Vlogging With Cold Urticaria: Starting Montelukast (AKA Singulair) [CC]
17
November

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , /


Hello! I have laryngitis today, and for the
last 4 days, uh, I hope you can still kind of understand what I’m saying, but the captions
will be on so turn those on if it is a problem, and I- I apologise. [upbeat intro music] Montelukast, I have now started it, I have been on it for about 11-12 days now, I would’ve
waited until Laryngitis went away but it doesn’t seem to be doing that, and it is kind of relevant
to this video. Let’s start with the pharmacology of montelukast. Partly because I’m a big nerd
and I just think it’s interesting. It won’t be long, promise. So montelukast is what we
call a leukotriene inhibitor. Basically it stops the action of leukotrienes. What are
leukotrienes? They are a signalling molecule made by leukocytes which are a type of white
blood cell. I like to think of it like a group text. So in the case of Cold Urticaria these
white blood cells are exposed to the cold and they send out a group text message saying
“hey guys, it’s cold, we should do something about this to protect the body” and this group
texts goes out to all different types of white blood cells. so for example when a mast cell
receives this group text, this leukotriene, it sends out its own group text to rally the
troops, so it draws other white blood cells to the area of cold exposure, um and it also
causes some localised inflammation and this inflammation is the reason why we get chest
tightness and wheezing on exposure to cold, or in asthmatics, whatever triggers your asthma.
This response is the same for asthmatic patients which is why both asthmatics and people with
Cold Urticaria can both take this drug. And because it works on allergic inflammation
it can also be used to treat allergic rhinitis which is like allergic sniffles, sinusitis,
face pain, um, and urticaria. I have already got rid of my patient leaflet because I am
a chaotic mess, but I have here some- the side effects, so let me just read these out.
Some of the common side effects include upper respiratory infections so infection in the
nose or the throat. Fever, headache, sore throat, cough, stomach pain, diarrhoea, ear
ache or ear infection, flu, runny nose, sinus infection, there can be some serious side
effects including behaviour and mood changes including anxiety, bad or vivid dreams, confusion,
agitation, trouble sleeping, suicidal thoughts or actions, hallucinations; increase in eosinophils
which are another type of white blood cell, increased bleeding which can manifest in bleeding
under the skin, longer bleeding from cuts, blood in the urine or faeces. You can also
have an allergic reaction from it and you can also get tooth pain. Some sources say
you can get tooth pain. My first dose of montelukast which was on the 2nd of November. You take
it in the evening and I didn’t actually intend on starting it the day I did I just bit the
bullet and did it. So I took it 2 hours after my normal medication, but after that I mixed
it in with my normal evening meds which I take at 8pm. When I woke up the next morning
I was dizzier than I normally am, my anxiety was worse than it normally is so last week
I talked about my anxiety in general and what it’s normally like, you can find this video
up here or down in the description and I do say in that video that I was making it to
put some context to this video. So my anxiety now, or my anxiety on- after my first day
of taking montelukast was different. So whereas normally it’s more like brain stuff and like
it’s more of like a pattern of thinking about something and then having a bodily response,
it was just the bodily response and it was closer to a panic attack than I normally get.
So I was just sitting on the tram on my way home and my heart rate was going up and my
breathing rate was going up, I was kind of a bit shaky and like I didn’t really know why,
there was no- there was nothing going on in my brain for that I was just thinking about cats, really yeah I was thinking
about cats and I was getting like really kind of panicky and there was like paranoia about
people- because I do get abuse for wearing a mask- I’ll also put another video link up
here, I haven’t linked it in a while, but check it out, I was getting more paranoid
than usual about that like a really unnecessary level of paranoia about that. But I could
breathe a bit better so riding home from the tram stop, I was a lot less tight so even
though I wear the mask, when I’m on my bike, cold air gets through faster so I do still
get like a little bit of wheezing but on the way home I just didn’t get any of that so
it was- so far it was working even though I was having some side effects but I did also
have hives on my skin because I wasn’t on fexofenadine and for me I don’t find for me
that it’s doing anything for the urticaria. So I get home, 8 o’clock, take my second dose.
Waking up the next day still very dizzy, I went for a ride in the freezing cold again,
um but I could breathe better than even day one, um but I was still getting some hives
on my skin. After taking my medication I also had stomach pain but it wasn’t bad enough
that I needed to medicate for it and it did eventually go away on its own. And also my
physical anxiety was quite bad. Waking up the next morning I was very dizzy again- ever
so slightly less dizzy than the first couple of days but still quite dizzy, alarmingly
dizzy but I was OK. I felt weird in my brain all day. The person I work for said “hey can
we talk about our working arrangement” and very unlike me my brain just went like “omg
they’re really mad at you, omg it’s- they’re gonna yell at you” and like, that- that was
so much more of a hostile response than I would normally have, the physical anxiety
just came like waving in with that and it was very- very much unlike me so it was- it was
definitely affecting my mental health. But side effects can go away if you stick with
it so I chose to stick with it. Day 4, bonfire night, I can’t remember what time I- I couldn’t
even remember when I wrote this down what time I took the medication I was suitably
distracted from seeing the fireworks that I just didn’t notice any side effects. Towards
the end of the evening though, I had quite a bad headache which I did have to take some
paracetamol for but then I slept. The day after, I woke up with the headache still but
it wasn’t as bad so I didn’t need to medicate or anything for it. I haven’t noticed any
more episodes of nausea from taking the medication but I’ve noticed that when I would normally
get nausea it has been a lot worse. So I do get travel sickness sometimes but usually
going into town and back on the bus is not so bad, but just starting this medication
but when I got nausea it was so much worse. the brain stuff was starting to calm down
and I could breathe even more. Day 6 I had- I either had a cold or I had cold like symptoms.
It was impossible for me to tell the difference. I woke up the next morning still feeling a
bit run down but not- not too bad and I was able to have a really productive day. Next
day I felt good, still had some nausea, but it was OK, no noticeable side effects. Very
much the same for the next day. On the 11th which was day 10 I had the onset of a cough
and laryngitis. and then on the 12th I had absolutely no voice at all. Awesome. I think
that is a side effect of montelukast because I’ve never had a cold turn into laryngitis
before. One of the reasons why montelukast can make you more susceptible to getting cold
and flu is because it’s stopping the response that you would get with invasions, so from
allergens, viruses, bacteria, anything. We need that inflammation to help us fight off
the infection because it raises the temperature so you can kill off the disease causing agent,
whatever that might be, virus, bacteria, allergen, you know the drill. Uh, and without that colds
can infect you easier um but obviously your immune system can still deal with it, it’s
just you’re just not having the recruitment of other white blood cells to come and deal
with it, you’re not having the initial inflammation to provide that barrier. and that’s kind of
why you might get colds and flu, also there’s many other reasons why you might get cold
and flu like symptoms with it and that’s down to increased eosinophils and there’s definitely
other diseases and syndromes that can be caused by this medication which I’m not going to
go into now otherwise we’ll be here all day. So I can’t definitely say it was the pills
but I can say it probably was. That’s as far as I’ve really got up to because I haven’t noticed
any more side effects, all the brain stuff is kind of gone, the breathing is good, I
can do short trips outside without my mask below 15 degrees, but I can’t go into town
and back and have not had to wear the mask the whole time, I can literally make it to
the co-op which is like a 5 minute walk, and back, so I’m not seeing that much benefit. I’m gonna
continue taking it and see if it gets better, see if side effects improve and then make
a decision whether I’m gonna continue doing it, but for now I don’t know… Like I’m very
happy that I can breathe and it’s nice having like a safety net of some more medication
to stop the wheezing so that if for some reason I have to take my mask off- so from cycling
home and it starts raining and my mask gets soaked it’s gonna be OK for me to take it
off and I’m not taking a massive risk by doing that because drowning through a wet mask is
like the least cute way to drown. But also the benefits haven’t been massive and the
side effects have so far been quite bad. But not- they’re not terrible but there’s been
a lot of them. If I keep getting colds and laryngitis and coughs for like the whole time
I don’t know if it’s gonna be worth it but if this sort of settles down I’ll have no
problem continuing to take it. Would I recommend montelukast for cold urticaria, I definitely
recommend giving it a go but also take in to account your own mental health because that has so far been the scariest symptom and the one that- if I had known at the start how much it might affect my mental health I might not have taken it. That is my experience of starting montelukast
and so far I’m happy to continue taking it that’s kind of where we’re going with that.
I’ll update you if I decide not to continue with it or whether I do continue to take it,
but probably won’t be it’s own video so make sure you are subscribed to my channel to keep
up to date with everything that I am posting. And while you are down there clicking that
lovely subscribe button, don’t forget to like this video and drop a comment below with your
experiences of montelukast or if you have any suggestions on how to ease laryngitis
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