Asthma

[h90]

double

Edited August 9, 2014 by h90

[draftvader]

Hi

Interested in people's experiences with asthma when changing countries/climates

I (from NZ) developed asthma last teens - years of inhalers, nebulisers and overnighters in hospital.

Except for the years I spent in my 20s living in Australia - Sydney and perth where asthma became a rare event for me, and just the odd Ventolin 'as required'

I've been a competitive distance swimmer and triathlete at national level, though always had the trusty Ventolin at hand 'in case'. Healthy living, even a dietitian!

On my first holiday to Thailand the asthma more than faded, it practically disappeared. I was running and cycling like I'd always wanted to, restrictions gone. First time ever i felt I could give a genuine 100% with no excuses. And many thoughts of 'if only' when looking at competition results that could have been better

Returned to Thailand for 5+ years and no issues whatsoever, decided that just as I had grown into asthma I had grown out of it.

This year I went back to NZ April-July and it hit me the worst of my life, from the very first day till the last - i went for 6mths work but called it quits at 3. Granted it was winter, and it was quite a shock going from high 20s to low 30s to daily temps of 8-9C and overnight lows of minus 2 (but no, I was not sleeping outside).

Back thru Bangkok and it's gone again. Arrived home 4 weeks ago and not a hint of breathing issues.

Simply put, seems I have a reaction against the climate/cold air. Allergic to NZ! I have to go back briefly early 2015 and am dreading it - can't see any way of avoiding the same problems I've just had; I've felt so much better overall minus the medication - and stress that comes with relying on it.

Can't be alone, surely? Anyone else had similar exp returning to a cooler eg UK climate? And how did you manage it?

thanks

Always observed this. The humidity keeps your lungs from drying out. Dry air is a massive contributor to asthma as there is so much dust in the air. Asthma is your lungs over-doing the response by producing too much fluid which reduces your lung capacity (constricting of the throat is the other reaction). When it is humid your lungs don't have this reaction. I remember when I first went to a Greek island on holiday at 13. I had suffered my worst asthma from 8 (diagnosed) to 12. At 13 I had started to get it under control and discovered I was an awesome long distance runner. Nonetheless I would always need my Ventolin within 400m of the start of a race. When on holiday I took myself out for long cross-country runs and never needed it once. Back to Blighty and "Bang" asthma!

Coincidentally I have also noticed this effect going from pollution to clean air or vice-versa. It is almost like your body adjusts even to pollution. Massive change...asthma. Knowing this stuff will happen is good as you can prepare by increasing your "preventative" (i.e. Seretide) for 48 hours prior to give your lungs a chance at coping with the change. Cold and dry....the worst!

[theguyfromanotherforum]

I was prescribed montek 10 at chula and find this medicine even worse than symbicort. Actually I wish I was back on symbicort as with this I am waking up at night experiencing shortness of breath. When I didn't use any medication I slept fine.

Edited August 19, 2014 by theguyfromanotherforum

[Sheryl]

How long have you been on the Montek and off the symbicort?

And given your lack of confidence in the care you are receiving why don't you seek another opinion? Preferrably from a doctor trained in the West who is used to involving the patient in treatment decisions.

BTW steroid only inhalers are most definitely still available in Thailand. And are the usual first line of treatment though there may be reasons unknown to me why not prescribed for you.

[theguyfromanotherforum]

Sheryl, I have been off Symbicort for a while and used it only as a reliever. I was on Montek for 2 weeks because I read that sometimes it takes a while to work. I was actually on it up until 2 days ago and now I feel better without it. It was also causing me depression episodes and would wake up at night without breath.

Anyway, I asked the doctor about testing me for Chlamydophila Pneumoniae as these Asthma meds don't seem to work. I was told I can only do this test if I produce sputum which I find very strange since I saw it online it can be simply done with a swab. I can not really produce any especially in the required colorful form. I lost faith in Chula. I gave it a shot on my GF recommendation and I regret it. So if you can recommend a hospital or who to see I would be grateful.

Edited August 22, 2014 by theguyfromanotherforum

[Sheryl]

Could try Dr. Phichai at St. Louis Hosp on Sathorn. I can't post link because my home intrrnet is down and posting from my android phone but if you tell them Dr. Phichsi chest specialist they'll know who you mean. Call firstto check his houts as not there everyday. If possible get your records from Chula first and bring with you.

[theguyfromanotherforum]

One last question. What are the chances of this being Cardiac "asthma"? I experience tiredness while climbing the stairs and during running in the beginning, but not after 30 minutes when my lungs actually seem to clear. I find that very strange and contrary to things I have read.

Also, if anyone is interested, I bought Symbicort 165/4.5 for 1350b (120 doses). I think it is a very good price if someone needs it. Chaopraya tourist boat from Saphan Taksin (40b) to Wang Lang station. Then it's a 5 minute walk on main street to the big pharmacy which is kinda hard to miss as it is super busy. Will ask my gf for a name.

[Sheryl]

If heart disease the problems would worsen as the exercise progressed and indeed limit how long you were able to keep at it. Doesn't seem to fit what you describe.

[simon43]

Anyone else had similar exp returning to a cooler eg UK climate

Whilst living in the UK, I contracted Aspergillosis (fungal spores in the lungs) from working in a damp, unheated and underground office. This illness caused me to suffer from mild asthma, regular bronchial attacks and several bouts of pneumonia.

In 2002, at the recommendation of my doctor, I emigrated to Phuket, with clean air and a warm, humid climate.

My illness went into remission! No symptoms at all!

On each occasion when I have returned to visit the UK, my illness has returned within 12 hours, in one case requiring hospitalisation in Bumrungrad on my return (advanced pneumonia).

If I travel to locations more northerly than Phuket, (such as Yangon and north Laos), my illness returns, albeit in a mild form.

So I am 'condemned' to live by the beach in north Phuket......

[danstarr]

Hi

Interested in people's experiences with asthma when changing countries/climates

I (from NZ) developed asthma last teens - years of inhalers, nebulisers and overnighters in hospital.

Except for the years I spent in my 20s living in Australia - Sydney and perth where asthma became a rare event for me, and just the odd Ventolin 'as required'

I've been a competitive distance swimmer and triathlete at national level, though always had the trusty Ventolin at hand 'in case'. Healthy living, even a dietitian!

On my first holiday to Thailand the asthma more than faded, it practically disappeared. I was running and cycling like I'd always wanted to, restrictions gone. First time ever i felt I could give a genuine 100% with no excuses. And many thoughts of 'if only' when looking at competition results that could have been better

Returned to Thailand for 5+ years and no issues whatsoever, decided that just as I had grown into asthma I had grown out of it.

This year I went back to NZ April-July and it hit me the worst of my life, from the very first day till the last - i went for 6mths work but called it quits at 3. Granted it was winter, and it was quite a shock going from high 20s to low 30s to daily temps of 8-9C and overnight lows of minus 2 (but no, I was not sleeping outside).

Back thru Bangkok and it's gone again. Arrived home 4 weeks ago and not a hint of breathing issues.

Simply put, seems I have a reaction against the climate/cold air. Allergic to NZ! I have to go back briefly early 2015 and am dreading it - can't see any way of avoiding the same problems I've just had; I've felt so much better overall minus the medication - and stress that comes with relying on it.

Can't be alone, surely? Anyone else had similar exp returning to a cooler eg UK climate? And how did you manage it?

thanks

I'm from the UK and this is virtually the same as I've experienced. My parents always said that the onset of my asthma was shortly after I was born (am now in my 40s); my schooling was affected and my parents told me that there were a number of times that they thought I wasn't going to make it whilst having attacks. The family doctor was pretty useless though and was always reluctant to send me to hospital.

They then tried intal (spinhaler) but this didn't seem to have much effect and I remember being simultaneously prescribed some type of tranquilizer which was used in conjunction whenever I had an attack.

Asthma took away a lot of my childhood and in the late 70's I ended up as an emergency case in the local hospital. But this is when my life totally changed - they gave me Ventolin for the first time - and it has saved my life. That and the preventer, Becotide, enabled me to have a new life - I found out that I could play football and cricket for the first time and started doing active outdoor activities.

Long story short, I'm now living here in Thailand and I need Ventolin far less often than I would if I were in the UK and I live in a pretty polluted city here. I even completed my first ever mini-marathon a couple of weeks ago because my breathing is significantly better here than in the UK.

I admit that I don't use my Becotide as often as I should but my Ventolin inhalers now last me a far longer time compared to England. My condition is far more stable here and I just hope that I can afford to stay!

Nevertheless, my Ventolin inhaler is my constant companion and probably always will be.

[theguyfromanotherforum]

Hell, everyone seems to be better off in Thailand while I seem to get worse.

It could be because I live in Bangkok/

[thaimite]

Hi

Interested in people's experiences with asthma when changing countries/climates

I (from NZ) developed asthma last teens - years of inhalers, nebulisers and overnighters in hospital.

Except for the years I spent in my 20s living in Australia - Sydney and perth where asthma became a rare event for me, and just the odd Ventolin 'as required'

I've been a competitive distance swimmer and triathlete at national level, though always had the trusty Ventolin at hand 'in case'. Healthy living, even a dietitian!

On my first holiday to Thailand the asthma more than faded, it practically disappeared. I was running and cycling like I'd always wanted to, restrictions gone. First time ever i felt I could give a genuine 100% with no excuses. And many thoughts of 'if only' when looking at competition results that could have been better

Returned to Thailand for 5+ years and no issues whatsoever, decided that just as I had grown into asthma I had grown out of it.

This year I went back to NZ April-July and it hit me the worst of my life, from the very first day till the last - i went for 6mths work but called it quits at 3. Granted it was winter, and it was quite a shock going from high 20s to low 30s to daily temps of 8-9C and overnight lows of minus 2 (but no, I was not sleeping outside).

Back thru Bangkok and it's gone again. Arrived home 4 weeks ago and not a hint of breathing issues.

Simply put, seems I have a reaction against the climate/cold air. Allergic to NZ! I have to go back briefly early 2015 and am dreading it - can't see any way of avoiding the same problems I've just had; I've felt so much better overall minus the medication - and stress that comes with relying on it.

Can't be alone, surely? Anyone else had similar exp returning to a cooler eg UK climate? And how did you manage it?

thanks

I'm from the UK and this is virtually the same as I've experienced. My parents always said that the onset of my asthma was shortly after I was born (am now in my 40s); my schooling was affected and my parents told me that there were a number of times that they thought I wasn't going to make it whilst having attacks. The family doctor was pretty useless though and was always reluctant to send me to hospital.

They then tried intal (spinhaler) but this didn't seem to have much effect and I remember being simultaneously prescribed some type of tranquilizer which was used in conjunction whenever I had an attack.

Asthma took away a lot of my childhood and in the late 70's I ended up as an emergency case in the local hospital. But this is when my life totally changed - they gave me Ventolin for the first time - and it has saved my life. That and the preventer, Becotide, enabled me to have a new life - I found out that I could play football and cricket for the first time and started doing active outdoor activities.

Long story short, I'm now living here in Thailand and I need Ventolin far less often than I would if I were in the UK and I live in a pretty polluted city here. I even completed my first ever mini-marathon a couple of weeks ago because my breathing is significantly better here than in the UK.

I admit that I don't use my Becotide as often as I should but my Ventolin inhalers now last me a far longer time compared to England. My condition is far more stable here and I just hope that I can afford to stay!

Nevertheless, my Ventolin inhaler is my constant companion and probably always will be.

Your experience seems to be almost identical to mine.

Born in the UK and have had asthma since shortly after borth (I am told 2 weeks). I havce a very disrupted childhood and many severe attacks and this continued until I left the UK to work in HK at the age of 40. In the UK Spin halers worked well for me if they were the Orange rather than the Yellow capsules.

Whilst in Asia Although I still needed the odd ventolin it was nothing like before. Since then, working in HK, here and other countries in the region and then to the middle east my asthma has been much better and more of a minor nuisance than anything else. Severe attacks are very few and far between. (maybe once or twice in 10 years) HOWEVER I am now living in a very rural area near to Ubon and my asthma is the worst it has been for many many years. If I leave here and go to some big polluted city even for only a day, it is much better. Obviously there is something in the air here that effects me and I have tried everything to narrow it down with no success.

I recently returned to the UK for the first time in almost 20 years and whilst my asthma was not bad it certainly was not as good as I have come to expect (except while here in Ubon )

[Sheryl]

Hell, everyone seems to be better off in Thailand while I seem to get worse.

It could be because I live in Bangkok/

Indeed yes. Many people have respiratory problems that do not improve until they move somewhere with less pollution. Have you had the chance to spend an extended period elsewhere in the country to see if it helps?

[theguyfromanotherforum]

When I go to the beach it does help.

[theguyfromanotherforum]

Another proof (most) doctors are idiots and can not be trusted.

You have to do your own research.

as I explained I have been struggling with Asthma for 2 years now. Yesterday I went to Vejthani and decided to also see ear nose throat specialist besides lung specialist. The woman looked inside my nose and right away she saw something, but her English was not that great, but she tried hard to explain that I have a big problem. I suspect I have nasal polyps. She wanted to give me antihistamines which I refused, but instead gave Nasonex. Sure enough after 2 days of sniffing, my "asthma" has improved a lot to the point I am not sure I should be using any inhalers whatsoever.

Ok, since I was a child I always had chronic sinusitis, but it never really bugged me and I sure never had any asthma symptoms. I also have almost no allergies. It occurred to be many times that this could be all coming from my sinuses, but doctors in both Canada and Thailand kept giving me Symbicort, Singulair and then would not believe me when the medication did not work.

Total nonsense and complete idiots.

[Thanyaburi Mac]

Another bump and update.

My adult onset asthma doc suggested that I give SERETIDE EVOHALER 25/50 a try, 120 metered actuations, cost at the pharmacy I trade at in the Rangsit Market is baht 600.

Bought it, now just waiting for the SYMBICORT I already have to run out about mid-July. Symbicort 120 does runs baht 1,380.

Mac

[theguyfromanotherforum]

Now that this thread is bumped, my comment above was wrong. Breathing difficulties due to reflux.

I wonder if there is such thing as adult onset asthma? Breathing difficulties seem due to weakening LES which comes with age. I remember dr. Oz show where he said that if you have trouble breathing in instead of breathing out you most likely have silent reflux, not asthma.

[Sheryl]

There definitely is such a thing as adult-onset asthma, and it is usually linked to allergies.

[NickJ]

I lived and worked in the middle of Bkk for well over a decade. Lived in a house most of that time. So was at street level. I developed asthma. I prefered taking tablets rather than using an inhaler. I also used and still use NAC long.

[sinbin]

I've been diagnosed as being Asthmatic. I'm in my early 60's and feel that the meds prescribed don't work. I think I can do without any meds as I don't feel it's affecting my health and I feel I can live with it. All I get is wheezing, coughing, sinus, coughing between 7am and 3pm. Thereafter and during the night no problems. Advice appreciated.

Edited June 22, 2016 by sinbin

[Searat7]

I lived in Silom for the better part of 11 years. During the last 4 years I developed asthma which was successfully controlled by a Seretide inhaler....the sinus problems I had were worse...I had to wear a carbon mask on the street and sometimes had migraine headaches if I spent too much time outside. When I live in USA I have no asthma problem.

[HooHaa]

Been using Ventolin/salbuteramol regularly for 30 years. Ironically now I only need it when I realize I'm out.

I recently lost 10 kilos bringing me back to the 68 kilos I was when I got here. A side benefit was an almost complete disappearance of asthma symptoms, unless as I said I realize the inhaler is lost or empty.

[sinbin]

I've been diagnosed as being Asthmatic. I'm in my early 60's and feel that the meds prescribed don't work. I think I can do without any meds as I don't feel it's affecting my health and I feel I can live with it. All I get is wheezing, coughing, sinus, coughing between 7am and 3pm. Thereafter and during the night no problems. Advice appreciated.

Can I just bump the above post? The meds I'm on are Seretide Accuhaler, Prednisolone 5mg, Cetirizine 10mg and Theophlline .

[Sheryl]

Nobody here is going to be able to tell you if you can stop these meds - that needs to be assessed by a good pulmonologist based on tests of your pulmonary function.

Be advised that if you were to stop these meds you would have to taper off very gradually and under medical supervision. Stopping the steroids in particular can cause severe flare-up of asthma, possibly even to a life threatening degree.

Best I can do is suggest a doctor. Are you in Bangkok?

[sinbin]

Nobody here is going to be able to tell you if you can stop these meds - that needs to be assessed by a good pulmonologist based on tests of your pulmonary function.

Be advised that if you were to stop these meds you would have to taper off very gradually and under medical supervision. Stopping the steroids in particular can cause severe flare-up of asthma, possibly even to a life threatening degree.

Best I can do is suggest a doctor. Are you in Bangkok?

Thank you for your reply Sheryl. I live a 4-5 hour drive away from BKK so the last thing I want is to go there. Hence my reason to try and find someone in a similar situation as myself whereby their Asthma meds do not work. I've been seeing doctors now for about 7-8 months and not once have I had a 'Pulmonary Function Test'. Initially my wheezing and cough was put down to Chronic Bronchitis and I was treated accordingly. The meds didn't work and I had a chest X-ray. I had Pneumonia. Antibiotics cleared that up but the wheezing persisted. Once again treated for Chronic Bronchitis.

I then changed hospitals. That was when I was told I had Asthma and given meds for it. Been on Asthma meds now for 3-4 months and nothing. I don't get attacks of breathing difficulties and never have. I just get wheezing etc between 7am and 3pm daily. All other times nothing. It doesn't cause me any life threatening problems and doesn't restrict my lifestyle, in that I cycle regular. A recommended activity for someone with Asthma, if Asthma is what I have?

Once again, thanks for you reply Sheryl. I've been off the steroids/meds for a few days now and nothing has changed.

Edited June 29, 2016 by sinbin

[theguyfromanotherforum]

Nobody here is going to be able to tell you if you can stop these meds - that needs to be assessed by a good pulmonologist based on tests of your pulmonary function.

Be advised that if you were to stop these meds you would have to taper off very gradually and under medical supervision. Stopping the steroids in particular can cause severe flare-up of asthma, possibly even to a life threatening degree.

Best I can do is suggest a doctor. Are you in Bangkok?

Thank you for your reply Sheryl. I live a 4-5 hour drive away from BKK so the last thing I want is to go there. Hence my reason to try and find someone in a similar situation as myself whereby their Asthma meds do not work. I've been seeing doctors now for about 7-8 months and not once have I had a 'Pulmonary Function Test'. Initially my wheezing and cough was put down to Chronic Bronchitis and I was treated accordingly. The meds didn't work and I had a chest X-ray. I had Pneumonia. Antibiotics cleared that up but the wheezing persisted. Once again treated for Chronic Bronchitis.

I then changed hospitals. That was when I was told I had Asthma and given meds for it. Been on Asthma meds now for 3-4 months and nothing. I don't get attacks of breathing difficulties and never have. I just get wheezing etc between 7am and 3pm daily. All other times nothing. It doesn't cause me any life threatening problems and doesn't restrict my lifestyle, in that I cycle regular. A recommended activity for someone with Asthma, if Asthma is what I have?

Once again, thanks for you reply Sheryl. I've been off the steroids/meds for a few days now and nothing has changed.

I got the exact same thing after getting sick. Doctors were insisting it was asthma, but meds were not helping at all.

You may be taking the meds for nothing and you could have reflux like I do.

Only through doing the research myself did I eventually figure out silent reflux, so I went to a GI.

I think this is where you should go next.

If you do have reflux, asthma meds may make it worse.

[theguyfromanotherforum]

double post

Edited June 29, 2016 by theguyfromanotherforum

[NickJ]

Google NAC long. its not a drug and it helps. .....

[Sheryl]

Nobody here is going to be able to tell you if you can stop these meds - that needs to be assessed by a good pulmonologist based on tests of your pulmonary function.

Be advised that if you were to stop these meds you would have to taper off very gradually and under medical supervision. Stopping the steroids in particular can cause severe flare-up of asthma, possibly even to a life threatening degree.

Best I can do is suggest a doctor. Are you in Bangkok?

Thank you for your reply Sheryl. I live a 4-5 hour drive away from BKK so the last thing I want is to go there. Hence my reason to try and find someone in a similar situation as myself whereby their Asthma meds do not work. I've been seeing doctors now for about 7-8 months and not once have I had a 'Pulmonary Function Test'. Initially my wheezing and cough was put down to Chronic Bronchitis and I was treated accordingly. The meds didn't work and I had a chest X-ray. I had Pneumonia. Antibiotics cleared that up but the wheezing persisted. Once again treated for Chronic Bronchitis.

I then changed hospitals. That was when I was told I had Asthma and given meds for it. Been on Asthma meds now for 3-4 months and nothing. I don't get attacks of breathing difficulties and never have. I just get wheezing etc between 7am and 3pm daily. All other times nothing. It doesn't cause me any life threatening problems and doesn't restrict my lifestyle, in that I cycle regular. A recommended activity for someone with Asthma, if Asthma is what I have?

Once again, thanks for you reply Sheryl. I've been off the steroids/meds for a few days now and nothing has changed.

From what you say, you may have been misdiagnosed. You need to see a better doctor. Where do you live? (4-5 hours from Bangkok could be many places).

And if the wheezing is only between 7 to 3 pm, could be allergy. Where are you during those hours and what in your environment or intake or activity changes after 3 pm? If nothing changes and it is just that you wake up with this and it gradually subsides as the day passes, another possibility would be that the problem is actually cardiac in origin. Either way, would benefit from seeing a good specialist.

Stopping steroids cold can cause serious problems regardless of whether you have asthma or needed to be on them in the first place. They suppress normal adrenal function and that takes some time to come back. A lot depends on the dose and how long you were on it.

[sinbin]

From what you say, you may have been misdiagnosed. You need to see a better doctor. Where do you live? (4-5 hours from Bangkok could be many places).

And if the wheezing is only between 7 to 3 pm, could be allergy. Where are you during those hours and what in your environment or intake or activity changes after 3 pm? If nothing changes and it is just that you wake up with this and it gradually subsides as the day passes, another possibility would be that the problem is actually cardiac in origin. Either way, would benefit from seeing a good specialist.

Stopping steroids cold can cause serious problems regardless of whether you have asthma or needed to be on them in the first place. They suppress normal adrenal function and that takes some time to come back. A lot depends on the dose and how long you were on it.

Thank you for all replies. I don't think it's 'Silent Reflux' as I don't have most of those symptoms. But I could be wrong. Sheryl, I live in Buriram Province. As far as I was told, I was already seeing the best Asthma specialist in the area and if I went somewhere else I'd just end up with the same Doc as I'm all ready seeing, private or government. With regards to an 'Allergy', initially I was taking meds for that but no response also. As for the time frame of '7 til 3', it doesn't matter where I am the symptoms are the same. I live in a rural area and it's not dusty due to the rains. It's the most baffling thing I find in that it doesn't occur outside that period.

NickJ, I Googled 'NAC long' and I will give that a go for a month as it sounds impressive. If after that I still have my condition then I'll have to think again. Thanks.