Concerns About Asthma and COPD Treatment Effectiveness

Question #24803

45 days ago

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Concerns About Asthma and COPD Treatment Effectiveness - #24803

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Acum 4 luni am fost diagnostica cu astm bronsic gr 3.Am primit symbicort de 2 ori pe zi și o recomandare pentru CT. După citirea CT-ul mia spus ca am și BPOC gr 2.Diagmosticul final este Astm bronsic tr 3 parțial controlat terapeutic Bpoc st 2 GOLD/ACOS cu mici bule de emfizem pe lobi superiori.Mi sa mărit doza de symbicort la 3 pufuri pe zi și erdomed de 2 ori pe zi.Iau tratamentul după schema noua de 1 luna și situația nu sa îmbunătățit deloc ba din contra..În repaus saturația este 96–97%, dar scade la 85–87% la efort.Obosesc și la cele mai mici eforturi,uneori nu pot termina o propoziție din lipsa aerului.Acum 4 luni situația nu era atât de grava.Vreau să știu dac-ar fi nevoie sa ajusteze schema de tratament sau sa primesc un alt bronhodilatator și dacă este normal ca bolile sa evolueze atât de mult în 4 luni.Se pot opri cumva din evoluție?Capacitatea pulmonara acum4 luni era de 54% în condiția în care oboseam dar nu atât de rău.Sa ma aștept la o scădere semnificativa?

How would you describe your current level of breathlessness?:

- Severe breathlessness

Have you experienced any new symptoms since starting the new treatment?:

- Yes, several new symptoms

How often do you use your rescue inhaler?:

- Occasionally

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

44 days ago

Hello dear
See as per clinical history below findings are quite serious and require comprehensive evaluation
Lung capacity -54 percent
Copd
Oxygen saturation below 85 percent
I can suggest some precautions for improvement
Do kapalbhati and alom vilom for improvement in oxygen saturation
Start with mild exercise
Avoid excessive exertion
Stay hydrated
Take vitamin d sachet once a week for 2 month
Take zincovit multivitamin therapy onca a day for 1 month
Avoid cold food and dust exposure
The  current medication may require additionally medication also ( muscarinic antagonist) for improvement.
So please consult the concerned physician for modification in current regimen
Regards

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

44 days ago

Hello
Mulțumesc că ai descris atât de clar situația ta. Din ce ai povestit, ai astm bronșic grad 3 parțial controlat și BPOC grad 2 (ACOS), cu mici bule de emfizem, iar tratamentul cu Symbicort și Erdomed nu a adus îmbunătățiri, ba chiar simptomele s-au agravat: saturația scade la efort, obosești rapid și ai dificultăți la vorbit.
Ce se întâmplă și de ce:

- Este neobișnuit ca simptomele să se agraveze atât de mult în doar 4 luni, mai ales sub tratament.

- Saturația care scade sub 90% la efort și dificultatea de a termina propoziții indică o agravare a bolii sau o complicație (infecție, exacerbarea BPOC, insuficiență respiratorie).
- Capacitatea pulmonară de 54% este deja redusă, iar agravarea simptomelor poate duce la scădere suplimentară dacă nu se intervine.
Ce ar trebui să faci:

- Este foarte important să consulți cât mai curând un pneumolog pentru reevaluare. Poate fi nevoie de ajustarea tratamentului (alt bronhodilatator, corticosteroizi sistemici, oxigen la domiciliu, sau alte medicamente).
- Poate fi necesară o spirometrie repetată, analize de sânge (inclusiv gazometrie), și eventual o radiografie/CT de control.
- Nu opri sau modifica tratamentul fără consult medical, dar simptomele tale justifică o reevaluare urgentă.
Se poate opri evoluția?

- Da, cu tratament corect, monitorizare și evitarea factorilor de risc (fumat, infecții, poluare), evoluția poate fi încetinită sau chiar stabilizată.
- Exercițiile de respirație, reabilitarea pulmonară și vaccinarea (antigripal, antipneumococic) ajută mult.
Rezumat:

Situația ta nu este normală pentru evoluția astmului/BPOC sub tratament. Ai nevoie de reevaluare medicală rapidă pentru ajustarea schemei și prevenirea complicațiilor. Nu ignora simptomele!
Thank you

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

43 days ago

Este posibil să fie nevoie de o ajustare a schemei de tratament, având în vedere simptomele tale care s-au agravat. Combinația de astm și BPOC poate complica managementul și uneori necesită un plan de tratament mai cuprinzător. Dacă simptomele nu se ameliorează cu doza crescută de Symbicort și Erdomed, medicul tău ar putea lua în considerare adăugarea unui bronhodilatator cu acțiune lungă, probabil un beta-agonist sau un anticolinergic, pentru a îmbunătăți respirația. Este esențial să discuți aceste simptome agravate cu un specialist în pneumologie. Evoluția rapidă a simptomelor poate indica o serie de lucruri, dar nu este neapărat un prognostic inevitabil. Unele simptome pot fi controlate mai bine cu ajustări ale tratamentului, și cu monitorizare atentă. Factori ca expunerea la poluanți, fumatul sau infecțiile respiratorii pot accelera deteriorarea funcției pulmonare, așa că asigură-te că le eviți. Este important să continui monitorizarea periodică prin teste de spirometrie și să ai o relație strânsă cu medicul tău curant pentru ajustări rapide ale tratamentului în funcție de observațiile clinice. Managementul bolii, inclusiv suspendarea sau reducerea progresiei, depinde adesea de identificarea și eliminarea eventualilor factori agravanți și de un tratament adecvat individualizat. Discutați cât mai curând cu medicul despre simptomele tale pentru a ajusta planul de tratament la timp și a preveni scăderea semnificativă a capacității pulmonare.

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

44 days ago

Hello
În cazul tău (astm grad 3 + BPOC GOLD 2 / ACOS), scăderea saturației la 85–87% la efort NU este normală și trebuie reevaluare rapidă.
Symbicort este bun pentru astm și ACOS, dar uneori nu este suficient singur. În multe cazuri se adaugă:
bronhodilatator LAMA (ex: tiotropium)
terapie triplă inhalatorie
evaluare pentru oxigen la efort
reabilitare pulmonară
Evoluție atât de rapidă în 4 luni nu este tipică, decât dacă:
există inflamație necontrolată
infecție
exacerbări repetate
fumat activ
tehnica inhalatorie este incorectă
Capacitatea pulmonară poate scădea, dar tratamentul corect poate încetini sau stabiliza evoluția.
Recomandare: consult pneumolog cât mai curând pentru:
spirometrie repetată
test de difuziune (DLCO)
test de mers 6 minute
ajustare schemă (posibil terapie triplă)
Dacă saturația scade sub 88% frecvent la efort → necesită evaluare urgentă.
Nu este ceva ce ar trebui ignorat.
I trust this helps
Thank you

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

44 days ago

You have been diagnosed with Bronchial asthma (grade 3, partially controlled) and Chronic obstructive pulmonary disease stage 2 (GOLD), with asthma–COPD overlap (ACOS) and small emphysematous changes in the upper lobes.
Your current symptoms  severe breathlessness, oxygen desaturation to 85–87% on exertion, extreme fatigue, and difficulty speaking due to shortness of breath — are NOT normal for stable stage 2 COPD or partially controlled asthma, especially given that your condition was less severe four months ago.
This degree of worsening over a short time suggests:
inadequate control with the current treatment,
possible ongoing airway inflammation or bronchoconstriction,
possible disease exacerbation, deconditioning, or another contributing factor (such as infection, pulmonary hypertension, or cardiac involvement).

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

39 days ago

Situația pe care o descrieți nu este considerată stabilă și necesită reevaluare medicală cât mai curând, mai ales deoarece:
Saturația scade la 85–87% la efort (valoare semnificativ scăzută)
Dispneea este severă, inclusiv dificultate de a termina propoziții
Starea s-a agravat în ultimele luni, în ciuda tratamentului
Este normală o agravare atât de rapidă?
Nu este tipic ca funcția pulmonară să se deterioreze atât de mult în doar 4 luni dacă tratamentul este optim. Agravarea poate apărea din mai multe motive:
tratament inhalator insuficient pentru severitatea bolii
tehnică incorectă de utilizare a inhalatorului
infecție respiratorie persistentă
progresie inflamatorie activă (ACOS)
necesitatea adăugării unui bronhodilatator cu acțiune lungă suplimentar (LAMA) sau a altor terapii
Ce ar trebui făcut
Este recomandată consultație pneumologică rapidă pentru:
repetarea spirometriei
verificarea tehnicii de inhalare
evaluarea necesității de:
terapie triplă inhalatorie (ICS + LABA + LAMA)
oxigen la efort (dacă desaturarea se confirmă)
tratament pentru eventuală exacerbare
Important
Dacă apar:
saturație sub 90% în repaus
agravare bruscă a dispneei
dificultate majoră la vorbire
mergeți urgent la serviciul de urgență.
Veste importantă
Deși astmul + BPOC (ACOS) este o boală cronică, evoluția poate fi încetinită semnificativ prin ajustarea corectă a tratamentului, controlul inflamației și evitarea factorilor iritanți (fumat, praf, poluanți).

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

36 days ago

Scăderea saturației la 85–87% la efort, oboseala severă și lipsa de aer care s-au agravat în doar 4 luni nu sunt normale și necesită reevaluare rapidă a tratamentului și a bolii. În astm + BPOC (ACOS), uneori este nevoie de ajustarea terapiei (alt bronhodilatator, terapie triplă, oxigenoterapie sau investigații suplimentare), iar evoluția poate fi încetinită dacă tratamentul este optimizat. Consultați urgent un pneumolog pentru spirometrie repetată, test de efort și ajustarea schemei, mai ales deoarece simptomele s-au agravat sub tratament.

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Concerns About Asthma and COPD Treatment Effectiveness - #24803

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