Just diagnosed with asthma ?steroid use

After attending my GP practice 7 times since the start of December with night time coughing, wheezing, shortness of breath and chest tightness which they kept saying was I was ""post viral!"" , I was eventually diagnosed with asthma after attending A&E last Wednesday at 5 am in the morning!

I have been given a Clenil 200mcgms inhaler to be taken 1 puff in the morning and 1 puff in the evening and a salbutamol inhaler to use as required and an oral course of steroids 40mgs a day for 6 days.

I finished my oral steroids on Wednesday and today I can feel the ""purr"" of the wheeze starting in my chest and I have used my blue inhaler about 6 times already today.

Can anybody give me any advice on how long it takes to stabilise asthma after first being diagnosed and will I have to be put on long term oral steroids?

Many thanks

[yaf_user681_30355]

Hello and welcome to the forum,

As you are newly diagnosed and still learning how to recognise what your asthma is doing, I would suggest going to get checked out again. It may be the 5 days of oral steroids weren't a long enough dose or you have an infection. There are many medications that can be given before long term oral steroids are used so don't worry about that. It may just take a while to calm things down.

Do you have a spacer to take your reliever with?It means you get more medication into your lungs rather than at the back of your throat.

Hope this helps.

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Hi JF thanks for the reply

Before my diagnosis last week I have already had 2 short courses (5 and 6 day of 30/40 mgs Pred) from my GP, I have had 3 short courses all together.

I have also had two courses of antibiotics before I had the diagnosis of asthma.

I do have an ""aero chamber"" I think this is the new name for a spacer? LOL....and use if for both blue and brown inhalers. Admittedly I am a bit over anxious as I do not want to suffer like I have been for the past 2 months so maybe I am a bit sensitive to feeling wheezy/short of breath and panicking a bit more than I usually would.

I just feel that it is every time my oral steroids cease that I start to get symptomatic again even though I have been using my inhalers religiously so may be becoming a bit comfortable on them and do not want the good times to stop if you know what I mean

Do you think it would be right to increase my Clenil to 2 puffs this evening to help reduce inflammation overnight?

I am at the moment having to keep a peak flow diary and I go back to see a GP within my practice that has an interest in Respiratory (she was recommended by the Respiratory Consultant I seen in A&E) on the 11th of February.

Another newbie question....I am thinking about asking for to be referred to the Asthma clinics at the hospital for my asthma to be managed rather than by my GP as I have no faith in them now with this condition due to their distinct lack of knowledge of the symptoms and considering on every occasion I appeared in their surgery with all typical asthma symptoms, does anybody else attend hospital rather than GP to help control their asthma?

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Hey and welcome!!!

Sorry you're having a rough time! It's perfectly normal l to feel anxious about it, a new diagnosis and not being able to breathe!!

Regarding your clenil, if you think you should increase it then I'd talk to your gp about it while it's all new. I've had a lot longer managing my asthma and still asky team about when I need to increase them and about when I can reduce them. It can take a few weeks though for the steroid in the clenil to start working properly, it won't work over night.

I totally get that you have lost faith in your gp from what you have said about them, but I doubt they'd refer you to your local hospital yet. Usually gps will only do this when they've explored every avenue they are comfortable to explore with you and usually you get well controlled as meds are altered/increased/trialled. On the other hand if you were ill and needed admitting to hospital there is usually a follow up in outpatients.

Keep strong! It's a lovely bunch of people on here who are very supportive - it has helped me a lot!!

Good luck xx

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Hey Laurs, thanks it is really nice to feel that I am not some drama queen,,,when people ask what has been wrong and I say asthma, you can see them looking as if to think ""it is only asthma!""....

I did not know that about the Clenil, that it takes time to get into your system!..maybe I do need to be asking more questions (note to self LOL) but at the moment I do not really have anybody to ask until I am seen at the GP. I do hope that I can get a referral to the hospital or even another community asthma clinic as I really do not trust my GP at all which is a shame because I previously had a good relationship with them probably because I was never there LOL

I suppose I also have to try and think rationally that I have only been on meds for just over a week and be realistic in my expectations...very hard to do

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Steroid inhalers take at least a couple of weeks to be really effective, and bearing in mind you have also been unwell with infection, you may need to be patient

Asthma has a stepwise approach, in that there are different stages of management. They (GP's) will usually manage asthma patients unless they get to step 3 with no improvement and need to move on to step four. You're quite a way off that yet. I get that its really frustrating when you feel crappy and just want to get better!

Don't know if it was mentioned, but you should rinse and gargle with water after using your steroid inhaler, to avoid oral thrush and voice problems caused by the steroid in the mouth and throat.

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Thanks Nursefurby, I know I need to learn to be patient :)....I clearly was too quick to get out the hospital and did not ask enough (if any I can't remember?) appropriate questions, thank you for letting me know steroid inhalers take up to two weeks to work.

I have been rinsing my mouth out after each use of my steroid inhaler because of the problems that can be caused by them but also because they taste disgusting!

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Does your GP practice have an asthma nurse? Most do now, and they are often more able to help with practical stuff and general advice.

As NF says, there's a protocol for referrals to secondary care for asthma - and at the moment you wouldn't make it through that 'filter'. Clenil takes up to 3 weeks to take effect I believe, but you could ask the asthma nurse or send a message to this GP saying that you're going to up it to 2 puffs morning and night.

The general rule in asthma with inhaled steroids is to increase (within the approved dosages) until you get good control (no night time symptoms, only using reliever once or twice a week or during exercise) and then step back when you've got that control established. Having said that, you've obviously had some infections and it is going to take a while to feel properly better. In the meantime taking the higher dose of Clenil seems pretty sensible to me.

If the clenil alone isn't enough to 'control' you then the next step is to add in a longer-acting-reliever (LABA). If that helps but isn't enough then they add in another treatment like montelukast - which tends to help if you have a sinus problem or a very sticky cough. Only after they've exhausted all of those options would you normally be referred for specialist care, unless your acute attacks are putting you in hospital regularly.

I understand why you've lost faith in your GP - but at this time of year there are some viruses that specifically cause asthma-like symptoms in people without asthma, which then clear up when the bug is gone, so they probably just didn't want to over-treat you, but unfortunately erred too far towards that side!

hth,

Cx

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Thanks everybody, this forum is fantastic and has really put my mind at ease and given me perspective of the fact there is many avenues to take with this condition and that the road is long LOL