Treatment for Night Time Symptoms

Hi,

After three months of fairly well controlled asthma (which I haven't had for years) I have been having severe nocturnal symptoms for nearly two weeks. This coincides with changing my inhalers after a hospital appointment, a weekend of bad hay fever and a possible virus (I teach 6 year olds and they have been passing round a feel tired but nothing else virus). It is not uncommon for me to wake several times in the night and need an inhaler several times a day but still manage to get by. However, this time I am having trouble getting the doctors to take it seriously. I have seen two nurses and two doctors since Friday. The first nurse thought it was the inhaler dosage and so added more steriod (this was somewhat expected as I had gone from Seretide 500 to Symbicort 200/6. The two doctors said my chest was clear (in the daytime and after several puffs of inhaler) and the nurse I saw today said I probably needed pred but the doctor obviously thinks I don't so we will stick to them. In the past I have had no trouble getting pred with a better peak flow and not as prolonged problems. It is not having pred that is worrying my but the fact that nobody seems to be taking it seriously.

The nurse today said it was best that I phoned the hospital tomorrow (I had a late appointment) and gave me a number but that means at least another night of little sleep, coughing and sitting SOB. Plus I doubt the hospital will see me tomorrow so then more nights after that. I'm really unsure of what is now the best thing to do. This may be because I have had very little sleep for two weeks.

Has anyone else had a similar problem and found a way to demonstrate the difference between day and night symptoms?

I should say that my usual GP is very helpful but is away on holiday at the moment. I have also spoken to the helpline who agreed I needed pred but even after following their advice, I have been unable to get any.

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Are you at work at the moment, or not going in? Is there any chance that you could go to the walk in centre/OOH about symptoms and explain what is happening? Perhaps take a diary of symptoms/meds usage and your asthma management plan? They may be more inclined to give you a short course of pred, which could carry you over to when your normal GP gets back?

You know your symptoms/what you need more than anyone, so try and persevere!

Hope you're feeling better soon!

Laura x

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Thank you Laura,

I had taken in my peak flow diary but the doctor seemed to have little interest in it. We also don't have a walk in centre just an urgent care centre which doesn't do asthma so you usually end up in a&e when it is not that bad.

However, I managed to get a late appointment with a GP who is usually very hard to get an appointment with. As this was at 7, I was not at my best and hadn't taken an inhaler for a while. Like you said, i had started a symptom diary and med chart to make it a bit more real for them. She said that while my chest was not too bad I was obviously having difficultly and my throat was very irritated so lungs are probably too. She was really sympathetic and gave my pred. I have never felt so happy to have it as usually it is the doctors saying you really must need it. I just hope it works quickly.

My next step is to try and get an action plan to stop this happening again.

Thank you again.

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Ahh good, I am so glad you got sorted and that they finally took it seriously!! You know your body better than anyone and know what you need!! Hopefully the pred will kick in now and you will have a better night sleep tonight now!! Have they suggested changing preventer/laba so that symptoms at sorted?

Do you know what is causing this flare up? Is it hay fever? I am struggling with it at the min too.

Look after yourself! Laura x

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Hi Laura,

Sorry to hear your hay fever is not good. I had really bad hay fever over the bank holiday and changed both my tablets and nasal spray last week. They have worked a treat. The hospital phoned me back today and said that after discussing it with the asthma nurse, they both thought that I should go back to Seretide. The consultant said that my blood test for all pollen allergies came back high so thinks my current issues are to do with hay fever. When I went to collect the prescription for the seretide, the nurse had also put my nasal spray on with a message that I must make sure I take it! The doctor I saw last night also said that with the changing weather and delayed pollen season, lots of people are struggling (I think that is reflected on other posts too).

Pred seems to be working. I was woken up by a strange dream rather than coughing last night anyway!

I hoe you are feeling better!

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I also forgot to say that the consultant said that from what my asthma nurse had told her (from looking at my notes) she was shocked that I hadn't been given pred on Monday. The asthma nurse then said she would speak to the doctor I saw as it was clear from my symptoms that I was struggling and that it says in my notes that I respond well to inhalers so don't always have symptoms when I see them.