Senior with asthmatic bronchitis wants to exercise

Q. I am 76 and work out with 25 pound weights every day plus many other exercises like bike riding, isometrics, crunches, etc. I came on with asthmatic bronchitis with severe coughing and just not feeling up to snuff. By doing all that exercise, did I prevent the bronchitis from getting worse or did I lower my immune system? I had to go to the doctor for steroids and antibiotics and after eight days, felt better.

A: By way of explanation, I will identify both asthma and bronchitis so I can progress on to asthmatic bronchitis.

Asthma is caused by inflammation that causes the airways of the lungs to swell and narrow that, in turn, lead to a reduced level of available air. This results in shortness of breath, wheezing, cough and tightness of the chest. Known triggers include respiratory infections, a smoking habit, molds, family history of the disorder, inhaled chemicals, pollen, stress, pet dander, and some medications. Attacks can last a few minutes or a few days in duration. Most people with the disorder will be symptom-free at times and have a very compromised respiratory experience at others.

Treatment consists of reducing inflammation of the airway through quick-relief drugs to be taken once an attack has begun or when an individual is going to exercise or engage in an activity that might promote an attack, and long-term preventive medications that are taken even when no symptoms are present.

Bronchitis is a respiratory condition in which the mucus membranes in the lung’s bronchial passages become inflamed, irritated, narrowed, and compromise a person’s airways. There are two forms of bronchitis – acute and chronic. An acute phase may last as long as three weeks, while a chronic form may last substantially longer. The individual will have a productive cough with yellow or green sputum. Chronic bronchitis is as it sounds – long term. This form is found in individuals such as coal miners, cigarette smokers, and those exposed to harsh chemicals in the workplace.

Asthmatic bronchitis is similar, causing wheezing with tightening of the airway. The patient has an infection and subsequent bronchospasms. This is a common respiratory disorder in our country that affects individuals of all ages; however, the elderly are at highest risk for developing it because of an increased sensitivity to airway irritation and inflammation. The most common cause for this condition is viral in nature. Inflammation leads to respiratory congestion and shortness of breath.

Signs and symptoms vary from person to person, depending on the severity of the infection. They include shortness of breath, wheezing, a productive cough, chest discomfort, and more. Risk factors include dust, pollen, animal dander, environmental pollutants, smoke (even second-hand from someone else in the household who smokes indoors), exposure to viruses and/or bacteria, and employment in a factory or other setting that may involve harsh chemicals being inhaled. The potential complications of asthmatic bronchitis are pulmonary hypertension (high blood pressure in the arteries of the lungs), pneumonia, chronic obstructive pulmonary disease (COPD), frequent upper respiratory infections, and more.

Treatment is geared toward reducing congestion and asthma-related bronchospasms and commonly includes anti-inflammatories and bronchodilators, adopting healthy lifestyle practices such as consuming a well-balanced diet, avoiding smoking or being in the presence of second-hand smoke, and washing hands frequently to prevent infection.

This appears to be a classic case of asthmatic bronchitis because you continue to exercise (which has known positive effects on the immune system); however, your doctor would know more based on your history and symptoms. Either way, the fact that you are active and exercise regularly works in your favor. You are not doing your immune system any harm by remaining active – quite the opposite. As long as you are not overdoing, you improve your lung function every time you work out. Speak with your primary care physician or a pulmonologist for direction on how much exercise is right for you.

Asthma med not for this gal

Q: I am a menopausal woman who has had asthma my entire life. Upon reaching menopause, however, it seems to have gotten worse and my doctor put me on Singulair.

I have had some really bad seizures since then with loss of bowel control, a badly bitten tongue, severe depression and thoughts of suicide. Do you think they are related and how would you proceed?

A: Singulair is prescribed to prevent asthma attacks in individuals one year of age and up, exercise-induced bronchospasms in those six and older and exercise-induced bronchoconstriction in people 15 and older. It is a leukotriene inhibitor. Leukotrienes are chemicals the body releases when an individual breathes in pollen or other allergens. When the chemicals are released, the result is tightening of the muscles around airways and swelling in the lungs, making it extremely difficult to breathe. The product may not work immediately and can take several weeks after initiation before symptoms improve. This is normal.

Side effects of montelukast, the active ingredient in Singulair, include worsening symptoms, skin rash, mood or behavioral changes, anxiety, easy bruising, depression, suicidal thoughts, tremors, sinus pain or irritation, headache, fatigue, fever, heartburn, upset stomach, nausea, diarrhea, sore throat, and more. Seizures are rare but have been reported. Paresthesias (numbness and tingling), hypoesthesia (an unusually poor response to stimulation such as touch, pain, heat and cold) and drowsiness have been reported in post-marketing experiences.

Those on this medication should avoid taking non-steroidal anti-inflammatory drugs to include ibuprofen, Advil, Motrin, Aleve, Naprosyn, some arthritis medications, Indocin and more. It is extremely important your physician has a complete listing of all prescribed medications, over-the-counters and supplements you are taking to be assured there will be no unwanted effects from the drug.

Based on my observations, I do believe the effects you are experiencing are directly related to the Singulair but without knowing how long you have been on the medication in relation to when the symptoms started, I cannot be certain. Therefore, I recommend you make an appointment with your prescribing physician and ask if there is another medication he or she might be able to prescribe that does not have the unwanted side effects you experience. Of major concern is that a seizure could occur when you are driving down the highway, you may act on those suicidal tendencies, the depression may impact you and everyone around you, having a very negative and permanent effect on your life. We all respond differently to drugs, even the common aspirin. I can only surmise Singulair is not for you.

Menopause can have an adverse effect on a woman because of the hormonal changes that occur. While a normal part of life, the impact can unexpectedly cause depression, hot flashes, fatigue, anxiousness, and more. If you find you are unable to deal with the changes within your body, speak with your physician or gynecologist for his or her suggestions regarding possible hormone replacement therapy and anti-depressants. If you are able to deal with this change in your life, embrace it with open arms, eat well and exercise as much as possible. There is a light at the end of this tunnel.

Readers who would like related information can order Dr. Gott’s Health Reports “Consumer Tips (for each report) US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) or print an order form from www.AskDrGottMD.com.

Humans and dogs share a similar malady

Q: I’ve got a Boston terrier. Since she has the typical pushed in nose, she sometimes has asthma attacks. They sound just like a human attack if you’ve never heard one. A friend told me what she does for her dog to stop them is to find the soft place directly under the ribs and near the stomach. Rub firmly in a circular motion until the attack subsides. It works for my dog and I use it a lot. Here’s the additional weird part: sometimes I have asthma attacks too and I don’t have a pushed in nose. After the rubbing under the ribs worked so well for the dog, I tried it on myself before I reached for my inhaler. It worked! I was amazed and so was my husband. I have no idea why it works. I showed the vet when my dog got her annual shots and she was amazed, too. You only have to rub the area firmly for maybe ten seconds. I like your column so much and have learned helpful things, such as the soap in the bed that helped my father a lot. Thank you.
[Read more...]

Chronic cough, lupus need specialist care

DEAR DR. GOTT: I’ve been diagnosed with asthma, bronchiectasis, lupus and fibromyalgia. I’ve had a chronic cough, and no one can find out where it’s coming from. I have no energy. I just want to take a nap all the time and eat. I’ve gained weight and can say I’m getting closer to being depressed as opposed to being just unhappy. Any ideas for me to check out?

DEAR READER: Yes. Initially, you should request a referral to a rheumatologist. Lupus, a serious inflammatory autoimmune disorder, can affect the joints, kidneys, lungs and several other parts of the body. Many of the symptoms, such as fatigue, joint pain, anxiety, depression and variations in weight, cross over to those of fibromyalgia. Therefore, you should confirm that you do suffer from both conditions.

You should also be under the care of a pulmonologist for control of your chronic cough, asthma and bronchiectasis. The cough could be medication-induced or a result of your asthma. In order to determine what triggers your attacks, it may be necessary for you to undergo testing and to see several other specialists. This may appear daunting but once your textbook complaints of fibromyalgia are better controlled, you will then be able to lift your veil of depression and get on with your life. There is help. The fact that you have written to me is a genuine indication you are ready to get to the bottom of things.

Is painful biopsy necessary for ex-smoker?

DEAR DR. GOTT: I am a 60-year-old female. After smoking for 40 years, I was finally able to stop. Now I suffer from many illnesses caused by my smoking — emphysema, asthma, COPD and bulla disease.

My white blood count has been high for years, and a year ago I was referred to an oncologist, who promptly performed a bone-marrow biopsy. My count has been in the 15,000 to 17,000 range but never higher than 22,000. The oncologist wants to do another biopsy. He doesn’t say exactly what he is looking for but implies that it might be leukemia.
[Read more...]

Plant worker suffers respiratory difficulties

DEAR DR. GOTT: Can you give me an idea or guess the problem that I have, as no one has yet diagnosed it? It’s a breathing problem that seems to be getting worse, but slowly.

My breathing is shallow, and I often count 20 or more intakes per minute. I quit smoking 24 years ago, and the problem was not there then. My wife often hears my breath from another room, and my camcorder microphone picks it up easily. I have grown used to it and often don’t realize the noise I make.

I have had a series of laboratory tests that all say there is nothing, but this condition can’t be right. My doctor says I definitely don’t have asthma, and he doubts that it’s pulmonary hypertension, though after reading about it, I do have some of the symptoms that are mentioned.
[Read more...]

Mother helped by Gott column

DEAR DR. GOTT: I enjoy your column and was excited to read about the National Eczema Association. All three of my children suffer with this condition as well as with food allergies and asthma. Often, their attacks coincide.
My 5-year-old daughter suffers the worst and is often treated cruelly because of it by other children. I was so happy to find a Web site to keep current on new treatments and possibly a support group to help all of us with the emotional effects this malady causes.
Eczema may not be fatal, but it is real and bothersome. Thank you for sharing the information. [Read more...]

Daily Column

DEAR DR. GOTT:
I am an 81-year-old male in fairly good physical condition. I have had some serious bouts with asthma and pneumonia and now take several nebulizer treatments a day as well as an inhaler. I get along pretty well with my breathing though.

Now to my question. I have type 2 diabetes. A few months ago I read that cinnamon was good for lowering sugar levels. I decided to try it mixed with Splenda on toast several times a day and it seemed to work. I then purchased 500 mg cinnamon capsules and started taking them twice a day, after breakfast and dinner.

Before the cinnamon, I was trying to control my diabetes with diet and exercise but it wasn’t really working. I would often have spikes of 250 or higher (before a meal) for no apparent reason. After the cinnamon, I have not had a reading over 130 before a meal.

Is there anything wrong with this treatment? Are there any side effects? I have also told a friend with severe diabetes about this. It seems to work for him as well.

DEAR READER:
I have received several letters from readers, such as you, who have had a favorable response to cinnamon therapy for diabetes. At the time cinnamon was first mentioned in my column by a reader who was using it for diabetes, he also claimed it lowered his cholesterol levels as well. Cinnamon for cholesterol does not appear to work for the number of readers who wrote to me with their results.

The one side effect I have heard about from my readers is diarrhea. It appears to be dose related. I do not know if this is common in the general public, however. Therefore, I see no reason why you shouldn’t try it (with doctor’s permission, of course).

That being said, there have been a couple of studies on the subject. One of note is found on www.WebMD.com. A researcher with the NWFP Agriculture University in Peshawar, Pakistan says that cinnamon, cloves, bay leaves, and turmeric have shown promise in improving insulin’s action in lab studies. He also says that cinnamon can improve glucose and cholesterol metabolism, improve function of small blood vessels and remove artery-damaging free radicals from the blood. Korean ginseng, flaxseed, garlic, and onions have similar effects.

The best results were achieved in individuals who took three to six grams (6-12-500 mg capsules or 1-1 ¾ teaspoons) each day. This is by no means a small amount and favorable results diminish soon after the cinnamon is stopped. For those people who participated, insulin sensitivity improved, triglyceride and LDL “bad” cholesterol levels were reduced and changes to the HDL “good” cholesterol levels were minor.

If you would like to read the WebMD article it can be found at http://diabetes.webmd.com/news/20031205/cinnamon-helps-type-2-diabetes.

To give you related information, I am sending you copies of my Health Reports “Living with Diabetes Mellitus” and “Understanding Cholesterol”. Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.