advair, seeing pulmonologist

[Guest guest]

Hi Barb,

Seeing a pulmonologist is an excellent idea. Sometimes different docs

have different thoughts on the treatment plan and a new doc can give a

fresh look at things. My allergist and pulmonologist do not always

agree on the best course of action! However, I've benefited from having

more ideas on things to try.

Advair and Spiriva are typical meds for someone with COPD and asthma.

The Spiriva is used mainly for COPD. As far as evaluating the effect of

the Advair, I have two thoughts. Are your peak flows any better since

you've been on the Advair and are you needing your rescue inhaler less?

If so, it may be helping even though you don't notice much effect. Most

patients I see don't seem to experience an immediate effect with Advair,

at least compared to using their albuterol inhaler where you immediately

notice improvement. I haven't been around too many people using the

Symbicort, but it seems very much like Advair from what they say. But

as we've all commented on, sometimes one med just seems to work better

or have less side effects for any given person.

The other thing is that the steroid and LABA in Advair have a

synergistic effect. If you weren't well controlled on a medium dose of

an inhaled steroid, instead of going to a high dose you can get

improvement by switching to Advair or Symbicort. The steroid and LABA

together allow a lower steroid dose to control the asthma. So a doctor

following the asthma step care guidelines might try Advair instead of

bumping up the steroid dose. Or if you were on a high dose of steroid

and still not well controlled, trying Advair could be a next step. I'd

ask your doctor exactly why he put you on the Advair if you don't feel

like it's helping. Maybe he would consider a trial without it on just

an inhaled steroid to see what happens if you are in good control.

Are you doing pretty well now or still having a lot of problems? Have

you been on the Spiriva long? I've heard several COPD patients say it

really helped. I've taken it myself for brief periods when the doctors

were trying to see if it would have any effect on my cough, but stopped

it when things got under better control and I was able to cut down some

of the medicine. I think with COPD it's a little tougher to see as much

improvement as with just asthma, since you have some damage that isn't

completely reversible.

Wishing you the best,

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> > Hi Barb,

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> > Foradil takes action quite rapidly, within a few minutes,

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