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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffering From Bronchitis, Frequent Attacks Of Asthma. Treatment?

I am a 40 yr old, normally in excellent physical conditiona. I workout almost on a daily basis if I am not sick. I got walking pneumonia 2 years ago and didn t take proper care of myself. (I am a single mother with my own business). I got better for a couple of months and then began getting Bronchitis every month. Finally, after a friends suggestion, I went to an allergist and was diagnosed with asthma . It was over a year before I was able to get everything under control. It s been 7 months since my last battle with bronchitis and I am in bed with it again. I was around a tractor that was pushing a lot of dust around and exhaust from a jeep. I was struggling to breathe. Within a few days, I was sick. Can my lungs be this sensitive to environmental factors? Is there anything I can do to make my lungs stronger? I run when I am well to try to help strengthen my lungs. I am so sick of being sick. It scares my child so much every time I get sick because of how ill I have been the last couple of years. Please tell me anything you think I can do to prevent me from getting bronchitis. Thank you so much!
Fri, 9 Nov 2012
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Allergist and Immunologist 's  Response
Hello,
If the lung function test was suggestive of asthma and hopefully you had skin tests to find the environmental triggers, the most important thing would be to get your asthma under control.
Combination inhalers will be the choice such as Symbicort turbohaler if budesonide 400 has not helped. You must keep asthalin (or the blue salbutamol) inhaler with you at all times and take 4-6 puffs as required but maximum 10 puffs at one go.
Montelukast 10mg addition at night will also significantly help.
You also need to know the current status of your immune system with IgG, IgA and IgM levels and functional antibodies against Hib, pneumococcus and tetanus if available. These tests if normal exclude an antibody deficiency, as these control recurrent chest infections (bronchitis).
You will also need a yearly influenza jab due to your asthma.
Hope that helps.
Thanks.
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General & Family Physician Dr. Debraj Jash's  Response
Hi,
Thanks for query. Are you a smoker? Infection and environmental pollutants are two most common triggering factors for exacerbation of asthma. You may get benefit from Influenza vaccination every year. It will not prevent the development of colds but will reduce severity and frequency of hospital admission. If you are a smoker I will also advise you to have pneumococcal vaccination. You need not to take it for atleast 5 years. Most important thing is to keep your asthma or COPD under control. For this you need to take MDI formoterol-budesonide twice daily. Physical exercise is always good in patients of long standing asthma. It will not influence the underlying airway inflammation in asthma but will improve the quality of life. Definite confirmation of allergy requires allergic testing.If you are allergic to dusts, you should avoid dust exposure.You may also get benefit from using Levocetrizine-montelukast for 2 weeks followed by levocetrizine O.D. I can not give a certain management programme without detailed physical examination. Please consult a pulmonologist. Hope, I satisfied your queries.
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Suffering From Bronchitis, Frequent Attacks Of Asthma. Treatment?

Hello, If the lung function test was suggestive of asthma and hopefully you had skin tests to find the environmental triggers, the most important thing would be to get your asthma under control. Combination inhalers will be the choice such as Symbicort turbohaler if budesonide 400 has not helped. You must keep asthalin (or the blue salbutamol) inhaler with you at all times and take 4-6 puffs as required but maximum 10 puffs at one go. Montelukast 10mg addition at night will also significantly help. You also need to know the current status of your immune system with IgG, IgA and IgM levels and functional antibodies against Hib, pneumococcus and tetanus if available. These tests if normal exclude an antibody deficiency, as these control recurrent chest infections (bronchitis). You will also need a yearly influenza jab due to your asthma. Hope that helps. Thanks.