Sunday, July 26, 2015

Recovering and Reconnecting

It has been half a year since I've posted on this blog site, and I would like to reconnect once again, after months of illness and recovery.

The day after Christmas, 2014, I came down with a serious strain of the flu that was "in the air" last winter. I had dutifully requested and received a flu shot, but that didn't protect me. I believe that the prevalent strain (H2N2?), with an epicenter in Charleston, had not been included in last year's flu shot. I haven't felt that sick since the Asian flu ravaged the country during my college years in the 1950s--I think it was the winter of 1957 - '58.

It took four months for me to feel nearly "normal" again - as normal as a person with COPD can feel. The first month (January), I was utterly exhausted and felt like I had several relapses of the virus. The second month (February), I had a bad respiratory reaction to a steroid (prednisone) prescribed by my pulmonologist to improve lung function. The third month (March), I had a bad reaction to an antibiotic (azithromycin) prescribed to fight a bacterial infection brought on by the prior heavy dose of prednisone. And the fourth month (April) I was battling breathing problems that were only transiently improved by using a nebulizer.

Ultimately, with the help of my pharmacist, I discovered that all of the medications giving me breathing trouble included sulfate: sodium-lauryl sulfate as an "inert ingredient" in the steroid and the antibiotic; and albuterol sulfate as the bronchodilator in the nebulizer. Although over-the-counter (OTC) medications are required to list inert ingredients, prescribed medications do not include inert ingredients in the package inserts!

[I already knew that I had a respiratory reaction to inorganic sulfur. Eating dried fruit treated with sulfur as a preservative had caused me to wheeze from the time I was an adolescent. And I later discovered that wine made me wheeze - especially wine containing sulfites. I essentially could never drink red wine (although I found a Bulgarian red wine that didn't cause me to wheeze). Eventually I stopped drinking wine altogether, because too many of the white wines also contained sulfite.]

After all the bad reactions to medications, in May I began to wean myself slowly from as many of the prescribed medications as I could. By now, I rarely take any prescribed medications unless I have a particularly acute problem.

I completely quit one medication (monteleukast), which did cut down on mucus production, but it made my respiratory system feel dry and irritated. It also seemed to make me slightly depressed.

And then I started to cut back slowly on the Advair, an inhaled steroid/bronchodilator combination which I had been taking for four years, since returning from a trip to India, where I experienced acute respiratory distress. I have been inhaling Advair (either 250 or 100) morning and evening. So I began to cut out the evening dose, and then I decreased the strength of the morning dose. I found a couple of OTC medications that worked pretty well as a bronchodilator (Primatine) and a mucolytic (Mucinex). I began using those intermittently if I needed additional relief. Everything was done in slow increments and recorded--along with the way I felt physically and psychologically--morning and afternoon.

I now seem to be doing pretty well with just one Primatine tablet in the morning and nothing in the evening. I also take a daily Zyrtec, an OTC antihistamine. I have not used inhaled Advair for three days, and I continue to feel better and better, both physically and psychologically.

So now it's time to get on with my life again!