But the steroids for treating severe asthma weren’t helping him to breathe easier or feel better. And a recent a study presented at the European Respiratory Society’s annual meeting in Barcelona, Spain in September supported Gaudet’s sentiment. Researchers found that people with severe asthma are less likely to respond to steroid treatment than those with mild asthma. The study was based on data from 300 children and 700 adults, some with severe asthma, some with mild to moderate asthma, and some without asthma. The study found that 55 percent of adults with severe asthma who were on regular oral corticosteroids had more airway obstruction than those with mild to moderate asthma. The patients with severe asthma still had exacerbations and severe symptoms despite chronic steroid therapy. Additional studies are necessary to determine why exactly this is the case. Gaudet said he was born “wheezing and short of breath.” He wasn’t diagnosed with asthma until he was about 4 though. He took steroids for asthma from age 15 to age 35, and when he was 49, his asthma was so severe that he had to retire from his job as a respiratory therapist. Today, Gaudet, 59, said he’s lucky to still be alive. He has had so many asthma-related emergency hospitalizations that he can’t count them all.

Chronic Breathlessness – The Norm For Severe Asthma

“All asthmatics can have a bad attack and [may] need a burst of oral corticosteroids once a year,” said Ileen Gilbert, MD, a pulmonary specialist at Froedtert & The Medical College of Wisconsin. But a very small percentage of the asthma population, perhaps 2 to 3 percent, have asthma so severe that they need to take low-dose steroids every day or every other day to control it long term, Dr. Gilbert said.  When you have an asthma attack, the inside walls of your airways swell and narrow.  Steroids work by reducing inflammation and swelling in the airways, allowing air to flow better, Gilbert explained. The problem is that oral steroids are carried to all parts of the body, not just the lungs, and can cause side effects including insomnia, weight gain, osteoporosis, high blood pressure, and high blood sugar. Gaudet found that some of the side effects of the steroids he was on were worse than his asthma. “And the longer you’re on the drug, the worse the symptoms get,” he said. Side effects that Gaudet suffered from as a result of asthma medication included bone problems (osteoporosis), skin problems (spontaneous bruising), and constant insomnia.“I was miserable on [steroids],” he said. “It got to the point really where I felt like I would rather die than stay on them.” Gaudet suspects he built up a resistance to the oral steroids over the years. “I respond only when I’m on IV, when I’m getting 300, 400, 500 milligrams per day. Lower doses don’t seem to help me any. I think it is because I’ve been on them for so long.” Gaudet’s pulmonologist now has him on bolus therapy, meaning he is given a large dose of corticosteroids intravenously only when he flares. “A high dose of [steroids] will get me over the hump, and then they put me on pill form and gradually wean me off,” Gaudet explained. RELATED: 7 Ways to Manage Weight Gain With Asthma Meds Though Gaudet stops taking oral steroids between bouts, he is not completely off steroids. “I’m on massive amounts of inhaler steroids,” he said. Gaudet has a nebulizer machine at home that he uses about six times a day. Inhaled steroids go only to the lungs, so used in short bursts, they are less likely to cause serious side effects. He also carries an inhaler that he uses about six times a day. Gaudet believes that because he’s never known what it’s like to breathe normally for any length of time, he has a higher tolerance for respiratory discomfort than most people. “I’m just at a low level of breathlessness all the time,” Gaudet said. Even so, he doesn’t let that discourage him from being active.

Breaking Records With Race Walking

Gaudet, who also has a blog called Breathinstephen.com, has found that exercise is an important part of coping day to day with severe asthma. He is a race walker and made headlines in 2009 when he became the first person with end-stage lung disease to complete the Boston Marathon. (It took him longer than seven hours.) He did it again in 2010 and 2011. These days 26 miles is too much for him, but he still race-walks a couple of miles most days, twice a day – early in the morning and early in the afternoon. “The only time I don’t walk is when I’m in the hospital,” he said.

Gasping For Air  When Oral Steroids For Asthma Stop Working   Everyday Health - 78