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Respiratory Therapist/Exacerbation of Asthma


Hi Larry,

I'm a 44 year old female. I have never smoked.  I was first diagnosed as having asthma at age 16.  But my asthma was caused if I was in the presence of allergens such as cats, dogs, chemical products, but never when exercising.  So for 30 years, I have been using ventolin inhaler, but not more than 5 times per year and I considered myself very lucky.

Since February 2013, I have been slightly wheezing but more rales.  And I feel the mucous moving in my back and chest.  I had 2 antibiotic treatments as the doctors (I saw 2) thought I had a lung infection.  But it didn't stop the rales.  Then in May, I saw  my family doctor again and this time she prescribed a treatment of Advair.  She told me to take it for one month.  It took 2 days and the wheezing and rales were practically gone.  AFter one week, everything was fine and I continued the treatment.

After the treatment, I was fine for 3 weeks, then it started all over again.  We know it's inflammation.  But my question is what could be causing this?  It's hard for me to believe that I am now afflicted with a more severe form of asthma.  Now, I can't make the slightest physical effort without feeling the constriction in my lungs and then wheezing. Never has this happened to me before in thirty years.  I'm worried.  I am seeing my doctor next week, but would like another opinion.  I have a feeling I will be on advair permanently but I am the type of person who has to know ''why'' this is happening after 30 years.  Nothing has changed in my life, no new allergies, at least that I know of.  What really worries me is the immediate symptoms after minimum effort.

If you could give me some insight, I would appreciate it.


Hi Jennifer,

Thanks for entrusting me with your personal medical concerns today.

Asthma can be triggered by many different thing, with allergies/allergens being one of the top triggers. Some asthma patients ONLY have breathing flare-ups when exposed to certain ittitants and/or allergens. So my initial thought was to ask what new allergens you are being exposed to, but you already stated nothing has changed. Advair is more of a drug that is meant to be used for long-term "maintenance" use for patients with reactive airways, as it contains both a good long-acting bronchodilator as well as the long-acting corticosteroid anti-inflammatory. It is not uncommon to experience an exertion-enhanced element of asthma later in life, as asthma does not always have a logical time or reason to show itself. Something as remote as genetics could be dictating why your breathing has changed over time.

I wish I could give you a more definitive answer, but I am not quite equipped to do that.

I hope this information is at least somewhat helpful to you.

Best of health to you,

Larry, RRT

Respiratory Therapist

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Larry W. Wical, BA-RRT


I CAN answer: ALL questions and queries related to the following topics... - Oxygen - Asthma - COPD - Bronchitis - Emphysema - Pneumonia (Viral/Bacterial) - Tuberculosis (TB) - SARS - Influenza (Flu) - Vaccines - Pulmonary Embolism - Pleural Effusion - Atelectasis - Inhalation injuries (burns, chemicals, etc.) - PFTs - Cardiovascular health - Sleep Apnea - BiPap/CPAP - Ventilators (Respirators) - Aspiration injuries - Thoracic injuries - Lung contusions - Tracheal injuries - Artificial Tracheostomy - Secretions - Prolotherapy/Regenerative Injection Therapy (RIT): A patient's experience/perspective - General health and fitness - Prolotherapy (from a patient's perspective) I CANNOT answer: Questions that vary too far from my primary scope of pulmonary and cardiovascular care and fitness. I promise to be open and honest about my knowledge of submitted topics, and will always openly provide my personal as well as professional feedback as it relates.


Registered Respiratory Therapist (RRT, RCP) since 2005. I have worked primarily in the acute care, critical care, burn care and home care settings.

NBRC - National Board of Respiratory Care AARC - American Association of Respiratory Care

-All About Kids Magazine -The Clermont Sun -Cincy Sports & Fitness Magazine -Many online Fitness and Health blogs and "webazines"

- B.A. in Communication (1997) - A.A.S. in Respiratory Science (2005) - RRT license (state of OH, KY and IN) - Basic Life Saving (BLS) - Advanced Cardiovascular Life Support (ACLS) - Advanced Burn Life Support (ABLS)

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Currently work in the city's largest academic/research hospital.

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