[BeyondtheRainbow]

I mostly control my asthma without inhalers b/c they make me agitated. But this year I've been forced into treating it with inhaled steroids and the nebulizer which also agitates me.This brand of inhaler (dulera) is better but still not fabulous.

So now I'm manic, had the mania made worse by adding the inevitable June Mania and now I'm needing meds that make it worse. I don't have a choice; if it gets worse and I need oral steroids there's my ticket to IP until the steroids are out of my system. They are ugly for me.

My pdoc says I have to breathe and just to treat it and we'll figure it out. Which is really how it has to be. But I'm just wondering if anyone has any other experiences that have helped with the combination of asthma and bipolar. My family dr is great about doing what I ask for trying to control this so I can get nearly anything. (I don't do caffeine so that easy tip isn't going to help).

Thanks

i'm not asthmatic myself, but just wanted to respond (because no one else has yet. lol)

hope you find something that works out for you

[BeyondtheRainbow]

Thanks. You made me smile. That's rare right now so I really appreciate it.

[~Christina]

I know you avoid caffeine. One thing that actually helps breathing is strong black coffee , you can do decaf. It helps open the bronchial tubes. I often just had to suck it up and take the steroids and increase my self care tenfold to help ward off a ugly mania.

Can you maybe switch from the Dulera to a old medication? Advair? or Symbicort? they have a smaller profile for inducing mania in general.

Hope you find a solution.

[BipolaRNurse]

I have asthma and bipolar, and oral prednisone makes me manic. I have to take it every few years when my asthma gets out of control, and the only thing to do is increase my APs until the steroids are out of my system. I don't use steroid inhalers because my case is mild/intermittent and I hardly even use my rescue inhaler. But when it gets bad, it gets bad, and the only thing that keeps me out of the hospital is prednisone. You have to treat the breathing as the first priority, and BP comes in second unfortunately.

[BeyondtheRainbow]

Dulera is about a thousand times better than Symbicort. Advair didn't control my asthma at all. I've tried I think about 7 or 8 drugs, mostly trying to get stabilized and Dulera is by far the best. Asthma is still pretty new to me so I keep hoping someone will develop "no-agitation-works-great-inhaler". (I developed asthma at 34 after catching whooping cough at work. I was allergic to the shots so didn't develop immunity. So I've had it 5 years now. The first year or two it was out of control completely but after I quit working in an extremely polluted area in very dirty, smoky homes and then moved out of my old home it got a lot better which let me go to steroid inhalers only when I am sick or wheezing. I just live with some low level of wheezing most of the time that doesn't bother me and my dr and I have just worked this out so it is ok.)

Oral steroids mean immediate hospitalization. I have avoided them so far and hopefully always will but I've had them once before I was diagnosed or even that symptomatic and they put me way over the edge even then. I've seen a pulmnologist who after talking to my amazing family dr on the phone for 30 minutes plus reading a 3 page letter my dr wrote about his years of working with me and that I'm incredibly compliant but am aware of things I can't do safely was committed also to treating me without triggering mania as well. I can probably go back to him if I have to although it would be expensive and hopefully this is just a few weeks until the thing I'm most allergic to dies off. But oral steroids are really just not an option unless it is an absolute emergency and I've made it out of the emergency room after writing on a paper towel "no oral/injected steroids unless no other option: severely bipolar" and waving it until someone read it. The treatment that would work best for me would be Xolair, because my asthma is allergic and this test they do to see if you qualify I had like twice the cells necessary to qualify but I can't have Xolair because you have to be able to use an epi-pen and I can't do that safely with my MAOI. It's fun.

I'll try the decaf coffee although I kind of hate the flavor after I stopped drinking the caffeinated kind. Until then, (I don't even own a coffee pot so will have to try this when I'm out tomorrow) I guess it's inhalers and nebulizers.

Fun stuff.....

I have asthma and BP too. I had to go to the hospital once because of a steroid inhaler that induced mania for me. So hard! I've found that hot showers before bed help and essential oils like lemon, peppermint, or lavender for my allergies. I just rub them on my chest and wrists or diffuse them in my room at night.

[BeyondtheRainbow]

Right now the problem with this, which is the normal plan (start oral steroids, admit to psych unit until stabilized with extra drugs) is that I am already so unstable that I'm waiting to start a 2nd AP and am maxed out on 1500 mg of Seroquel along with a couple of low-dose weaker stabilizers (see signature) an a lot of benzos. Next week I'll either be starting Latuda (if my dr has managed to procure samples since she isn't allowed to stockpile them) or some other neuroleptic AP (unless my dr goes somewhere I'd be shocked about since I'm still hallucinating on this dose). So there is no increasing my AP and getting through this. I just have to deal with more mania from the albuterol and inhalers and make it through until I see my pdoc Monday. I already was manic and then started improving but my June mania hit right on time so I have mania stacked on mania with a nice layer of agitation from asthma treatments now and I'm pretty well stuck until next week. It's just one more thing that may land me IP for med adjustments next week and of course if they admit me and the exposure to allergens goes away then I will be fine in the nice hospital air. I've been through this before. For some oddball reason my hospital doesn't let nurses do inhalers, so an RT comes around twice a day to administer the inhaler that I don't even need in that sealed environment. It's goofy. After I had surgery last summer my dr put me on an inhaler even though I wasn't using one at home and they kept coming at the most ridiculous times, like partway through having my nerve block replaced which resulted in a lot of "STERILE PROCEDURE!!!" yelling which fortunately came from the attending and not the very nervous intern placing one of his very first blocks. Or when I was about to hop to the bathroom (a long trip ) or going to have a PT assessment. They were amazing. In psych they come at meals and so everyone gets to watch me fumble with using the oh, crap, lost my words, chamber that the med goes in instead of just using the inhaler directly. I cannot coordinate that thing. I know it is supposed to be easier but I mess it up. Especially when 9 other patients are staring at me.

I don't know. I'll get through this somehow and there just won't be oral steroids unless nobody can think of anything and my family dr has fought long and hard to avoid them to date to hopefully he's got more ideas. When I got this from pertussis that damaged my lungs he kept telling me that he felt bad because with my other meds and med allergies he can keep me alive but not comfortable. That's been our approach to asthma all along and I guess I just suck it up and am uncomfortable (and more manic) for a while.

Originally Posted by BipolaRNurse

I have asthma and bipolar, and oral prednisone makes me manic. I have to take it every few years when my asthma gets out of control, and the only thing to do is increase my APs until the steroids are out of my system. I don't use steroid inhalers because my case is mild/intermittent and I hardly even use my rescue inhaler. But when it gets bad, it gets bad, and the only thing that keeps me out of the hospital is prednisone. You have to treat the breathing as the first priority, and BP comes in second unfortunately.