Expert: Bailey - 12/20/2008

Question
Hi,

My mom, aged 58 has been suffering from chronic asthma ever since she was a child. Over the years, medicines like Deriphyllin retard,Aminophyllin etc have been prescribed.Lately she has been using Deriphyllin tablets and also uses the Ventorlin or Asthalin inhalers as well as a Nebullizer Her problems/symptoms include:
Early morning severe and continuous coughing spasms (sometimes accompanied by  phleghm)
Almost constant wheezing and shortness of breath
Inability to exert herself (a few steps or climbing stairs etc causes breathlessness

To give you a brief idea about her history, after tests conducted, diabetes, heart disease etc has been ruled out. She is, however a heavy smoker since the past 30 years. She is also overweight (height of 5 ft, weight is 80kgs) and has severe swelling in both her feet , the area where the swelling is, looks blackish in colour and the swelling extends from her toes till a little bit above the ankles. If she stands for some time, her feet burn her quite a bit. She sometimes gets a tingling sensation in her arm and fingers which is why we tested her for heart related disease but there was no such diagnosis made.Many years ago, she had contacted TB from my dad but was cured after following the required course of medicine.

My question is :

1) Are there any good medicines that can help alleviate her suffering with regard to the asthma ( I know she has to quit smoking to begin with)
2) What could be the reason for the swelling/burning feet? ( I think she was once diagnosed with a stone in the bladder)
3) What kind of exercise could she do to reduce weight because as of now any sort of light exercise also leaves her panting for breath (Is the weight because of the asthma medication apart from heredity factors i.e)
4) One doctor said she could be having COPD but there was no real result he arrived at.

I look forward to your expertise in this to help me arrive at some solution for my poor mum...thanks!

Answer
Ruth,
 My first thought on this would be COPD as well. Breathing problems can be tricky to diagnose however. One thing you could try is getting a peak flow meter. This is a little device you blow into and is used to measure lung functioning and can be helpful in detecting some patterns in breathing problems.

There are many many medications out there. If the ones she is currently on are not working then I would recommend she talk to her doctor about the possibility of trying another kind. There are many different options,  but it is important to give the medication at least a couple weeks to start working, unless of course symptoms get worse.

Swelling in the feet can be side effects of some types of asthma medications, particularly steroid type medications. Is there any correlation with the swelling and the use of certain medications? Did it start while using a certain medication, or has it always been that way? There are many causes that could potentially cause swelling in the ankles or feet and it should be evaluated by a doctor to rule out anything serious.

An excellent activity for asthmatics is swimming. If this is possible to do, it is usually beneficial to asthmatics. If it's not possible, then even something such as walking can improve lung function and overall health. And as you mentioned, quitting smoking will probably lead to improvements in the breathing problems and ultimately with the amount of exercise she is able to do. I would definitely encourage this.

-Bailey