Question:

Jenn Santa Clara, CA

So Jenn, just how big are those puppys? And do they bounce nice when you run?

Response:

Thank you to everyone who responded. I gravitated immediately to "I’m just not pushing it enough." At the end of my marathon training last year, I was diagnosed with persistent asthma and to be honest, the wheezing and coughing scare me. But I ran hard today for three miles and was able to push it to 9 min/miles. Quite obviously, I’ve let my fear of not being able to breathe slow me down. Now that I know I am easily capable of more, I’ll take all of the great advice here and put it into action. Best, Lynne Durham Benton Harbor, Michigan

– Hide quoted text — Show quoted text – Hi everyone. Okay, so I know that track work is one way to run faster, and it’s one I can do. But I’ve also heard that running with people who are faster than you are is another way to run faster. My question is: how much faster than I am should they be for me to benefit? I’ve tried running with a group, and within a couple of city blocks their slowest runners had already dropped me (I was averaging 11 min/mile over 8.5 miles). I’ve been invited to run with women who are planning on 10 min miles. Is that still to fast for me to aim for immediately? Trying to get faster! Lynne Durham Benton Harbor, Michigan

Response:

I’m a new runner and have a somewhat related question.  I currently run only 2 miles (and walk a half mile before and after).  I’ve read that I should only increase my mileage about 10% every two weeks.  In

How frequently do you do this ? Usually, I’d recommend a slower rate of increase, about 10% every 3 weeks, but if your milage is very low (less than 10 miles per week) you could bring it up a little faster by adding more sessions each week. the meantime, I expect my speed to improve, currently I probably average about 11 minutes per mile.   (I am also an experienced cyclist, so I already have a decent level of fitness.)

Yes, I’d expect that your speed would improve quite a lot even if your general fitness is quite good. Specific adaptions have an enormous effect. While running about the same distances over the weeks (with small increases as per above), would it be better for me to run at a moderate heart rate and hope that over time my speed picks up, or is it better to run at a faster speed and higher heart rate and hope that over time my heart rate drops so that the effort becomes less? Obviously, if I want to run longer miles I need to be able to do them at a sustainable heart rate, but at my current short distance, I can get by with a higher heart rate.  

That’s one of the problems with doing short runs. You’ll get better gains in your endurance from doing longer runs at an easier pace. However, you need to increase distance gradually. I’m just not sure which method is better.  It sounds like Donovan is recommending the lower heart rate method.  

Yes. More intense training carries a greater risk of injury. Even when you get more experience, it’s better to do most of your training at aerobic intensity. I’m just worried that I’ll develop a "comfort level" at too low a speed and have trouble breaking out of it later.

I think you will develop worse habits by trying to do your training runs too quickly. Most beginners tend to perform their training runs too quickly, and their speed workouts too slowly.  Attempting to run fast on your training runs is *not* going to adequately prepare you to properly perform a speed workout. If you are still concerned about this, I think the best preparation for getting familiar with the effort level that speed work requires, I’d suggest finding a good hill to do reps on. If your usual pace for 2 miles is 11:00 pace, then running up a moderately steep hill will force you to increase your effort level well beyond your 2 mile pace. Even then, I would not recommend doing this more than once a week. Cheers, — Donovan Rebbechi http://pegasus.rutgers.edu/~elflord/

Response:

Donovan, Thanks for your replies.  I only run about 3 times a week, because I’m busy cycling on most of the other days (and sometimes I do both).  So far my idea has been that on one of the run days I will try to run faster, and the other two days I will run at a comfortable level and not worry about my speed much.  I am looking forward to increasing my mileage and incorporating walking recovery periods into my runs to help lengthen them, but I don’t want to injure myself, so I’m increasing the mileage slowly. Unfortunately I don’t have a hill I can reach on foot, so I’ll let that wait until I get serious enough to actually want to fire up a vehicle in order to run in a specific place.  For now I just run around my neighborhood with our two dogs.  It’s exactly 1/2 mile around my block, so that gives me an easy option for a known mileage. Jenn Santa Clara, CA – Hide quoted text — Show quoted text – I’m a new runner and have a somewhat related question.  I currently run only 2 miles (and walk a half mile before and after).  I’ve read that I should only increase my mileage about 10% every two weeks.  In How frequently do you do this ? Usually, I’d recommend a slower rate of increase, about 10% every 3 weeks, but if your milage is very low (less than 10 miles per week) you could bring it up a little faster by adding more sessions each week. the meantime, I expect my speed to improve, currently I probably average about 11 minutes per mile.   (I am also an experienced cyclist, so I already have a decent level of fitness.) Yes, I’d expect that your speed would improve quite a lot even if your general fitness is quite good. Specific adaptions have an enormous effect. While running about the same distances over the weeks (with small increases as per above), would it be better for me to run at a moderate heart rate and hope that over time my speed picks up, or is it better to run at a faster speed and higher heart rate and hope that over time my heart rate drops so that the effort becomes less? Obviously, if I want to run longer miles I need to be able to do them at a sustainable heart rate, but at my current short distance, I can get by with a higher heart rate.   That’s one of the problems with doing short runs. You’ll get better gains in your endurance from doing longer runs at an easier pace. However, you need to increase distance gradually. I’m just not sure which method is better.  It sounds like Donovan is recommending the lower heart rate method.   Yes. More intense training carries a greater risk of injury. Even when you get more experience, it’s better to do most of your training at aerobic intensity. I’m just worried that I’ll develop a "comfort level" at too low a speed and have trouble breaking out of it later. I think you will develop worse habits by trying to do your training runs too quickly. Most beginners tend to perform their training runs too quickly, and their speed workouts too slowly.  Attempting to run fast on your training runs is *not* going to adequately prepare you to properly perform a speed workout. If you are still concerned about this, I think the best preparation for getting familiar with the effort level that speed work requires, I’d suggest finding a good hill to do reps on. If your usual pace for 2 miles is 11:00 pace, then running up a moderately steep hill will force you to increase your effort level well beyond your 2 mile pace. Even then, I would not recommend doing this more than once a week. Cheers,

Response:

Jog up to the biggest, dirtiest, hairiest, biker you can find, and call him a quiche eating sissy.  You’ll find yourself running faster than ever before.

Nah, even an 11" pace would put him beyond bottle throwing distance in a few seconds and that would exceed the attention span of the individual you describe. When you do speed work the payoff comes weeks later. Simply measuring more and closer will make you focus on your form and effort. Just do something once or twice a week or race and you will improve.

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Is increasing speed what you need, i.e., can you keep up with the people you want for a short distance? Or, is it the ability to run at a faster pace before going into oxygen debt? I haven’t been following this thread so don’t know what has been suggested before. jack

Response:

Hi everyone. Okay, so I know that track work is one way to run faster, and it’s one I can do. But I’ve also heard that running with people who are faster than you are is another way to run faster.

It can be, but running all-out for long runs is very stressful and can only be done sparingly. The best way to do this is just enter a race.  The best way to run hard in a group is to do speed work with people who are at about your level of ability. This usually leads to everyone working harder. You can do some sort of quality work once a week if you find it enjoyable, but it’s not necessary at this stage. If you do want to do this, I’d recommend hills.  You will get quite a boost both physiologically and psychologically from conquering a tough hill. Slower beginners tend to really struggle on hills, so it’s a good entry point into quality training. slowest runners had already dropped me (I was averaging 11 min/mile over 8.5 miles).

If you’re running at 11 minutes per mile, you are probably some way below your genetic potential — with some training, you will probably surpass this pace by a large margin. I think it’s premature to worry about trying to run as fast as you can at this stage. I’d suggest entering a race to get a record of your current performance level, and then focus on easy running at "conversational pace". The most important factor in your training for now is consistency. Log all your milage, and be consistent. Don’t worry about doing high milage, high distance or high frequency, but be consistent. If you’ve been running 4 days and 15 miles a week, try to stick to that closely — make sure you get those 4 workouts and 15 miles in but don’t try to get in 6 days and 25 miles. Cheers, — Donovan Rebbechi http://pegasus.rutgers.edu/~elflord/

Response:

I’m a new runner and have a somewhat related question.  I currently run only 2 miles (and walk a half mile before and after).  I’ve read that I should only increase my mileage about 10% every two weeks.  In the meantime, I expect my speed to improve, currently I probably average about 11 minutes per mile.  (I am also an experienced cyclist, so I already have a decent level of fitness.) While running about the same distances over the weeks (with small increases as per above), would it be better for me to run at a moderate heart rate and hope that over time my speed picks up, or is it better to run at a faster speed and higher heart rate and hope that over time my heart rate drops so that the effort becomes less? Obviously, if I want to run longer miles I need to be able to do them at a sustainable heart rate, but at my current short distance, I can get by with a higher heart rate.  I’m just not sure which method is better.  It sounds like Donovan is recommending the lower heart rate method.  I’m just worried that I’ll develop a "comfort level" at too low a speed and have trouble breaking out of it later. Thanks, Jenn Santa Clara, CA – Hide quoted text — Show quoted text – It can be, but running all-out for long runs is very stressful and can only be done sparingly. The best way to do this is just enter a race.  The best way to run hard in a group is to do speed work with people who are at about your level of ability. This usually leads to everyone working harder. You can do some sort of quality work once a week if you find it enjoyable, but it’s not necessary at this stage. If you do want to do this, I’d recommend hills.  You will get quite a boost both physiologically and psychologically from conquering a tough hill. Slower beginners tend to really struggle on hills, so it’s a good entry point into quality training. slowest runners had already dropped me (I was averaging 11 min/mile over 8.5 miles). If you’re running at 11 minutes per mile, you are probably some way below your genetic potential — with some training, you will probably surpass this pace by a large margin. I think it’s premature to worry about trying to run as fast as you can at this stage. I’d suggest entering a race to get a record of your current performance level, and then focus on easy running at "conversational pace". The most important factor in your training for now is consistency. Log all your milage, and be consistent. Don’t worry about doing high milage, high distance or high frequency, but be consistent. If you’ve been running 4 days and 15 miles a week, try to stick to that closely — make sure you get those 4 workouts and 15 miles in but don’t try to get in 6 days and 25 miles. Cheers,

Response:

Hi everyone. Okay, so I know that track work is one way to run faster, and it’s one I can do. But I’ve also heard that running with people who are faster than you are is another way to run faster.

Yes, but track work is very boring IMHO. My question is: how much faster than I am should they be for me to benefit? I’ve tried running with a group, and within a couple of city blocks their slowest runners had already dropped me (I was averaging 11 min/mile over 8.5 miles).

Running with others unless they have very similar abilities as yourself is usually a big mistake because speedwork should be a small percentage of your total running time.  Racing is better to get you running faster and your effort will count more because its a personal measure of your ability. I’ve been invited to run with women who are planning on 10 min miles. Is that still to fast for me to aim for immediately?

That might work for you. Trying to get faster!

I suggest speedplay workouts called fartlek (swedish) workouts, in which you vary your pace a great deal, simulating intervals of various types.  If you want to get more sophisticated, then get a heart rate monitor so you can run most of your workouts in the proper moderate effort zone, and your speed workouts at a heart rate that will boost your lactate threshold (LT) heart rate.  If you have a scientific bent then it can be alot of fun to read about this and experiment. – Hide quoted text — Show quoted text -Lynne Durham Benton Harbor, Michigan

Response:

Jog up to the biggest, dirtiest, hairiest, biker you can find, and call him a quiche eating sissy.  You’ll find yourself running faster than ever before.

Response:

Hi everyone. Okay, so I know that track work is one way to run faster, and it’s one I can do. But I’ve also heard that running with people who are faster than you are is another way to run faster. My question is: how much faster than I am should they be for me to benefit? I’ve tried running with a group, and within a couple of city blocks their slowest runners had already dropped me (I was averaging 11 min/mile over 8.5 miles). I’ve been invited to run with women who are planning on 10 min miles. Is that still to fast for me to aim for immediately? Trying to get faster! Lynne Durham Benton Harbor, Michigan

Response:

- Hide quoted text — Show quoted text – Hi everyone. Okay, so I know that track work is one way to run faster, and it’s one I can do. But I’ve also heard that running with people who are faster than you are is another way to run faster. My question is: how much faster than I am should they be for me to benefit? I’ve tried running with a group, and within a couple of city blocks their slowest runners had already dropped me (I was averaging 11 min/mile over 8.5 miles). I’ve been invited to run with women who are planning on 10 min miles. Is that still to fast for me to aim for immediately? Trying to get faster! Lynne Durham Benton Harbor, Michigan

If you are running at an 11" pace and feel maxed out, you probably are putting out a high perceived effort. Sometimes people can fool themselves into thinking they are working hard and they may actually be doing a 60% effort. Running with slightly faster people can improve cadence and overall effort. But the major gain in speed is likely to come from a change in form. Review some of the concepts put forth in the archives of this group. Experiment and you might hit on something that works for you. Aging marathoner Bill Rodgers of Boston always said he could never understand how people could run for 3-4 hours straight. He said this because he believed those people were putting out a major effort just like he was and he’d hate to do it for 4 hours. The difference is efficiency and, of course, physical attributes that can’t be changed. So work on your form and efficiency to get more out for a given effort.

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Question:

- Hide quoted text — Show quoted text – [snip]  those responding seem to be approaching the risk in a similar manner (calcium supplements and/or exercise). Great minds think alike, eh?  ;) But, considering we’re supposed to be doing that *anyway*–I can’t help wondering how much good it’s doing!  ’,:-

You all are doing better than me…I take about 40 minute walk 3 times a week and I don’t take calcium and I don’t drink milk, ack!  I am only 21 I started on inhaled steriods when I was 18…the findings about bone loss are really worriesome especially because my grandmother has osteroperosis.  I’m sort of mad at my doctors for not saying a word about it, I mean I guess I’m not at any immediate risk but the sooner I start worrying about bone loss the better off I’d be right?  I just take so many pills/medicines I hate adding something else to the routine.  Anyway, could anyone recommend a good calcium supplement besides Tums?  Thanks. -Amy

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You all are doing better than me…I take about 40 minute walk 3 times a week and I don’t take calcium and I don’t drink milk, ack!  I am only 21 I started on inhaled steriods when I was 18…the findings about bone loss are really worriesome especially because my grandmother has osteroperosis.  I’m sort of mad at my doctors for not saying a word about it, I mean I guess I’m not at any immediate risk but the sooner I start worrying about bone loss the better off I’d be right?  I just take so many pills/medicines I hate adding something else to the routine.  Anyway, could anyone recommend a good calcium supplement besides Tums?  Thanks. -Amy

Amy – You’re doing great to be thinking of these things now — definitely better to consider now how best to mitigate the risk, than to wait until later. You might ask your pharmacist or doctor, but last I heard Calcium Citrate was a good choice (it’s the calcium supplement I use). Stay away from Calcium Carbonate — my understanding is that it can sometimes contain lead/contaminants. Best regards, Karen

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I talked to my doctor the other day about the need for extra calcium due to the systemic effect of corticosteriods. And he said the avg daily dose of calcium should be between 1000-1500mg. Dana

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– Hide quoted text — Show quoted text – You all are doing better than me…I take about 40 minute walk 3 times a week and I don’t take calcium and I don’t drink milk, ack!  I am only 21 I started on inhaled steriods when I was 18…the findings about bone loss are really worriesome especially because my grandmother has osteroperosis.  I’m sort of mad at my doctors for not saying a word about it, I mean I guess I’m not at any immediate risk but the sooner I start worrying about bone loss the better off I’d be right?  I just take so many pills/medicines I hate adding something else to the routine.  Anyway, could anyone recommend a good calcium supplement besides Tums?  Thanks. -Amy Amy – You’re doing great to be thinking of these things now — definitely better to consider now how best to mitigate the risk, than to wait until later. You might ask your pharmacist or doctor, but last I heard Calcium Citrate was a good choice (it’s the calcium supplement I use). Stay away from Calcium Carbonate — my understanding is that it can sometimes contain lead/contaminants. Best regards, Karen

           Hi!  To take calcium supplements is good,            but exercise like backpacking is needed, when            you can get it, so that the bones do more load-            bearing and this makes them denser.  Important            for the elderly.

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I have only recently upped my Flovent to 220 mcg and have had pain in my legs and arms. Additional calcium seems to help. Anyone else? Dana

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I have only recently upped my Flovent to 220 mcg and have had pain in my legs and arms. Additional calcium seems to help. Anyone else? Dana

Yes, I felt concerned about the findings presented in this article, as well. I have to admit, it did help to reinforce for me the importance being diligent about getting in a brisk hour walk *daily*. Nonetheless, I find it worrisome. Best regards, Karen

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Karen, I too have started taking daily walks. It sure can’t hurt. Are we the only ones concerned? I would think not. Dana

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Can’t win for losing, huh? I once had a doctor innocently tell me that a medicine he was prescribing didn’t have any side affects. What he may have meant is that it didn’t have *severe* side affects. I take extra calcium, too. Can’t be too careful. Nell – Hide quoted text — Show quoted text -Karen, I too have started taking daily walks. It sure can’t hurt. Are we the only ones concerned? I would think not. Dana

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Karen, I too have started taking daily walks. It sure can’t hurt. Are we the only ones concerned? I would think not.

No, I’ve been concerned for some time–I know I’ve heard this information before, quite some time ago (maybe it hadn’t been conclusively proven at the time?).   I’ve been on inhaled steroids for years, and, unless something else comes along, I will probably be on them for years more.  I’d rather have an intact skeleton, too.  :-  I also walk (for lots of reasons!) and do some weight-training–not specifically in an attempt to hang on to calcium, but again, hey–can’t hurt. zg

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Karen, I too have started taking daily walks. It sure can’t hurt. Are we the only ones concerned? I would think not. Dana

From the sound of it, we’re not the only ones who are concerned…  those responding seem to be approaching the risk in a similar manner (calcium supplements and/or exercise). Great minds think alike, eh?  ;) Best regards to all, Karen

Response:

[snip]   those responding seem to be approaching the risk in a similar manner (calcium supplements and/or exercise). Great minds think alike, eh?  ;)

But, considering we’re supposed to be doing that *anyway*–I can’t help wondering how much good it’s doing!  ’,:-

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Common Asthma Therapy Ups Risk of Osteoporosis   NEW YORK (Reuters Health) – Young women who use inhaled steroids to control their asthma may   be putting themselves at risk of developing osteoporosis and hip fracture over the long term, new study   findings suggest.   The study revealed that inhaled glucocorticoids, or steroids, which are among the safest and most   effective treatments for persistent asthma, were associated with a loss of bone density in the hip and   upper thighbone, and that higher doses correlated with greater bone loss in premenopausal women.   Bone density in other areas such as the femoral neck (part of the thighbone between the knob-like   head of the femur and the upper thighbone) and the spine was not affected.   The results indicate that healthcare providers should prescribe the lowest possible doses of inhaled   steroids for premenopausal women with asthma and take steps to minimize bone loss among patients   who receive higher doses, the researchers report in the September 27th issue of The New England   Journal of Medicine (news – web sites).   “Overall, these findings do not suggest that patients should stop their steroid inhalers, or tolerate poor   asthma control, but rather they should work with their doctors to find the lowest dose of inhaled   glucocorticoid that can be used to achieve control of their asthma symptoms,” Dr. Elliot Israel, the   study’s lead investigator from Harvard Medical School (news – web sites) in Boston, Massachusetts,   said in a statement.   Inhaled steroids reduce inflammation in the airways. While steroids taken orally are known to reduce   bone mass, it is unclear whether steroids taken through an inhaler have the same effect.   To investigate, the researchers measured bone density at various sites in 109 women aged 18 to 45,   over a 3-year period. All women were treated with a particular steroid, triamcinolone acetonide, with   an inhaler that delivered 100 micrograms of medication per puff.   Women who inhaled more than eight puffs a day experienced more bone loss than women consuming   four to eight puffs daily, and both groups lost more bone from key areas compared with a group of   women who did not take inhaled glucocorticoids. In fact, each additional puff was associated with a   decline in bone density in certain areas of the skeleton.   In an accompanying editorial, Dr. Bess Dawson-Hughes from Boston-based Tufts University adds that   healthcare providers should monitor bone density in young women taking these medications and   recommend weight-bearing exercise and adequate intake of calcium and vitamin D, which help to   preserve bone.   SOURCE: The New England Journal of Medicine 2001;345:941-947, 989-991. — Lisa M. DeSavage Hinsbar Laboratories, Inc. www.hinsbarlabs.com

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Question:

– Hide quoted text — Show quoted text – I’ve come across an interesting controversy and am looking for more info. I’ve always been told (25 years now) that I have severe cough variant asthma.  Further, I’ve been told that the only difference between CVA and other forms of asthma is that I cough rather than wheeze. My son was recently diagnosed with asthma, and I joined an asthma parents mailing list. I mentioned on this list that I have severe CVA.  I was informed repeatedly by someone there (who seems to project herself as some type of expert) that CVA can only be mild.  She futher insists that my pulmonlolgist is wrong and that if I cough, but need meds, I must have "asthma which appears as cough" or "bronchial asthma". Her inisistance is that CVA is only mild and the only med you will ever need with CVA is albuterol. I could find no supporting evidence for this on any medical websites, nor could she provide any, so I was tempted to just write this woman off as a wacko.  Someone I know mentioned this ng, so thought I’d see what you have to say on this matter.

I agree that CVA is probably not that different than other types of asthma, other than the presenting sign. I see no reason to assume it is less severe than other presentations of asthma and wholeheartedly disagree with the assertion that only albuterol is needed. Coughing can be a symptom of asthma. If you are having symptoms more than three times per week, unstable peak flows, nocturnal symptoms, or other easily induced symptoms then you need a preventative such as inhaled steroids. — CBI, MD

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I’ve come across an interesting controversy and am looking for more info. I’ve always been told (25 years now) that I have severe cough variant asthma.  Further, I’ve been told that the only difference between CVA and other forms of asthma is that I cough rather than wheeze.

Correct. My son was recently diagnosed with asthma, and I joined an asthma parents mailing list. I mentioned on this list that I have severe CVA.  I was informed repeatedly by someone there (who seems to project herself as some type of expert) that CVA can only be mild.  She futher insists that my pulmonlolgist is wrong and that if I cough, but need meds, I must have "asthma which appears as cough" or "bronchial asthma". Her inisistance is that CVA is only mild and the only med you will ever need with CVA is albuterol.

This ‘expert’ is wrong.  I have CVA and am considered to have ‘moderate persistent’ asthma.  Listen to your doctor here. "Being responsible sometimes means pissing people off."    General Colin Powell

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I’ve come across an interesting controversy and am looking for more info. I’ve always been told (25 years now) that I have severe cough variant asthma.  Further, I’ve been told that the only difference between CVA and other forms of asthma is that I cough rather than wheeze. My son was recently diagnosed with asthma, and I joined an asthma parents mailing list. I mentioned on this list that I have severe CVA.  I was informed repeatedly by someone there (who seems to project herself as some type of expert) that CVA can only be mild.  She futher insists that my pulmonlolgist is wrong and that if I cough, but need meds, I must have "asthma which appears as cough" or "bronchial asthma". Her inisistance is that CVA is only mild and the only med you will ever need with CVA is albuterol. I could find no supporting evidence for this on any medical websites, nor could she provide any, so I was tempted to just write this woman off as a wacko.  Someone I know mentioned this ng, so thought I’d see what you have to say on this matter.

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Question:

Would someone please explain the difference in these two drungs other then the fact that flovent is newer, I think.

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Would someone please explain the difference in these two drungs other then the fact that flovent is newer, I think.

Both drugs are steroids that can be used in the treatment of asthma. They have similar side effects (to different extents).  The differences may, and I say may, be in the efficacy (how well they work).  There have been (few) clinical studies comparing the two drugs.  Here are some examples: Vanceril (beclomethasone)  Flovent (Fluticasone) 1.  A comparison of multiple doses of fluticasone propionate and beclomethasone dipropionate in subjects with persistent asthma. OBJECTIVE:  We sought to compare the efficacy and safety of 2 doses of fluticasone propionate (Flovent) (88 micrograms twice daily and 220 micrograms twice daily) with 2 doses of beclomethasone dipropionate (Vanceril) (168 micrograms twice daily and 336 micrograms twice daily) in subjects with persistent asthma. CONCLUSION:  Fluticasone propionate provides greater asthma control at roughly half the dose of beclomethasone dipropionate, with a comparable adverse event profile. 2.  Safety and efficacy of fluticasone and beclomethasone in moderate to severe asthma. OBJECTIVE:  To compare the safety and efficacy of fluticasone propionate (FP) and beclomethasone dipropionate (BDP) in patients with moderate to severe asthma. CONCLUSION:  Chronic treatment with FP, at half the dose of BDP, results in a similar antiasthma effect but a more favorable safety profile with respect to bone metabolism and mineral density. So, there are some clinical studies, but there are few.  Essentially, they are steroids that work the same way, but they work at different doses.  One may have less side or adverse effects (better safety). Is this at all what you were asking for?  Sorry if its not. Dave Check out: www.ama-assn.org/special/asthma/treatmnt/drug/vanceril.htm www.ama-assn.org/special/asthma/treatmnt/drug/flovent.htm

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I  forwarded you the table "estimated comparitive daily dosages for inhaled corticosteroid" which is on the Virtual Hospital site.  Vanceril is  a brand name for beclomethasone, aka Beclovent.  Flovent a brand name for fluticasone. You can see from the numbers, mcgms per day, that one appears to be only a little stronger than the other.  But the  Vanceril is available in only two strengths,  while the Flovent has  six: three in the traditional MDI and three in the powder version.   I’ve  only used the Vamceril and in the weaker strength.   I prefer many  mild puffs.  My physician gave me Aerobid (flunisolide)  at one time but after a few months of it I begged for a change as this ’steroid, much stronger per puff,  gave me a little dry cough upon inhalation and just  didn’t feel right. Arn’t all of them supposed to do approximately the same things?  It’s up to you and your doctor to find the better one  and the right dosage for you.   Corticosteroids  are  real  medicine and merit keen consideration.  

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Would someone please explain the difference in these two drungs other then the fact that flovent is newer, I think.

Vanceril [beclomethsone] and Flovent [fluticasone] are both corticosteroid inhalers. Fluticasone is considered more powerful than beclomethasone; approx a factor of 2 at low to medium doses, so needs fewer puffs and mcg. Vanceril is available in 2 strengths; regular [42 mcg/pf] and double strength [84 mcg/pf]. Flovent is available in 3 strengths; 44, 110, & 220 mcg/puff [MDI, at the nozzle] Some studies seem to show Flovent is more effect than Vanceril when given in the same therapeutic dose, but I don’t think this has been proven. Both drugs are made by the same company, Glaxo. Bottom line is it takes fewer puffs of Flovent compared to Vanceril. This can be significant for Moderate to Severe asthma. The other new high strength steroid inhaler to consider is the Pulmicort Turbuhaler [200 mcg/pf budesonide]. It’s a Dry Powder Inhaler, no propellant or additives. [Flovent is also available as a DPI]. Ellis

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Vanceril is available in 2 strengths; regular [42 mcg/pf] and double strength [84 mcg/pf]. Flovent is available in 3 strengths; 44, 110, & 220 mcg/puff [MDI, at the nozzle]

Correction: Flovent MDI is available in 3 strengths; 44, 110, & 220 mcg/puff measured at the mouthpiece, which is the US measurement system. The rest of the world measures at the nozzle and rates the same inhalers at 50, 125, and 250 mcg/puff. Flovent also available as a Rotadisk at 3 strengths: 50, 100, & 250 mcg/pf. Ellis

Response:

I may be wrong, but it is my understanding that vanceril comes in only one dosage, whereas Flovent, comes in three different dosages, therefore your dose can be administered, according to the severity of your asthma.  My dose is 220, my brother uses the 110, I think.

Response:

CONCLUSION:  Chronic treatment with FP, at half the dose of BDP, results in a similar antiasthma effect but a more favorable safety profile with respect to bone metabolism and mineral density.

This is what I was looking for as the VA would not put me on Flovent as it was not in their system. They do not keep up with new drugs and also go for the cheaper drug. I had arrived at the conclusion that Flovent was better then Vanceril in respect to bone metabolism and mineral density but wanted additional verification. Thanks to everyone that responded.

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Question:

With this information you can look up the source scientific research and evaluate it yourself.  I learned to only use research citations when (during the days I was running an asthma quackery website) I discovered that what the marketeers were saying about scientific research was not what the authors of the articles were saying. This would be wonderful if all sources provided all of this info.

Responsible sources do. Since the internet is intended for a multi-faceted group, and since some sources of research are magazines like Time or Newsweek, not all sources provide all information.

Popular magazines do a horrible job of reporting on scientific matters.  You are virtually guaranteed that there will be a relevant scientific error in every story from a newsmagazine. Generally, if you are willing to dig, you can get to a citation reference.  My experience has been that the easier the authors make it to find the source scientific reports, the more accurate the information.  The reverse has also been my experience. "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

I am really hoping for citations from real scientific research. I’m sure you’ll take this as being either gullible or beligerant, but isnt’ it possible that all of your citatios are listed in the appendices or bibliography of this book.  Would it not behoove you to look into the book and see what it lists, rather than just assume that because its not the way you want it, its not valid.

I intend to review the scientific references in order to make my decision on whether to buy the book. If they are unwilling to provide them, why should I waste my money? "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

Bingo. The references (citations are at the end of each chapter). I am glad for an inteligent and reasonable person on the internet. All I have said is repeatedly look at the research for yourself. I realize the site mentioned is "commercial" but the reason I use it is because all one has to do is hit the ‘hot’ buttons to do the research. Ie. there is a link already that automatically looks up all the citations of glutathione and ashtma. etc.

I have been asking you for citation references.  All I got was a link to a site that made all kinds of wild claims about the product (not something that inspires confidence). "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

With this information you can look up the source scientific research and evaluate it yourself.  I learned to only use research citations when (during the days I was running an asthma quackery website) I discovered that what the marketeers were saying about scientific research was not what the authors of the articles were saying. This would be wonderful if all sources provided all of this info. Responsible sources do.

REspsonble sources provide information, but not necessarily in the form or fucntion which you seem to require. Since the internet is intended for a multi-faceted group, and since some sources of research are magazines like Time or Newsweek, not all sources provide all information. Popular magazines do a horrible job of reporting on scientific matters.  You are virtually guaranteed that there will be a relevant scientific error in every story from a newsmagazine.

I’m sorry that you feel that way.  However, I believe that if several reputable news sources provide the same information, and are able to verify their source, it has a very good chance of being accurate. Generally, if you are willing to dig, you can get to a citation reference.  My experience has been that the easier the authors make it to find the source scientific reports, the more accurate the information.  The reverse has also been my experience.

I have spent hours upon hours reseraching this.  I don’t know if you have children, or if so if any of your children have any medical conditions.  If so, you would know that as a parent you spend every waking minute qeusitioning, and every possible moment trying to find answers to these questions, often going w/o food or sleep in order to do so.    I have spent hours on the internet, at the library, in local colleges anduniversities going through their matierals. As a layperson, not all marterials are accessible to me.  Nor are many of the quetsions I have something which a large percentage of the popluation has an interest in.  Both of these things can make it difficult to find the precious exact citations you seem to require.  I strongly suggest that you make yourself willing to do a little leg work on your own.  If you ask for what information people have, then you should be willing to give what they have. You had questions and I offered to give you what material I had found, even stating that I was not a professional and that some of the sources were not professional studies themselves, but articles concerning those studies. If you do not want the information, just say so in the first place.  Don’t ask people for their information, and then make negative commnet about it. It puts you in a very bad light.

Response:

– Hide quoted text — Show quoted text – I am really hoping for citations from real scientific research. I’m sure you’ll take this as being either gullible or beligerant, but isnt’ it possible that all of your citatios are listed in the appendices or bibliography of this book.  Would it not behoove you to look into the book and see what it lists, rather than just assume that because its not the way you want it, its not valid. I intend to review the scientific references in order to make my decision on whether to buy the book. If they are unwilling to provide them, why should I waste my money?

You could go to the library and read the references.  You could go to a bookstore and read the references. With both of these situations you would then be able to do the reserach you seem to require.  Maybe you just need to do a little leg work on your own. Others are willing to do this when we have questions we would like answers to.

Response:

REspsonble sources provide information, but not necessarily in the form or fucntion which you seem to require.

A very good rule of thumb is that the easier it is for you to get to source material the more likely it is for the information to be correct. Popular magazines do a horrible job of reporting on scientific matters.  You are virtually guaranteed that there will be a relevant scientific error in every story from a newsmagazine. I’m sorry that you feel that way.  However, I believe that if several reputable news sources provide the same information, and are able to verify their source, it has a very good chance of being accurate.

Very wrong.  The people reporting in popular news magazines typically do not have scientific backgrounds.  I recommend that you start looking up the source scientific research in areas where you have some expertise and comparing it what the reporters in popular media said. You will be amazed at how poor a job they did of interpreting the research. As a layperson, not all marterials are accessible to me.  Nor are many of the quetsions I have something which a large percentage of the popluation has an interest in.  Both of these things can make it difficult to find the precious exact citations you seem to require.  I strongly suggest that you make yourself willing to do a little leg work on your own.  If you ask for what information people have, then you should be willing to give what they have.

I am willing to the leg work when I feel that the subject is likely to be worth the effort.   You had questions and I offered to give you what material I had found, even stating that I was not a professional and that some of the sources were not professional studies themselves, but articles concerning those studies. If you do not want the information, just say so in the first place.  Don’t ask people for their information, and then make negative commnet about it. It puts you in a very bad light.

I have strict standards.  I do not compromise my standards.  Look at it this way, you now know what my standards are, if I say something then that information has meet a higher level of quality control. "Being responsible sometimes means pissing people off."    General Colin Powell

Response:

N-acetyl-L-cysteine Has anyone had any success using this amino acid supplement A coworker traveling in Holland was prescribed NAC and it has helped his Asthma immensely.    Once back in the US he found that the supplement was an over the counter supplement, and recommended this to another coworker with asthma, who now  swears by NAC as a major improvement to his condition.  Anyone have more details??   I’ve seen some studies out there for NAC and bronchitis and for former smokers but nothing directly on Asthma. Steve

Response:

– Hide quoted text — Show quoted text – I’m sure you’ll take this as being either gullible or beligerant, but isnt’ it possible that all of your citatios are listed in the appendices or bibliography of this book.  Would it not behoove you to look into the book and see what it lists, rather than just assume that because its not the way you want it, its not valid. As I repeatedly read over your posts insisting that things must have full citations in the way you wish them to be or they are not valid, I can’t help but think of my son. My son has an austisc spectrum disorder, and his life is based around order and a strict following of  "THE RULES".  A great deal of our time is spent guiding him to the understanding that just becuase something isn’t exactly the way you want it, or the way you would do it, it isn’t wrong. Simply becuase a citation is not given in the exact form you request, doesn not mean that a study was not done, or that a citation does not exist.

Bingo. The references (citations are at the end of each chapter). I am glad for an inteligent and reasonable person on the internet. All I have said is repeatedly look at the research for yourself. I realize the site mentioned is "commercial" but the reason I use it is because all one has to do is hit the ‘hot’ buttons to do the research. Ie. there is a link already that automatically looks up all the citations of glutathione and ashtma. etc. The other is fine too it just  means you have to know what you are looking for. But you don’t want to find it. It is well written "Can the blind lead the blind? shall they not both fall into the ditch?" Do you want to wait 15 years for the information to become mainstream like H. Pylori? or will you look for yourself in an intelligent objective manner? C’est votre vie — touch

Question:

I always first use Ventolin(blue) and Atrovent(grey).Wait for a couple of minutes That way the brochodilators take effect. Then I use my Serevent(green) and Pulmicort(brown). It

Question:

For those of you who were concerned I have tried every other steroid inhaler and I have the fewest side effects with megadoses of Azmacort.  WE are trying Intal again to see if it helps the exercise induced effects of teaching PE all day every day.  Have only been teaching 1-2 classes a day and coaching prior to this year and this was not a problem we had anticipated.  I am currently on 16 puffs a day of Azmacort and 16 puffs a day of Intal.  WE ahve tried Flovent (severe side effects like cushingoid and high blood pressure), Aerobid (allergic to something in it), Pulmicort (not available to US Military overseas), Vanceril (not strong enough), I can take about 20 mgs a day of Pred and be fine but who wants to go there.  We went back to Azmacort because it was best tolerated and with the fewest side effects.  I know you all might think I am crazy but I would rather put up with the extra puffs and be a bit symptomatic than to have the side effects and problems I had with Flovent or the continuous cough I got with Aerobid. When in real trouble I do not hesitate to run a neb or two and start Pred for a burst.  I just found this site and thought I would join and see what you all thought and I guess I did.  I see an Internal Medicine Specialist, an Allergist, a Pulmonary Specialist and a Family Practice Doctor so do not think I am trying to treat this with no help.  I guess I should have been a bit more specific about my situation.  See ya all later.  Lori    -**** Posted from RemarQ, http://www.remarq.com/?a ****-  Search and Read Usenet Discussions in your Browser – FREE –

Response:

Hi everyone.  I am new here and just to give you a quick rundown of my problems–I am a PE teacher with severe persistent asthma and I am currently on Allegra, Maxzide, Prilosec, Albuterol, Serevent, Intal, Azmacort, Vancenase and several other things as needed like Pred about once every 6 weeks.  I hope I can help make suggestions etc all of you here.  I am known as the Queen of De’Nial (De’Nile) most of the time as I manage to do many things my doctors do not think I should just becuase I choose to ignor the asthma except for taking my meds as prescribed.  Lori    -**** Posted from RemarQ, http://www.remarq.com/?a ****-  Search and Read Usenet Discussions in your Browser – FREE –

Response:

Hi everyone.  I am new here and just to give you a quick rundown of my problems–I am a PE teacher with severe persistent asthma and I am currently on Allegra, Maxzide, Prilosec, Albuterol, Serevent, Intal, Azmacort, Vancenase and several other things as needed like Pred about once every 6 weeks.  I hope I can help make suggestions etc all of you here.  I am known as the Queen of De’Nial (De’Nile) most of the time as I manage to do many things my doctors do not think I should just becuase I choose to ignor the asthma except for taking my meds as prescribed.

If you have severe persistent asthma then I would question the use of Intal and Azmacort.  These are low strength medications that are typically associated with he treatment of ‘mild intermittent’ and ‘mild persistent’ asthma. "Usenet is like a herd of performing elephants with diarrhea — massive, diffucult to redirect, awe-inspiring, entertaining, and a source of mind boggling amounts of excrement when you least expect it." Gene Spafford 1992

Response:

I am known as the Queen of De’Nial (De’Nile) most of the time as I manage to do many things my doctors do not think I should just becuase I choose to ignor the asthma except for taking my meds as prescribed.  Lori

I would say you are not in denial if you take your meds as prescribed. You are acknowledgeing the asthma just not giving into it.  My daughter is steroid dependant, but continues to train 30plus hrs a week(gymnast).  Sometimes she ignores the symptoms(not good), but nonetheless she does take her regular meds on schedule. This is the ways ones life should be in my opinion doing as much of what you enjoy as your body will allow-and being able to recognize warning signs and treat appropriately.

Response:

If you have severe persistent asthma then I would question the use of Intal and Azmacort.  These are low strength medications that are typically associated with he treatment of ‘mild intermittent’ and ‘mild persistent’ asthma.

I am in agreement with that. We passed those on long ago.

Response:

If you have severe persistent asthma then I would question the use of Intal and Azmacort.  These are low strength medications that are typically associated with he treatment of ‘mild intermittent’ and ‘mild persistent’ asthma.

However, for some people they work well. My MD has one patient who has severe persistent asthma.  But she is fine and has zero symptoms [except when she gets a viral infection about once a year] if she is on Intal.  Take her off the intal and she ends up in the ICU and on near-continuous pred.  Keep her on it [Intal] and she is fine and you wouldn’t know she has asthma. So, for *some* people, Intal can make a significant difference, even with sevre asthma. SW.

Response:

– Hide quoted text — Show quoted text -If you have severe persistent asthma then I would question the use of Intal and Azmacort.  These are low strength medications that are typically associated with he treatment of ‘mild intermittent’ and ‘mild persistent’ asthma. However, for some people they work well. My MD has one patient who has severe persistent asthma.  But she is fine and has zero symptoms [except when she gets a viral infection about once a year] if she is on Intal.  Take her off the intal and she ends up in the ICU and on near-continuous pred.  Keep her on it [Intal] and she is fine and you wouldn’t know she has asthma. So, for *some* people, Intal can make a significant difference, even with sevre asthma.

But the original poster sounds as if she isn’t at all under control. Sue SW.

Official Secretary of OSGSL "All empty souls tend to extreme opinions."          William Butler Yeats

Response:

If you have severe persistent asthma then I would question the use of Intal and Azmacort.  These are low strength medications that are typically associated with he treatment of ‘mild intermittent’ and ‘mild persistent’ asthma. I am in agreement with that. We passed those on long ago.

 I also agree.  Why hasn’t this person’s doctor tried one of the newer steroid inhalers?   Sue, on FloVent Official Secretary of OSGSL "All empty souls tend to extreme opinions."          William Butler Yeats

Response:

Hi everyone.  I am new here and just to give you a quick rundown of my problems–I am a PE teacher with severe persistent asthma and I am currently on Allegra, Maxzide, Prilosec, Albuterol, Serevent, Intal, Azmacort, Vancenase and several other things as needed like Pred about once every 6 weeks.  I hope I can help make suggestions etc all of you here.  I am known as the Queen of De’Nial (De’Nile) most of the time as I manage to do many things my doctors do not think I should just becuase I choose to ignor the asthma except for taking my meds as prescribed.  Lori

hi Lori isn’t denial it’s defiance you are probably aware of the large number of to athletes with asthma…taking asthma seriously doesn’t mean giving up on life…and I believe in having a go at pretty much anything…though if it sets an attack off I won’t go back and do it again unless it is a hell of a lot of fun eric

Response:

Hi everyone.  I am new here and just to give you a quick rundown of my problems–I am a PE teacher with severe persistent asthma and I am currently on Allegra, Maxzide, Prilosec, Albuterol, Serevent, Intal, Azmacort, Vancenase and several other things as needed like Pred about once every 6 weeks.  I hope I can help make suggestions etc all of you here.  I am known as the Queen of De’Nial (De’Nile) most of the time as I manage to do many things my doctors do not think I should just becuase I choose to ignor the asthma except for taking my meds as prescribed.  Lori

As others have stated, Azmacort (triamcinolone) is a weak steroid inhaler not really suitable for Severe Persistent Asthma. A better steroid inhaler is one of the new high strength ones; either Pulmicort Turbuhaler (my favorite), or Flovent 220. To get a High Dose of Azmacort suitable for Severe Persistent Asthma requires taking 20-40 puffs/day (been there, done that) With Pulmicort or Flovent 220, only requires 4-8 pf/day. The fact you need to go on pred every 6 weeks is another indicator of undertreatment. Current guidelines recommend the use of an Action Plan and use of a Peak flow meter at home to monitor lung function. When peak flow drops in to Yellow zone, inhaled steroids are doubled and rescue inhaler used as needed. This can often prevent the need to go on pred. Links; http://www.ama-assn.org/special/asthma/treatmnt/updates/patient.htm Patient Asthma Action Plans http://www.ama-assn.org/special/asthma/support/educate/action.htm Asthma Action Plan Ellis

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Question:

Hi there, Before I was "officially" diagnosed with endo, I did a round of Depo for a year. It helped with the pain and such, but I had my period CONSTANTLY for a year. And it also seemed to help with the cysts on my ovaries. But, I’ve been off depo for a while now and my period still hasn’t stopped. And the doctors can’t quite figure out why. So when you start the depo really pay attention to your bleeding. A few months of spotting is normal, but if it continues for any length of time, do something about it. Like i said, I’m off the depo now, but my pain is abck full force along with a host of other less than pleasant things AND I’m still bleeding,so give it some thought. Juliet

Response:

 I received my first Lupron injection yesterday.  I’ve had the lap, bcp, depo and don’t even remember what all else.  I sure hope this helps.  The Lupron injections will be for six months.    I will be 19 in August and if this doesn’t work, then I will have a hysterectomy…I just can’t take this pain! Since infertility is so prevalent with this condition, I really don’t see what diference it makes anyway….I will probably never conceive (although no dr has ever said that to me).

Response:

Well, went and had my appt. with the gyn. today.  I thought it went well, the nurse and doctor were very nice and asked almost as many questions as I did. And the doctor brought up the possibility of endo before I ever got a chance to mention it!  She took all my info (I typed out a bunch of stuff ahead of time, all my symptoms, ect.  I turn brain dead in dr.’s offices).  and said that my symptoms did suggest endometriosis.  Then she did the pelvic, and she was by far the gentlest doctor I ever had do one, hardly any pain at all.  When she did the internal exam she was suprised to find a lot of scar tisue behind by uterus and left fallopian tube, she said she was suprised I went as long as I did without seeing a gyn. and said the bcps I have been on were probably all that saved me from a lot more trouble.  After that was done we talked about my options.  She said if I wasnt such a poor surgical candidate (severe persistent asthma) she would like to do a lap, but given my poor lung condition she would prefer to try to treat this medically.  I am fine with this, it is what I expected.  So, when I get to the beginning of my cycle again I go in to get my first Depo-Provera shot.  IF the Depo doesnt help, then we will call a meeting between her and I and my pulmonologist to discuss my surgical options.  She did mention that she isnt crazy about Lupron therapy, particularly for me since I already am prone to osteoporosis from all the asthma steroids.  She said if we ever have to resort to it, it wass be post-surgical and only for 6 months, tops.  She also said if it turns out I have very advanced endo and need laparotomy she will send me t Brigham and Womens in Boston for it. Seems like I found a winner and boy is all this a major load off my mind!!!! Jennifer the happy camper today!!! Jennifer Landry reply-to is anti-spammed, use above link

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Question:

I have been more fortunate but my story is similar. After a miserable bronchial infection on top of a problem with GERD (reflux disease) I started to cough. Except for those times when the medication is working well, I have never stopped. That was two years ago. My job’s demands are not extremely physical so I still have that. Good luck in finding improvement without draconian surgeries. – Hide quoted text — Show quoted text – Dear Colleen: May I ask your approximate age? And have you had asthma a very long time? I am 55 and am not always sure whether I am reading very young asthma sufferers’ mail — aging (in my case) may have an effect. Hi David, I’m 58, and have suffered  daily with uncontrollable  severe asthma for over 20 years –despite constant (daily) aggressive corticosteroid treatment and the full complement of all the other standard asthma medications. I was diagnosed with severe persistent (adult onset) asthma at age 37 and moderate emphysema (via CTscan) last year. My asthma has been chronically severe  for nearly 21 years. I had no previous history of asthma or lung problems before age 37 when I was admitted to the ICU ( in an emergency situation) due to complications caused from a severe chest infection.  Before that  I was in excellent health and I never even had a  family doctor, and never took any medication. I had two young children ( under 12 year old)  at that time;  after that first horrible episode in the ICU, my life changed totally. I went from a very active mom, to a chronic  invalid practically over-night. And have been disabled ever since. However, my mind still functions and I make good use of it.  I am very thankful for my computer and Internet connection which has allowed me to communicate with the outside world again and to continue with my constant research. I was referred to a transplant unit for assessment for a single lung transplant close to  6 years ago, however, after a great deal of research into the long term survival rate of single lung  transplants, (which at that time averaged 12 months) I decided not to go ahead with it. My lung specialist is constantly urging  me to have the transplant while I am still able to. (the cut-off age here is 60 years of age), however, I have made up my mind not to have any surgery. Had I gone ahead and had it then, I wouldn’t be here talking with you today. I am still hoping for a medication break-through that will control my asthma. That would make my life a lot easier. My life is very difficult, however, I am still alive and still have hope for control or a cure. The CT scan last year (which diagnosed the emphysema) was done to determine whether I would be eligable for LVRS (Lung volume reduction surgery). I will not persue that surgery  either. Cheers, Colleen

Response:

Dear Colleen: May I ask your approximate age? And have you had asthma a very long time? I am 55 and am not always sure whether I am reading very young asthma sufferers’ mail — aging (in my case) may have an effect.

Hi David, I’m 58, and have suffered  daily with uncontrollable  severe asthma for over 20 years –despite constant (daily) aggressive corticosteroid treatment and the full complement of all the other standard asthma medications. I was diagnosed with severe persistent (adult onset) asthma at age 37 and moderate emphysema (via CTscan) last year. My asthma has been chronically severe  for nearly 21 years. I had no previous history of asthma or lung problems before age 37 when I was admitted to the ICU ( in an emergency situation) due to complications caused from a severe chest infection.  Before that  I was in excellent health and I never even had a  family doctor, and never took any medication. I had two young children ( under 12 year old)  at that time;  after that first horrible episode in the ICU, my life changed totally. I went from a very active mom, to a chronic  invalid practically over-night. And have been disabled ever since. However, my mind still functions and I make good use of it.  I am very thankful for my computer and Internet connection which has allowed me to communicate with the outside world again and to continue with my constant research. I was referred to a transplant unit for assessment for a single lung transplant close to  6 years ago, however, after a great deal of research into the long term survival rate of single lung  transplants, (which at that time averaged 12 months) I decided not to go ahead with it. My lung specialist is constantly urging  me to have the transplant while I am still able to. (the cut-off age here is 60 years of age), however, I have made up my mind not to have any surgery. Had I gone ahead and had it then, I wouldn’t be here talking with you today. I am still hoping for a medication break-through that will control my asthma. That would make my life a lot easier. My life is very difficult, however, I am still alive and still have hope for control or a cure. The CT scan last year (which diagnosed the emphysema) was done to determine whether I would be eligable for LVRS (Lung volume reduction surgery). I will not persue that surgery  either.   Cheers, Colleen

Response:

Dear Colleen: Thank you for your posting. I do take dialators also (serevent, maxair on occasion).  You have had your fair share of troubles. I take a little less Pulmicort than you do. May I ask your approximate age?  And have you had asthma a very long time? I am 55 and am not always sure whether I am reading very young asthma sufferers’ mail — aging (in my case) may have an effect. – Hide quoted text — Show quoted text – I use an inhaled steroid — Pulmicort. I do not know if I am using a medium or high dose (total of six inhales daily at 200 mcg per dose). I am persuaded that asthma damages airways in the long run without steroids. I do even better on eight inhales (four twice daily). SHORT TERM SIDE EFFECTS:  I don’t know if these are common effects. I get leg cramps. My feet seem painful sometimes when I stand up for a long time. But cramps seem to run in my family and lots of people have sore feet. It seems a lot worse — could it be Pulmicort?  LONG TERM SIDE EFFECTS:  these sound ominous, with diabetes, glaucoma and cataracts, osteoporosis, heading the list. How common are these in people who don’t take oral steriods? How do you watch for them, or help prevent them? Are any of you with longstanding use of steroids OLD and PRETTY HEALTHY? I am getting old myself at 55 (asthma reactivated after years of not having much). Thanks for you input, it’s appreciated. DAVID Hello David, Yes, 1200mcg is considered a high dose of inhaled corticosteroids. How long have you been taking inhaled steroids? do you take bursts of systemic steroids too? The leg cramping might be a sign of an electrolyte imbalance. I experience foot and leg muscle spasms  occasionally as well, usually during the  night. Taking extra calcium is helpful. You should also have your potassium and magnesium levels checked. Are you taking any other medication for your asthma? if so what are you taking? According to the information found on the following URL’s, "Asthma experts warn against excessive steroid use" http://www.canoe.ca/HealthNews/980619_asthma.html ". . ."Inhaled steroids are very effective but not universally," Chapman told a recent medical debate on patient treatment choices. "It has long been thought that increasing the dose will obtain more benefits, but there is a law of diminishing returns. "Doubling the dose will not reduce symptoms by half." In fact, he said, an excess of inhaled steroids can be absorbed into the bloodstream and result in side effects such as cataracts and a loss in bone density.. . ."

http://pharmacy.drake.edu/faculty/A_Blash/PHA191-327/thcpati/asthma/A… te/Asthma_Web_Site/Asthma_WebSite/Asthma_Web_Page/webpage/InhaledCorticoste roids .html – Hide quoted text — Show quoted text – "Cautions:  Data is not completely sufficient, but long-term high doses (88 mcg/day) of inhaled corticosteroids may be associated with adverse systemic effects." According to my records, I have taken 2000mcg (2mg)of Pulmicort [Budesonide] daily via nebulizer since 1994 and 1600mcg daily from 1990-1994. prior to that I was taking another inhaled corticosteroid (Beclomethasone) –4 puffs 4 times day. Side effects I’ve noted for several years, which I’ve attribute to corticosteroid use (Medrol and Pulmicort), are: weight gain, fluid retension — abdominal bloating, hypertension, chronic sinus infections, visual degradation (no sign of cataracts or glaucoma), short term memory loss, adrenal supression, very fragile (very thin) skin with loss of fat deposits under skin–causing "peaking effects" the slightest bump or scrape will cause bruising under the skin and break-through bleeding. I was diagnosed (via full PFT) with severe persistent asthma 20 years ago, at age 37, and diagnosed (via CTscan and full PFT) last year with moderate emphysema. I also suffer from MCS. And the propellent in MDI’s provoke bronchospasm. My lung disease has created severe mobility limitations for me. My airways are very reactive to environmental and chemical pollutants (fumes such as cigarette smoke, perfumes, hot tar, auto-exhaust etc.,] Severe shortness of breath (during any exertion) is my primary symptom. My PEFR (for the last 10 years) has averaged 160 and my FEV1 is 30% of predicted.  Besides Pulmicort, I am currently taking Medrol (tapering), Singulair, Uniphyl, Foradil (Formoterol), Atrovent (via nebulizer), Salbutamol (via nebulizer), Triazide (Triamterene/HCTZ (50/25). FWIW: While taking any type of corticosteroid therapy, don’t use salt or eat salty foods, and if you can’t cut out sweets entirely, keep your sugar intake to a bare minimum. You should also take Calcium and Magnesium supplements and Vitamin C. Hope that helps, Cheers, Colleen

Response:

Sugars of 300 are horrendous control. You should tell the PMD to control both or refer to one or both of the specialists. — Good Luck, CBI, M.D. – Hide quoted text — Show quoted text – I’m concerned about my husband’s use of Pulmicort. He’s been thrilled with it, because he can finally breathe easily (and I don’t poke him in the night and tell him to use his inhaler). He uses 6-8 puffs of Pulmicort (1200-1600 mcg) daily along with Serevent twice a day (I think 2 puffs each time). He reduces to 6 puffs of Pulmicort when he’s feeling okay, but that usually doesn’t last long before he’s back to 8 puffs. So, it’s treating the asthma just great! The problem is that he also has diabetes (he takes Glucatrol). His blood suger has been shooting up like you wouldn’t believe! I’m sure it’s from the Pulmicort. His blood suger is responding as it would to oral steroids. I keep telling him he needs to be referred to an endocrinologist and maybe a pulmonologist so they can work out the best combination for him — treat his asthma AND keep his blood suger levels low. He’s seeing a family doctor who doesn’t seem too concerned about his high blood readings. I’m talking about going from a high of about 160 (2 hours after eating) to a high of 300! Mary Normally a high dosis pulmicort (more than 800 – 1600

Question:

I have noticed when I take extra strength Tylonel or Advil, I have a slight asthmatic reaction, just the wheezing mostly.  Has anyone else experienced this?  I have been told by several people that have had the same problem. Needless to say, I don’t take the above items. thanks c

Response:

I have noticed when I take extra strength Tylonel or Advil, I have a slight asthmatic reaction, just the wheezing mostly.  Has anyone else experienced this?  I have been told by several people that have had the same problem. Needless to say, I don’t take the above items.

Good; because, if you read the PDR on either, you will learn that they aren’t advised for asthmatics.  The reason being that both suppress the cycloxygenase half of the arachadonic acid cascade in favor of the leukotriene pathways; LC4 is also known as slow reacting substance of anaphylaxis, and is one of the major causitive factors in asthma attacks. Chris Owens

Response:

<note new email address Good; because, if you read the PDR on either, you will learn that they aren’t advised for asthmatics.  The reason being that both suppress the cycloxygenase half of the arachadonic acid cascade in favor of the leukotriene pathways; LC4 is also known as slow reacting substance of anaphylaxis, and is one of the major causitive factors in asthma attacks.

Tylenol isn’t recommended for asthmatics either?  That’s something I didn’t know, and is useful information. What painkillers are considered okay for asthmatics?  Just straight aspirin?  (Which as a kid they thought I was allergic too, but which I’m not sure was truly the case, now.)

Response:

I have noticed when I take extra strength Tylonel or Advil, I have a slight asthmatic reaction, just the wheezing mostly.  Has anyone else experienced this?  I have been told by several people that have had the same problem. Needless to say, I don’t take the above items. thanks

About 15% of asthmatics are sensitive to aspirin and other NSAIDs, including Advil (ibuprofen). Perhaps you are in this category. If so, you will need to read labels carefully. In some cases, it can provoke a life-threatening attack. Asthmatics who are not NSAID sensitive can continue to use them, under current guidelines (EPR2). Regular Tylenol is generally considered safe for asthmatics in the category. However multi-drug combinations of Tylenol, like the extra strength, may include NSAIDs. Better to stay with plain Tylenol. Ellis — Posted via Talkway – http://www.talkway.com Surf Usenet at home, on the road, and by email — always at Talkway.

Response:

Tylenol isn’t recommended for asthmatics either?  That’s something I didn’t know, and is useful information. What painkillers are considered okay for asthmatics?  Just straight aspirin?  (Which as a kid they thought I was allergic too, but which I’m not sure was truly the case, now.)

Aspirin is a definite no-no.  Tylenol is less risky, but still dangerous for a different reason:  Most asthmatics have some impairment of hepatic function, and acetaminophen is rough on livers.  The best pain reliever for an asthmatic is a narcotic. Chris Owens

Response:

Regular Tylenol is generally considered safe for asthmatics in the category. However multi-drug combinations of Tylenol, like the extra strength, may include NSAIDs. Better to stay with plain Tylenol.

Hmmm… the only Extra Strength Tylenol I have ever seen in either Canada or the US is simply nearly twice the dose of acetaminophen as a regular strength Tylenol — nothing else is different. There *are* multidrug combinations of Tylenol, such as Tylenol Cold or Tylenol Flu or Tylenol Sinus, but they are clearly labelled as such. SOme of these combinations have extra strength in the name [such as extra strength tylenol flu], but you still know by the name and ingredient list that it is NOT ‘extra strength tylenol’. Also, I have never seen a Tylenol-branded combination that has NSAIDs in it.  Decongestants, yes, but NOT NSAIDs. SW.

Response:

No, I don’t get any asthma from any of these that I know of, but I understand that people who can’t take aspirin may not be able to take Ibuprofen or Naproxin Sodium because they are in the same family.  I’m pretty sure that it’s also marked on the label that they can also trigger asthma in some people. Laura I have noticed when I take extra strength Tylonel or Advil, I have a slight asthmatic reaction, just the wheezing mostly.  Has anyone else experienced this?  I have been told by several people that have had the same problem. Needless to say, I don’t take the above items. thanks c

Response:

– Hide quoted text — Show quoted text – Regular Tylenol is generally considered safe for asthmatics in the category. However multi-drug combinations of Tylenol, like the extra strength, may include NSAIDs. Better to stay with plain Tylenol. Hmmm… the only Extra Strength Tylenol I have ever seen in either Canada or the US is simply nearly twice the dose of acetaminophen as a regular strength Tylenol — nothing else is different. There *are* multidrug combinations of Tylenol, such as Tylenol Cold or Tylenol Flu or Tylenol Sinus, but they are clearly labelled as such. SOme of these combinations have extra strength in the name [such as extra strength tylenol flu], but you still know by the name and ingredient list that it is NOT ‘extra strength tylenol’. Also, I have never seen a Tylenol-branded combination that has NSAIDs in it.  Decongestants, yes, but NOT NSAIDs. SW.

I checked the drugstore and couldn’t find regular strength Tylenol, only Extra Strength. Extra Strength Tylenol is 500 mg acetaminophen, no aspirin. Looks like Tylenol makes a point to avoid using aspirin in combination with acetaminophen; since that’s one of their selling points (aspirin-free). www.tylenol.com I think there are other companies that make a combination of acetaminophen and aspirin. I never use Tylenol myself, mainly aspirin, since it helps keep the blood flowing. I notice on the Aleve (ibuprofen) package there is a warning for asthmatics not to use it if you are sensitive to it. Ellis — Posted via Talkway – http://www.talkway.com Surf Usenet at home, on the road, and by email — always at Talkway.

Response:

– Hide quoted text — Show quoted text – <note new email address Good; because, if you read the PDR on either, you will learn that they aren’t advised for asthmatics.  The reason being that both suppress the cycloxygenase half of the arachadonic acid cascade in favor of the leukotriene pathways; LC4 is also known as slow reacting substance of anaphylaxis, and is one of the major causitive factors in asthma attacks. Tylenol isn’t recommended for asthmatics either?  That’s something I didn’t know, and is useful information. What painkillers are considered okay for asthmatics?  Just straight aspirin?  (Which as a kid they thought I was allergic too, but which I’m not sure was truly the case, now.)

No aspirin for asthmatics who are sensitive to it. Link: http://www.ama-assn.org/special/asthma/treatmnt/guide/guidelin/comp2/… Aspirin Sensitivity JAMA Aspirin Sensitivity Adult patients with asthma should be questioned regarding precipitation of bronchoconstriction by aspirin and other nonsteroidal anti-inflammatory drugs. If they have experienced a reaction to any of these drugs, they should be informed of the potential for all these drugs to precipitate severe and even fatal exacerbations. Adult patients with severe persistent asthma or nasal polyps should be counseled regarding the risk of using these drugs. Usually safe alternatives to aspirin include acetaminophen or salsalate (Szczeklik et al. 1977; Settipane et al. 1995). From 3 percent of patients with asthma seen in a private allergy practice (Chafee and Settipane 1974) to 39 percent of adults with asthma admitted to an asthma referral hospital (Spector et al. 1979) have been reported to experience severe and even fatal exacerbations of asthma after taking aspirin or certain other nonsteroidal anti-inflammatory drugs. The prevalence of aspirin sensitivity increases with increasing age and severity of asthma (Chafee and Settipane 1974; Spector et al. 1979). " http://www.mayohealth.org/mayo/9310/htm/sidee_sb.htm   Side Effects of Aspirin (Mayo) Excerpt: "Allergy