Have been taking asthma/allergy medications for 5 months and symptoms still persist. Any advice on next steps/what to ask doctor? Why else could I be having difficulty breathing? : Asthma

I have exercise- and cold weather-induced asthma. Am I boned? : Asthma

I’ve been going to my doctor and an allergist, but I wanted to ask what you all think.

I grew up in LA with asthma, mostly induced by cold and exercise. I also had food allergies that manifested as eczema, but my parents and I also think it was induced by foods I was allergic too as well. I grew up taking advair and claritin, and albuterol nebulizer/inhaler occasionally if I needed it. As I got into high school, I outgrew my symptoms and stopped taking my medications regularly. When I got to college in the northeast 7 years ago, I stopped advair altogether and only took claritin occasionally. I was completely fine and very rarely felt any symptoms, and if I did they were minor. 3 years ago, I moved to a different northeast city, continued not to take meds, and was still fine.

A year ago, I moved to Charlottesville, Virginia. I changed nothing about my lifestyle at all. I was fine all summer, and then after getting a cold in October, I started have asthma symptoms (shortness of breath, wheezing) even when I was not moving and when I was inside. I took prednisone (5mg/day) for a week and a low dose of advair for a few months, and had to break out my nebulizer for the first time in 10 years, but it seemed to get better. However, it seems notable to me that although when I was younger, albuterol worked instantly and effects lasted long, it felt like in Charlottesville albuterol wouldn’t work as well and effects didn’t last long at all.

I went home to LA in December for a month, and things seemed to be fine, but in the last few days of my trip I felt myself start wheezing again (perhaps because it about to start raining and was raining at the end of the trip) and when I got back to Charlottesville, it became full-blown. I presume it was some sort of pollen, because I had been living in cold areas and with more stressful situations before. I finally started asthma medications in February (5 months ago), and have been taking them ever since:

  1. Prednisone (40 mg for the first 10 days I was taking below meds)
  2. Advair 500/50 (one puff, 2x/day)
  3. Flovent 220 (one puff, 2x/day)
  4. Singulair (1 pill, 1x/day)
  5. Zyrtec (1 pill, 1x/day)
  6. Flonase (2 sprays in each nostril, 1x/day)
  7. Albuterol (as needed)

It got much better, but never felt completely better. I always felt low-grade breathlessness, especially at night. I never woke up in the middle of the night, but it was tough falling asleep sometimes. I got sick in May again and had a cough for over a month, and my asthma returned. Took more prednisone, felt slightly better.

I returned home to LA almost a month ago. Cough has gone away, but asthma symptoms persist (difficulty breathing, wheezing). I always wake up feeling fine, but as day goes on, it gets worse and worse. I went to my PCP and allergist, and got chest x-ray, environmental blood test, and pulmonary function tests (PFTs). Results:

  1. Chest x-ray was normal
  2. PFTs were pretty normal (haven’t seen paperwork, but guy who performed them said I was performing normally). He also ran a test and showed the albuterol wasn’t opening my airways.
  3. environmental blood test came back with the following allergies:
    1. Mugwort Weed
    2. Chinese Elm Trees
    3. Hormodendrum Cladosporium Mold
    4. Aspergillus Fumigatus Mold
    5. House Dust Mite
    6. Dog Hair
    7. Lamb’s Quarter
    8. Ragweed
    9. Alder
    10. Oak
    11. Walnut Tree

Why am I still feeling symptoms even though I’m taking all of the necessary medication and I’m in the place I grew up, where I’ve never really had symptoms before? I’m just sitting right now and I feel like I can’t breathe properly. And albuterol still doesn’t help that much. My parents’ house is clean and we wash bedding frequently. We also take care to use low-irritant cleaning products. And I haven’t changed my lifestyle at all. I have never smoked. Is there anything else I’m not considering that I should ask my doctor? The allergist said to come back in a month (which is now in 2 weeks). Thanks!

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