Please review my logic regarding an increase in SC rating. I am currently SC (6602) 10% for asthma bronchiole and would like to increase it above 10%.
Here is a snippet from 4.97 - Schedule of ratings - respiratory system
6602 Asthma, bronchial
FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications
100 %
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids
60 %
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication
30 %
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy
10 %
Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.
Here are the corticosteroid I was prescribed in my medical records
2009-12-16 Aristospan corticosteroid (Non-VA, for lumbar epidural injection)
2009-12-11 Asmanex 220 mcg - Mometasone furoate corticosteroid inhaler (VA)
Note: I was prescribed Prednisone and Medrol corticosteroids orally three times within the last 12 months.
I also take a Singulair pill and a puff from my Albuterol inhaler daily.
Regarding Mometasone Furoate
The Asmanex 220 mcg instructions say to inhale once daily at bedtime.
The Nasonex 50 mcg instructions say to spray twice in both nostrils twice daily.
Inhaled
220 mcg
Nasal
50 mcg x 2 sprays x 2 nostrils x 2 times per day = 400 mcg
I'm getting 620 mcg of this stuff per day!
Without taking my Albuterol inhaler, I can blow about a 350-400 l/min on my peak flow meter. For my age (38) and height (68"), I should be normally pushing about 650 l/min, placing my lung capacity at about 54-61% of normal. If I take my Albuterol inhaler, things improve a good bit.
Please review and offer your recommendation as to the appropriate SC percentage.
Question
Vync
Please review my logic regarding an increase in SC rating. I am currently SC (6602) 10% for asthma bronchiole and would like to increase it above 10%.
Here is a snippet from 4.97 - Schedule of ratings - respiratory system
6602 Asthma, bronchial
FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications
100 %
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids
60 %
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication
30 %
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy
10 %
Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.
Here are the corticosteroid I was prescribed in my medical records
2009-12-16 Aristospan corticosteroid (Non-VA, for lumbar epidural injection)
2009-12-11 Asmanex 220 mcg - Mometasone furoate corticosteroid inhaler (VA)
2009-12-11 Nasonex 50 mcg - Mometasone furoate corticosteroid nasal spray (VA)
2009-11-03 Aristospan corticosteroid (Non-VA, for lumbar epidural injection)
2009-10-23 Asmanex 220 mcg - Mometasone furoate corticosteroid inhaler (VA)
2009-09-03 Asmanex 220 mcg - Mometasone furoate corticosteroid inhaler (VA)
2009-09-03 Prednisone corticosteroid (VA) *** 1 ***
2009-08-28 Nasonex 50 mcg - Mometasone furoate corticosteroid nasal spray (VA)
2009-04-07 Nasonex 50 mcg - Mometasone furoate corticosteroid nasal spray (VA)
2009-02-13 Nasonex 50 mcg - Mometasone furoate corticosteroid nasal spray (VA)
2009-01-15 Prednisone corticosteroid (VA) *** 2 ***
2009-01-06 Medrol corticosteroid (Non-VA) *** 3 ***
2008-12-01 Decadron corticosteroid (Non-VA)
2008-10-02 Prednisone corticosteroid (VA)
2008-09-10 Decadron corticosteroid (Non-VA)
2007-11-09 Prednisone corticosteroid (VA)
2005-05-24 Prednisone corticosteroid (VA)
2002-03-27 Prednisone corticosteroid (VA)
Note: I was prescribed Prednisone and Medrol corticosteroids orally three times within the last 12 months.
I also take a Singulair pill and a puff from my Albuterol inhaler daily.
Regarding Mometasone Furoate
The Asmanex 220 mcg instructions say to inhale once daily at bedtime.
The Nasonex 50 mcg instructions say to spray twice in both nostrils twice daily.
Inhaled
220 mcg
Nasal
50 mcg x 2 sprays x 2 nostrils x 2 times per day = 400 mcg
I'm getting 620 mcg of this stuff per day!
Without taking my Albuterol inhaler, I can blow about a 350-400 l/min on my peak flow meter. For my age (38) and height (68"), I should be normally pushing about 650 l/min, placing my lung capacity at about 54-61% of normal. If I take my Albuterol inhaler, things improve a good bit.
Please review and offer your recommendation as to the appropriate SC percentage.
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