Worse cough from inhaler?

[traci]

everyone. I posted quite a while ago about an ongoing cough for, what is now, almost 7 months. I still don't know what is wrong with me whether it is copd or not. I finally had an appointment with a pulmonologist and he checked my recent chest xray - it's good, and listened to my lungs - sound good, and then ordered a methacholine challenge and gave me a symbicort inhaler. The methacholine challenge will be months away (yes, I live in Canada) The reason for my post is that my cough is much much worse with the inhaler and I'm coughing a bit more phlegm. My cough has always been slightly productive though not enough to submit a sputum sample for testing. It still is a small amount but more than before the inhaler. It's been 6 days on the symbicort and I don't know how much longer I can take it. I'm coughing so much I'm getting really scared. Has anyone else had a worsening cough from an inhaler?

[sandy07]

Some of the inhalers have a dryness to them and will start the coughing. I didn't look back at the previous posts so don't remember what was said. Did anyone suggest sucking on a candy or mint. Just being dry might start you coughing. That's a simple solution. Wouldn't it be nice if it was that simple. But...it would be worth trying. If you'd been on long term antibiotics you could have gotten thrush in your throat. That could make you cough.

Are you SOB (short of breath) ? If not, why did the doctor give you Symbicort? Did he think it would help the cough? The pulmonologist didn't do a pulmonary function test? That's the normal thing for confirming COPD. I don't know what a methacholine challenge is but will be checking into it right away. I hope you get it figured out soon. I'd be looking for a second opinion if not.

[sandy07]

Okay.....I looked up methacholine challenge. It will be able to tell the doctor whether you have asthma or some other restrictive lung disease. Did you read up on it? I just read the description on Wikepedia. Read it before you have the test, just so you know what it will be like.

[Blossom/Jackie W.]

Traci...... you'd been on Advair and you stopped it awhile back. Did you find it made you cough worse (like with the Symbicort) or the same amount coughing that you do normally? Also; did anything come out of the allergy testing or barium swallow?

[traci]

I don't think the Advair made me cough more but at that time I was coughing pretty much non-stop anyway. When taking the Advair I remember often feeling panicky and my chest feeling achy but I wasn't totally sure it was due to the Advair since that was at the beginnning. Now I can say for sure that inhalers make my chest feel achy and I get a SOB feeling that makes me panicky. The SOB feeling is not that I'm out of breath like from running but that something is wrong in my chest and breathing but I don't feel like there is a strong restriction to my ability to inhale or exhale. Once it awhile, I feel it takes a bit more effort to inhale fully. Hard for me to describe but what helps is to flair my nostrils (sounds weird I know). I stopped the symbicort last night, even my husband was getting scared by the amount and sound of my coughing and I couldn't stand getting that panicked feeling anymore. Something unusual happened though yesterday morning. I got up and took the symbicort at 6 am then went back to bed for awhile to read and I got heartburn. I hadn't eaten or drank anything. Maybe the inhalers are causing acid reflux.

I wasn't allergic to anything and the barium swallow is another interesting story. At the end of the test, I was standing in front of whatever it is that the radiologist looks at and I said to the radiologist, "I'm guessing that I have a hiatus hernia" (I thought so because I often feel worse after supper) and he said no but you do have reflux and I said but I don't get heartburn and he said but the barium is still in your stomach and it should be gone so the acid is probably so dilute from your slow emptying stomach that you wouldn't feel the burning. I was so excited and said could this be causing my cough and he said yes it can even cause infection. Wow I was happy.....until I went in to my regular dr. and the report came back saying no relux but delayed stomach emptying . Did he review the pictures and change his mind??? Then, a month later of course, I went for a delayed gastric emptying study which was normal. Then came the appointment with the pulmonologist and the symbicort.

Today I am going to get some kind of OTC acid reflux med and try it myself. At this rate I won't know what is wrong with me for another 6 months or so . If the relux med doesn't work I'll try some mucinex to see if I can't take down the phlegm in my chest.
The only reason I can think of why an inhaler would make me worse is that it increased relux or that I have an infection that flairs up from the steroid. But I can't figure out if the inhaler is causing more phlegm or just loosening it up. In any case I can't take the panicky feeling and increased cough that comes with it. When I do finally get a diagnosis, I'll have plenty of time for inhalers if I need them.

Sorry for the long post. I have much frustration coming out and fear. I never imagined that I would have to wait more than a year to know what is wrong. I also ordered a peak flow meter that also measures fev1 so maybe I can have some peace of mind. I'm already terrified that I have copd and have been living this way for 7 months now. It's like my life is on hold.

[Blossom/Jackie W.]

Advair's quite similar to Symbicort; some can use the one, but not the other. I don't think there's an infection though that gets "flared up from" the steroid. It would help in that regard. Sometimes though, especially the rescue puffer for instance, can loosen and make a person cough up a bit more initially but.... I don't think that's what you're talking about. And sometimes yes; like Sandy was saying about the coughing when using the Symbicort. I've had a few nasty rounds of that myself. And; it'n not always a wet/productive cough.

Is your mucous discolored at all? If it isn't, and sometimes coughing can be counterproductive, I've been known to take a bit of cough supressant. I use Robitussin DM. That's ME; and I'm not recommending it, just mentioning......

If your phlegm is discolored, unusual for you, then I would suggest you march yourself into your Dr's office and see about an anti. Just a suggestion.

As for the Peak Flow meter..... I didn't know there was one (PFM) that measures your FEV 1. However; even if you do get something, like a Piko 6 for your FEV1, I don't think it would help you a great deal since you've yet to find out what your baseline is. You've no starting point as yet.

Looking back over your earlier posts, and I think you agree, anxiety seems to play a large part in your life right now; particularly becasue of your Dad. I do hope however that they can find out what the problem is becasue it has got to be sooooo frustrating overall for you.

[Deborah]

Traci: I can't add much to the great advice from Jackie and Sandy and others who have responded before. I am in a slightly similar circumstance in that I am waiting to see the respirologist (plus some other tests). We did find out some things from a CT scan and an ears/nose/throat specialist, but I won't know the full picture until I see the respirologist. It is very frustrating as things move on at work without me and I don't know if I will be able to go back or when or how.

This state of uncertainty has been going on since the end of October. What I have found has helped is this forum, in particular. I have also set up some routines so that I can do whatever I can to maximize my health although I do tend to slip off that from time to time (exercise, eating, meditation). I have a log that tracks how I feel and what I do on a daily basis so I can - hopefully - identify patterns for discussion with the specialist as well as self-managing. It also gives me a small sense of accomplishment on those days when I can't do much else. I know that a limited amount of counselling helped me get through some of the grief and sense of loss, as well as the fear/anxiety during this waiting period.

Do you have someone local that you can talk to? Has your doctor talked to you at all about depression/anxiety medications? You sound so distressed and it is completely understandable in trying to get through this period of not knowing.

I hope you find a good way to take care of yourself and to get whatever help you need while waiting for some certainty. Keep talking in this forum - the advice I've received has helped me a lot and has been compassionate and heartfelt.

Deborah

[traci]

Thanks Sandy, Jackie, and Deborah for the advice and support.

Deborah - How terrible to have to be waiting since October to have answers! Have you had a PFT yet? I don't think the doctors know how hard it is to have to wait so long for every test and every appointment. My doctor seems to find it strange that I would be anxious. I bet he would also be anxious if he coughed for 7 months! My husband is also stressed out because it is scary not knowing what is going on. Even some co-workers are scared for me. Everyone always knows where I am because they can hear me coughing.

Jackie - My phlegm is always white and still is even with this increased coughing and chest aching. I'm sure the panicky feeling has something to do with the inhaler because in the 4 months that I wasn't taking advair or symbicort, I didn't have this feeling. I'm glad to know that you don't think an inhaler could flair up an infection. It did seem like a strange occurrence but I could think of no other explanation for the ramped up coughing. The PFM that I ordered is from Costco and is called an asthma meter and measures both peak flow and fev1. Maybe this is a bad idea but I thought that if I had a decent fev1 compared to expected then I could relax a bit. If it is bad then I will really freak out so I am unsure what I will do when it arrives. My dad having emphysema is an issue for me for sure.

I made an appointment with my family dr. in 2 weeks and I'm going to ask for a trial of Nexium in case reflux is playing a role. I've tried antibiotics and inhalers so I think reflux meds are worth a try.

How are you ladies doing?

[Blossom/Jackie W.]

Sorry I missed this post earlier Traci.....

Good news on your phlegm color.

Your FEV 1 is basically based on "your region/area" as the norm for same , with your age, weight/sex etc. So; what I'm saying is that you can look up "generic" info as to expected numbers, but it may not be overly accurate. And then there's the what's normal for you.

I was going to say that I'm still not familiar with any type of Peak Flow Meter that gives an FEV1. Never heard of it. (I have a Piko) But hey; I learn something new every day. Anyway; I googled it .... . I'll be darned. For anyone interested; here's a link. (It also looks user friendlier than the the Pikp models)

www.costco.ca/browse/product.aspx?prodid=10302810

I've yet to read up on it; this is a quick post, but I'm definitely going to tomorrow!

Thanks for the info Traci!

Sorry; I can't comment on the reflux meds. Never used them.

[sandy07]

traci....the doctor gave me a script for Prevacid...which I haven't had filled yet. I was trying to help the reflux using OTC stuff. However, it looks like I'll be filling the script soon because the OTC doesn't seem to work that well or that long. I really haven't noticed that the reflux affects my breathing tho. I guess I should pay more attention since I've read that for others it DOES affect their breathing.

I have aching and pain in my chest as well and am thinking it is the reflux since it goes away for a while if I take something for it. Acid reflux is common among COPDers. It is caused by our long lungs pushing down on the stomach. I was diagnosed in 2003 and now have an FEV1 of 29. It has just been the last few months that the reflux has bothered me. I sure hope you get some answers.

BTW...you haven't had a PFT yet have you? Has it ever been rescheduled?

[Deborah]

Sandy: I just want to say that this is the first time I've seen an explanation of why there is such a high correlation of acid reflux for COPDers. Thank you.

I hadn't thought the hiatus hernia interfered with me at all, but evidently it has been irritating my vocal cords and making it harder to breathe. Every little bit hinders, I'm finding! I hope the drugs help you a lot.

Deborah

[sandy07]

Deborah....I simplified the reflux explanation quite a bit. There's more to it. A little too technical for my simple mind. It's also VERY important that the reflux or GERD (gastro esophageal reflux disease) be treated appropriately.
It can cause even more serious problems if left untreated.

A full, heavy stomach pushing on our diaphragm/lungs makes it very difficult to breath as well. That's why it is best to eat smaller more frequent meals.

[traci]

Sandy, no I still haven't had a PFT. The pulmonologist is ordering a methacholine challenge which will be months away. I don't understand why he wouldn't have ordered a PFT unless the methacholine challenge will give him the same information that a PFT would??? So I have been left to freak out for another several months which is why I ordered that peak flow meter that also measures fev1. I knew my peak flow was decent because I had an old peak flow meter at home from when my son had asthma when he was younger, so I thought maybe if my fev1 was decent it would help to figure out what is going on with my violent chronic productive cough, chest ache and discomfort, and shortness of breath. This was made much worse from the symbicort so much so that I now have stress incontinence all the time from the hard coughing.

The PFM arrived, is really easy to use, and I'm very relieved that my fev1 is good for my height and age. So I still don't know what's going on but at least I'm not so scared. I'm thinking it must be silent reflux. Sandy you should start that Prevacid because relux can be aspirated into your lungs which causes all those bad symptoms.

[sandy07]

Good to know your FEV1 is okay. I've been using Zantac but usually only when I need to. I better do it BEFORE I think I need it. Might work better. I see the doctor again on Monday. I've been holding off taking the Prevacid script to the drugstore in case something showed up in the lab tests I had done. Actually....just too lazy to take it in.

[Barbara]

Jul 15, 2012 17:16:54 GMT -5 traci said:

everyone. I posted quite a while ago about an ongoing cough for, what is now, almost 7 months. I still don't know what is wrong with me whether it is copd or not. I finally had an appointment with a pulmonologist and he checked my recent chest xray - it's good, and listened to my lungs - sound good, and then ordered a methacholine challenge and gave me a symbicort inhaler. The methacholine challenge will be months away (yes, I live in Canada) The reason for my post is that my cough is much much worse with the inhaler and I'm coughing a bit more phlegm. My cough has always been slightly productive though not enough to submit a sputum sample for testing. It still is a small amount but more than before the inhaler. It's been 6 days on the symbicort and I don't know how much longer I can take it. I'm coughing so much I'm getting really scared. Has anyone else had a worsening cough from an inhaler?

[lavishgail]

I do! I get to coughing samething. It's bringing up all our phlegm or our ongoing congestion maybe if you take a Mucinex that might help get it up even more and it is part of COPD I'm sorry. I think we all cough awful, sometimes I just tell people it's my allergies or the dryness . No worries but you should call on you're reg doctor could possibly have a chest infection?

[jade]

Sometimes lifting hands up, while coughing helps to stop.

[lavishgail]

Jade yes, I forgot about that! When my kids were babies and they would start to cough I'd say " lift up you're arms " they would stop. I hope you feel better and you get to see you're doctor soon? Please keep us updated?

[jade]

Gail, did I give impression that I am not well? 🌞

[lavishgail]

Oh no Jade! I meant that to the women having a bad cough! But I just became aware this whole post is very old! . Go to beginning and look at the date on this haha I think I'm not well hahaha!

[jade]

☀️

[lavishgail]

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