Brief Answer:
Recommend: steroid inhaler, Tessalon, cool outdoor air.

Detailed Answer:
Hello XXXXXXX

I have asthma too, and can relate to that this must be miserable.

Although croup is less common in adults than it is in babies and children, it can still happen to adults. It gives a deep hoarse cough that feels like it involves your vocal chords too. That is because it causes inflammation of the larynx, trachea, and bronchi.

So I am not surprised that you are starting to wheeze and don't have a voice. It does sound like you may have croup.

Given that you have a history of asthma, if you are not already on one, you likely need a corticosteroid inhaler to decrease the inflammation in your airways. That is if you are otherwise breathing ok. If you are starting to get quite tight in your breathing, then an oral corticosteroid may be needed as an inhaled one may take longer to start working. If you are already on a maintenance steroid inhaler, your doctor may want you to double the dose until this current episode resolves.

In addition, cool moist air is very good for the inflammation of croup. There is the phenomenon we see as doctors working in ER where parents call with a sick child who has a severe barking cough and is gasping for breath. But when the family would arrive in the ER the child would be breathing comfortably. And what made the difference was the cool or cold air the child was exposed to on the way over to the ER. Some doctors recommend vaporizers but that is going in the wrong direction for this. Bundle up and go outside when the inflammation is worse at night time.

Finally, if the coughing is causing chest wall pain, and the codeine isn't helping, talk with your doctor or urgent care doctor. Codeine is a good cough suppressant but doesn't work for everyone, and possibly you may benefit from Tessalon (benzonatate) instead.

I do hope you feel better soon. Please let me know if I can provide further information or help.

---

Brief Answer:
Double the dose of fluticasone (Flovent) is generally recommended.

Detailed Answer:
Yes, the recommendations are to double the dose of inhaled steroid during a period of increased risk for asthma exacerbation.

Tessalon is generally safe but allergic and sensitivity reactions have occurred in people who have allergies to the class of medicine that lidocaine is in (the anesthetic used for numbing in dental work or wound suturing), and in people who are sensitive to PABA. A lot of the side effects that have been reported are due to people chewing or in other way opening the capsules (such as allowing them to dissolve in the mouth). Also, you should not go over the prescribed amount. Given these guidelines, the side effects should not be that worrisome.

---