My son who is 45 years old has asthma from the last 40 years.in the last 3 months he had severe attacks which was very near to DEATH  and was dangerous.THE FIRST ATTACK WAS WHEN HE WENT TO TOILET - HE GOT AN ATTACK WHICH WAS LIFE RISK.   HIS FACE TURNED BLUE - LOST HIS CONCIOUSNESS.ACCIDENTALY BY THE GRACE OF GOD ONE FAMILY MEMBER GAVE MOUTH TO MOUTH RESPIRATION AND SAVED HIS LIFE.    MEDICALLY NOTHING WAS FOUND.HE WAS TRATED BY NEBULIZER IN A HOSPITAL    HIS LIFE WAS SAVED.THE SECOND FEW DAYS - SOON AFTER GETTING FROM BED HE WEN TO URINAL.   WHEN HE WAS ALMOST EMPTYING HIS URINE HE GOT A SEVERE ATTACK OF ASTHMA - BREATHLESSNESS .THE THIRD ATTACK WAS A DAY LATER EXACTLY THE SAME WAY.  FIRST THING IN THE MORNING AS SOON AS HE GOT OUT OF THE BED IN THE EARLY MORNING IN THE END OF URINATION HE GOT HIS 3RD ATTACK - SAVED BY NEBULIZER.CAN YOU HELP ME - CAN YOU DIRECT THE TREATMENT- I AM SENDING THIS MESSAGE FROM   I N D I AEMAIL  -  YYYY@YYYY                 YYYY@YYYY
Hello, Thank you for asking at Chat Doctor. I went through your sons history and would like to know more about him as follows:a. He has asthma since childhood. How it was treated? What were the medications used? What are the medications he is currently using?b. Regarding 3 episodes of fainting, what were his symptoms? How did he lose balance? Did he have black out? Was his blood pressure measured at that time? How much time it took to completely recover? I want to know this as such things could be due to postural hypotension or anaphylaxis, a more serious form of allergy.c. As all 3 episodes of fainting occurred in washroom, is there anything special about washroom? Is there mold inside washroom? (mold is a very common allergen) Does it contain fumes of acids/cleaners, etc’d. How are his asthma symptoms in between? Does he have breathing difficulty, cough or wheezing?e. Are there any seasonal variations?f. Does he have any other medical conditions? Does he take any other medications regularly/frequently?g. Does he have nose symptoms? - nose congestion, sneezing, running nose, etc.?h. Does he have any digestive problems? Constipation, acidity, heart burn, etc.?i. Does he smoke? Any other exposure to dusts, smokes or air pollution?j. Is stresses an important factor in his life? Does stress worsen his symptoms? Above details would help me to know more about his health and therefore to make more specific suggestions for him. At present, from your provided information, I would like to make more specific suggestions for him as follows:1. I would suggest him spirometry with post-bronchodilator reversibility testing. This will help to know his lung capacity, status of his asthma as well as it will also help to better choose his medications.2. I would also suggest him allergy testing for common allergens. In addition, I would also suggest him serum total IGE and baseline serum treatise levels. (serum treatise levels are done only at a few centers in India at present)3. If such further episode occurs, I would also suggest you to get him examined by a doctor as soon as possible, get his blood sugar and blood pressure measured. 4. As he has severe asthma, I usually suggest my such patients regular use of inhalers like inhaled corticosteroids. For in-between asthma symptoms, I would suggest him to use albuterol inhaler on as-and-when-needed basis. Further medications can be suggested only after detailed information.5. In general, I would suggest him plenty of fluids during day to maintain HY Chat Doctor.  I would also suggest him to not immediately stand up after awakening in the morning. He should sit upright in the bed for a few minutes and then slowly stand up and go to washroom. This may help if he has postural hypotension. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish your son the best of the health ahead. Thank you & Regards.