The last couple of years my asthma has been getting worse and worse and I've kept picking up chest infections. The last year my asthma has officially been diagnosed as being both severe and brittle. Mostly type 1 in that I am very symptomatic on a daily basis, but then also have the rapid type 2 attacks far too often for my liking.
Over the last year I've been in and out of hospital with my asthma and not a couple of weeks has gone by without being put on abx, this usually leads to an admission. Right now I'm managing to stop at home, but am on the second back to back course of antibiotics to try and clear it!!
I'm on a cocktail of asthma meds band stuff to prevent the side effects from it, currently abx and have home nebs!!
Has this happened to anyone else? Will it/can it improve or is this likely going to be the best it's going to get? I'm only in my 20s I don't want to think if this as a ""for the rest of my life"" thing ...
I used to be like you. I was but on azithoycin and doxycyline to try and reduce infections and reduce inflammation (as both have anti-inflamtory action) and gone from at least an admission a month to around every 2. I also found despite being symptomatic to try being active by swimming etc to help move that mucus abit
Ah ok, thanks
I'm feeling a little frustrated by my consultant on that front, as during an admission azirthromycin was suggested as a 3 month trial, but my consultant wasn't willing to try as there's no evidence of it being beneficial or flares being caused by infection. Yet this is the only infection I've had which hasn't put me in costa?! On my second course of doxy and hanging at home - just! Surely it's worth a try?
My cons is also looking for everything it could be instead of asthma, which all come back as fine and I respond well to asthma stuff. When during an admission even, ABGs were done and I was very hypoxic with high co2 and the other numbers were bad, plus resp rate of <50 he decided it must have been venous; because I ""couldn't possibly"" have such bad numbers. This was done twice on 2 seperate wrists by 2 different drs. I disagree with him. I went to HDU from resus and really was very poorly.
Just feeling frustrated as I've been home for my longest period in a long time, can feel it deteriorating and don't want to end up back in costa
Hi Laura,
rubbish for you but I just wanted to say that I from about 15-22 I was constantly on and off of antibiotics - regularly had to have three or four courses back to back.
It got better - so there must be hope for you too!
For the years since then, I've been down to an average of 3 chest infections per year. Less in the last few years as I've intentionally controlled my exposure to other people, especially kids :/
Of course you're probably in a horrible trap where every time you're admitted to the resp ward you get to pick up a new bug from someone else in there, which then takes a week or two to incubate.
And of course the amount of pred you're on will make sure that you have no immune system to speak of.
Don't be too down about your consultant looking for other things - I think it's the way they phrase these things that makes it sound like it's our fault for having organs that don't obey they algorithms in their text books!
Good luck.
Tried to talk at my asthma nurse today - failed miserably. It's got tonight to sort itself or gotta go in as it's been at this level and slowly getting worse for too long now . She's said it can have a last ditch attempt to quit this behaviour! Canny be bothered with he faff and fuss!
I know I bang on about it lol, but my infections have reduced by around 80% by managing my reflux (which was NON symptomatic apart from infection). I never, ever lay flat, never go to bed with a full stomach, and sleep at 45 degrees (anything less results in infection). I was barely lasting three weeks between courses of additional antibiotics prior to this, despite being on permanent amoxycillin (daily) and azithromycin (three times a week). Now I am no longer on permanent daily antibiotics and have only had three infections in the last 12 months - two were 'user error' (!) i.e. me not being compliant with the above, and one was following flu jab.
I already take omeprazole due to being on a high dose of pred. 20mg 2x a day. Wouldn't that sort any reflux? I already sleep at an angle or lungs act up. Gonna have to talk to cons again about other stuff it might be worth trialling though.
The annoying/upsetting/frustrating thing is that this is the longest period in a long long time I've been out of hospital - it's been a month and though I've had a fair few quite sudden and severe attacks, they have sorted at home. I've also had my best period in a long time when I spent about 3 days entirely in my green zone - ignoring the times of day like first thing pfs. I've also managed (even this week) to get into work every day and not ring in sick. Days I've been off work I've been pretty ill though. And it's the first time an infection hasn't seen me admitted in a long long time! So I think meds changes have helped and the long, severe admission I had last month! But this doesn't seem to want to be good - I guess I'm just greedy likening to be at home more than costa?!!
No is the short answer! Omeprazole does not stop reflux - it does not stop the mechanical action of stuff travelling up your oesophagus, all it does is reduce the amount of acid you are producing so that stomach contents are in theory less damaging. I was taking 80 - yes 80 mg of omeprazole a day, plus 20mg of domperidone three times a day (to speed up gastric emptying) and still having constant infections. None of that (drugs) made much, if any difference - it was the lifestyle changes (sleeping minimum 45 degrees (that is practically sitting up btw) and ensuring no full tummy when going to bed, which has worked. One night of failing to do this and Im back on IV antibiotics within a few days. The sleeping thing is a biggie because you need to ensure you stay in that position all night when you are asleep, and don't slide down, otherwise reflux and aspiration can occur.
My last reflux study (24hr ph monitoring) showed no episodes of reflux whilst sleeping upright (as I have no symptoms the only thing I can go on is infection rate and ph monitoring) - thats totally different to the previous ones, and bore out the massive reduction in LRTI's.
Driving me crazy now 2 weeks ago ended up in ooh, who wanted to admit me, lungs sounded awful and I wasn't great - had a chest infection which was making asthma play up as per usual! Started on antibiotics for the infection. Then continued to go steadily downhill, finished the course but the infection was still there so my amazing gp prescribed a second course over the phone so I didn't have to see her or leave the house. Wouldn't shift and asthma was getting worse until I ended up being admitted, then I spent 3 days on IV antibiotics as well as being treated for ""severe acute asthma"" before being discharged (too early but as they know me well, they know that I'd be there for months and never hit the discharge criteria in terms of pf etc!). Was still very poorly when I got out, but over yesterday seemed to improve, finished the oral antibiotics I'd been converted to and was needing to neb less frequently as well as a steady increase in pf
However over today, my lungs have become more and more stroppy, sob and tight etc, they are very painful and just generally deteriorating again. Don't really want to end up needing to go back in! It's a bit upsetting. I'd just like them to stop acting the ass and behave for a bit!!
Any advice guys?
Sounds like they didn't actually clear to the infection - did they do a sputum culture/sensitivity? I need 10 days of IV antibiotics to clear infection otherwise it's straight back. Oral just doesn't cut it.
No they didn't, but cxr ""wasn't great"" whatever that means!
I can't end up back in - just can't!! Been home 3 days and the hokey kokey is driving me crazy :'-(
Id been doing better then got the chest infection!! Which won't budge and keeps putting me in costa!! Over the summer my max amount of time at home was 2 weeks but after a long admission I was more stable for a month before it took hold. Now back in and miffed I didn't even last 2 weeks!! A bit scared it'll go back to the yoyoing in and out of earlier in the year!!
After getting out today though - just finished on the aminophylline and hoping they don't put up another bag! I just need my pf to behave when the cons comes round!! Not being in hospital over Christmas!!
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