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 When to start emergency Prednisone
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Jillar
Rookie

USA
7 Posts

Posted - Apr 11 2021 :  12:28:58 PM  Show Profile  Reply with Quote
Hi everyone, last January I went into ICU with respiratory failure and was told I had severe emphysema. After 10 days in the hospital I was sent home. The meds I'm on now are
Trelegy once a day
Azithromycin 250 M-W-F
Albuterol rescue inhaler
O2: 2L 24/7
Amlodipine for high blood pressure
Low dose aspirin
I was also given a five day treatment of prednisone in case of a flair up.
My question is I don't know when I should use the Prednisone. I currently have a cold and am terrified of ending up in ICU again. My new pulmonologist had me do a DNR because my lungs are so bad so I think if I went in I wouldn't come out, if you know what I mean.
I have very little if any phlegm.
Thank you for any help you can give me

Dave-OH
Administrator

USA
4353 Posts

Posted - Apr 11 2021 :  1:59:03 PM  Show Profile  Reply with Quote
Prednisone is for inflammation. It does not sound like with a cold you are at that point. Keep an eye on your symptoms. If worse on Monday, call your doctor for advice.

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
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Jillar
Rookie

USA
7 Posts

Posted - Apr 11 2021 :  2:06:42 PM  Show Profile  Reply with Quote
Thank you for your reply.
But how will I know when I'm to the point of needing to use it? My pulmonologist isn't the quickest to reply to messages as he works in two different cities and our hospital. And my general Dr doesn't know much about COPD and just tells me to do what the pulmo tells me to do... :(
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jmrommes
Contributing Member

2135 Posts

Posted - Apr 11 2021 :  8:49:20 PM  Show Profile  Reply with Quote
I agree with Dave, but I'd add this caveat. Make an appointment to see the guy and take a copy of an Action Plan with you. Here's a good one:

https://www.copdfoundation.org/Learn-More/Educational-Materials-Resources/Downloads.aspx

Use it to have a conversation with your pulmo and the two of you figure out what your yellow flags are and when you should react and how. Use this opportunity to find out more about your disease, what you can do to manage and control it rather than flounder around, even though you've got good tools. Ask, for instance, why he gave you prednisone and not an antibiotic. My doc gives me both and I start whichever meets the criteria we've established and then call his office to let him know what's going on, what I've done and ask what else he wants me to do.

Exercise not only lets me live, it enables me to have a life.
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Jillar
Rookie

USA
7 Posts

Posted - Apr 11 2021 :  10:27:17 PM  Show Profile  Reply with Quote
Thank you for your reply. I don't have an iPad or iPhone so am not able to download the action plan :(
I am on Azythromycin 250 3x a week and so just have the emergency Prednisone for now. He seems to be good about refilling my prescriptions so I think if I needed both he would write one. Its just getting my insurance to realize its separate from my existing prescription of 3x a week.
I have been looking at the videos for the action plan and feel a little better about when I should go into action but this is all so new to me and my first cold since getting out of the hospital so I was freaking myself out a little.
Sorry so long, I hopefully can find a print out of that action plan to start using. Thanks again, jillar
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jmrommes
Contributing Member

2135 Posts

Posted - Apr 12 2021 :  10:14:56 AM  Show Profile  Reply with Quote
You don't need a phone or tablet to download the Action Plan to. Simply click on the link and then print it to take with you. A hard copy is easier to deal with in the doc's office and they can make a copy for your files. You can also take it back and forth when you need to review it and make changes, which should be done annually. If you're posting on this forum, you have the capability of getting the Action plan downloaded and printed.

Exercise not only lets me live, it enables me to have a life.
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Jillar
Rookie

USA
7 Posts

Posted - Apr 12 2021 :  1:25:51 PM  Show Profile  Reply with Quote
Hi jm, I wasn't able to download it with that link. It just took me to a logon screen and my username and password that I use here wasn't working. But I did scroll down and finally find it and was able to print it out. Thank you very much. Here's the link I used to get it:
https://www.copdfoundation.org/Downloads/MyCOPDActionPlan.pdf
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Sandy9s
Senior Member

USA
606 Posts

Posted - Apr 12 2021 :  4:36:48 PM  Show Profile  Reply with Quote
I do everything in my power to keep from going on the prednisone I have here. This is because 2 yrs. ago, I went into Afib after being on high doses of the prednisone for over a month. Everyone has different triggers of "when I'm bad."

My "bad" is not breathing because I have too much mucus and phlegm blocking all of my airways and I cannot get it out during a coughing spell. When "bad," these coughing spells happen 3 and 4 times a day or night. And they totally wear me out. Nothing seems to help, including generic Mucinex 400 mg. x 3 times each day.

In addition to all of my meds, I start using my personal steam inhaler. This helps a lot. I also have a Smart Vest (percussion vest) which I use back up to 3 times a day. My normal meds are:

Trelegy x 1/day
Azithromycin 250 mg. x 3/week
Combivent Inhaler (rescue)
Duo Nebs (in nebulizer) x 3/day
Diltiazen 360 mg. x 1/day for Afib
Lasix 20 mg. (sometimes 40 mg) for edema
Eliquis Generic x 2/day (blood thinner due to Afib)

On 02 -- 24/7 -- 2.5L/most times; 5L when showering

Anyway -- by doing all of my "tricks," I can sometimes get past the thought of needing prednisone. Sometimes I do a 10-day regimen beginning with 10 mg. or 20 mg.

The idea is that having an Action Plan makes the COPD "seem" more manageable.

If you have to use your prednisone, it's not the end of the word -------- just use it up.........and then call your Pulm. to get some more. It's a cheap medicine.
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Jillar
Rookie

USA
7 Posts

Posted - Apr 12 2021 :  5:34:47 PM  Show Profile  Reply with Quote
quote:
Originally posted by Sandy9s

I do everything in my power to keep from going on the prednisone I have here. This is because 2 yrs. ago, I went into Afib after being on high doses of the prednisone for over a month. Everyone has different triggers of "when I'm bad."

My "bad" is not breathing because I have too much mucus and phlegm blocking all of my airways and I cannot get it out during a coughing spell. When "bad," these coughing spells happen 3 and 4 times a day or night. And they totally wear me out. Nothing seems to help, including generic Mucinex 400 mg. x 3 times each day.

In addition to all of my meds, I start using my personal steam inhaler. This helps a lot. I also have a Smart Vest (percussion vest) which I use back up to 3 times a day. My normal meds are:

Trelegy x 1/day
Azithromycin 250 mg. x 3/week
Combivent Inhaler (rescue)
Duo Nebs (in nebulizer) x 3/day
Diltiazen 360 mg. x 1/day for Afib
Lasix 20 mg. (sometimes 40 mg) for edema
Eliquis Generic x 2/day (blood thinner due to Afib)

On 02 -- 24/7 -- 2.5L/most times; 5L when showering

Anyway -- by doing all of my "tricks," I can sometimes get past the thought of needing prednisone. Sometimes I do a 10-day regimen beginning with 10 mg. or 20 mg.

The idea is that having an Action Plan makes the COPD "seem" more manageable.

If you have to use your prednisone, it's not the end of the word -------- just use it up.........and then call your Pulm. to get some more. It's a cheap medicine.



Thank you very much for the clues Sandy #129303;
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gms
Member

USA
148 Posts

Posted - Apr 24 2021 :  12:00:56 PM  Show Profile  Reply with Quote
quote:
Originally posted by Sandy9s



In addition to all of my meds, I start using my personal steam inhaler. This helps a lot. I also have a Smart Vest (percussion vest) which I use back up to 3 times a day. My normal meds are:



Sandy, when you use your steam inhaler do you just use water or are you adding some saline to it? My mucus has really been getting worse the past few months and it's getting harder to clear it. Thought I'd try a steam inhaler to see if that will help.
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Sandy9s
Senior Member

USA
606 Posts

Posted - Apr 24 2021 :  4:21:19 PM  Show Profile  Reply with Quote
gms asked if I add saline to my steamer. The answer is no -- I just use bottled water.

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rjh-spokane
Member

USA
84 Posts

Posted - Apr 26 2021 :  02:39:31 AM  Show Profile  Reply with Quote
Jillar, I have found the best thing for me is to nebulize albuterol 4 times a day as prescribed. Then if I have problems similar to yours, I nebulize two dosses' at once. Sometimes I use a vial of saltwater with the albuterol to get more moisture into my lungs to thin the mucus so i can cough it out. Your not having any mucus to cough out may be that is is too thick to cough out.
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Sandy9s
Senior Member

USA
606 Posts

Posted - May 09 2021 :  7:29:17 PM  Show Profile  Reply with Quote
Well, it seems I didn't respond fast enough to my earlier inclinations to start a prednisone regimen! Friday night, 911 had to take me into the ER due to Respiratory Failure due to COPD exacerbation. I had been coughing a lot for 2 weeks from the cold virus that my husband gave me. Of course it landed right into my copd/bronchitis and emphysema. But I thought it was under control -- NOT! Friday midnite I started shivering very hard, found that my SATS were only at about 87 and not going up -- even with my oxygen on. Couldn't get much air out or in. And my Pulse rate was reading about 125 (up from normal 84). I knew I'd better get to the ER. As it turned out, it took the 911 people half hour to get to our house. I survived by breathing very shallowly.

In the hospital, they said it was Reapiratory Failure and I was given steroid injections and breathing treatments. They helped to open up the breathing passages. I was put into a Hospital Room about 7 AM, where I stayed until Sunday afternoon (today at 2:30 PM). I'm home now with a 4-day 20 mg. prednisone regimen, Zyrtec once a day, azithromycin x 3/week (normal), mucinex x 3/day, normal duo nebs x 4/day, normal combivent inhaler.

Whew! I'm somewhat better, but still tight in my chest -- doing some phlegm coughing up, but not near enough yet.

Of course I'm edgy as to what's next. But what I learned is that I should not have waited so long to start the Prednisone. So HOW do we determine when it is correct to start the prednisone regimen???
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jmrommes
Contributing Member

2135 Posts

Posted - May 09 2021 :  9:04:17 PM  Show Profile  Reply with Quote
Sandy, the coughing and the cold should have sent you to your doc or started the pred. Those things aren't something we can mess with. As soon as you get something respiratory, you start pred or see your doc or both or at least call the doc. i'd take the action plan that's linked in a message further up this thread and go through it with your doc. Between you you should be able to figure out your yellow flags. See the last one? I feel like I'm catching a cold.......that's your yellow flag! If you don't like that form, here's a page where there are a number of them. https://tinyurl.com/bzkn77kb

Exercise not only lets me live, it enables me to have a life.
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