What's your asthma action plan?

[madmazda86]

I've seen lots of folk posting here who have been newly diagnosed with asthma so I thought it'd be interesting for those folks if we all shared our asthma action plans so they could see what we do to stay on top of our symptoms

My asthma type:

Cough-variant with normal SATs and peak flow during exacerbations. Best peak flow is 450, I'm 29.

My old treatment:

Clenil 100, 4 puffs a day; Ventolin before exercise and when required.

My asthma triggers:

Cold weather, high humidity, exercise, laughing, infections

My asthma action plan:

With an increase in symptoms (coughing), needing Ventolin more than three times a week or needing it during the night, or manifestation of illness.

1) Max Clenil dose to 8 puffs a day.

2) If no improvement in 2-3 days, get oral prednisolone course from GP.

But during my last flare-up I totally failed to respond to prednisolone. On the final day of the course I was still needing Ventolin every 90 minutes from 4am onwards. So I had to go back to the GP and was given a Fostair inhaler. Nobody here will probably be surprised to know that my GP didn't explain to me how to manage my asthma with this inhaler. Fortunately some googling found me some Fostair guidelines from NHS Tayside but if I'd been stuck I would have phoned the AsthmaUK helpline again.

My new treatment:

Fostair 100/60, 2 puffs a day.

My new asthma action plan:

In response to same exacerbation hints as above,

1) Increase Fostair up to 4 puffs a day with Ventolin as and when required.

2) If still needing Ventolin in the night etc after that, ditch the Ventolin and start taking Fostair as my only inhaler, up to 8 puffs a day.

3) ??? (I don't know what to do if that doesn't work, I'll need to discuss that with my asthma nurse. I'll keep you posted!)

Share your asthma action plan!

[Slb306]

Hi

Good idea!

My asthma - eosinophilic, little wheeze even when really rough, but feels like an elephant sat on your chest.....

Triggers - infection, cold weather

Peak flow. 460 on a good day, 220 on a bad one.

Routine treatment:

Fostair 2 puffs bd

QVAR 2 puffs bd

Tiotropium 0.18 od

Montelukast 10mg od

Ventolin as required

When peak flow down 20% double up Fostair and Ventolin regularly.

If down 30% d w GP and until this week 40mgs prednisone if no improvement after 2 days or further deterioration of pf. Nebulised Ventolin (but if using more than 4 times a day) have to see respiratory team at hospital.

Sadly developed severe steroid related hypertension this week after 10 days of steroids. BP went through the roof, from 120/70 - my normal to 230/120! After having been so well for so long all came as a bit of a shock. Had to stop steroids stat (defo not recommended unless under direct supervision of medics.....) and start frusemide. Risk of stroke or coronary are very high with that reading (I'm 52) BP heading right back to normal now but have to have urgent review to agree what instead of steroids in the future. Anyone else had this?

[pucageorgie in reply to Slb306]

Yes Slb306, I've had surges in high blood pressure on steroids before, once felt like I was having a heart attack this time last year. Had heart trace and bloods etc, they couldn't find anything and consultant warned me to keep taking steroids as needed, but I'm wary now.

[gerrytlloyd in reply to pucageorgie]

My experience is: GP's will end every consultation with a reiteration of the standard procedure. I found that salmeterol actually CAUSED wheezing if I use it twice per day. In desperation, I googled the problem and, sure enough, salmeterol is known to do this because it is breathed in as a powder, and the build up of powder is the cause of the wheezing. My GP accepted this explanation during my last visit, but ended the visitation by reading aloud that I must use salmeterol "TWICE DAILY". I cope very well now with single puffs of salmeterol, because I fend off most asthma quite well with aspirin, only 'resorting' to salmeterol once every few days (when stubborn tight chest occurs, depending on the weather.) bit.ly/salamol

[sharshy]

Wow! thats a good peak flow. I am only 250 on a normal day.Could be something to do with my age 65. It has got worse the older I get.

I have many triggers like you and seem to be allergic to everything, wheat, dairy, dust e-numbers (also used in tablets that coat medications like penicillin). Hay fever, tree mould. the list goes on.

[pucageorgie]

That's really useful! I don't have an asthma action plan anymore since I'm on maximum doses of all my meds, so can't increase even temporarily. I always have a course of steroids on hand, and am supposed to start them myself in case of an exacerbation; but after that if it worsens, it's down to guesswork on my part.

Another thing on my list to talk to the new team about!

[gerrytlloyd in reply to pucageorgie]

See if anything here helps you with your experimenting: bit.ly/salamol

[gerrytlloyd]

I've written out the plan as it evolved. My suspicion of steroidal medicines made me cautious with prescription medications, but I had a very serious side-effect, nevertheless. Then a piece of luck: aspirin before bed stopped wheezing when it had quickly become extreme at night. Now, aspirin fends off asthma: I also take one before showering and one before going out for an evening in cold air. Every few days, an episode of tight chest has still been getting a grip, and then one puff of salmeterol sets me back to 'normal' for two days or more; back to coping by intake of aspirin. bit.ly/salamol

[netochka]

Oh so 9 days of 40mg prednisone could have caused the mega bp the GP recorded last time! It was so high she was going to make me wait around to recheck it but we forgot because busy arguing about prednisone intake.

I still love my steroids though...

[netochka in reply to netochka]

Does anyone know if that is dangerous / how dangerous?

[madmazda86 in reply to netochka]

Uncontrolled bp can cause problems in the long term, yes.

[Kashwi]

I have been on pred now for almost 3 weeks but this explains why my BP has been so hight for my age!!

[Snowdrop27]

My asthma plan is as follows which is the asthma action plan from my GP. On the back it recommends you look for information from asthma UK. It gives you information on asthma and instructions on how to use your inhaler.

2 puffs of seretide 250/25 twice a day. Rinse mouth out afterwards.

Take 2 puffs of your puffs of your inhaler called Ventolin 4 hourly as needed.

Please come and see an asthma nurse or doctor if your asthma is getting poorly for example.

1. You are using your blue inhaler more than 2-3 times a week.

2. You waking up at night

3. You are waking up first thing in the morning and needing your blue inhaler

4. You are needing to use your inhaler most nights before going to bed.

5. You are starting to struggle with every day activities because of your asthma.

Then what to do in an asthma attack

If you chest is very tight you may be wheezing or coughing and you can't speak in full sentences.

2. take 2 puffs of your blue inhaler(30 seconds apart) .If your asthma doesn't improve take your blue inhaler, 1 puff at 5 minute intervals up to 6 puffs in total. (call 999)

3. If your asthma attack improves, you should contact your GP surgery or out of hours services (111) within 24 hrs

If your asthma is not any better dial 999 and take another 4 puffs (10 in total)

REMEMBER if you take a lot of blue inhaler it will make your heart beat faster and you may shake. This will wear off.

I used the Asthma Attack instructions when I had my first asthma attack in November. Then I was only on Ventolin as I had mild asthma for 10 yrs. It really helped me know what to do and I didn't panic just did what it said and my asthma didn't improve so I called 999 for a paramedic. My Peak flow was measure by the paramedic after 10 lots of Ventolin 300. My peak flow measurement for me is 420.

I have also been asked to do a peak flow diary till I see my GP in mid March. (12 wks from starting seretide) I do it first think in the morning and about 5 pm in the afternoon. My peak flow is perfect and has been for over 3 wks. I haven't to use Ventolin for over two weeks. The cold air does make my chest sore if I am out in it alot. I cover up with a scarf over my nose and mouth. My other triggers are Smelly candles, cats, mold, pollution and colds (that go to my chest). I had my flu jab nearly three weeks ago. Good thing too my husband came down with flu last week.

[kelgat]

hi, just a quick reply. I have been feeling absolutely horrific over the past two weeks, my chest is so tight and constant cough, worse during the night! Have got an appointment on monday with my gp, see what she can do.

[madmazda86 in reply to kelgat]

Hope your GP can get you sorted!