First hospital admission - worried

[hb1977]

Hi Everyone

I've been asthmatic for over 18 years (I'm now approaching 40!) Between December 2013 and August 2014 I needed four courses of Pred and antibiotics. But from August 2014 I've had good consultant care and an excellent home action plan.

Usual medications are;

Seretide 250 2 puffs twice a day

Montelukast 10mg at night

Salbutamol & Atrovent inhalers at night.

On Monday I started with the symptoms of a cold (cough, congested and a sort throat) I added in Flixotide 250 2 puffs twice a day as per my plan. At that time my peak flow was 83% of best and by the evening it was 69% of best, I started regular reliever.

My plan states to start steroids once the peak flow falls to 69% of best.

I woke on Tuesday quite short of breath with a peak flow 48% of best so I continued regular reliever and made an emergency GP appointment.

Sadly the GP didn't seem interested, she didn't do my peak flow or ask me about recent readings. She listed to my chest and said there was no wheeze and a few crackles. She gave me antibiotics and said I didn't need steroids.

I started steroids later that morning after getting in touch with my consultant, However later that evening I took myself to ED as I was very short of breath, only able to speak in short sentences and getting no relief from my inhalers.

ED was busy so I waited almost 2 hours to be assessed; I was told my chest was tight, quiet but that there was no wheeze.

I had 2 Salbutamol and one atrovent neb plus additional steroids. These worked brilliantly. I was admitted to a ward as it was about 2 in the morning. At about 5 in the morning I deteriorated again and had Salbutamol and Atrovent back to back, narrowly avoiding Magnesium.

I've now been discharged and am on stepped up treatment and a 5 day course of steroids.

I'm concerned that this deterioration happened quite quickly; I've only even been to ED twice before and only ever needed 1-2 nebs before being allowed home. On speaking to the consultants in hospital they all noted nobody could hear a wheeze but that everyone had written how quiet my chest was.

Where do I go from here; I do think the GP should have taken more notice and provided incorrect advice about not starting steroids! I also think it's going to be difficult if I don't always wheeze.

Any advice, suggestions or help welcome.

Thanks

[Hidden]

Sorry to hear you've been so unwell. I too have had this problem as I don't wheeze unless I have an infection. I just make a point of telling anyone that is treating me upfront that I don't wheeze that my main asthma symptom is a cough. It's difficukt I think because asthma is so variable from person to person the blanket approach most medical staff have (who aren't specific in asthma) can come off as a bit abrupt.

Sorry not much advice but i would be firm with your GP (difficult i know) and tell them you need it noted that wheezing just isn't a symptom for you.

I'm under consultant care and found since letters going back and forth from him and my GP they are more willing to listen.

Do you have an asthma nurse at your doctors? I Always find that they are more clued up on asthma flare ups and new techniques. Not to say gps aren't good but the nurses usually have more specific training.

I'm going through a bad flare up just now and every doc I have seen has prescribed the standard pred and antibiotics but had a review with my asthma nurse yesterday and she really took time to go through all meds and symptoms I was having.

Hope you improve soon

[hb1977]

Hi

Thanks for your reply.

I'm also under consultant care; this is the first major issue I've had, sadly I was admitted to a hospital other than the one my consultant works in. I don't really find the asthma nurse at my surgery that useful as she'd previously tried to wean my medications even when the Asthma has been difficult to control.

I've spoken to one of the other GP's at the surgery, one who I've seen lots with Asthma, he knows me quite well. He's agreed that the absence of wheeze isn't necessarily a good thing and has apologised for what happened.

He's going to add some notes to my notes and put on a copy of my personal asthma action plan and I'll see if my consultant can also add this into clinic letters.

Things haven't improved as much as they should; I'm now on more Pred and started antibiotics. Irritatingly I'd been started on antibiotics last week but they were stopped in hospital as the hospital felt the exacerbation was likely viral; now the sputum result is back it is indeed bacterial so the antibiotics are back on again!

Waiting for the dramatic improvement and writing my list of questions for when I see the consultant next month!!

Hope you too feel better ASAP