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Suggest Remedies For Maintaining Lung Clarity In A COPD Patient

Posted on Sat, 16 Jul 2016

Question: I have severe COPD. Have managed it for 15 to 20 years. I have 'episodes' and can usually recover in a minute or so. Recently, upon waking, I had a burning sensation across my chest as if my skin was on fire. It washed over my body 3 times. I had gone in the bathroom and could hardly get back to sit on the edge of my bed. After sitting and struggling for air (it was like someone put my lungs in a plastic bag) -- even my savior Combivent didn't help. I ended up in the hospital on Prednisone and am now on a 5 week weaning protocol -- then the burning occurred again the other night, worse than before. After I made my way back to bed and sat for a few minutes - from one second to the text I was back to normal. The burning was not addressed while in the hospital. Also, the Pred weaning process feels better than anything in a long time. IS THERE ANYTHING TO HELP MAINTAIN THE LUNG CLARITY I AM EXPERIENDING? i know you can't stay on this drug indefinately. I'm terrified for what happens when I'm done with it. Thank you.

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
Consult psychiatrist and get done counselling sessions.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Honestly speaking, there is no organic disease which causes burning sensations in one minute and immediately normalize in next minute.
So no need to worry for any heart or lung or stomach related diseases.
In my opinion, your this burning symptom is associated with stress and anxiety.
So consult psychiatrist and get done counselling sessions.
Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too.
Don't worry, you will be alright with all these.
Hope I have solved your query. I will be happy to helpto help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (17 hours later)

That was the worst and most incorrect response I have ever experienced. You're a pulmonologist and didn't even address my concern about Prednosone or is there is anything I can take after being weaned off? If I am anxious about anything, I have Xanax which I don't usually take - but if I need to, it's there and helps my breathing. One thing I didn't mention is that, when I wake up, my blood pressure is usually high but settles down within a couple of hours. I take Bisoprolol PM and Quinapril AM. Heart was tested for everything while in hospital - all OK. Blood pressure has always been in 120's/70's. Thinking early morning high BP may be cause of burning. I will not be alright with BODE-8. COPD is only problem. If I could breathe, I could be living like was 50. No other XXXXXXX type problems of any kind.

Answered by Dr. Drkaushal85 (15 minutes later)

Brief Answer:
Are you taking any other inhaler other than combivent?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry if you are not satisfied with my answer.
You have mentioned only one inhaler infection your first question, combivent.
Combivent is having ipratropium and albuterol.
Both are short acting bronchodilators.
You are improved with prednisone (steroid).
So you should definitely try inhaled corticosteroids (ICS). ICS are safe for long term use as there are minimal systemic side effects as compare to prednisone.
So please let me know
1. Are you taking any other inhaler other than combivent?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (23 hours later)

Thank you for a much more appropriate answer. I also take Symbicort twice a day but haven't found it to be especially helpful. Use the Combivent about every 4 hours but less while on the Prednisone weaning doses. Now you mentioned ICS. I have asked what can be taken after Pred (yes, feel much better with) but DR has never mentioned inhaled corticosteroids. Would you please NAME one or more of this particular drug? I am very disappointed in my DR if this is actually something that would help. Again, thanks.

Answered by Dr. Drkaushal85 (23 minutes later)

Brief Answer:
Symbicort is having ICS.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
Symbicort i having formoterol and budesonide. Budesonide is ICS only. So your doctor is not at fault.
Please let me know
1. Which dose of symbicort you are taking? Is it 200 or 400?
2. What is your weight?
You might improve with increasing dose of ICS.
So please let me know answers of above asked questions,so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 hours later)

Symbicort - 160 / 4.5 Twice a day
180 lbs.
I was on a dose pack years ago for weaning from Prednisone. I felt so good, I asked my dr if I could keep taking it. Of course, he said no. Now, having been on a 5 week weaning from Pred, I would still like to know if there is ANYTHING that will help as much as this has (1st week - 4 10 mg pills, 2nd week - 3 pills, 3rd week 2 pills, etc.). I'm told to continue would put me in the morgue. Is there
anything, anything at all, that can help. Thank you for your prompt answers and I'm sorry for my smart-ass response above.

Answered by Dr. Drkaushal85 (16 minutes later)

Brief Answer:
In addition to this symbicort,you should also take budesonide plain twice.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
In my opinion you will improve with additional ICS like budesonide.
So start plain budesonide MDI twice daily. In XXXXXXX plain budeonide is available as a brand name of budecort,Budate etc. You should take it 200 micrograms twice daily along with symbicort.
This will mostly give you same relief which was achieved by oral prednisone.
Hope I have solved your query. If you are not having further queries,then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 days later)

One, maybe two more questions. Dr. getting me RX of inhaled budesonide. You implied taking same time as symbicort. Asking if I can alternate Symbicort and Budesonide between doses of Combivent which I take about every 4 hours. Seems
like defeating the purpose to take Sym and Bud at the same time since it would not be budesonide PLAIN now. Did you mean inhaled budesonide or a pill which would be the 200 mg> Like this......
6am - combivent; 8am symbicort; 10am combivent; 12 noon budesonide;
4pm combivent; 6pm symbicort; 8pm combivent; 10pm budesonide.

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Budesonide is not a pill, it is inhaler only.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No, budesonide is not a pill. It is inhaled corticosteroid comes in inhaler only. It comes with 200micrograms strength.
You should take 1 puff twice daily.
So take budesonide after 15-20 minutes of symbicort.
Suggested timings for symbicort and budesonide are, 8 am first take symbicort, after 15-20 minutes take budesonide, 8 pm symbicort followed by (15-20 minutes) budesonide.
Take combivent four times a day according to the schedule.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (12 hours later)

OK - I will do this exactly as you have explained. Your help has been the most
encouraging I have received and I have been through some pretty heavy stuff in an effort to breathe better (stem cell therapy, a study called Enprove requiring little umbrellas inserted in my lungs, etc.) Hope this relatively simple solution, by comparison, works. Thank you so much. Will close now.

Answered by Dr. Drkaushal85 (10 minutes later)

Brief Answer:
Yes, you can try budesonide with symbicort.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Thanks for your kind words.
I am truly obliged by this gesture of yours.
In my opinion, you will improve with budesonide and symbicort as directed by me.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar