Question RE SOB

[asmakis]

I am in need of some answers and reasurement. I've hit this panic point with my dad- he is currently being weened off of Pregnesone (sp?) and is experiencing severe fatigue and SOB. He was only on the steroid for one month and it was great- he had energy and was not short of breath, but now that he is down to 10 mg a day, he can barely get out of bed and then even a short walk from the living room to the kitchen leaves him breathless. Any suggestion, advise, or words of encouragement would be so very much appreciated.

Amanda

[Elaine W]

Is SOB shortness of breath?

Some of the LCSC jargon isn't in our glossary.

[mary colleen]

Yes, shortness of breath. Well, here, anyway:)

[Chanwit]

Steroids do work their wonders but there is a price to pay. Lisa was given large doses of Dexamethasone IV in hospital and 4mg 3 times a day during her Whole Brain Radiation (WBR). (used to reduced and prevent swelling inside the scull) It works very well. Dexamethasone is stronger than Prednisone.

After that there was a tapering off. Lisa was very weak, feeling nervous and shakey and SOB.

She then tapered down with prednisone in ever decreasing doses and days of 5mg.

Sounds like your husband needs an O2 Concentrator to help him breathe and especially at night. That might help him have more energy.

Lisa took anxiety pills for her shakyness.

She never could get off the prednisone until she started taking Tarceva and that drug dissolved her lung cancer and she didn't need prednisone again.

Chanwit

[Connie B]

Seroids work different for everyone. Theose drugs do wonders for those of us that have SOB problems. Coming off of them can make us SOB again. It's a wonderful drug, but it can cause serious issues as well.

Have any of you or your family members talked to the doctor about this and asked what he or she thought about what was going on. Please don't leave the doctor's in the dark. They really need to know and they need to be kept on top of these issues. Its good for the patient and the doctor and the family to work together as a team.

Make a phone call and get some answers from the doc.

This is nothing to play around with.

Good luck.

[alicia]

Alimta is known to cause shortness of breath, which could be contributing to his problem. Perhaps the Predinsone kept it at bay, but without it, it is more severe. My dad just recently had a problem with Alimta. One of his main complaints has always been shortness of breath and the Alimta made it significantly worse.

==Alicia

[Linda661]

Amanda:

You have received excellent advice from others in this thread: the Alimta issue, steriod issues of themselves, etc. as potential contributors to SOB. I'll just add one further point as we just have to watch multiple contributing factors with this dx -- how's the red blood cell count? If it's low, that will also contribute to SOB problems.

Keep us posted.

Linda

[teresag]

Hi Amanda,

Shortness of breath can be caused by many things, including the disease itself. Other illnesses like COPD (emphysema/bronchitis), heart failure, & asthma can also contribute.

Medications (such as inhalers if airway narrowing is a problem) and breathing exercises to strengthen the respiratory muscles help. Of course, you will check with the physician first to see if there are medications that will be of use and to diagnose any new problems that need attention. There are also techniques that those with shortness of breath can learn. These have been shown in clinical trials to be helpful. If you wish, I will supply references to the papers.

Avoid the impulse to rest when feeling fatigued and short of breath - insufficient physical activity will worsen both of these symptoms. Although exercise probably seems out of the question now, as much activity as tolerable is a good thing. Slowly increase as able - simple things like lifting a can of beans to exercise the arms really do help.

It is important for people who are short of breath to realize that this symptom has "more bark than bite." That is, it is frightening to be short of breath, but

it does not mean anything threatening is going to happen. The human body has an astonishing sensitivity to minute changes in its respiratory system, and even though these changes are often not dangerous, they are interpreted as such by our brains. Most importantly, shortness of breath does not mean insufficient oxygen; in fact, there is only a weak relationship between oxygenation and shortness of breath.

It is very useful to control the anxiety that inevitably accompanies an acute episode of shortness of breath. Progressive relaxation, guided imagery, & self-hypnosis are among the array of methods that a person can learn while feeling well so they can be employed while short of breath.

Many of these techniques are taught in pulmonary rehabilitation programs. For various reasons, people with lung cancer are rarely offered this option, although it is quite effective for reducing shortness of breath and improving tolerance of physical activity. Ask the physician about it.

I hope that this current problem is temporary, and that a swift resolution is on its way. With wishes for easy breathing, Teresa

[DrWest]

Amanda,

In addition to suggestions others have posted, let me just add a few thoughts. You said that your father was doing well on a higher dose of prednisone but has had problems with SOB since tapering down to 10 mg per day. To me, that is a hint that the prednisone has likely been helpful treating inflammation in the setting of a post-radiation pneumonitis, or inflammation in the lungs within the field of prior radiation (especially if chemo is given with or after the radiation, it can increase the risk and/or severity, but can happen with radiation alone). Steroids do often help this inflammation, and some people have a hard time tolerating coming off of them. For these patients, they do well on a higher dose of prednisone, but become increasingly symptomatic as the dose of prednisone is tapered.

To me, your father's situation sounds pretty consistent with that picture; probably worth having him review the situation with his oncologist.

Good luck!

[bunny]

for what it's worth, my mom experienced SOB with each 'change' in her treatment, as if she had to adjust to each coming on/going off of medication, etc. for her, slowing down but continuing to move as much as she could manage helped regulate her breathing. I am pretty sure she also used an inhaler for a long time - may still use it. good luck to both of you.

[shineladysue]

Amanda,

My husband experienced pneumonitis as a side effect of Alimta. The doctor was treating him for what he believed was lung infection, but CT scan showed a broken glass pattern in the lungs which , evidently ,shows as a reflection of the infection from pneumonitis. His SOB became severe and the only treatment was to stop Alimta and take high doses of Prednisone. He was also put on oxygen to aid his breathing. I always hesitate a moment before posting about this , but I think that it has become evident across this board that SOB and inflammation in the lungs is tied to Alimta therapy.

I would take the time to search Alimta on the board and I think you will see a pattern worth taking note of and presenting to the oncologist.

I would like to say that all people respond differently to different chemo treatments and what happened with my husband or others does not mean it will happen to another. I just wanted to share our experience in that it may help.

Many prayers,

Sue