What is worse than asthma? my mother is 50 years old and has a severe case of asthma. i think there is a deeper problem and the doctors are missing it. in the past year she has been hospitalized twice due to the extreme swelling. she is currently on the h

Your : Your mom should request to have pulmonary function tests done, she may be dealing with COPD not asthma. She should also have an echocardiogram of her heart to rule out heart failure. She needs a chest x ray at minimum and possibly a ct scan of her chest. I hope she finds answers and relief soon.

I'm : I'm sorry your mother is having so much trouble. Unfortunately, asthma is sometimes so severe that it can only be controlled with high-dose steroids and round-the-clock nebulizer treatments. Your description of your mother's pulmonary function tests is classic for someone with asthma, which is the archetypical obstructive pulmonary disease. By definition, obstructive pulmonary diseases interfere with exhalation to a greater extent than inhalation, although both functions are usually impaired as these diseases progress. The obstruction seen in asthma is caused by narrowed airways -- bronchi and bronchioles, mainly -- not by anatomical problems in the throat. In essence, the pipes that carry air to and from the lungs are simply too narrow to do their job. As you know, steroids have some significant side effects, including fluid retention. This extra fluid can compound the underlying congestive heart failure that frequently accompanies chronic obstructive pulmonary disease. (the physiology is somewhat complex, but COPD causes heart failure by increasing the "backpressure" on the right side of the heart. As the heart fails, patients tend to retain more and more fluid, which further worsens the heart failure, leading to a vicious cycle that's sometimes hard to break.) your mother's situation is pretty typical for someone with chronic, severe asthma. Her thrush should certainly be treated, of course, and she should not be exposed to smoke, aerosols, and allergens if at all possible, but her symptoms are caused by what's happening in her lungs. She might benefit from supplemental oxygen therapy (if she's not already on it), but her doctors are probably giving her the maximal doses of the best medications to control her asthma.