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Hoping for advice

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Hi - I have been diagnosed with suspected asthma for the last 6 weeks. I have been on steroids for 5 days, am on a blue inhaler 4 times and day and as required and also on Seretide 500. It did get a bit better on the first lot of steroids and when I went on to Seretide, but I have been really tight chested for a week since the snow came. It is nearly like this all the time except when in bed, and if I do any activity at all even normal moving around it seems to get worse. I asked the GP for more steroids which I have been taking for 5 days and these have not helped.

Please is this normal with asthma, as the blue inhaler helps a bit, but is not getting it back to normal, and the steroids really helped last time? I am feeling quite scared about it all, and wondering if I have uncontrolled asthma or something else. I have had a chest xray which was clear, blood tests which were clear and my heart seems ok.

At what stage should I go to see a doctor when it gets tight, as I would have to go every day the way things are at the moment?

Thanks

Jill

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9 Replies

Hi Jill, I'm really sorry to here your having problems. Its very difficult to say as no one on here can actually see you, so I'll just start of by saying were not allowed to give medical advice as such (see the T&C of the board) and If at anypoint your too breathless to talk in full sentences, your lips are turinging blue or your blue inhaler isn't working you should be phoning 999 or getting yourself to A&E asap. However from your post I don't think this is directly what you were asking for...

If your second lot of steroids arn't as effective as the 1st lot then I would definetly say you need to go back to the doctors, pretty sharpish.. so maybe in the morning? maybe the emergancy doctors if you can't get an appointment? Be clear with the GP that they are not helping, where as you had some effect with the last course. Can I ask how many steroid tablets (I'm guessing there prednisolone) you've been given? and for how many days? as it may just be that you need a stronger dose.

As for if it is uncontrolled asthma or something else... thats something you really need to discuss with your GP. Your GP should be able to send you to have some more tests which might be able to confirm or not your diagnosis of asthma. Do you have a peak flow meter? Do you have any other symotoms apart from a tight chest?

If it is asthma then long term controll is important. It sounds like you need further preventative medication, (preventative medications are anything you take everyday to prevent symptoms and to try and stop you having to use your reliever medication -your blue inhaler). It maybe you need a stronger dose of your purple seretide inhaler - can I ask which dose it is? or it maybe that you need another drug adding in. Do not worry there are plenty of medications and different options that your GP can give you to controll your asthma, and you should be aiming to be completly symptom free. The vast majority of asthmatics can have completly controllable asthma and lead symptom free lives!

You said that your blue inhaler is helping a bit which is good, but concerning that it's not getting you back to normal as such. Maybe you could give NHS Direct a call, and speak to a nurse so see what they advise? It maybe that you need to see a doctor.. and speaking to someone on NHS direct maybe put your mind at ease aswell. Have you been given a spacer to use with your inhaler? (a tube that attaches to your inhaler to make it more effective?) If not it would be a good idea to ask your GP for one.

I hope I've been of some help and not just rambled on too much, and I really hope you get sorted really really soon!

ally

Firsty i would avoid prenislone on a regular basis it can cause more problems than its worth!

It could just be that the medication you are on is not best for you. Different drugs can effect people in different ways. There is a tablet called singlair that can help. But currently you are on drug stage 2 out of 5 so still plenty of stuff to try.

IK am not a Dr but from what you said I think that its unlikely to be uncontrable asthma as you have not had the acute attacks than have landed you in ED. Asthma in some people this time of year due to the cold can make it worse. You could aslo have a virus or something thats making it worse

When to go back to the Dr is a diffucult one... I dont go to my GP for my asthma so cant realy comment (tend to just go the the specilist nurses at the hospital). You practice may have a Asthma nurse than can sometimes be better than the GP's.

Signs that your asthma isnt under control may include:

Waking at night with coughing, wheezing, shortness of breath or a tightness in the chest

Having to take time off work because of your asthma

Finding it difficult to breathe, and breathing short shallow breaths

Needing more and more reliever treatment

Finding that your reliever does not seem to be working

Having to take your reliever more frequently than every four hours

Feeling that you cannot keep up with your usual level of activity or exercise.

hi JillG

sorry to here your having a tough time at the moment.

I can understand as I also seem to be the same.

I would go see your gp even if just to put your mind at rest.

You could have a virus or chest infection and making your asthma and lungs more grumpy.

Never worry about going the doctors to much and hope you soon feel a little better.

love Glynis xxxx

Hello Jill

Sorry you are having a tough time at present, it sounds in part that just didn't get on top of the Asthma before your control started to slip again, this happens some times, do please try not to panic as stress only aggravates the situation. In respect of taking a second course of Prednisolone, your GP wouldn't have prescribed them if he didn't feel your Asthma warranted another course, so don't worry about any long term side effects at this point. Short courses when the situation warrants it, are a life saver, please don't ever forget that.

Long term Prednisolone isn't great but for many people it is a necessary part of life and for someone like myself who has taken them constantly for 20 years, the benefits have far outweighed the disadvantages, but I don't think this is something you need even think about just yet.

There are many other types of inhaled steriod based inhalers, and medications you have yet to try and it usually takes a little tinkering for your GP to find the right one for you.

In the meantime you really must visit your GP soon, as maybe you have a cold virus and these can affect how long it takes for your Asthma control to improve, plus I feel you need some reassurance. Make an appointment and before hand make a brief note of your concerns and questions, take this with you and use it to gain the best from your GP.

And finally if out of your normal GP hours you feel scared and think that your symptoms are worsening get someone or if necessary call for help to take you to A & E. A & E staff would rather see and treat you as necessary sooner than later.

Take Care and Hope the New Year brings much improved Asthma Control

Katina

Thank you for all your replies and advice. I went along to the out of hours centre after three days of being tight chested just to get checked. They nebulised me which has really helped my lungs and breathing, though makes me feel a bit tired and heavy. It has really worked though. I'm not sure how long this effect will last, but it is better. They have also given me a Symbicort to try instead of the Seretide. They have said it is a bit of an unusual case and said for me to see a specialist for further tests, but the nurse said it could be a viral infection which is causing this and that it can take a long time to go.

Thanks again

Jill

Hi. I was just wondering how long the effects of the nebuliser work for, as I am not feeling as good today, and my chest is heavier and tighter. It felt so good yesterday.

hey Jill,

I'm sorry to say that it will probably of warn off by now, they should last about 4-6 hours, but it depends on the situation. The best thing to do would be to try taking 10 puffs of your inhaler through a spacer, as this should have the same effect as a nebuliser, or go back to the emergancy doctors and get another nebuliser. You would have been given a salbutomol nebuliser which is the same drug as which is in your blue inhaler just a much larger dose of it, so the same problem exists that it is just a short term reliever, and the effects arn't pernament so it is important that your overall controll is sorted out, so i'm really sorry to say you need to head back to the docs asap...

ally

Recent research has surggested that 10 quick puffs through of a spacer of salbutamol can be just as effective as a nebuliser so you could try that!

Hi Jill

Maybe you just dont get on with Seretide, this happened to me.

I was diagnosed about 15 months ago and was initially prescribed Symbiocort (another combination inhaler) by my GP. My control wasn't great so I was referred to a chest clinic who changed me to Seretide as the consultant ""was a great fan of Seretide""! My asthma went downhill quite quickly culminating in me needing a nebuliser and a course of steriods. I went back to Symbicort and, after trying out different regimes, have got my asthma under reasonable control. Maybe you will get on better with symbicort but it might take time. I was up to the maximum dose for a while and still not right but I have reduced it now and am using the SMART regime with some success. Dont be afraid to go back to your doctor and tell them if you are not happy, I left it longer than I should have done and have learnt my lesson. Another thing I have learnt is that you know best how your asthma is and it is a case of trying different ways of controlling it until you find what suits you.

Hope that helps. It does get easier once you start to understand your asthma and feel more in control.

Anguilla

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