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87 years old. Taking medicine for asthma. Not getting cure. Suggest effective treatment

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General & Family Physician
Practicing since : 2009
Answered : 3094 Questions
My mother is 87 yrs old. For many year years she has been battling asthma and one infection after another. She has been treated by her PC and her pulmonologist, with antibiotics, prednisone, and nebulizers. Now for the last several months, she is getting these episodes one after another. We are at our wits end trying to find the reason for this problem. I do not feel she is getting the right care. We want to send her to another doctor, but do not know what kind. Any suggestions?
Posted Thu, 14 Mar 2013 in Asthma and Allergy
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Hi and thanks for the question,
before changing a doctor, I would love that we get a closer look at a few issues with respect to her health condition, chronic asthma.
- Taking drugs alone might not be enough to manage this condition if she is continually being exposed to an allergen or asthmatic trigger. It would be important to consider if she has changed environment lately, changed town or house lately, is there any new drug that has been introduced in her regimen since then she started having these attacks?
- There exist other more potent drugs for the control of chronic symptomatic asthma than prednisolone, and also corticosteroid nebulizers with proven benefit in chronic resistant asthmatic conditions like Seretide mut be tried before coming to such conclusions. Bronchodialators like Bricanyl are real options. I think there are sill many options in his management that have not been tried yet.
- There are infectious diseases that could have asthmatiform presentations and these conditions must be also considered carefully in patients resistant to treatment. These include pulmonary Aspergilloses, Pulmonary Larav migrans syndrome or Loeffler, s syndrome, atypical bacteria, Pneumocystis carinni infections. These conditions must be studied and excluded before insisting on asthma as main diagnosis. A chest X XXXXXXX gives a simple manner in excluded heart manifestations like in heart failure, that could preset in some cases like what is called cardiac asthma.

I would suggest you XXXXXXX a Pulmonologist for all these issues to be carefully studied and considered. If all the other conditions are excluded and asthma retained as the main diagnosis, environmental triggers should d be sought and other intensive treatment options in asthma be tried.

Thanks and best regards,
Do not hesitate asking further questions if need be, will be honored giving my suggestions.
Luchuo, MD.
Above answer was peer-reviewed by
Follow-up: 87 years old. Taking medicine for asthma. Not getting cure. Suggest effective treatment 22 hours later
During one of her hospitalizations they found the bacterial infection psuedomonous in the lower lobe of her lung. She takes Advair already.
Answered by Dr. Luchuo Engelbert Bain 10 minutes later
Hi and thanks for the question,
she should the drug she is currently on till the end. Then lets see how she will be clinically. I hope and believe it should work.
That not withstanding, she should still see her pulmonologist at the end of treatment for evaluation.
Thanks and best regards,
Still ready to give my contributions,
Just the best,
Luchuo, MD.
Above answer was peer-reviewed by
Follow-up: 87 years old. Taking medicine for asthma. Not getting cure. Suggest effective treatment 6 minutes later
My mother said that she feels her asthma is pretty much in control. It is the frequent respiratory infection, which exacerbates her asthma, is the problem.
Answered by Dr. Luchuo Engelbert Bain 42 minutes later
Sure, I think she will need a more intensive treatment, one that deals with atypical germs.
I suggest she gets some Levofloxacine 500mg, 1 tablet daily for 10 days. thanks and hope it helps.
Luchuo, MD. Thereafter, if there are other issues we would see other alternatives. I suggest this and Believe it could be of help.
Above answer was peer-reviewed by
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