Hi everyone,
I'm just looking for information before I see the asthma nurse next month. I am on loratadine 10mg daily for 'hayfever asthma.' I have tried various others and find this one the best. Can I add another one to this to see if it helps? I need to ask the pharmacist this question really to check with the meds I'm on but thought I would ask on here as people on here have so much knowledge and experience. I normally react to pollens/moulds February to November.
Thanks xx
sorry - no answer - but something i want to know too, because i still have mild but annoying allergy symptoms desptite being on antihistamines!
Ive never taken two antihistamines, but Im on high dose telfast (fexofenadine 180mg) and double the standard dose of Singulair (monteleukast) (20mg). Something to discuss with your GP or consultant I guess
Lynda 
Thanks for your replies. I had heard the pollen was extra-high the last 2 years but hadn't heard why or that moulds were also high.
I had thought about trying the higher dose of fexofenadine as have only tried 120mg before. Unfortunately, montelukast didn't work the first time I tried it and the second time I had flu symptoms whilst on it.
I will wait and see what my asthma does when it calms down after the recent virus I had. (It is calming thank goodness but at it's own pace.) And just get the asthma nurse and pharmacist's opinion before seeing my GP if things aren't as calm as they should be. Before the virus, I was having the odd ventolin-free day so that is where I want to be again but obviously it will be 'pollen-time' then!
Thanks again xx
I take fexofenadine, as neither loratidine nor cetirizine made much difference to my symptoms. Have been much better since taking it but still do get symptoms. Have started already this year as I seem to be allergic to the tree pollens.
If there was anything else I could ask GP to try/do I would be interested to know as even with the fexofenadine had quite bad symptoms in May/June still last year.
My worst time is mid May until the end of July if I am having a difficult year. I just want to be prepared!! I will add to this post when I have learned anything. Are you on the higher dose of fexofenodine Spookymilo? (180mg)
Not sure, will have to check the packet when I next go upstairs.
Does anyone else get worse allergy symptoms when they are tired? I find that in allergy season my sore eyes, headache and blocked nose are much worse if I'm really tired, and I also get sore ears. Is this the allergies or do I just get this as a result of being tired?
I take Fexofenadine 180 for hayfever and Nasonex nasal spray both of these were prescribed by my doctor.
They work wonders for me.
My symptoms mostly start as nasal that progress to chest so that's how I tackle things. Medication wise I use Monteleukast, Desloratadine and Avamys. Don't forget eye drops too as when they are runny they can irritate your sinuses too. I've also tried other nasal sprays, some of which make things worse rather than better.these things seem to be a bit of a dark art for me as what works one year may not help the next.
Nasal rinses are a godsend and I find they are a really good way to 'clean' things up in the morning!
Well, I have just had the weirdest appt ever!
Why is it GP asthma nurses are focussed on reduce reduce reduce, when it comes to asthma meds?!
I was asked by my GP to make this appt following a respiratory virus in Jan/Feb. I am currently using 4 -6 puffs ventolin a day and on the odd day more, so have not reduced my Symbicort 400/12 from 3 puffs twice a day yet. I have been on this medication for the last 24 months and only managed to reduce it in December 2012 for the first time until I caught this virus.
So what does the asthma nurse suggest? To change to Symbicort SMART using the 200/6 inhaler!! Reassuring me I can use up to 8 puffs a day. I was gobsmacked and horrified. I love Symbicort SMART and was on it for 3 years before my latest and current flare up started in May 2010. But where is her common sense? I fought my corner and she said you obviously know what you are doing and completely backed down.
Am I just overreacting or is her idea crazy?!
I did come away with permission to use up to 15 puffs of ventolin in my spacer when I don't have my nebuliser on me and I did ask about the antihistamine but she didn't know and suggested to ask a pharmacist.
Thanks from a speechless me xx
You're not overreacting in my view. I'm similar, but have high dose seretide (not symbicort) and if someone suggested SMART to me I think I might have a bit of an eyes on stalks moment. It's worked very well for a friend of mine, so I wouldn't be averse to trying it if it were appropriate. I think you're perfectly justified in fighting your corner and saying that it's just not appropriate for you, with 8 puffs a day you wouldn't even be getting the maintainance dose that you need. As for antihistamines I take cetirizine, but have also had loratadine (which I sometimes use)and fexofenadine (which didn't work for me). xx
Thanks Lou,
I would love my asthma to be well enough to be back on Symbicort SMART, but not right now.
Her reasoning was because I am taking high doses of steroid and ventolin. I don't think she read much of my details because 4-6 puffs of ventolin a day is not a lot when compared to me possibly using my neb 4 times a day and still using 8 or more puffs of ventolin. I have had enough of seeing these GP asthma nurses, it is pot luck whether they know what to do with someone with more difficult asthma.
Also, when I was still on Symbicort SMART when my flare up started, I was using 12 puffs of the 200/6 and ventolin and was still off sick from work with my asthma, why would I risk such a jump down in meds now?
Hehe, eyes on stalks describes it perfectly! xx
i hate t when they just reduce meds, even when uncontrolled. My cons once argued that as i had managed to keep at 10mg of prednisilone for 2 weeks without going back up then i was ok to reduce to stop completely (starting by jumping straight down to 2mg) until i pointed out that i'd been in A&E twice during that time but as he has put a note somewhere not to increase my steroids (and i suspect it says something about trying not to admit me - it may be paranoia but if my co2 is at all elevated, other hospitals talk about ICU and this hosp still tends to discharge me) then obvs i hadnt gone back up - thats fine by me, but surely therefore cannot be used as an argument that im better controlled!!!
With anti-histamines, i have been on fexofenadine which worked but they changed it to see if another one helped my asthma, im now on cetirizine, but do get some symptoms, the GP said to try loratidine and see if it made me drowsy. He did say that theoretically if the loratidine alone made me drowsy then i could take citirizine in the morning (as i currently do) and then take loratidine PRN at bedtime. H said it was quite unusual but then he pointed out that my lungs were pretty weird so he could work with unusual!
ive never understood what symbicort SMART actually is, how does it work?
The SMART stands for Symbicort Maintenance And Reliever Therapy.
I was using the 200/6 inhaler (Which I think is the usual one used for this)
You use the inhaler for maintenance doses and as a reliever, I was on 2 puffs am and pm maintenance. My guidelines were, I could use up to 12 puffs a day including my maintenance doses. If I used 8 puffs or more everyday for 2 weeks I needed to see GP or asthma nurse. I could only use 6 puffs max at any one time.
It was fabulous for me for about 3 years and carrying around only 1 inhaler was so convenient. The way it works is, if ever you needed to use your reliever more you also took more steroid, without having to think about it. I would quite often almost hit the 2 week mark and then everything would calm down again.
I hope that explains it clearly...
Jumping into this a bit late because I'm not on antihistamines or anything and hadn't realised it had taken this turn!
I've had the same recently with my consultant. I've written a bit of a ramble on my other post so won't repeat here but basically: yes he knows I have asthma, yes there is something going on but he is convinced the asthma is very little of the problem. I think it's more (even if just being set off by whatever the other element is). So he told me I don't need to be on nearly as much medication as I am and that basically the only reason I take so much Ventolin is because I'm not trying hard enough to not reach straight for the Ventolin. Even though I do try and I have told him this, he doesn't believe me.
So he told me to drop down to 2 puffs twice a day of Symbicort 400/12. I gave it a go for a week, even though I'm coming out of a flare-up and not at my best. Result: a LOT more Ventolin, the return of the cough I'd almost got rid of and some very interesting noises which I was informed by my medic housemate were lower resp wheezes (cons says you can't hear asthma wheezes without a stethoscope, housemate though more junior disagrees and anyway was fairly sure some on here have mentioned loud wheezing?) GP said to go back up if it had got worse on the lower dose; don't think lungs got the message they don't need all that.
Wish I had fought my corner like you JF, but I've given it a try now. I don't know if he'll listen but yes, it is annoying when you're struggling and they want to reduce - I would love to if appropriate but I don't want to be dropped down if I've been having trouble enough on the ones I'm on!
Asthma wheeze can be heard from the outside, when I'm bad I have an audible wheeze, lots of resp specialists have heard it and not said anything about it, so I assume its normal to for some people!
The annoying thing for me Philomela was that I had only gone to see her because my GP had said to, 6 weeks after the virus. I wasn't looking for advice on my current meds. I explained to her I wasn't back to how I was before the virus, but I was having slight improvements every 2 weeks so my meds are working albeit in their usual, slow fashion.
The only reason I was adamant not to do what she suggested was because I said to her I do not want to get ill and be off sick again and I am single and have bills to pay including my mortgage and I would not risk messing all of the progress I have made so far! She did look taken aback by my response but I was past caring, I just wanted to get the hell out of there!! Lol.
I will be discussing it with my GP when I next see him, but that could be months away (fingers crossed).
JF - That is even more annoying then if it was unasked! Completely see your point; I do think sometimes they don't seem to get that we can't afford to be off ill, or even that it's not very pleasant to lose control and it can take a while to get it back. I don't think my cons listened at all when I said rather desperately that I need this to be sorted one way or the other because I am brainless right now and keep needing to take naps which is not conducive to working and applying for things or anything else; I also make stupid mistakes when like this and it's a bit worrying, but his solution was 'reduce the meds' and do more physio, even though the current exercises are giving some improvement but not enough and he seemed to think I was getting nowhere. If he wants to reduce meds I think he needs to have something else in mind to sort things.
I hope you don't need to see the GP for ages and keep improving! Crossing fingers the progress is sustained - and that at some point you actually are in a position to go back on SMART! Also hoping you don't have to see that nurse again.
Soph - thanks. I thought that too. tbh I really don't know how he can be so confident about a wheeze he hasn't heard (because naturally, if my lungs are going to wheeze expecting them to do it in a cons appt is waaayy too much to ask lol).
lungs deffo know when someone is listening - not sure how we are going to prove it but one day we will find a way to show them!!! my HR also shoots up as soon as ANYONE looks at it. I can be sat happily plodding along at 115, then nurse comes in to write it down and its 140!!! its completely insane, bless the nurse today, he knew how keen i was to get home, sat in my room for ages while i lay down and took slow deep breaths until he spotted a number i didnt mind him recording
Also - do you have an inspiratory or expiratory wheeze? I thought that asthma started off as an exhale issue, then when it was more severe and things like air trapping came into play then you start struggling to get air in - that was my understanding of how it worked - had paramedics yesterday that said that as i only wheezed on the exhale it couldnt be an asthma attack! Although tbh unless i deteriorated rapidly once they'd started me on nebs they mistook 'no breath sounds' for 'clear chest' based on what two A&E docs heard! so not 100% sure i trust them - certainly trust you guys a lot more
and yeah - all cons 'know' exactly what your breathing is like 24/7 apparently - in fact i dont know why they bother to listen to our lungs at all - i think i could roll a dice with more consistency than my lungs behaviour but apparently my cons knows exactly what they do all the time!?!
Hmm I always understood asthma was an expiratory wheeze as well. That was what I had the other night and before that when I've been coughing, a wheeze at the end of respiration. My housemate, who ok is a baby doc but was actually there and does have medical training - they trust him to know this sort of thing at work - said just sitting there (I do have to fend him off at times when he wants to practise listening but I won't let him) that it was lower airways and the larger ones. Physio has also said, asthma is generally trouble breathing out, and if I feel that then I should defo just take my inhaler - but cons just always says I'm taking it too much and never asks why I felt the need for it for 20 puffs in one day when I'd been on 4-6 puffs max the previous week. I'm just not trying hard enough to not take it apparently.
Maybe the way to cure asthma is to have drs follow us around constantly trying to listen to our lungs? It might get annoying at times lol but based on previous experience it would make them behave!
Oh, and my HR goes a bit crazy at times too - it was 130 BEFORE I did my spiro at appt and nurse seemed to think I was about to collapse and made me sit there until I 'felt better'. Cons took it again but didn't seem bothered, probably because he thinks I'm mainlining inhaler - though this is true right now, except that I hadn't had that much that morning. I think it was probably the Symbicort tbh; the side effects went away but are back now and I've found I can't last on 2 puffs right now.
Sorry JF, we are getting way off topic here...
hmmm....maybe some kind of recording device listening to our lungs that we can play to docs in the future if needs be - that would shut them up without the need for a doctor. I once had a nurse tell me off coz i took four puffs of salbutamol fairly close together (in her opinion i didnt let the first two have time to work) now, my standard protocol is ten puffs before exercise - so 4 really aint a big deal. Anyway - she got mad at me when she did my obs and HR was 140 - well i know for a fact that i have a lower HR than that after 9 back to back nebs of salbutamol, so it surely cant have been the equiv of half a neb doing that, but apparantly thats me just being silly! People respond oddly to being tachy - sometimes they get all freaky , sometimes its coz we cant breathe, sometimes its coz of the salbutamol, and sometimes its coz we're panicking! Had a really annoying nurse in resus who ignored me for ages while she chatted to someone about their holiday, when im hooked up to monitors in resus and theyre beeping constantly i sometimes get to a point where i keep looking at them - im not even registering the numbers on any level, i suspect its coz im so tired by that point that the beeping keeps registering as a new sound, my brain cant just filter it out. Anyway she got all annoyed at me for looking at the monitors as 'it wasnt going to change the numbers and it would only stress me out' and she turned the monitors away from me and continued chatting to her friends. Now i usually have pretty good obs, so the fact that she thought i was gonna be stressed by them worried me somewhat - although saw them when i got up to pee and they were absolutely fine so i have no idea what she was going on about. Grrrrr! it just annoys me when they seem to think we're being paranoid!
My physio is a highly confusing combination of 'all your asthma attacks are caused by you hyperventilating' and 'the pain in the base of your lungs is air trapping and you should take your inhaler for that' which just silly - i dont NEED my inhaler for the pain, i need it when i cant breathe so why can i take my inhaler when i dont need it but not when i do!?! all very strange. Ive gotten into a bad habbit physio-wise although i suspect i was discharged from them last time i was in hosp but really hated physio so part of me is glad i dont have to go back!
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