Tag Archives: asthma

Asthma Medication Rant

Like many other ‘eczema’ sufferers/atopic individuals out there, I also have asthma and have had it since childhood.  My asthma is very well controlled with the help of the wonderful pill Singulair.  I almost never have to use my rescue inhaler and my daily activities aren’t limited – I can generally do high intensity exercise with no trouble breathing.

Singulair used to only be available in a brand name form, but recently (within in the past year), drug companies have been given the green light to go ahead and produce this medication in a generic form, with the same active ingredient, montelukast sodium.

This past fall, I received the generic and when I tried it, my eczema got worse and I got puffy eyes.  When I stopped taking the medication, these effects went away.  I don’t think this was just a fluke because I then tried it again and got the same results.

At the time, I filed a claim with the FDA and also called the drug manufacturer to get a list of the ingredients.

This is what is in generic montelukast sodium tablets:

Each 10 mg film-coated montelukast sodium tablet contains the following inactive ingredients: hydroxypropyl cellulose, hypromellose, iron oxide red, iron oxide yellow, lactose monohydrate (128.6 mg), magnesium stearate, pregelatinized starch, sodium lauryl sulfate, sodium starch glycolate, and titanium dioxide.

Basically mostly a bunch of colors and fillers, but the one thing that worries me is seeing Sodium Lauryl Sulfate, or SLS, in the list.  According to the Environmental Working Group, SLS is suspected to be an environmental toxin and has strong evidence of being a human irritant.  I don’t have the focus to get all science-y in my blog like one of my overseas TSW buddies, Miss Kitty Fantastico, although I’m sure this subject is just begging for some graphs and diagrams, but hell, let’s briefly give you a bit more evidence why this SLS stuff probably sucks for all of us.

Let me present a few studies to you where healthy controls were compared with atopic controls being exposed to SLS.  Atopic folks were found to have a statistically significant response with irritant dermatitis.  Here is another article that is pretty comprehensive and cites other scientific research.

So, okay, these types of studies are all over the place, we know that SLS isn’t the greatest thing to be using in our products like shampoos and hand soaps, ESPECIALLY if we have a compromised skin barrier due to eczema or contact dermatitis.

But if I’m actually ingesting this stuff, how does that bode for me?  I find it very ironic that, on the Material Safety Data Sheet for SLS, it says, “Hazardous in case of ingestion.”  Then we read under the Toxicological Information, in part:

Special Remarks on other Toxic Effects on Humans:
Acute Potential Health Effects: Skin: Causes mild to moderate skin irritation. May cause allergic reaction (dermatitis) Eyes:
Causes moderate eye irritation. Inhalation: Material is irritating to mucous membranes and upper respiratory tract. May cause
allergic respiratory reaction. Ingestion: Causes gastrointestinal tract irritation with nausea, vomiting, hypermotility, diarrhea,
and bloating. May also affect behavior (ataxia, somnolence), and cardiovascular system. Chronic Potential Health Effects:
Skin: Prolonged or repeated skin contact may cause allergic dermatitis. Ingestion: Prolonged or repeated ingestion may affect the liver. Inhalation: Prolonged or repeated inhalation may cause allergic respiratory reaction (asthma).
Oh great!  Nausea, vomiting, diarrhea, and bloating?  Not my idea of a fun evening.  Maybe I should be glad I *only* had puffy eyes and rash.  And does anyone else find it ironic that in the last sentence it mentions this chemical may cause asthma, but it’s an ingredient in the very medication used to TREAT asthma??  No wonder you can find accounts all over the internet of people that took the generic Singulair and had their asthma actually get worse.  Do I believe everything I read on the internet…. no, but one can certainly see why lots of people might be reacting to this medication.
My insurance recently told me the lovely decision that “We no longer will cover brand-name Singulair because of the cheaper generic version available.”  After spending enough time on the phone to grow a couple gray hairs and insisting to every customer service rep and pharmacist that the brand name is medically necessary for me and that my doctor is aware it’s a drug that needs to be D.A.W. (dispensed as written – meaning, Don’t give me the generic stuff, this girl needs the real thing), the only thing I can do now is file a letter of appeal to the healthcare company.
If the letter of appeal has no effect, I have two choices.  I can pay out of pocket for brand-name Singulair, which by my calculation, is over $3.00 for a pill PER DAY.  At this rate I could be forced into poverty, but boy, will my lungs be clear and healthy, which will bode well for me when I become homeless and have to live under a bridge on the freeway and be subjected to repeated onslaughts of car exhaust.  [Please keep in mind this post is written slightly tongue-in-cheek, so don’t feel like I’m a charity case with a “poor me” attitude… I’m not 🙂 ].  My other choice is to simply stop taking ANY pill form of asthma medication and just rely on my inhaler if I need it.
I’m of the mindset “If it ain’t broke, why fix it”, and being that I’ve taken brand name Singulair for nearly 10 years, I’m naturally suspicious of what could happen if I cease taking it.  Now back relating to TSW, I have read some hopeful things on the forums and such about people whose asthma got MUCH better once they healed from their steroid usage.  I believe this is perfectly credible.  I saw my own suspected food ‘sensitivities’ and seasonal allergies completely disappear now that I’m healing nicely from TSW.  However, I had asthma well before using any sort of topical steroids, so for me personally, I feel like they are not intertwined, but who knows.  Maybe the only way to tell is to do a test for a week or more where I take ZERO asthma pills, and then go back to the Singulair while I still have the buffer of about a month’s supply left, which is likely what I’ll do.
I’d love to hear anyone else weigh in if you’ve reacted to generic montelukast as well, if you’ve also experienced the hassle of trying to get insurance coverage for Singulair, or if you just have any thoughts or recommendations on this situation in general!
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Food Allergies – All in the Family?

Food-AllergiesFrom reading other eczema and allergy blogs, it seems that sometimes there is no set pattern to who gets the allergies in the family and who does not.  Sometimes all siblings are afflicted, sometimes only one has it very badly.

I have one older brother, and although we both have some variation of allergies, asthma, and eczema (he has asthma worse, I have eczema worse), we are most certainly not equal when it comes to food allergies.  I don’t have any ‘confirmed’ food allergies, and he has a LOT!  When pondering my upcoming desire to do an Elimination Diet, I had to wonder if perhaps I am sensitive to the same foods that my brother is allergic to.

Growing up with my brother, I became an expert label-reader whenever we went to the grocery store.  At a young age, I understood all the ingredients that were derived from dairy.  In restaurants, after he placed his order, all of us would clamor to confirm with the server, “And that isn’t made with butter, right?  Or cream?  Or any dairy or eggs?”

My brother, let’s call him Luke, is allergic to the following:

  • Eggs
  • All dairy
  • Nuts
  • Beans
  • Peas

As a baby, Luke was allergic to other foods, which he then grew out of.  (There are baby pictures of him with a red, rashy face and hands after eating corn, and I never recall him eating fish until adulthood).  The others, though, he did not grow out of.  I have a vivid memory of young EczemaExcellence and Luke, happily munching Sociables crackers together in the family car and then him promptly throwing up over the back seat (must have had whey or something in them – oops).

My mother got off blessedly free of any of the “atopic triad”, while my dear old dad must have been the carrier since he has all three as well (pretty mild as I’ve known him, although he was very sickly as a child with asthma).  Dad does not have any food allergies save the vague complaint that “Honey makes my mouth itch”.

So it makes me wonder – is there reason to believe that I would be sensitive to the same foods that Luke is allergic to?  I DO eat a lot of nuts and beans, but haven’t linked them directly to any ill effects.  And, while dairy DOES seem to be linked to making me itch, eggs seem to be quite benign (I recently ate six eggs in a 24 hour span and noticed no difference in symptoms).

Do allergies, food or otherwise, run in your family?  Do you and your parents/siblings have similar or different food sensitivities/allergies?

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Exercising with Eczema and Asthma

running-shoes-many-pairs-colorfulI like to exercise.  I also have both eczema and asthma.  I don’t talk a lot about asthma on this blog, mainly because it’s quite well controlled (thankfully) and doesn’t impact my daily life like eczema does, but many people, like me, are in the same boat with the “atopic triad” of allergies, asthma, and eczema.  So this post is my take and my musings on exercising with both of these conditions.

ASTHMA:

I have been on Singulair for about 10 years.  I just take one pill every evening, and I’m generally able to exercise and do whatever I want, wherever I want.  I do have a rescue inhaler (ProAir), but I barely need to use it.  My asthma, though, if it comes on, is usually exercise-induced.  There are three instances in where I will get short of breath and feel my asthma start to affect me:

  • If it is very hot and humid out.  This doesn’t happen much in the upper Midwest here, but when it does, this will actually make me SUPER short of breath.  I have woken up (rarely) during a hot summer morning barely able to breathe and grasping around frantically for my rescue inhaler.  This is also where I have an audible whistling wheeze when breathing, because my airway is just so narrowed.  During these infrequent situations, exercise is completely out of the question, as I get winded just existing and schlepping  around the house.
  • If I am exercising hard in very cold weather.
  • If I have started to exercise reasonably hard without a warm-up.

If you are reading this blog and you’re a non-asthma sufferer, here is an approximation of what it feels like to have asthma.  Take a big breath.  Really big.  As big as you can.  Go on, try it!  Did you do it?  Holding your breath?  Good.  Now try to take another breath on top of that one.  Feel how uncomfortable it is to try and suck down more air?  Of course, that would simulate REALLY BAD asthma, so to simulate more mild asthma, take like half a big breath.  It’s still an uneasy feeling to know you can’t get a full amount of air into your lungs.

My advice to other exercising asthma sufferers: DO NOT UNDERESTIMATE the power of the warm-up.  I am an impatient person when it comes to exercise.  I want to go out and do it, get it done, feel accomplished, and move on with my day.  I want to launch into high energy activities like running and kickboxing FULL TILT.  I do not like to warm up!  But, I know that I will often start to get that uncomfortable feeling, maybe even start to wheeze a little.  It is so much better if I ease into it gradually, or if I do a warm-up for 5-10 minutes first.  Cooling down is also a good idea.

Also be aware that having asthma can make you tired during exercise.  Even if you are not actively wheezing or feel short of breath, your airways might still feel compromised and the respiratory muscles of a person with asthma have to work harder to get that air in.   Sure, I have had days where I had to cut my exercise short because of this, and felt very disappointed.  However, I have kept at it and been able to build up my cardiovascular fitness and do lots of fun exercise-y things, like a 2 hour kickboxing jam, a 60 mile bike ride, and a full marathon.

ECZEMA:

No matter what your state of eczema or how uncomfortable your skin, I am a firm believer that exercise is always good for you.  The release of stress, the increase in circulation, the psychological benefit to your self-esteem and well-being – all excellent.  It doesn’t even have to be hard exercise where you sweat, as sweat can irritate eczema.  Walking, light yoga, and weight training are all good choices that are not extremely sweaty activities.

For me, I don’t generally get too itchy DURING activity – the exercise itself is usually enough of a distraction.  But, when exercise is over, if I am really sweaty and let the sweat sit on my body (i.e., if I don’t get to shower immediately after), or have been wearing clothing tight to the body that holds the sweat in, I can start to get itchy.

However, this can be a double-edged sword.  Although theoretically I should be wearing very light, loose, minimal clothing so that the sweat won’t get trapped, sometimes I simply cannot wear shorts without feeling self-conscious, if I have rashes and am in a public place like a gym.  Tank tops are usually no problem as my arms are often okay, but my legs have been one of my worst rash sites for years.  Even when they are rash-free, I have lots of scars from scratching.  I belonged to a large gym in the past, where there were rows and rows of treadmills, and I could kind of hide away in a corner treadmill with minimal worry that people could see that I had eczema.  Here, I would run in running shorts, but as soon as I was done, I would put on athletic pants and THEN be able to walk back to the weight-lifting floor or back out of the gym feeling covered up and secure.

Another option if you want to get really sweaty and get a great workout, but don’t want to worry about feeling on display, are group fitness classes.  Depending on the gym (and this held true for the one I went to), the classes are often held in semi-darkness with dim lighting.  Also, I guarantee people aren’t checking out your skin… they’re too busy concentrating on their own moves during the class.  I would go and take a spot near the back row, bring a long sleeved tech shirt and/or pants with me, exercise in shorts, etc., and then put on the covering-up clothing before I walked out of the studio door into the bright lighting.  I’m actually considering going back to this gym – I haven’t belonged to it for months just ’cause I have had a bad bout of feeling very self conscious, eczema-wise, and also I’ve been simply exercising outside which is free.  I also want to go back to the gym as I would like to become more regular about doing yoga – I think the calming meditative aspect of it might benefit my eczema in situations where I scratch simply out of habit and/or stress.

Home exercise also must not be underestimated.  I will be frank that I get kind of lazy and unfocused if all I have is an exercise DVD.  I find it hard to get the motivation to do it, since there are always other things I could be doing around the house.  I would much rather exercise outside if I can.  But, I have been using some P90x on DVD here and there, and it is nice to be able to wear whatever I want and not have to worry about anyone seeing, since I’m in the privacy of my own home.

What are your experiences exercising with eczema and/or asthma?  Are there any activities you avoid?  What are your favorite ways to exercise?

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