Re: cold air asthma--advair seems to make me catch every infection under the sun. albuterol only helps a little. what other options are there?

Controllers: Controller medicines help your airways heal and prevent asthma attacks. Besides advair, there's symbicort (budesonide and formoterol) and plain steroid inhalers like flovent, qvar, pulmicort. There's also singulair. Take your controllers regularly when colds weather hits. Any other factors during chilly weather time? Forced air heating with dirty filters=more dust? More mildew or mold?

Ipratropium: My asthma patients, and I have quite a few, don't report increased respiratory infections when they take advair or other inhaled corticosteroids to help control their asthma. Quite the opposite, really. So this unusual association is something you should report to your physician. Atrovent (ipratropium) is a useful bronchodilator that can help block symptoms of triggered asthma by cold air.

Be Careful: A study published last year in the journal of allergy and clinical immunology revealed that asthmatics on inhaled steroid therapy are at higher risk for strep pneumonia.

Reduce dose: Advair contains inhaled steroids that have been demonstrated to increase the risk of pneumonia, the risk increases with higher doses. Your best bet is first prevention by limiting exposure to cold air. Next is using the lowest effective dose of steroids possible. Your doctor can choose a different steroid as well. Options that do not include steroids are limited. Check for airborne allergens.