Expert: Marc Rubin, RPh Asthma Educator - 6/19/2010

Question
I've been having moderate breathing problems for a long time now, but ever since my old apartment (in a basement) flooded, I've been having a lot more trouble. I immediately moved out and went to my doctor and was prescribed Advair, I've been unable to take it regularly until the last two days, because I couldn't afford it.
Now, for the past 4 days or so I've been having sever breathing trouble, with a lot of pressure, tightness, and pain in my chest. I wen to the emergency room last night as it's been very hard to handle. They gave me a breathing treatment and prescribed me 4 days of 40mg of prednisone, along with the dose they gave me. I felt about half way better after the treatment, but by the time I got home I felt bad again.
Woke up this morning gasping for air, tried like hell to go back to sleep. Things haven't improved over the course of the day at all. My rescue inhaler isn't helping. I've tried tons of home remedies, none so far have helped.
I'm worried there may be mold in my new house now as well, have only found a little spot of it, but I know it can be hidden and all that. SO... if I go to my dad's house (which is much nicer and cleaner and certainly less moldy potentially than mine), how long should it take for me to start feeling better, so that I know there is most likely mold, or some other allergen(s) in my house?
Also, since I'm not feeling better and the pain in my chest is slowly getting worse (or perhaps staying the same, just getting harder to handle because of the duration), when should I stop waiting for the meds to work, and go back to the hospital?

Not sure what to do... someone please give me some good advice here. I can't take much more of this and NOTHING I try seems to be getting me much relief, if any.

Thanks

Answer
Hi Allison,

Fist, I want to address the Advair financial issue. Go to > http://www.advair.com/copd/coupons-and-special-offers/coupons-special-offers.htm...

You can get the first month FREE. In addition, Glaxo has additional programs that may also apply. Go to > http://www.gskforyou.com/

Okay, now as to time of recovery. I would have had you on a longer "potential" therapy. When a severe, sudden attack occurs, the guidelines call for treating with oral steroids for 3 to 14 days, where you stop when your peak flow readings are at 70% or better. I would have figured around 7 days for your from a mold infestation. If you do not have insurance to see an allergist, you may need to get back to the hospital.

Technique with the asthma devises is critical. With your rescue inhaler, you need to shake the unit, exhale deeply, and AFTER you begin to SLOWLY inhale with the unit in your mouth, fire the spray while continuing to inhale. It also helps to be looking up  slightly, like looking at a clock on the wall. With the Advair, if it is the round, discus unit, you need to hold it flat, not exhale into it , and inhale in a rapid, deep breath, then rinse your mouth.

It may be of benefit to add another drug, a nasal steroid such as Fluticasone, to the therapy. If your sinuses are inflamed, it will keep your lungs from recovering as quickly. There are also coupons for that (Veramyst, Nasonex, etc.). If unalbe to get coupons, let me know, and I will speak with my contacts about getting some mailed to you. Until you get this part resolved, it may help to get an over-the-counter saline nasal spray(which is under $5) to rinse your sinuses.

It is REALLY important for find housing where allergens such as mold and animal dander are not present. At the big hardware stores, they carry inexpensive kits for mold testing. This will help give you that answer. Keep in mind, outside pollens are way up this year, especially with all the rain. This may be contributing to your problem too.

Let me know how this goes. Also, what city and state do you live in?

Sincerely,

Marc