first time being sick since pots...tips, what to expect?

[Ginger_]

it's the time of the year again where i can't tell if this is allergies or a cold coming on.  i know pots can flare with viral illness so any tips for preventing that or making it easier? i don't have a severe case of pots but I'd rather be safe than sorry with basic precautions

[MikeO]

6 minutes ago, Ginger_ said:

it's the time of the year again where i can't tell if this is allergies or a cold coming on.  i know pots can flare with viral illness so any tips for preventing that or making it easier? i don't have a severe case of pots but I'd rather be safe than sorry with basic precautions

Over the last few weeks i have noticed an uptick with my nose running (just after turning the heat back on). So that sparked me to do a thorough cleaning "carpet, bedding, dusting, replace furnace filters" not sure what else i can do either. I am finally going in for allergy testing this week. i am going to ask the same question. 

[Ginger_]

On 10/4/2022 at 9:52 AM, MikeO said:

Over the last few weeks i have noticed an uptick with my nose running (just after turning the heat back on). So that sparked me to do a thorough cleaning "carpet, bedding, dusting, replace furnace filters" not sure what else i can do either. I am finally going in for allergy testing this week. i am going to ask the same question. 

Ah that’s fair, I’m not sure if ours have been done yet.

interestingly I haven’t had a flare with it so far, quite the opposite in fact.  My HR has stayed the exact same walking around the house or while making the bed, when previously it would go up a noticeable amount with those activities.

[MikeO]

45 minutes ago, DysautonmiaMatt said:

@MikeO Perhaps a  good HEPA air cleaner would help. They also can clean all the HVAC duct work. Are they doing the needle stick test on arm or just blood work for allergy testing?

Hey. I just came back from allergy. They did a food panel on my back (sure i have a smiley face drawn on there i have not looked) Good news is i don't have a food allergy (epipen worthy) but the doc is going with food intolerance. Down side she did pick up on my weezing (has been bad the last few weeks) we did some respiratory tests and she is confirming asthma and has started me on prednisone and Trelegy. I did respond after taking the nebulizer med 37% to 52%.

I do go back in for more testing in three weeks. I know i have been labeled from copd, chronic bronchitis and asthma in the past i will have to work on who is dropping the ball on this one. But i am getting help. I am the gift that keeps giving.

My daughter did buy me a HEPA air cleaner sure it is time to fire it up again.  

 

[MikeO]

On 10/6/2022 at 6:12 PM, DysautonmiaMatt said:

Be very careful of prednisone which I am sure you know already as it can suppress your adrenal function among other things.

Well if this didn't come back and bit me. A couple of days into the treatment i started having chest pains (very noticeable from my normal) so i had to taper off the prednisone rather quickly. Looking into the root of what happened seems like prednisone has the grapefruit affect (CYP3A4 enzyme) which is contradicted with the ranolazine that i take. @Sushiknows all about this. Not sure if this is going to be a patient responsibly to screen my drugs first or do better at educating my healthcare folks in my neck of the woods (no one has ever heard of Ranolazine) i know it is not a typical drug prescribed but i have to say it is very effective.

https://reference.medscape.com/drug/ranexa-aspruzyo-sprinkle-ranolazine-342284#:~:text=prednisone will decrease the level,Avoid or Use Alternate Drug.&text=primidone will decrease the level,Avoid or Use Alternate Drug.

https://en.wikipedia.org/wiki/CYP3A4

[MikeO]

4 hours ago, DysautonmiaMatt said:

Might help to talk to your pharmacist. Seems many doctors do not know about stuff like this - especially an allergy doc and your pharmacist will know all the meds you are on and can check for interactions. Otherwise you will have to research each one and double check yourself which you should not have to do but that is a result of what I call our segmented health care system where specialists rarely communicate with each other. 

Well on this one i might have well whized down my pants leg. I don't blame allergy and if i would have asked pharmacy they would have just googled it. I did send out a flurry of messages as to what transpired. For now no more med changes.

[MikeO]

11 minutes ago, DysautonmiaMatt said:

I believe there is a way besides googling for a pharmacist to look up drug interactions. I think its one of their responsibilities when filling a script to check for drug interactions as a final check. My new primary care doc called me today about what to do with the Lexapro withdrawals/body readjusting I am going through and she wanted to script a drug I am already taking!  Just shows sometimes doctors don't look at all those forms we have to fill out.  

There is but real world just like Docs don't always look into drug interactions. I will never trust the pharmacy to tell me a drug interaction is ok (walgreens) I have seen insurance (we don't want to fill the drug you are already on a statin). Regardless i made the point with my care team. i am getting help.

[Pistol]

@MikeO @DysautonmiaMatt pharmacists and doctors alike have a program that alerts them if there is a drug that interacts with other meds. For example, my doctor prescribed a new med for me and his system alerted him that there was a potential side effect with Lexapro ( which I take ). But based on the nature of the potential adverse reaction he dismissed the warning because the benefit was greater than the risk. 

When I filled the prescription at the pharmacy they said they had to check with the doctor first because there was a potential interaction with the Lexapro. Of course the doctor told them to fill it and all was well. 

This is why it is important that we fill ALL our prescriptions at the same pharmacy and update our med lists at doctor offices because that is how they get alerted of interactions. As to why your doc was not aware of you already taking a drug - well, that sounds like he didnt do his job! My docs always look over my med list at every visit, and they review it again when prescribing new meds. 

[MikeO]

2 hours ago, Pistol said:

@MikeO @DysautonmiaMatt pharmacists and doctors alike have a program that alerts them if there is a drug that interacts with other meds. For example, my doctor prescribed a new med for me and his system alerted him that there was a potential side effect with Lexapro ( which I take ). But based on the nature of the potential adverse reaction he dismissed the warning because the benefit was greater than the risk. 

When I filled the prescription at the pharmacy they said they had to check with the doctor first because there was a potential interaction with the Lexapro. Of course the doctor told them to fill it and all was well. 

This is why it is important that we fill ALL our prescriptions at the same pharmacy and update our med lists at doctor offices because that is how they get alerted of interactions. As to why your doc was not aware of you already taking a drug - well, that sounds like he didnt do his job! My docs always look over my med list at every visit, and they review it again when prescribing new meds. 

Well at my 6 month PCP visits i always update my med list (my PCP only prescribes 2 of them and my Cardiologist has the rest) the clinic always prints out a ambulatory med list that i bring into other providers i.e Cardio, dentist, vascular, orthopedics and now this allergist. I don't fault any Doc as to not being familiar or ever hearing of a med.

Like you said she may have out wayed the risk over benefits or thought the risk way low enough. My ortho was willing to pull the trigger on the prednisone but i chose the lidocaine patches instead. The prednisone meds were filled in the office at the allergy clinic. 

No i don't trust a pharmacy telling me a potential drug interaction is OK.

I guess i need to still be my own advocate as a last line when it comes to meds. Prednisone is now on my charts no take list.   

[Sushi]

On 10/14/2022 at 5:05 AM, MikeO said:

Not sure if this is going to be a patient responsibly to screen my drugs first or do better at educating my healthcare folks in my neck of the woods (no one has ever heard of Ranolazine) i know it is not a typical drug prescribed but i have to say it is very effective.

Well, it shouldn’t be the patient’s responsibility but, I my experience, it often is. I always check interactions and metabolic pathways when I start a new drug as the doctors never do! Kinda shocking. Twice I’ve found life-threatening contraindications. And what about the majority of patients who would never think to check or not know how?