often, when I experience difficulty breathing, I constantly cough. When I have otherwise recovered from colds, a cough can persist for weeks. I saw a doctor about this twice during the last year. Seems a difficult thing to 'diagnose'. Any thoughts much appreciated.

At the end of the day, I just feel 'constricted' in the upper airways, and my breathing feels strained/laboured.

Thanks all.

[987931]

Hmm, looking at another post, I have to wonder whether I am chronically hyperventilating. I wonder whether this has developed in response to anemia, and could be triggered by tightness with allergy. I sometimes feel better when I focus on slow breathing from diaphragm.

I wonder whether chronic hyperventilation has triggers like asthma?

Anyhow, I yawn and intermittently take very deep breaths, get dizzy, produce too much mucus, all of which seem consistent with hyperventilation. Very confusing. I have been here and done this: once before I had anemia and that time I also had a terrible time with breathing.