Does Advair cause weight gain?

This is something that has been discussed a lot in asthma communities, as you can see here and here and here and here and here and here. Yet there has been very little documented evidence as to whether it is true or not.

Someone askes me this question here, and my answer was a quick, "Studies have shown that if you rinse your mouth out really well after using your Advair inhaler systemic side effects are very rare."

Yet considering the broad discussions on this topic, I'm now wondering if I was wrong. Is it possible that Advair does cause weight gain.

Asthma.emedtv.com notes that while weight gain was not listed among the side effects of Advair during initial testing, many asthmatics on Advair have noted weight gain. So perhaps further testing on this is merited.

I know I have seen some websites note that the higher dose (500/50) of Advair have been linked to increased side effects, even if you rinse your mouth after each use.

Yet most studies show that if you rinse your mouth well after using the lower dose of Advair (250/50) side effects are rare. So, this makes me wonder if I might be correct, and perhaps all those folks complaining of Advair weight gain were either on the higher dose, or not rinsing.

Still, for some reason that doesn't seem plausible.

Another consideration that might cause weight gain for some who take Advair, and this is listed as a possible side effect, is possible fluid retention. Now this may lead to weight gain. Of course fluid retention is also a complication of illnesses such as heart failure, so if you have this then you ought to be calling your doctor.

As far as my experience with weight gain and Advair, in the past when I did the Body For Life diet I lost up to 40 pounds in one 12 week period. Yet recently I only lost 20 in 20 weeks. Now this could be age catching up to me, or the fact I didn't stick to the diet as well as I did in the past.

Yet, and this idea crossed my mind, it could be that I am now on Advair. When I lost 40 pounds in 2002 to when I was trying to get in shape for my wedding, I was not on Advair. And, chances are, I was not the most compliant with my Flovent. So the level of steroids in my blood may be higher now than then.

However, I am only speculating. My weight loss has been slow as compared to in the past. Other folks on Advair who exercise have also noted a similar slow weight loss, or none at all. So I'm not alone in thinking this way.

Yet any of us who choose to blame the Advair may simply be trying to come up with an excuse for being overweight. I'm not blaming the Advair at all, just curious. Yet I have observed that I am constantly hungry. Is this genetics or Advair? Hard to know for sure. No studies have been done.

So what do you think? What is your experience with Advair and weight gain? Are there studies out there I'm not aware of? Discuss.

It appears mosquitos love asthma blood

My 1 YO baby had a large mosquito bite on her back, and so I humbly got out the bug spray and sprayed her little body to prevent any further damage. Moments later I noticed I was wheezing and a little tight.

This brought back a memory of many bug bites on my legs. I remember I used to get more than most other kids. I'd be up all night itching away, and by morning I'd have scarred up legs. Usually by the time school started in the fall I was glad there was a no shorts policy at our school.

I remember how there could be 20 people sitting around a camp fire, and all the mosquitos would be around me. Sometimes I could see a dark, swarming cloud of the little annoying pests over my head. They loved me, or at least my blood, and I hated them. I kept swatting and they kept biting. Yet I stayed outside because I was a kid, and loved the outside. I wanted to be like a normal person, and hang out where the fun was.

Yet I remember my mom and dad not allowing me to use bug spray because if I used it I usually had trouble breathing. I don't know if it was the smell or something in the spray itself. So there was actually a double edged sword per se, where if I used the spray the bugs didn't get me but I had trouble breathing. And if I didn't use it the bugs got me and I could breathe.

And it seemed that for some reason, even if no one used bug spray, the bugs just seemed to swarm around me. I don't know why this was. Perhaps they loved asthmatic blood better than normal blood.

As an adult this doesn't happen so much. Now I can use bug spray most of the time and it doesn't bother me. I suppose this could be because my air passages are larger, yet I bet it's also because modern wisdom has allowed me to obtain better asthma control.

The neat thing about my episode last night was I never had to use my rescue inhaler. I simply waited it out, and the long acting beta adrenergic I obtained from using Advair earlier in the day did the job. It's neat how that works. It never was like that in years past.

I never really thought of it when I was a kid, how much asthma effected my life. I never realized how tough of a kid I was, being willing to tough out another asthma attack just so I could be normal and hang with my relatives and friends.

The asthma never stopped me, and neither did the bugs -- bug spray or not.

Strabismus: Day 7-10

If you thought the redness, swelling and itchiness would be gone by day 10, you guessed wrong. However, over the past four days the irritation has progressively improved. I am now to the point I can actually keep both eyes open during the day, although vision is still blurred in the operated on eye.

I actually had to skip several of my children's baseball games, even though I figured by now I'd be able to go. I missed both due to windiness and blowing sand. This is also the main reason I find I'm unable to go to the beach.

When I had this surgery when I was 15 I remember being told to avoid getting your eye wet by swimming for at least a couple months, yet my doctor told me this time on more than one occasion he only wanted me to keep my eye dry for a week. However, I feel much more comfortable not swimming, and not getting my eye wet. Maybe there's been some research that shows it's okay, but until I see it first hand, I'm not swimming.

I still find myself with the urge to rub my eyes, something I'm prone to habitually do anyway due to chronic allergies. And I can't wait until I can rub my eyes at will again.

So everything's pretty much back to normal otherwise. The asthma is considerably good considering the high heat and humidity, the constant sound of lawnmowers, and the pollen of summer.

Tomorrow I get to go back to work, and I'm looking forward to it actually. I imagine I'll be getting a lot of looks and questions about my red eye.

---

Update:

August 28, 2010: By about the three week mark the itching is pretty much gone. The eye feels relatively normal. I'm still tentative to touch or rub it though.

August 19, 2010: Saw the eye doctor today. He said everything looks good, including alignment, and he expects the eye to be good for another 30-40 years. He said there is still some redness and swelling, although minor. He also noted my healing process will take a little longer due to all the eye repair I've had in the past. No big deal. Feeling good. It's really neat as I navigate through life with my new vision. The surgery was definitely worth it.

Strabismus surgery day #6

Ah, if day #1 was the worse for having strabismus surgery, day #6 was the second worse. By now I'm feeling no pain, yet the itching in my eye is downright terrible. The worse part about the itching is it feels as though there are little bugs in there trying to get at my brain through my eyeball.

Although I saw my doctor today and he insisted the surgery was a success. My vision is still blurred in my right eye, but he insists as the inflammation goes down the itching will subside and my vision will be good as ever. His optimism was repeated by the eye muscle specialist.

So instead of having me use antibiotic eye drops, from now on it's prednisolone eye drops. Yes, good old steroids work to reduce inflammation just about anywhere in the body, and for me not only do I take inhaled steroids, it's eye steroids too. Only for the case of my eyes, it's only temporary.

After the 3 hour round trip to my opthamologist's office my eye was so itchy I had to start rubbing my left eye just so I could rub something. That's probably the worse part about having an itchy eye post strabismus surgery is you can't touch the eye. I also have allergies, so that probably doesn't help either.

So there really isn't much you can do for itchy eye. My doctor said the steroids should help, although it will probably take a day or two. We often say in the medical field things can seem to get worse before they get better, and day #6 post strabismus surgery might just be that "worse" they are talking about.

From here on out I'm expecting a downhill ride. The irritation was so bad that I couldn't think, so I popped a couple vicodin pills I had left over hoping it would at least allow me to get through the rest of the day. I'd say it worked.

The strabismus surgery is worth it

Our Journey With Stabismus is a blog that journey's the tale of one family willing to do whatever it takes to help their child with strabismus, the esotropia type, that is his eyes, or at least one of them, are facing in. While I have the exotropia type, one of my eyes faces outward while I'm focusing with the other, I can relate that stabismus can provide some challenges.

For one thing, you can't focus really well. And when the sun is bright you have to close the eye that wants to drift up toward the sun. And sometimes when you come around corners your brain has a hard time deciding what eye to use, and the object you are looking for seems to bob back and forth. You have to stop, close one eye and focus in order to see it.

It can also make you see double at times, especially when you're tired. When you're tired your eyes wander even more; or they become lazy. So, you can see how getting stabismus fixed can really help a person. It will help put you on equal footing with other people. It may help you hit a baseball better, and make it easier to see a football, or the other player once as opposed to twice. And it will probably make you a better learner, as you'll be able to focus on the page
better.

I've always been able to read, but I'm not really fast at it. I remember my teachers putting me in a special class for reading when I was a kid, although I bet the real problem that my teachers, doctors and parents never figured out was that the real problem was probably strabismus.

So yes, despite the discomfort, and despite the nausea, and despite the fact that parents have to sacrifice several days to coddle their post operative child, the benefits of this surgery far outweight the disadvantages. And, despite a less than 5% chance of going blind in the eye if an infeciton occurs, the side effects are relatively rare.

I had the surgery when I was 2, 10, 15 and just two days ago at 40. So I’ve gone through the procedure at all stages of development, and I can honestly say it is well worth it. From the patient end, I can say it does feel kind of funny after someone pokes your eye, and there’s always that urge to rub it.

I remember being bothered by this when I was 10, which is why I had to be watched 24 hours afterwords back then. Of course today it’s an outpatient procedure, yet back in 1980 it wasn’t. Or maybe that was just because I was a kid. Well, the last strabismus surgery lasted 25 years for me, so hopefully your son’s procedure can last that long or, better yet, longer. I figure if mine lasts another 25 years I’ll be good to go.

My doctor told my wife as soon as I had the patch off it might seem to me he overcorrected, and that I still have strabismus, but he believes it will correct itself over time. Basically, your brain needs time to make the adjustment.

Pyrotechnics and asthma

As I was lying in the cool grass, a warm breeze crossed with smoke wafted over my shoulders and into the face of my Laney, a warning flashed through my head redolent with the snap, crackle, pop, fizz of the amateur pyrotechnics shows nearly at every angle around us.

Taking my eyes off Laney, and ignoring the chants of my wife and the discordant din of a thousand other voices, I turned to see what was going on around me, and noticed a thick, white cloud was covering the park. In the diminishing light, and peering through my sunglasses I was wearing to prevent Laney from poking my bad eye, the shadow of folks and the lights from each encampment made me think of a civil war camp surrounded by enemy fire. While the "enemy fire" during the Civil War, or the Revolutionary War was real, the enemy fire in the case of July 4, 2010, was the billowing remains of all the amateurs. Man, I couldn't believe how much smoke there was. And it wasn't going away anytime soon.

It was actually illegal to light armature pyrotechnics on the beach, or in the park, or near the playgrounds, or near the condominiums that lined the skyline behind me and to the East (a calm Lake Michigan sat to the West on this 87 degree, hot and humid evening), it was not even remotely possible for this to be enforced.

Moments later, when the real fire works show started, you could hear the bang of the bombs echo as they seemed to bounce off the condominiums. It was almost as though you could see the initial firework, followed by a bang, and then you'd hear the bang echo, and then you'd hear it again, moments later, as it seemed to ricochet off those condominiums.

So, while the other folks were busy entertaining their minds with the light show, or trying to aim Laney in that direction (as her mind was amazed by the light show yet easily sidetracked), I was busy looking around, and enjoying the noise and the smoke. Quite frankly, other than me, or other than the few who have a visual head and a love for history and no need to see any more fireworks, I doubt there were many who let their mind wander in such a fashion -- as they breathed in a puff of stale, humid, smokey air.

Hence, one could only have empathy for any asthmatics who might have been fighting in the wars of our past, where such encampments were common place, and the bangs, and the smoke. To avoid it would be nearly impossible. To avoid the humidity in days of old would have been impossible as well. So one could see, or at least this humble asthmatic, that war would also be a place for an asthmatic to avoid -- as well as the public pyrotechnics displays.

Today, yes today, this asthmatic and all those around me, would get up and wander to their cars, and slowly drive off, or walk away (as was the case with my family) to their cars where they would turn on the air conditioning and enjoy the fresh, cool air. And then they would go home and sleep in the comforts of their own cozy beds.

Now keep in mind none of the smoke was from the professionally set fireworks but from armatures . And the smoke didn't really bother my asthma, as mine is really well controlled. Although I can remember times in the past where there was poor asthma control, and the inevitable trip to the ER soon followed. I wondered how many asthmatics would be making such a trip this evening.

Stabismus surgery day #4

To peel the eye open in the morning it still takes a warm, wet cloth placed over the eye for about 15 minutes, followed by an eye drop properly inserted into the corner of the eye by my wife while lying in a supine position in the recliner.

However, despite that slow start, this was the first day I was actually able to keep my right eye open all day. I was actually back to my normal, dry humorous self as my wife and I ventured to my parent's to meet my brother who so happened to come up all the way from Detroit.

Today was also the first day I didn't need to take Vicoden to take the edge of the pain off, although my wife did make me take 800 mg of Motrin to reduce some of the inflammation. So, when my dad offered me a Natural Light I so humbly, and graciously agreed to take it.

And after that was gone, two more followed. Since I didn't eat much at that point in the day, the alcohol seemed to hit me hard, and it was there I realized that I got better relief from alcohol than from the Vicoden. I was thinking I should have just stayed drunk and I would have been fine throughout this whole process (of eye surgery).

Yet the down side to alcohol is you drink too much of it your system dries out, and a dry eye is not what I want right now. So I limited myself to the three Natty lights. Although they were among three of the best beers I've had in a long while.

The warm breeze from the southwest was absolutely beautiful to go along with the beautiful son on a clear blue day. And the social company of my brother and father was really nice. It was nice just to get out of the house for a change. It was nice to have my eye feeling good enough to WANT to get out of the house for a change. Hopefully I'll feel even better tomorrow.

My daughter is 20 months, and my brother's daughter is 12 months, and yet my brother's daughter is larger than my own -- although each equally cute. It was neat to watch them play together. While they had selfish goals on this day, I bet soon they will become good friends.

The biggest obstacle was keeping the wind from irritating my eye. Rather, the biggest obstacle was keeping my baby from poking out my eye. And for this the sunglasses came in handy. I also think it was the sunglasses that made me able to keep my eye open outside where the sun was shining brightly overhead. Yet by the tree, the shade and the breeze felt great.

Yet after a couple hours of socializing ache rushed into my head, and it was time to go back home. My eye is still blood shot red, and my wife noted that it looks as though my eye muscles are sitting atop the eye. Then she added, "But it looks better today." That's reassuring, I guess.

It was nice to make it through a day with both my eyes open, although my right eye still feels kind of prickly. It almost seems like it's been a lot of work keeping it open, and thus this seems to make me tire easily. Actually, I think what makes me tire easily is that I can't focus really well yet. I can't look left without my right eye watering or hurting. And I can't look right. So, as my wife noted earlier, I walk around without craning my neck: like a robot.

So I hope my kids are worn out soon, because this humble RT is ready for bed.

First, however, my wife must return with the gallon of Vanilla Ice Cream. This dad has a priority, and ice cream is #1 on that list. Ice cream, and then it's time for bed. The neighbors might offer me a beer, yet I might be forced to forgo it one more night.