Advice please....

Hi,

I am new to this forum and I would be really grateful if someone could give me some advice please. I have had a chest infection for a week now. I know that a week is not along time but I have been really ill with it and have been waking up in the night struggling to breath. My cough has made me vomit on several occasions. I am taking antibiotics but when I went to GP the other day I was prescribed Seretide 250/25. I understand now that this is a very strong dose and I had a rapid heart rate (140 beats per minute). I had called the dr for advice and spoke to the asthma nurse, she saw me the same day and although not stated explicitly she did imply that I should not have been prescribed this. I have now got a lower dose turbo version of this. I am getting some relief from this but my cough is very persistent. It is particularly worse when I leave the house. I have had asthma when younger but had no symptoms for years.

I woke up this morning and there was blood in my phlegm. I am wondering if I do actually have asthma or a just a very bad infection, I am uncertain as to how a dr can distinguish between the two? I feel unable to take any deep breaths without experiencing a dull ache in my chest. I am wondering where things are gong to go from here? Am I experiencing normal asthma symptoms? Is this likely to go away when my infection has gone? I have woken up tonight unable to catch my breath through coughing. I am wondering if this is the same as an asthma attack? Although I do not have a peak flow monitor at home at the drs the other day it was 350.

Hope this all makes sense!!!!

Thanks

Kat

XXX

[Hidden]

Hi Kat,

Welcome, and sorry to hear your having trouble.

The antiB's should help with the chest, was there also any steroid tablets (prednisolone) usually go together for asthma and chest infections.

I wouldn't worry about the seretide dose, that isn't really very high, and you have the option of dropping to a lower dose once better and symptoms are under control. The priority is to get that sorted. The worry you have is not so much a problem with inhaled steroids, but the oral tablets like prednisolone when taken long term.

Waking at night isn't great, I know have been doing that myself for the last 3 nights, but I have no symptoms and a good PF reading so it could be weather for me, but as you're suffering, then if not already tried, try to sleep more upright, or I did and still have is trigged the head of the bed up so there is a slope, seems to help. A few phone books etc under the legs should help, extra pillows just seem to cause a stiff neck/back.

Take care, hope you get better soon,

Chris

[Hidden]

Thanks for your advice Chris, sorry not to get back to you sooner. Sleeping more upright has been helpful so thanks for the tip. I did not get any prednisalone, I think on the whole the dr has not been helpful. Although I am feeling better than last week I still needing the relieve of an inhaler about 6 times a day. Antibiotics finish tomorrow will go back to the drs. Hope you have been able to sleep better.

Thanks

Kat

[Hidden]

Hi Kat

Yes thanks, sleeping fine now. Glad to see you find it a little easier as well.

To answer or even raise a few more questions from your OP.

The high heart rate, could be something as simple as that your body is stressed and heart rates do go up.

The thing that does give me slight concern is the blood in the phlegm, what did the Dr say, he should have at least be a little curious. Mine is always interested in the colour and consistency of any fluids that leave the body no mater where from, he's very keen to always emphasise that.

You ask how does he know it's asthma, well he's probably going by the fact that you use to have it, but most GP practices can do a simple test called spirometry, failing that a simple but not 100% is to do a peakflow, turn up without using your ventolin for at least 4 hrs, take a PF test, then take 10 puffs of ventolin and wait 10mins before repeating the PF. There should be a significant increase, whilst not certainly asthma, it's a good indication.

Good luck at the GP's.

Chris

[Hidden]

HI Chris,

Thanks for you message. I think that you are right about the heart rate, asthma nurse had said that the chest infection is likely to be contributing to this. The dr does not know about the blood, I will tell her tomorrow I think it likely to be a result of coughing so hard. I suspect I need another course of antibiotics. It is hard to know when to go back to work as I am fine until I start coughing then I can't catch my breath. Although this is only happening once or twice at home, it is so embarrassing when this happens in public. Hoping to try and go back tomorrow.

I did do have a spirometry test when I went to see the nurse but she said the result were not accurate as I had taken the Seretide, she was concerned that my peak flow was low. I am going back to see her in a month which I think is useful as she seems to have more knowledge that the GP about asthma.

Thank you for taking the time to get back to me I appreciate the support.

Kat

[Hidden]

Kat,

To give you some indication of what your predicted peakflow is, try this tinyurl.com/dj2sa6

Don't worry if you are currently way below it, I was half my predicted minimum last year at diagnosis, and still managed to swim, cycle and run, with the help of lots of ventolin. It's nice to have an idea of where you should hopefully be aiming for though.

Strange order to do things in, spirometery after being given seretide. Each GP has there own ways i guess, mine and the one I cycle with do the test before giving any meds other than ventolin, as it's easier to see if ventolin makes any difference before booking the test.

The cough you have when you leave the house, is that because it's colder outside? not significantly much yet, but come winter it may be, and cold air can be a trigger, i know it is for me and a scarf or I prefer a buff over my mouth really works, alternately, could be traffic fumes if you live in a city.

Chris