Chasing the effects of Symbicort and COVID-19 as my illness moves into its third week
By Dawn Pier
Special to JenniferMargulis.net
Nineteen days ago, I got sick with what was probably COVID-19. You can read that story here. I’ve been quarantined, alone out in the countryside, living in a solar-powered beach house off-the-grid for twelve days now. I’ve also been taking Symbicort, which has created a combustible mix of other problems. Between Symbicort and COVID-19, I’m not sure what’s causing what.
Self-quarantine worked out reasonably well for me. I have internet, so I can keep working. Friends have dropped essentials off at the gate or outside the house, like green apples, bone broth, and vegetables, taking care not to come too close.
Four days ago I really felt like I was on the mend. The hacking cough I had when I first got sick was gone, which I attributed in part to the inhaler of Symbicort my doctor prescribed at double the dose (two puffs two times daily).
I did notice though that my tongue didn’t feel normal and my sense of taste was “off.”
Nothing tasted good, not even the homemade organic whole wheat bread I’d made or the red wine a friend gave me.
I poured myself a small glass as a treat to go with the bread. It tasted so bad that I was pretty sure it had gone off.
Symptoms of COVID-19 or something else?
Friends told me that loss of taste was another COVID-19 symptom.
I was having other symptoms: nerve twitches, cramps in my feet, and general muscle weakness and fatigue. I attributed all of this to the virus. I didn’t even consider Symbicort and COVID-19, or one and not the other could be at work within my system.
But as the days rolled by, I started to wonder when I was going to feel truly “well” again.
While my muscles felt fatigued, I had a lot of mental energy. So much so I was having trouble settling down at night to go to bed. I kept having a surge of energy right at night, kind of like I’d had coffee, which I rarely drink.
Several friends called to ask me how I was doing.
“Better,” I said. “But weird. My energy feels off,” I heard myself commenting.
“I’m sure it’s just that you’ve been so sick,” they reassured me. “You just need to rest.”
Something about that didn’t sit right with me though. Except for the muscle fatigue, I started to realize that the symptoms I was having weren’t normally those you get recovering from an illness.
A racing heart
The next morning, I got up and did my morning routine, including making myself a cup of green tea and using my inhaler of Symbicort.
I paused after pouring the hot water over the teabag. I noticed I felt like I’d had caffeine already. A lot of caffeine. Right then, my boss texted me. I’d forgotten we had a video conference call. I grabbed my mug and headed to the computer.
Throughout the day, the sensation that I’d had too much coffee—we’re talking 10 double espressos here—got worse. At one point I felt like my heart was going to pound itself out of my chest. I tried to take my pulse. My heart was beating so fast I couldn’t count it, not even for 15 seconds.
I started to feel claustrophobic and anxious like my whole body was inside a massive vice grip squeezing down on me.
I tried to push the sensation away and focus on the work in front of me. I had pressing matters to deal with, especially having missed a lot of work with my past illness. But as I read legal opinions online, I couldn’t focus.
Several times during the day I forced myself to get up and move around. I made myself a large brunch—a two-egg, bean, and cheese burrito—thinking maybe something heavy would bring my energy down.
I drank copious amounts of water, but couldn’t slake my thirst.
The frantic sensation that consumed me continued unabated.
Late in the afternoon, I couldn’t take it anymore. I had to do something to dissipate the crazy energy. I called the dogs and took them for a walk on the beach.
Partway through my walk, I could still feel the anxiety and pressure in my chest.
I told myself to breathe, to try to relax. I invoked the Sanskrit mantra, “Om Namah Shivaya,” and tried to do walking meditation. I’d chanted the mantra for a minute or so when a memory popped into my head.
Around 1990, when I was in university, my friend Arnie, a chronic asthmatic, sat on the couch in my living room coughing and having trouble catching his breath.
“Why don’t you use your inhaler?” I asked.
Arnie took a big gasp of air and responded in a wheeze about using Symbicort, “I have to be careful about using it too often. It can give me heart palpitations and makes me feel high.”
He gulped some air before continuing, “Some people really like the sensation and get addicted to their inhaler. I hate the feeling.”
Back on the beach in Baja California Sur, I realized what was going on.
Symbicort and COVID-19, side effects from which?
Symbicort is used to treat wheezing and shortness of breath. It contains 2 medications: budesonide and formoterol.
- Budesonide is a corticosteroid that works by reducing irritation and swelling of the airways.
- Formoterol is a long-acting beta-agonist that works by opening airways in the lungs to make breathing easier.
Symbicort side effects can include headache, nausea, fungal infections in the mouth, heart palpitations, and blood pressure spikes. More rarely it can cause pneumonia. It’s also been associated with death.
Some people use Symbicort without any noticeable effects. Others experience severe side effects.
When Jennifer asked about Symbicort on Facebook, hundreds of people chimed in. Some said it’s a drug that’s saved their lives. But, like with another problematic but frequently prescribed drug, Tamiflu, others who have taken Symbicort say they’ve experienced dangerous side effects:
“As someone who has asthma and takes albuterol during attacks, I can tell you I do everything I can to NOT have to take it because it causes about 12 hours of heart racing and dizziness for me. I hate the stuff but it keeps my airways open.” ~Kassandra.
“Severe anxiety is a very well known and very common side effect of all steroids. My daughter, when in college, suffered severe anxiety following a prescription of prednisone for anaphylactic shock. She literally thought she was going crazy. Doctors were of no help. It was a school counselor who figured out the cause. So this reaction should come as no surprise.” ~Charles Solis.
“Years ago I took it for asthma. Gave me heart palpitations, adrenalin rush (like a dozen espresso shots), etc. Different people react differently (as you know). The adrenalin rush helps open up the airways.” ~Vivienne.
Even more chilling: “Symbicort almost killed me and I’ve been fighting every day for the last 5 years to stay alive. I cannot begin to explain the agony this drug helped induce.” ~Mathias.
Back at home, I did a search online, “Symbicort heart attack.”
I’m not being melodramatic. I’d felt all day like my heart was going to explode. A few expletives ran through my head when I read about a Taiwanese study of over 280,000 participants.
The study, published in the January 2018 issue of JAMA Internal Medicine, suggested that COPD patients who initiate new treatment with Symbicort and other long-acting asthma inhalers:
“may be at a heightened risk for serious heart problems during the first 30 days of treatment. [My emphasis.]
… The analysis indicated that patients who used either type of long-acting inhaler were 50% more likely to experience cardiovascular problems like a heart attack or stroke within the first 30 days of initiating treatment.”
I pulled up another website, which laid out all the potential side effects, many of which I’d been experiencing. Then I came across this one: stomach discomfort.
My pulmonary specialist first prescribed Symbicort to me in early January when he diagnosed me with asthma. In late January, I came down with acute pain in my stomach.
A gastroenterologist told me the lining of my stomach was irritated. He attributed the irritation to my habit of drinking water with a tablespoon of apple cider vinegar first thing in the morning and because I like to put cacao powder and cinnamon in my tea.
The cheap tequila I’d shared with some friends a few days earlier hadn’t helped either.
Now, reading about the side effects of Symbicort, I started to wonder if my stomach pain had been caused by the inhaler. By early February, I’d stopped using it. My lungs felt healthy and my cough was gone. The stomach pain went away with medication and dietary adjustments.
More heart problems in the middle of the night
At 10:00 p.m. that night, I felt the tension in my body start to let up a bit. I took my pulse. It was 80 beats per minute. My normal resting heart rate is 58.
At two o’clock in the morning, I was still wide awake and, I admit it, freaking out.
When I walked into the bathroom to brush my teeth, I glared at the inhaler dispenser and resisted the temptation to throw it out the window.
As I slid into bed, I wondered, was I going to have a heart attack that night?
“Your heart is strong. You’ll be fine. Go to sleep!” I told myself.
I turned off the lights and said a prayer. I could feel my heart in my chest, aching, not in grief, not for a lost love, but physically sore from pounding so hard and so fast it was like I’d been in a running sprint all day.
The next morning I woke at dawn as I always do, but made myself go back to sleep, my orange tabby curled against my lower legs.
I woke at 10:30 a.m., grateful to open my eyes.
The Symbicort sits untouched on the bathroom vanity. This drug isn’t safe for me. I’m never using it again. In this time of hyper-focus on the pandemic, it’s worth asking if Symbicort and COVID-19 are a good combination. And rather than wonder if it did permanent damage to my heart, as soon as the threat of COVID-19 is over, I’m going to get checked out by a cardiologist.
Editor’s Note: The post is not medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Do not ignore professional medical advice in seeking treatment because of something you have read on-line. If you are having a medical emergency, please close the computer and dial 911 (if you are in the United States) or call your doctor immediately. Patients should be advised to consult their doctors before making any changes to any prescription medication.
About the author: Dawn Pier is a Canadian living in San Jose del Cabo in Baja California Sur, Mexico. She’s a writer, surfer, environmental scientist, and real estate agent. Dawn Pier worked as a research scientist and did fieldwork at military radar stations. She earned her Master’s degree in Science, with a specialty in Biology, from Queen’s University in Kingston, Ontario, one of Canada’s top universities. Dawn spent ten years (from 1992 to 2002) as a research associate studying the role of arctic vascular plants as indicators of organochlorine redistribution from local point sources. She has also published original research on PCBs in sea turtles in Baja. In 2002, Dawn decided she’d had enough of the cold, however, and moved to the tiny off-grid village of Cabo Pulmo on southern Baja’s East Cape to follow her dream to learn to surf. To her surprise, she ended up founding a community organization, Amigos para la Conservacion de Cabo Pulmo, A.C. (Friends for the Conservation of Cabo Pulmo), to protect the coral reef in Cabo Pulmo National Park (CPNP) and worked as its director for several years. Thanks to her efforts and those of the local Mexican community members, in 2012, the park was declared the most successful marine park in the world, when it was demonstrated to have experienced a 463% increase in fish abundance over a nine-year period starting in 2003. She blogs at “Dawn Revealed” and is currently working on a memoir, tentatively titled Wavestruck.