At a loss with symptoms

I've had asthma for 28 years and for the first time I'm actually at a loss as to what the heck is going on with my symptoms.

Initially this started off with a crackly cough and that crackly wheezy feeling in the chest like when you feel you have a chest infection. So given that it was at an earlys stage I went to the Dr who said all my 'asthma vitals' were fine and chest was clear but as I have asthma she suggested giving me a dose of antibiotics just incase something was brewing in the respiratory tract.

As the days went on the cough was becoming more productive, more chest, more crackly and my peak flow was dropping to 400 and under (normally a good strong 450-470) so I went back to the Dr 9 days later, explained all my symptoms, worsening cough etc and worsening peak flow and that I was now getting a lot of discomfort in my throat and on my back I'm assuming from the worsening of the cough. Despite my worsening peak flow I was sent away with more antibiotics - to say I was annoyed is an understatement as the 1st Dr I saw said if things got worse to go back and I'd probably need a course of prednisolone.

Another 5 days later and my symptoms are getting worse, peak flow faltering to 350 with a horrendous cough that feels its coming right from the lungs and so bad at times I'm struggling to catch a breath inbetween each 'batch' of coughing! Its like every cough is sucking the little air in my lungs out. I call my Dr's again and ask for a phone consultation with my known GP and over 3 hours later I get a call back. Eventually she decides to give me prednisolone after I politely decline the offer of going into an 'open free for all surgery' just to get them the next day. I've been twice already and cannot get out without relying on someone to take me.

So I have now been on prednisolone for 4 days... yet finding very little improvement in my peak flow or the coughing. I'm slightly breathless when I walk about my house, feel utterly lethargic, tired, like my back has been kicked by a size 10 boot, have muscle aches and feel utterly unwell. I also have this weird feeling in my throat, well according to diagrams its more around the trachea area (under the adams apple bit), its not a sore throat as such, more a feeling of when I breath in it feels... kind of like a cold air going over something inflamed! I guess in a way it probably is with all the coughing to be honest.

But what I'm struggling to get to grips with is that I never had a cold before this, the coughing just appeared. At first it was thought it could just be a respiratory infection but there is part of me wondering if its morphed into a form of bronchitis?

But I don't know what to do next? The coughing is a nightmare and with my peak flow not improving I don't know what to do next? Should I wait until after the weekend and see the Dr again or see someone sooner?

What also doesn't help is my Dr and my asthma nurse giving me conflicting advice. WHen my peak flow drops, according to my asthma nurse, the new guidance is to use the reliever inhaler as its an 'immediate effect', however the Dr told me to increase my preventer inhaler which I am led to believe can take a few days to get into the system? Whose guidance am I meant to follow?

While I have concerns that my peak flow hasn't shown signs of improving so far, my main concern is this cough, when I'm coughing it isw like my lungs are squeezing out every little last bit of air and I have to not panic and force myself to somehow get a breath as I know I'm going to cough again and trying not pass out.

thanks for reading.

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So I have now been on prednisolone for 4 days... yet finding very little improvement in my peak flow or the coughing.

What also doesn't help is my Dr and my asthma nurse giving me conflicting advice. WHen my peak flow drops, according to my asthma nurse, the new guidance is to use the reliever inhaler as its an 'immediate effect', however the Dr told me to increase my preventer inhaler which I am led to believe can take a few days to get into the system? Whose guidance am I meant to follow?

How long were you told to take the steroids for? If you're not better by the end of the course then you should go back to see your gp, you may need more days or a higher dose (if you're on 30mg a day you might need 40mg). If you're not better it could also be down to not having removed the trigger, maybe a chest infection that's been resistant to the previous antibiotics, or dust or pollution etc

Both your nurse and doctor have given common advice, and I think generally should be combined. If you have asthma symptoms/peak flow drops you should use your reliever inhaler for immediate relief, however it will not work for more than a few hours so you then have to keep taking it. If you're using your reliever often then an increased dose of steroid inhaler will reduce sensitivity in your airways and reduce symptoms (over several days), therefore reducing the amount of reliever use and getting out of the cycle. As you're on Prednisolone the effect of increased inhaled steroid will have very little effect as the Prednisolone is much much stronger.

Hope you're feeling better soon

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Thanks for your reply Lou. This is really the first time I've not felt in control of my asthma symptoms!

I'm on 40mcg of prednisolone for 7 days and had been praying it would have cleared things up even a bit. Most of the symptoms I can cope with but it's this cough that feels it's right from the lungs and is sucking out the air or what little there is that I'm struggling with.

Is there not a stage where they think a chest/lung xray is needed just to check things?

Just getting me down a bit now as this all started just before Easter.