ASTHMA - QUESTIONS AND ANSWERS

marijuana smoking in 14 yr. old with light asthma symptoms
Tue, 4 Mar 1997 06:30:35 -0800 (PST)
From: Jan Standefer <janis@Alaska.NET>
Dear Doc, Just found out my 14 year old daughter has been smoking pot since age 12. She has some allergies: long haired cats, dust. Uses inhaler occationally. Had cold that turned to bronchitus last 4 months. I haven't done any extensive questioning yet as to how often she's smoking,ie; every day or weekends, etc. Do you have any sources on information to ingredients of smoke and it's effects on young smokers. I am of the hippie generation, so have also BTDT, and don't want to her to go thru what I did. I always thought she was so much more together then I was and so proud of her?! I would like to be able to present some research data and facts to her to see what she is doing to her body. She is a good student, on swim and track teams, and concerned with health and what she eats. Thank you, a concerned and heart broken mom! jan

Che Guevara used marijuana as a bronchodilator (he was a physician as well as revolutionary). The oils in the modern day pot are far more damaging as is the method of smoking it. Not much low tar pot out there. Why is she smoking pot. Self medicating depression? Lack of a spiritual life? Urine testing will indicate use for several months after she stops. Marijuana and Lung Cancer Transcripts from the daily syndicated WellnessWise Radio Program (all scripts copyright 1995 by David J. DeRose, MD, MPH). Is marijuana safer than tobacco? I'm Doctor David DeRose. We'll look at some recent evidence in a moment on WellnessWise. In most peoples' minds the case against cigarette smoking is closed. Over 300,000 Americans are estimated to die each year from cancer and heart disease caused by cigarette smoking. But what about marijuana smoking? Is it safer than tobacco? Recent research on the subject has come from the University of California at San Francisco and other centers. These reports show that marijuana and tobacco smoking cause similar lung changes--with one difference--marijuana has a much more potent effect. In terms of lung damage, one joint is equivalent to a full pack of 20 cigarettes. Why does marijuana appear to be more dangerous? First, the total amount of tar is greater in marijuana than in tobacco smoke. Second, marijuana contains many of the same lung irritants and cancer-causing compounds that are found in tobacco smoke. Some of those chemicals--such as the potent carcinogen benzopyrene--are found in greater amounts in marijuana. Third, marijuana is smoked more deeply and held in the lungs for a longer time, thus multiplying its danger. Compared to tobacco, our national experience with marijuana is relatively brief--but the current results suggest it is also a powerful respiratory poison with cancer-producing potential. For WellnessWise I'm Dr. David DeRose. Reference: Kevin Starr, MD, and Mark Renneker, MD, A cytologic evaluation of sputum in marijuana smokers, The Journal of Family Practice 39(4):359-363. October 1994. July 3, 1995 Issue Maintained by Dave Albrecht (dalbrec@cba.bgsu.edu) Last updated on 11/27/95


Fwd: Can inhalers make asthma worse?
Tue, 4 Mar 1997 06:32:28 -0800 (PST)
From: MMMILANI@aol.com
I have only unremitting coughing and spasms of coughing foe asthma. I startes using Serevent and Azmacort but continued to wrosen for 10 days. Then I had an "attack" of violent coughing which led to me not being able to breathe. The doctor put me on prednisone. My chronic cough is diminished but my throat spasms and gasping for breath have continued. I think it is the inhaler. The spasm is high in my throat and it closes off, making it very difficult to breathe. This is always preceded by coughing from deep in my chest. The pharmacist told me the propellant could be a problem. Can the inhalers be causing the problem? mmmilani@aol.com

You have chronic moderate asthma in severe exacerbation. The new Maxair autohaler maybe easier for you to use or theodur/slobid by mouth or volmax 8 mg LA. As your asthma is controlled you will not cough with inhalation.


asthma
Tue, 4 Mar 1997 06:53:03 -0800 (PST)
From: herman gordon <hygor@webtv.net>
I heard on national T V there were two exceptionly good asthma drugs on the market - I couldm't get the names but one sounded like " accolade" -Does that help you? Thank you

Accolate is a new class of drug for fighting inflammation. My patients are not overwhelmed that it is the miracle cure.


asthma and exercise
Wed, 5 Mar 1997 20:21:43 -0800 (PST)
From: george cote <gcote@edge.net>
I am a 42 year old white female with a 20 year history of chronic severe asthma. Over the last year, with the help of an excellent physician, my asthma is finally undercontrol. After 20 years of inactivity I am excited to feel able to exercise again(I was physically active befor the onset of the asthma) Any suggestions of what is the best way to start. Thanks

i'm not sure what the end of your question is but yes you can exercise again. it will take six or more weeks of gradual persistent increase in severity of exercise to regain any kind of aerobic condition. Start with walking all stairs, park far from the store at the parking lot and graduate to walking then hiking uphill. Good luck!


Prescription
Sat, 8 Mar 1997 05:40:33 -0800 (PST)
From: BDoughe491@aol.com
I received a prescription for Tussionex cough due to Asthma. What is in this medicine? Is this Diallaud (spelling?) Cough Syrup?

HYdrocodone - a powerful narcotic. A drug of abuse for some.


Asthma Nebulizers / Reading Problems
Mon, 10 Mar 1997 05:46:22 -0800 (PST)
From: EiMc@aol.com
My nephew is 8 years old. Has been using inhalers and nebulizer for a few years. He is having problems with reading. Diagnosed as problem with spatial relationships. Is going into a special reading program. His other skills seem normal or above average. Someone suggested a possible connection with his asthma condition. Can you add anything?

There was a study that suggested use of theophyllin could interfere with learning. This was not confirmed.


persistent cough
Tue, 11 Mar 1997 05:42:07 -0800 (PST)
From: Jewelchick@aol.com
I have a six month old baby boy. He has a really bad cough since he was born. Very loud and irritating cough. He also has wheezing in his chest. If you put your hand on his back you hear all the congestion. He has been on medicine (albuterol, pediacare, etc.) but nothing has calmed it down. He was given chest x-rays which came back negative. He was given a sweat test for cycstic fibrosis. That to came back negative. His doctor put him on a nebulizer 3 times daily for the next six months using intel & albuterol. Using both medications for five to six days the cough started drying up. I took him offf the albuterol and was just using the intel for about 3 days. I am starting to hear the cough coming back along with the wheezing in the chest, and he doesn't have any kind of cold. The doctor is calling it bronchiolitis. He recommended my son see a lung specialist ( which he is going to). I am very concerned that my son has some sort of lung disease. Any help would be appreciated. Do you feel he should be hospitalized?

Your son probably contracted an "asthmagenic" virus early from some kind visitor. This will bring about whezzing with every cold for the next two years. Since he has a positive response to medicine I doubt that he has gastroesophageal reflux, tracheoesophageal fistula, and so forth but your consultant may request a barium swallow to look for these things. DO NOT ALLOW HIM TO BE EXPOSED TO CIGARETTE SMOKE OR COLDS AND HALF YOUR JOB WILL BE DONE!


Too much medicine!?
Wed, 26 Mar 1997 21:20:47 -0800 (PST)
From: Todd Burnside <RCCB@worldnet.att.net>
I have a 18mo old boy who has severe asthma. We had 8 hospital admission in 1996 alone. I feel like he has been on every medication under the sun. I have developed into a sponge looking for any more info I can find. He is seeing a great pulmonologist at Cook's Children's Hospital in Ft. Worth, Texas. He has been allergy tested and nothing shows up right now. I am worried about the amounts of medicine he is on, but the doctors don't seem worried. They say this is what we have to do to keep him attack free. He is currently on Theophylline 75mg 2x a day, 12 puffs of Beclovent a day and Ventolin and Saline in a nebulizer 3x a day. He was on steroids (Prelone) for over a month until they had to pull him off due to no response to the drug. I feel like I sometimes have my pharmacy degree. If you have any new ideas please send them my way. I know he has to have the medicine to stay healthy but when is it too much?

small dose of theophyllin, pulmocort coming out soon for nebulizer, not unreasonable treament to prevent further hoospitalizations. Do not allow him around cigarette smoike or other children who are ill.


Humidifiers
Thu, 27 Mar 1997 05:16:11 -0800 (PST)
From: Bobbyaber@aol.com
It seems that no one has a straight forward answer on when to use a cool mist humidifier. My little girl has a slight case of asthma , we have a nebulizer to give her treatments when she needs them, which is a couple of times a year, we have been very fortunate. Sometimes she coughs at night when she gets a cold, we give her cough medicine which helps but for only half the night. We wonder if it is recommended to use a humidifier in her room?

No,it's a great source of mold and the moisturized air does not get into her lower respiratory tract


Relaxation Training
Thu, 27 Mar 1997 05:25:25 -0800 (PST)
From: Dody Lilly <MKLILLY@aol.com>
I am a clinical psychology Ph.D. student at Virginia Tech in Blacksburg, Virginia, and have a quick question. I am working on a grant that involves the development of a multimedia, interactive computer program for children ages 6-10 with asthma. We would like to include some simple instruction for relaxation for these children. Clearly it is not feesible to teach relaxation techniques as one would in the clinic (e.g., multiple sessions, using biofeedback), but I am interested in your suggestions for the most useful self-instruction information for this age group that could be conveyed via an interactive computer video. Thank you for your help. Kristine Lilly

The ACT program has some nice exercises,Open Airways does to. Bettina Hillman MD is down your way and has worked on a Nintendo game;Bronkie the Bronkosaurus (RAYA Health Systems). Dale Umetsu at Stanford can givwe you a hand too.


asthma
Thu, 3 Apr 1997 03:45:03 -0800 (PST)
From: Lemming72@aol.com
Dr. Landon, I've twenty four years old and have been struggling with asthma symptoms for three years now. It seems as though my prescription offers only brief alleviation for a few weeks or months at a time. I'm told that asthma is dynamic so that there should always be the anticipation of renewed symptoms. Last November I began a prescription of Serevent (two puffs twice a day) and Azmacort (six puffs twice a day) and for two months, my asthma was nearly entirely controlled. Then, suddenly, symptoms returned in January in the form of constantly needing to clear my throat, on a daily basis. That's where I am now. Is throat-clearing a part of asthma, or could it be another problem (post nasal drip perhaps?) just exacerbated by asthma? I'm also terrified by the prospect of getting back into running, because I'm afraid that the symptoms which continue to plague me will only get worse when I start exercing. Last year I stopped running after only two or three times because I found that it was testing my respiratory tract more than my legs. Now that's bad! What do you recommend? Thanks. Joe

Allergic rhinitis will trigger asthma or make it more difficult to control. Use Vancenase DS if inside your nose it is pale and boggy, not the red of infection. Juniper would be a nice January trigger - consider skin testing to a few local allergens. Run with a Proventil HFA pre treatment. The mist is finer and more effective than the "generic" albuterol and you'll find it will give a mist even if it is cold outside - no ozone depleting propellant! Run indoors first, like a treadmill, use your peak flow meter (YOU DO HAVE ONE, DON'T YOU!), before, during and after. No asthma cripples, please!


Cardiolyte Stress Test
Thu, 3 Apr 1997 04:13:56 -0800 (PST)
From: Terry Mabe <terrym@computer.net>
My sixty-year old husband is scheduled for a Cardiolyte Stress Test on Monday and is apprehensive about the cobalt injected into his veins. He is thinking about calling off the test because of this. Is it safe? He has begun to jog and went in for a physical. During jogging he has begun to wheeze. The doctor thinks the heart is not getting enough oxygen, thus my husband's heart is skipping. (My husbans thinks he has a bad valve.) Thanks so much! Terry Mabe Mahopac, NY

Has he had an EKG? Wheezing with exercise is asthma - has he been treated with Proventil HFA on a trial basis? Wheezing with exercise as a result of congestive heart failure seems the less likely scenario. Maybe he has told the doctor some other symptoms indicating the need for the stress test. He is avoiding having large cathers thrust into his groin followed by a dye that makes you feel like you hacve caught fire. Give me the cobalt!


Asthma
Thu, 3 Apr 1997 04:42:05 -0800 (PST)
From: Evechase@aol.com
I am taking Ventolin, Atrovent and Beclovent and my physician told me two years ago when I began taking these steroid medications that I would have to stay on them for the rest of my life. Am I literally chained to these medicines or can I wean myself off of them? Thank you for your advise.

Patients often times will "burn out" their asthma over a two year period. Stop the Ventolin first - if no symptoms stop the Atrovent - if no symptoms - stop the beclovent.


Incessant coughing
Thu, 3 Apr 1997 04:47:28 -0800 (PST)
From: Pantomime1@aol.com
My 15 month old grandson seems to have been coughing since the day he was born. When the cold and flu season hit this winter, it got worse. He may have a few days where he seems to be better and suddenly he is coughing until he gags and throws up light colored mucus. If he has eaten recently, all his food will come up. He does not show any other evidence of having a head or chest cold. This happens with such regularity that we consider it normal for him to be gagging and throwing up. We expect it. He will do this repeatedly for days. We have tried starting antihistimines and decongestants as soon as the cough shows up but it has had no effect. Within a few days he will be diagnosed with an ear infection and begin a 10 day regime of antoboitics. A few days later the cough lessens but starts up again as soon as the antibiotics are finished. His coughing and gagging sounds like he is strangling. It is unnerving. I recently read as much as I could find on cyctic fibrosis, which does not run in his family, and even tasted his skin for saltiness but noticed nothing unusual. He is a bright, healthy looking, energitic, well nourished child who walks around hacking his head off all day. He sounds like an old man with a very bad cigarette cough. His pediatrician has been asked about this cough several times but he says there is not much he can do except advise the use of antihistimines and decongestants. Is there something more we should be doing?

Get him tested with a sweat chloride. Then you can stop worrying. It sounds like he has cough variant asthma. A trial of Proventil syrup and even a one day course of steroids would help make the diagnosis.


asthma
Thu, 3 Apr 1997 05:05:51 -0800 (PST)
From: Louise Lyons <llyons@idi.org.au>
My four year old daughter has very mild asthma, and has so far not had an "episode" nor does she have a wheeze. She has an occasional cough, either in the morning or after exercise. She had a ventolin puffer for about a month and now she has it when she has symptoms. Should she have the puffer all the time or just when it is needed (two doctors have given different opinions so far). Also, what are her chances of "growing out of it" or developing full blown asthma in the future? We live in Melbourne, Australia, where some of the highest rates of allergy related incidences are recorded.

Yes your daughter has mild asthma. Moderate asthma, requiring daily use of Ventolin would also indicate the need for an antiinflammatory such as Vanceril DS . Use the inhaler before exercise. You might consider the new Proventil HFA as it has a gentler mist. Usually children will have infectious exacerbations but then "outgrow it".
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