Expert: Marc Rubin, RPh Asthma Educator - 9/30/2009

Question
I smoked for 20 years but not heavily until the last ten years.  I have never had a lung problem but have always had bad sinus problems even to the extent of polyps being removed from my sinus cavities.  I quit smoking in May, and yes I intentionally quit smoking with the aid of Chantix.

Since I have quit smoking, I can not breathe.  I have been to the doctor eight different times and twice to the emergency room with one asthma attack.  When the mess first started I ran very high fever, I have been on numerous rounds of antibiotics, breathing treatments, Alberto inhalers, predisone, singular, and steroid injections.  All is fine and dandy as long as I'm taking either the antibiotics and the steroids, but as soon as the antibiotics and steroids runs out, I right back where I started within a few days; however, my sinuses have continuously drained through this whole ordeal to where I can hear and feel the fluid in my ears.

I recently finished a two week round of predisone and my chest is tightening again and breathing is starting to become difficult and the wheezing has begun.  The last time I was in the emergency room, the respiratory therapist dispensed three breathing treatments in a row and I was still wheezing, even she was dumbfounded.

No one has ran any test to try and determine exactly what the problem may be, course it doesn't help that I do not have insurance.  I've been diagnosed as having sinusitis with bronchitis, asthma, and chronic bronchitis; but no one has mentioned COPD.

Therefore, I will probably be going back to the doctor in the next couple of days.  What should I tell these doctors who I can't seem to get through to?  Cause I know what is going to happen, I'm going to go in there and they will give me a few breathing treatments, inject me with some steroids, and send me home with another round of antibiotics and steroids.  This has been the routine for the last five months, is this normal with asthma patients?  or I've been told this is the lungs rejuvenating themselves?  or should other precautions be taken?

Answer
Hi Shontea,

Sorry to hear how poorly you have been doing, as well as the inadequacy of health care you are receiving.

I'm disappointed that the only daily controller medication they have prescribed is Singulair. With your symptoms level and frequency, you should be on a steroid inhaler, and possible a long-acting bronchodilator (your albuterol lasts for 4 hours, the long acting versions last 12 hours, and are given as a combo in a single unit with the steroid).

I'd suggest contacting you local health department for guidance. Some doctors volunteer at clinics on a rotating basis, and they may able to meet your present needs. Also, for patients without prescription insurance, there are a number of programs that may be able to help you out.
Try these three:
1) http://www.RxHelp360.org
2) http://www.helping patients.org, 1(800)762-4636
3) http://www.togetherrx.com 1(800) 865-7211

What you are  going through is not good health care. This should not be happening to asthmatic who is being followed by a physician. Lungs do not rejuvenate themselves. Yes, there can be a clearing of "junk", but the damaged tissue does not rebuild.

Chronic bronchitis is one of the COPD diseases, but the parameters are that you have had at least 2 consecutive years of bronchitis lasting over 2 months. Lung testing is essential to make a proper diagnosis, and it is inexcusable for them not to do the lung testing to clearly determine what you have, so you can then get the most appropriate treatment.

Bottom line, you need to be seen by a physician who will agree to work with you, and establish a continuing care relationship. I just hope the county office will help you. I'm proud of you for 1) quitting smoking, and 2) for trying to take control of your condition. If you wish to receive a greater knowledge of asthma so you can be in a better position to take control, send me another
email, but marked PRIVATE, and include you name, birthdate and email address, and I'll get you going on a formalized asthma education program at no cost. The program is done online, from Emmi Solutions.

I hope this helps you some.

Sincerely,

Marc