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Asthma Injections...BTDT? (Read 45 times)

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rectumdamnnearkilledem

    A year ago I discontinued my monthly maintenance allergy shots after 6 years. In the past year my asthma has gradually worsened to pre-shots levels (or worse). I'm also short a lung lobe, due to metastatic cancer. So my allergist is putting me on the highest dose Symbicort (the stuff formulated for COPD patients).

     

    I'm kinda not real thrilled about this. Radiation treatments and chemo have left me with osteopenia. Inhaled steroids can compound the bone loss, apparently. I also cannot do HRT, so I've been in menopause since 44 (4 years).

     

    I don't know an awful lot about the newer monoclonal antibody asthma injections, but on paper it sounds like they might be a doable option. It sounds like insurance companies drag their feet on covering them, fairly often, but I'm guessing they wouldn't want to pay to treat a broken hip in a middle-aged woman, either.

    '21 Goals:

    No published goals...not going to jinx things • $500

     

    Getting the wind knocked out of you is the only way to

    remind your lungs how much they like the taste of air.    

         ~ Sarah Kay

    darkwave


    Mother of Cats

      No idea about the monoclonal antibody treatments.

       

      FWIW, I am on the biologic drug Xolair for my asthma - I get two injections every 28 days.  It has been an absolute game changer for me.  That being said, there is some indication of an increased incidence of cancer with it (though the connection has not been proven) so that might contradict it for you.

       

      Regarding inhaled corticosteroids - I myself am on the border between osteopenia and osteoporosis (vary between -2.3 to -2.6) and have been since long before I started on inhaled corticosteroids.  I have not seen any worsening of my bone density since starting inhaled corticosteroids (currently Breo and Qvar; I was on Advair in the past).  My primary care doctor, rheumatologist, and asthma doctor have all reassured me that inhaled corticosteroids are very low risk for bone density - it's systematic corticosteroids (i.e. oral) that are the concern.

       

      Of course, my doctors are not your doctors.  Just offering as a data point.

       

      Good luck!

      Everyone's gotta running blog; I'm the only one with a POOL-RUNNING blog.

       

      And...if you want a running Instagram where all the pictures are of cats, I've got you covered.

      zoom-zoom


      rectumdamnnearkilledem

        That makes me SO wish that I'd had a baseline bone density scan BEFORE menopause and cancer treatments. I'd really like to know where I was before my 44th birthday.

        '21 Goals:

        No published goals...not going to jinx things • $500

         

        Getting the wind knocked out of you is the only way to

        remind your lungs how much they like the taste of air.    

             ~ Sarah Kay

        cinnamon girl


          Xolair is a monoclonal antibody - so I'll leave it to you two to discuss.

           

          I have asthma - I was the only kid in gym class who couldn't make it around the football field. I had allergy shots for many years as a kid. I was diagnosed with severe osteopenia in my late 20s and was told I had the bones of an 80 yof. They wanted to put me on an entire cocktail of medications to try and increase my bone density - all of which I refused. Thank god I never started fosamax back then. I am a pharmacist (currently working primarily in oncology)  All I take for my asthma is albuterol inhaler before my runs and any other time I struggle breathing. Maybe I could breathe better if I took different medications but I breathe well enough to function well enough. I am nearing post-menopausal stage so I anticipate any day I will just crumble to pieces - but until then I'm going to continue enjoy running 50-60 mile weeks. I have yet to have a stress fracture. I prefer to keep things simple and not take steroids even if inhaled. But that's just me. I'm a lightweight so I don't have much more added stress impact on my bones than needed, and I have had a diet high in dairy fat and get tons of natural Vitamin D over the past 10 years, I think that has been hugely beneficial but I don't really know.

           

          Insurance is likely to push back and make you jump through hoops I assume, but I've never worked a day in retail so I don't know that end.

           

          zoom-zoom running missing a lobe and with metastatic cancer - 💪 I assume you've had thorough work up of your worsening shortness of breath and that it's been attributed to asthma.


          Train SMART

            If asthma is severe then Symbicort is indicated and better than oral steroids. Have you tried Singulair? I only ask because my experience is that if your astma is leukotriene triggered then it can be a game changer. I think 1/3 of asthmatics notice profound effects, 1/3 notice some benefit and 1/3 notice no benefit. It is a clean drug so worth a 2 month trial if you haven't.

             

            I have asthma and allergies all my life. I have come to realize if your immune system is compromised you will struggle more. One natural product that has been a game changer for me is Quercetin and Bromelain combined on empty stomach. Also take Curcumin. I am not making claims and you can Google Quercetin but noticable benefits since I started it 25 years ago. My allergies are barely noticable these days other than some itchy eyes. I only take Albuterol before races and hard runs. One puff on runs and 2 before races.

             

            On a side note, Vitamin D, K2 and magnesium need to be part of the equation to keep bones strong.

            THE RECOVERY MAN. Run Injury Free. www.smartapproachtraining.com

            Luciplay


              This is an interesting topic to discuss. I learned a lot, thank you.

              darkwave


              Mother of Cats

                Xolair is a monoclonal antibody - so I'll leave it to you two to discuss.

                 

                I have asthma - I was the only kid in gym class who couldn't make it around the football field. I had allergy shots for many years as a kid. I was diagnosed with severe osteopenia in my late 20s and was told I had the bones of an 80 yof. They wanted to put me on an entire cocktail of medications to try and increase my bone density - all of which I refused. Thank god I never started fosamax back then. I am a pharmacist (currently working primarily in oncology)  All I take for my asthma is albuterol inhaler before my runs and any other time I struggle breathing. Maybe I could breathe better if I took different medications but I breathe well enough to function well enough. I am nearing post-menopausal stage so I anticipate any day I will just crumble to pieces - but until then I'm going to continue enjoy running 50-60 mile weeks. I have yet to have a stress fracture. I prefer to keep things simple and not take steroids even if inhaled. But that's just me. I'm a lightweight so I don't have much more added stress impact on my bones than needed, and I have had a diet high in dairy fat and get tons of natural Vitamin D over the past 10 years, I think that has been hugely beneficial but I don't really know.

                 

                Insurance is likely to push back and make you jump through hoops I assume, but I've never worked a day in retail so I don't know that end.

                 

                zoom-zoom running missing a lobe and with metastatic cancer - 💪 I assume you've had thorough work up of your worsening shortness of breath and that it's been attributed to asthma.

                 

                Interesting on the Xolair being a Monoclonal Antibody - thanks for the clarification!

                 

                Cinnamon - very interesting to read your thoughts on Fosamax.  I was strongly encouraged to go on it in my 30s when one of my Dexa scans crossed the magic line into osteoporosis.  I don't have your knowledge, but I was really worried about the points that a) it worked by slowing bone turnover and b) was indicated for women much older and less active than myself.

                 

                My doctor and I agreed to watch and wait, and fortunately I've not had any fractures that would indicate a bone strength issue.  It's good to know, based on your comments, that you made a similar call.

                Everyone's gotta running blog; I'm the only one with a POOL-RUNNING blog.

                 

                And...if you want a running Instagram where all the pictures are of cats, I've got you covered.

                zoom-zoom


                rectumdamnnearkilledem

                   

                   zoom-zoom running missing a lobe and with metastatic cancer - 💪 I assume you've had thorough work up of your worsening shortness of breath and that it's been attributed to asthma.

                   

                  The shortness of breath wasn't super noticeable until allergy season kicked-in, but I think it's been there for a while. There's always a fair amount of "is my breathing crap because of asthma or the missing lobe or will my next CT scan be horrifying...?" I've been NED since my lobectomy nearly 2 years ago. I'm still on CT scan and bloodwork surveillance for another year or two. I really regret discontinuing allergy shots, but after 6 years it seemed like the monthly maintenance shots weren't worth the risk of sitting in a waiting area when we have been a Covid hot-spot off-and-on.

                   

                  I'm happy to hear that others are not jumping at the bone-building drugs. My recommendation was to keep taking Calcium + D3 and continue the good impact of running...or, in my case, "running."

                  '21 Goals:

                  No published goals...not going to jinx things • $500

                   

                  Getting the wind knocked out of you is the only way to

                  remind your lungs how much they like the taste of air.    

                       ~ Sarah Kay

                  zoom-zoom


                  rectumdamnnearkilledem

                    If asthma is severe then Symbicort is indicated and better than oral steroids. Have you tried Singulair? I only ask because my experience is that if your astma is leukotriene triggered then it can be a game changer. I think 1/3 of asthmatics notice profound effects, 1/3 notice some benefit and 1/3 notice no benefit. It is a clean drug so worth a 2 month trial if you haven't.

                     

                    I have asthma and allergies all my life. I have come to realize if your immune system is compromised you will struggle more. One natural product that has been a game changer for me is Quercetin and Bromelain combined on empty stomach. Also take Curcumin. I am not making claims and you can Google Quercetin but noticable benefits since I started it 25 years ago. My allergies are barely noticable these days other than some itchy eyes. I only take Albuterol before races and hard runs. One puff on runs and 2 before races.

                     

                    On a side note, Vitamin D, K2 and magnesium need to be part of the equation to keep bones strong.

                     

                    Yup, I tried Singulair way back when I was first running. Unfortunately it was like a sugar pill. My son has been on it and had no success, either. Bummer, because the idea of taking a pill that would help allergies AND asthma is sort of dreamy.

                     

                    A friend of mine swears by quercetin for his allergies. I may have to try that combo, especially as we approach peak allergy Hell time.

                    '21 Goals:

                    No published goals...not going to jinx things • $500

                     

                    Getting the wind knocked out of you is the only way to

                    remind your lungs how much they like the taste of air.    

                         ~ Sarah Kay


                    Train SMART

                      Yeah, be diligent with Quercetin dosing. I did 1500 mg a day for first month. I now do 1000 mg daily as maintenance. Bromelain helps absorption. Quercetin many other benefits too.

                       

                      Here are also a couple more opinions by me on bone health. I was in this industry for 16 years. I actually sold Fosamax and then worked in fracture healing many years. Ortho docs sometimes overheard me talking about Vitamin K2 and Magnesium to patients and called me into there offices to discuss. I remember one doc telling me, “I overheard your conversation with &#%€ and was very surprised with your knowledge about bone health and importance of Magnesium and K2. I have never heard of K2. Please share with me”.

                       

                      More than likely your doctors are unaware as well. Everyone knows about K1 found in Kale etc. not K2. K2 has other benefits. American diets are often low in K2 and magnesium while our whole body is saturated with calcium but we have a challenge keeping it and getting it to the bone. This is where synergism of all these nutrients come in to play for optimal bone health and heart health as well. Here is a general article that can help. 
                      https://www.nutritionaloutlook.com/view/bone-health-superheroes-magnesium-collagen-and-vitamin-k2

                       

                      I wish you well.

                      THE RECOVERY MAN. Run Injury Free. www.smartapproachtraining.com

                      zoom-zoom


                      rectumdamnnearkilledem

                        I'd have to double-check, but I think what's in my multi-vit is K2...I had read something re: calcium absorption and K2 a few years back.

                        '21 Goals:

                        No published goals...not going to jinx things • $500

                         

                        Getting the wind knocked out of you is the only way to

                        remind your lungs how much they like the taste of air.    

                             ~ Sarah Kay

                        DavePNW


                          We need an asthmatics forum! I also have had it basically my whole life, and got doctors' notes to excuse me from running the mile in gym class all the way through high school. Which is fun to tell people who didn't know me then, but know me now running marathons.

                           

                          I had never really heard about the injections, so that is pretty interesting.

                           

                          I used to have periodic allergy flare-ups triggered by who knows what. But several years ago, I started taking both Singulair (as generic Montelukast) and Zyrtec every day, year round. My allergy problems have pretty much vanished, and I wish I'd done this a long time ago. Even helped my sleep, since a lot of my sleep disruptions (sadly not all) were allergy-related. I feel like I could probably drop one of these two drugs, but my doc says it makes some sense to take both and plenty of people do it, plus I'm reluctant to mess with what works.

                           

                          I actually started Singulair/Montelukast in hopes of helping my asthma, but it did nothing. And that was mainly looking for a replacement for Advair, when my insurance changed and it started costing $375. The other related drugs e.g. Symbiocort and Breo, were a similar price. However Breo was new at that time, and I got a coupon for $10 per refill for a year. I was able to keep getting that for a few years, but now it's no longer available so it's back up to $380ish. However Advair has now come down to $137, because they finally came out with a generic. So, I'm back on that. I haven't taken any of these year round; I start on them when I have a flare-up, use them for maybe a month or three, then go back off. Don't want to waste stuff that's so precious; breathing gets expensive. 'Murica!

                           

                          I too take Albuterol before every run. Once in a while I find I need it in the evening as well, which is usually an indicator that I need to get back on the Advair. Could I try running without it? Maybe. On the rare occasion I forget, I notice it about a half mile in, but I can still finish the run. The comment about taking one puff before a run and two before a race - I always take two puffs, and 3-4 before a race. But maybe I should try cutting back and saving some money. That stuff is not super-expensive, but more than it should be considering it's been around since I was a kid.

                          Dave

                          zoom-zoom


                          rectumdamnnearkilledem

                            We need an asthmatics forum! I also have had it basically my whole life, and got doctors' notes to excuse me from running the mile in gym class all the way through high school. Which is fun to tell people who didn't know me then, but know me now running marathons.

                             

                            I wasn't diagnosed until 33, when I was doing C25k. My mom apologizes for not having my allergies and breathing addressed as a teenager. Track was rough. Races were fine, as I ran the 100 and 200. But training...that was rough. Distances were never a good time.

                            '21 Goals:

                            No published goals...not going to jinx things • $500

                             

                            Getting the wind knocked out of you is the only way to

                            remind your lungs how much they like the taste of air.    

                                 ~ Sarah Kay

                            Luciplay


                              This thread is really good. I learned a lot from here.