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Avatar universal

Occupational Asthma and how to deal with it

48 Year old female generally healthy condition, smoker, smoked for about 30 years off and on, ½ pack a day. Past medical history: had myocarditis, and pericarditis at 18, worked really hard and recovered from this and went on to become a top athlete and played competitive softball up till the age of 44, stopped playing because
energy level began to decrease to the point where I was exhausted when I would exert myself with strenuous exercise or continuous exercise on a less extreme level.
Work history: Have worked in Industrial Settings for 30 years, must currently as a Senior Manager with an International company for the past 7 years. Job settings have been pulp, paper, chemical. The past 7 years were spent in chemical environment in a hands on management position including being a first responder to chemical spills and to situations involving improper handling of chemicals or mislabeled chemicals, and maintenance of entire facility including exhaust and emission devices. Chemicals include hardeners, resins, formaldehyde, ammonias, biocides, etc. Most chemicals are irritants per MSDS sheets and there were probably in excess of 200 different chemicals used in process over the past 7 years which were mixed in batching processes.
When I went to work for this company I was in good health, I am not one who enjoys doctors visits so I would see a doctor many once every 5 to 6 years for a cold if I could not shake it. About 4 years ago I began to get bronchitis a couple of times a year and would have to go to doctor to get antibiotics to make it go away, could no longer fight it on my own, energy level began to decrease and I was tired a lot of the time. Within the past 3 years I had bronchitis about 4 times a year, and 2 years ago I had an exposode where I was at work and could not catch my breath no matter how hard I tried, I felt like I was suffocating. I left work and went to doc, doc told me that I was not moving air in lungs, had me do breathing treatments in office to get air. Gave me meds, told me to stay out of work till I was better. She sent me for Chest X-Ray. A week later I went back to see her and was breathing better. She asked me what kind of work I did, I told her, she said that she thought maybe something at work was bothering me and that she was giving me some meds to try and see if it would help. She gave me Astilin, and Combivent. She told me that the X-Rays showed that there was the beginning of scaring on my lungs and that I could be developing COPD. I went back to work…This began a cycle of every 2 to 3 months I would get bronchitis, go to doc, get antibiotics and other meds, be out of work for a few days or so, feel a bit better go back to work and get worse. I forced myself to keep going but life became a cycle of work, fall in bed when I got home, get up, work, fall in bed exhausted when I got home. I had no energy, was exhausted all of the time. I worked from 8 to 14 to 16 hours a day on a continual basis. I am not one who likes missing work and I was extremely dedicated to my career and my employer.
11 months ago I got really sick and could not force air into my lungs, went to doc, they gave me steroid shots, breathing treatments, and put me on predisone. After a week I was not much better, I was never really awake, slept about 22 hours out of the day. Was unable to work, Doc told me I needed to see pulmonary specialist and not to go back to work till I did. If I got up and walked 5 feet I would be so weak I could not stand. Went to see specialist couple weeks later, by this time was fighting terrible mood swings, felt out of control, really, really bad mood swings and fatigue. Doc told me to stop taking Predisone, that I was having severe reaction to it. Doc did PFT tests, was told I had to stay out or work till better, thought I had Emphysema, and COPD. Put me on Spriva, and Symbicort. 2 months later I felt like a different person, felt great, felt better then I had felt in years, by the third month out of work I was able to walk 4 to 6 miles a day. I would  work from 7 in the morn till 11 at night around the farm and in woodworking shop and never get tired. And I was perfoming strenuous physical work and no signs of fatigue and no problems with breathing. Felt clearer headed then I had in years, memory was better, no headaches, no sinues problems, I felt like a new person.  I mean I had so much energy I was amazed. I would go to bed only because I knew I needed to get rest, and I slept like a log, felt rested when I got up, ready to face the day. I felt great.
I had stopped smoking when I first got sick so I thought maybe this was why I felt so much better. Doc was happy, said I was doing great, she said I could go back to work, but she said I may want to consider changing jobs because she was amazed at the change in my lung functions and  that with COPD or Emphysema she would not have expected me to improve as I did. She said she thinks I have occupational asthma because I had improved so much so she was wondering if maybe work was contributing to me being sick instead of lung disease.

Went back to work, within 2 days I started losing energy, head, throat, lungs were bothering me again. Was losing voice again like before, hard to breathe. Went back to doc, she increased meds, told me to use Combivent 3 times a day. Within 3 weeks I was really feeling lousy, had bronchitis again, went to doc, gave me meds, told me to stay out of work till better. Got better, went back to work, sick again. Pulmonary doc said she wanted to do Mechacoline challenge test. Went for test, results were positive in the first round of inhaling the stuff and they had to stop the test, they had trouble getting the effects to reverse and had to give me more meds then normal. I was exhausted. Went to work the next day and suddenly I could not breathe, kept using combivent trying to get it into lungs, remember  being on ground on hands and knees trying to get air and get combivent in lungs. Finally got where I could breathe a bit easier and didn’t feel so disoriented and was able to get to doc. Doc told me to stay out of work till better. slept for 4 days straight before I started feeling better. Went back to work and cycle started again. At this point Doc wrote letter to employer telling them I could not be around any chemicals because something there was making me sick. Employer told me to turn in company property and that I could not come back to work until I was released from doc with clean bill of health. Doc says she doesn’t know what is making me sick, but something, is, to find another job. She wanted to refer me to occupational specialist but my company would not agree. This is what is happening now…
Anytime I am around any type of chemical I have hard time breathing. Cleaning supplies, disinfectants, perfumes, solvents, floor wax, or stripper, bath oils etc…pretty much anything that has a smell makes my airways close off. Sinuses, throat and lungs….I became allergic to Astilin, can not take it anymore. Became allergic to Symbicort.
taking Spriva, Lung Doc says lungs are much, much better..has released me, says she can refer me to Occupational Specialist to help with determining what I can, or can not be around and effects of exposures and what to be careful of. She says she only treats sick lungs…not occupational issues. What should I do, should I go to see this specialist? I have seen so many docs, and been sent to other docs by my employer that I don’t know what to do anymore…It seems that what the docs say is dependent on who sent me to them, if company sends me to them they say smoking is what caused me to get sick, if I was refered to them by people not related to my employer they say I have hyperactive airway disease and they feel it is because I have been exposed to something and I have to be careful and stay away from all chemicals…who do I believe? What should I do?
If I am around chemicals will it cause long term damage?
1 Responses
Avatar universal
In regards to primary care physician, I have one, but as far as coordination of care goes, it seems when you become sick due to work related conditions, doctors like to pass you off to someone else and your care is not the primary goal.

Do I have a specific question? I have tons of questions at this point but I guess the most important one is this:

The pulmonoligist that first saw me a year and a half ago felt strongly that I needed to see an occupational medicine specialist, which I have found does not seem to exist in this area. What is the difference in occupational medicine specialist and an allergist? Would an occupational medicine specialist have more concern for the fact that my life has been turned upside down and that my ability to be work within my career field has been destroyed and have the guts to  stand up to a big company instead of leaving me out hanging on a limb and telling me to "avoid everything" and find a job where I can avoid everything. I am so frustrated and feel like giving up. Doctors just want to give more and more meds, I react to the meds, this is insane. What good are meds if you become so hyper you can not stand still and your blood pressure goes through the roof...Why do doctors keep sending you to other doctors because the meds they give cause problems because you react to them...this is a vicious cycle... doctor gives meds that cause excruciating cramps in the hands and feet and calves, you tell doctor about this and their answer is "go see your primary care physician, the primary care physician says "go see the allergist because the cramps are caused by the meds, so all you do is spend weeks waiting to see the other doctor to be told to go back to the other doctor...this can turn a totally sane person insane....
Where do I find a doctor who will deal with the whole picture instead of shuffling me to other doctors because they do not want to deal with Occupational Asthma and deal with someone whose whole problem goes back to chemical sensitivity and due to the fact drugs are chemicals and does not react to drugs well...I can not help the fact that I do not respond to drugs the way 99% of the population does, what am I supposed to do? I wish Doctors would have to experience what patients do, maybe they would have a different approach to things....I really hate being punished because of the fact I got sick and it is work related, I did not chose this and I hate having to be dependent on someone to help me but at least if I had a doctor who had dealt with this before maybe I would have a chance of finding help.
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