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Post by dmb247 on Mar 16, 2015 2:31:39 GMT -5
Well after 15-16 years old, asthma symptoms magically disappeared (28 now), and I never had any issue with it anymore. Passed my spirometry with good numbers. It may end up that the double doses are just too much for me, and that's ok. But I'm going to ride it out and see if it gets better as I adjust to it. I didn't have this problem on the 4U carts. only a slight cough at first. It's just using 2 8U back to back thing seems to be a problem. I'll keep testing!
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Post by jpg on Mar 16, 2015 2:57:28 GMT -5
Well after 15-16 years old, asthma symptoms magically disappeared (28 now), and I never had any issue with it anymore. Passed my spirometry with good numbers. It may end up that the double doses are just too much for me, and that's ok. But I'm going to ride it out and see if it gets better as I adjust to it. I didn't have this problem on the 4U carts. only a slight cough at first. It's just using 2 8U back to back thing seems to be a problem. I'll keep testing! Thank you for the response.
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Post by silentbob on Mar 16, 2015 4:34:22 GMT -5
Good news about the Lantus dose! I'm glad your dose stops ballooning now!
Asthma is an inflammatory disease and your BG has been out of control, which could raise your level of inflammation (has your crp been increasing?). I'm just theorizing but your asthma may have been slowly creeping back, maybe below the level of detection, and either Afrezza or the deep inhalations could be making it noticeable now.
I agree with jpg, you should be careful. I am not convinced Afrezza is bad for all asthmatics, but this needs a lot more study and is currently a dark spot in our knowledge. It is up to you to consider the pros and the cons, but do keep in mind that you are might making a decision in uncertainty.
Good luck and take good care of yourself!
sbs
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Post by kball on Mar 16, 2015 6:07:18 GMT -5
silentbob, I will look into it, thanks. I've been increasing the Lantus so quickly because the result hasn't been as desired. The most I've one in a day is 8unit increase, and I am extra careful when I change anything. I'm checking my BG 12-16x a day sometimes. I'm up to 70U a day now, 35 2times, and I have found that seems to be the magic number. It keeps me steady once my post prandial BGs are sorted out. I haven't increased it in 3 days now, and it seems to be working pretty well. I am having issues with wheezing after taking 2 8U cartridges though unfortunately. Haven't had any asthma issue in nearly 15 years. I hope it sorts itself out like the cough did originally, but if not, Afrezza might have to be my #2 with Humalog being my primary insulin. in which case, I can see a pump in my future. dmb- As someone w Asthma (and likely to develop diabetes based on family history and my own numbers) i'm very interested in how this plays out. Can i suggest taking a 'slower' inhale of Afrezza. When my main asthma med went from a spray to a powder (due to ozone concerns i think) I would wheeze after inhalation because of the speed at which i inhaled. I was trying to get the medication in quickly and deeply. I started taking a nice even slow normal breath and no longer had an issue. Hope this works for you as well. Also, ive mentioned before but i always gargle and rinse w water after taking a dose but havent heard of Afrezza users doing this. Not sure if it'll help any. Good luck as you experiment.
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Post by dmb247 on Mar 16, 2015 15:38:00 GMT -5
Thanks guys. And I agree silentbob, it's definitely an unknown, but I don't mind testing it. I think Afrezza is worth it!
kball, today i pulled out my albuterol, took a puff, then did 16U with no problem at all.
I will try your technique of breathing in slowly and see how that works as well. I have definitely been putting a bit of effort in to the inhalation part lol.
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Post by kball on Mar 16, 2015 15:50:23 GMT -5
Thanks guys. And I agree silentbob, it's definitely an unknown, but I don't mind testing it. I think Afrezza is worth it! kball, today i pulled out my albuterol, took a puff, then did 16U with no problem at all.
I will try your technique of breathing in slowly and see how that works as well. I have definitely been putting a bit of effort in to the inhalation part lol. I was used to the Albuterol rescue inhaler technique which i always suck down far and fast. Then hold. I think thats why i initially did this with my powdered inhalation. But slow and steady seems better suited for it for sure. I had serious thoughts over about the first week if i'd need to change asthma medication, before i changed breathing. Not sure if Afrezza might produce a similar reaction
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Post by dmb247 on Mar 16, 2015 16:22:25 GMT -5
Thanks guys. And I agree silentbob, it's definitely an unknown, but I don't mind testing it. I think Afrezza is worth it! kball, today i pulled out my albuterol, took a puff, then did 16U with no problem at all.
I will try your technique of breathing in slowly and see how that works as well. I have definitely been putting a bit of effort in to the inhalation part lol. I was used to the Albuterol rescue inhaler technique which i always suck down far and fast. Then hold. I think thats why i initially did this with my powdered inhalation. But slow and steady seems better suited for it for sure. I had serious thoughts over about the first week if i'd need to change asthma medication, before i changed breathing. Not sure if Afrezza might produce a similar reaction It very well may be the case. I think I've been inhaling even harder with the 8U which may be a problem. I'm going to try your suggestion at dinner tonight.
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Post by dmb247 on Mar 16, 2015 23:40:46 GMT -5
I tried your suggestion at dinner and noticed far less discomfort from the 8U. i didn't need 16. I felt discomfort before with the 8U, but it wasn't bad at all, and this time was barely noticeable.
Also, big news. I added metformin back today just to see if I have a reaction to it. So far so good! And wow, it makes afrezza work 3X better!
I took 8U afrezza at a 118 mg/dl reading. I ate 30 carbs. I would normally dose 9U for this of Humalog. I expected after 2 hours to be around 120-125 with this dose of afrezza, and would have been around 100 with 9U of humalog.
I just checked and was at 77!!!! That's with just 1000mg of metformin today! I know I said I didn't want to take metformin, but in the 4 months i was on it, my liver enzymes were fine, so I'm going to continue this unless i start breaking out again and if my liver enzymes start to get funky.
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Post by kball on Mar 17, 2015 6:01:35 GMT -5
Good to hear. Definitely sounds like theres going to be a learning curve with Afrezza. Some may end up discontinuing use before getting things dialed in.
Can anyone confirm if their are clear or specific inhalation instructions besides 'at the start of meal"?
The velocity which it enters the lungs seems such an important point to cover.
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Post by silentbob on Mar 17, 2015 6:24:03 GMT -5
I tried your suggestion at dinner and noticed far less discomfort from the 8U. i didn't need 16. I felt discomfort before with the 8U, but it wasn't bad at all, and this time was barely noticeable. Also, big news. I added metformin back today just to see if I have a reaction to it. So far so good! And wow, it makes afrezza work 3X better! I took 8U afrezza at a 118 mg/dl reading. I ate 30 carbs. I would normally dose 9U for this of Humalog. I expected after 2 hours to be around 120-125 with this dose of afrezza, and would have been around 100 with 9U of humalog. I just checked and was at 77!!!! That's with just 1000mg of metformin today! I know I said I didn't want to take metformin, but in the 4 months i was on it, my liver enzymes were fine, so I'm going to continue this unless i start breaking out again and if my liver enzymes start to get funky. This is great news dmb! I hope you can continue with the Metformin long term! How much did you reduce your basal dose when starting the metformin? I ask because the Metformin will also increase effectiveness of the Lantus which could give you trouble at night? Also in the Afrezza prescribing information it is noted that there is supposed to be a 90-box of only 8U cartridges available. Did you manage to get your hands on those, or are they just as elusive as the 180 cartridge pack? products.sanofi.us/afrezza/afrezza.pdf
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Post by bobw on Mar 17, 2015 7:23:25 GMT -5
Thanks guys. And I agree silentbob, it's definitely an unknown, but I don't mind testing it. I think Afrezza is worth it! kball, today i pulled out my albuterol, took a puff, then did 16U with no problem at all. I will try your technique of breathing in slowly and see how that works as well. I have definitely been putting a bit of effort in to the inhalation part lol. Hi dmb, my wife has asthma and used albuterol, but never had good control. Albuterol is intended to treat acute attacks and does not work that well when used chronically. She started using Advair instead an hasn't had an attack in years nor has she needed the albuterol. If you find yourself frequently using albuterol you might want to talk to your doctor about it. It took us a couple of years to learn this.
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Post by kball on Mar 17, 2015 9:15:13 GMT -5
Thanks guys. And I agree silentbob, it's definitely an unknown, but I don't mind testing it. I think Afrezza is worth it! kball, today i pulled out my albuterol, took a puff, then did 16U with no problem at all. I will try your technique of breathing in slowly and see how that works as well. I have definitely been putting a bit of effort in to the inhalation part lol. Hi dmb, my wife has asthma and used albuterol, but never had good control. Albuterol is intended to treat acute attacks and does not work that well when used chronically. She started using Advair instead an hasn't had an attack in years nor has she needed the albuterol. If you find yourself frequently using albuterol you might want to talk to your doctor about it. It took us a couple of years to learn this. Not to get too far off afrezza...but dmb just tried what many asthmatics do when they expect a high probability of an imminent attack...like many who get exercised induced asthma attacks...and thats take a puff of albuterol to to prevent one. Some folks who use albuterol don't even know this trick and ultimately need a puff AND suffer the attack first. Better to not have the attack imo sounded to me dmb's asthma is a non issue and he only has a rescue inhaler out of history w the disease for the very seldom times he might one day have an attack
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Post by BlueCat on Mar 17, 2015 13:41:07 GMT -5
Hi dmb, my wife has asthma and used albuterol, but never had good control. Albuterol is intended to treat acute attacks and does not work that well when used chronically. She started using Advair instead an hasn't had an attack in years nor has she needed the albuterol. If you find yourself frequently using albuterol you might want to talk to your doctor about it. It took us a couple of years to learn this. Not to get too far off afrezza...but dmb just tried what many asthmatics do when they expect a high probability of an imminent attack...like many who get exercised induced asthma attacks...and thats take a puff of albuterol to to prevent one. Some folks who use albuterol don't even know this trick and ultimately need a puff AND suffer the attack first. Better to not have the attack imo sounded to me dmb's asthma is a non issue and he only has a rescue inhaler out of history w the disease for the very seldom times he might one day have an attack DISCLAIMER: NOT an MD. But definitely a patient of pulmonary doctors. So can speak to that experience. I had done that same transition to powder-based a while ago and had the same exact experience of fast inhale and gag. I have a puffer-fish like reaction to any irritant. Moving to slow and steady made the difference. Had poor control for years, and yep, rescue inhaler before suspicious activity always best. Good control on Breo now - another (relatively) recent FDA approval, using off label in US (tho on label in EU, interestingly enough). Net - agreed. Easy does it may make the difference with the Afrezza if its a lung sensitivity issue. IDEA - If you don't already have one of those home-testers (the one where you exhale and try to move the needle), perhaps your MD can prescribe/give you one for some basic home pulmonary function testing. Then you can chart it daily which would be much more granular than the occasional doc office visit. And you can even try to correlate before and after, etc. I think this board would be highly interested to hear the results between Afrezza doses and your numbers. Though, you'd best first baseline line it if you can (or if had earlier, healthy-normal numbers you could compare too.) Best of luck ! PS> Regarding liver - depending on other meds you may take, metaformin isn't the only drug that pulls on that liver. Like Spiro's experience - it can easily be cumulative across multiple drugs and eventually cause a problem. And who needs more
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Post by dmb247 on Mar 17, 2015 15:00:57 GMT -5
Another update! I wanted to really test afrezza today, so I went to carb heaven -- taco bell.
2 soft tacos, and a steak quesadilla. I took 500mg of Metformin, 16U afrezza - before meal, and 8U afrezza 40 mins after last bite
BG was 105 at start, and 114 1.5 hours later. This would have been in the 170s for sure had I used afrezza alone. I am amazed what metformin does in conjunction with Afrezza.
Thankfully I took Metformin for 4 months before starting the other orals, and had no issues/rash or change in liver enzymes which i why I am still willing to test it. I am just shocked right now at how well Afrezza can work when your resistance is lessened.
PS, i did use a puff of albuterol before the 16U and I felt nothing! Not that I am willing to do this every time, but I'm doing it so that hopefully I can wean myself off it. Also the 8U 40 mins later did not bother me in the least, even without an albuterol puff.
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Post by babaoriley on Mar 17, 2015 15:13:02 GMT -5
dmb, surely you know far better than I, but please consider telling your doc what you're doing, all that mixing and matching strikes me as worth discussing with a good doc.
Good luck.
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