Brand new to this, well, sort of - and need help to learn

[Wheezycat]

My question is: when do I know I should take ventolin? This may sound odd, but perhaps less so with my story below.

Now in my sixties I was diagnosed in the last couple of years. I had noticed myself wheezing intermittently and briefly, and then For a period found it hard to breathe out on excercise. So after some thought, and my daughter occasionally offering me her inhaler based on her observations of me, and a doctor friend also occasionally noticing my occasional wheezing, I was diagnosed. However, I still blamed myself as unfit when I got breathless and wheezy going up hills. Increasing excercise to get more fit never helped. It never occurred to me to use an inhaler except if I had a bit of a throat infection - and those I seemed to get all the time even though it rarely developed into a cold. 

So, come this year, I acquired a local, nasty virus which attacked chests. Lots and lots of coughing. I managed to half ignore that and carry on - or limp on - as usual, even though with reduced activities. However, after a month I really got quite ill, and could no longer ignore it. I finally went to the doctors and got antibiotics quickly, two lots. Also a lot of encouragement to increase my use of beclomethasone (Clenil Modulite). I was exhausted and unable to do much at all. My husband behaved like a cross, anxious and very bossy mother hen (cross because I had half neglected myself before, so half brought it on myself). My friend, the doctor, read me the riot act, and said in no uncertain terms that I had uncontrolled asthma. She, and others noticed my laboured breathing, and my inability to speak a whole sentence without needing to breathe. I didn't. I had habituated to having asthma. Apparently it can happen. 

So, now that I have learned the hard way, but still unsure of my bodily sensations and how to interpret them (I no longer trust myself to adequately recognise asthma symptoms in myself), I have brought out the old peak-flow and use it daily and I record. I have no idea yet what my 'normal' peak flow should be, as I am still recovering. 

The stupid thing is that not only did my father die young from status asthmaticus, but our daughter has had asthma, diagnosed when she was five, and I was always the main carer. I was well versed with becotide, ventolin, peak flow meters, theophylline, collapsed lobe in the lung (yes, that happened) and so on. Yet, as a carer of myself I have a lot to learn. I now also suspect that I have always had mild asthma, based on the fact that I cough for a hobby and have always done. It was never diagnosed, except a bit once after flu, but then my childhood was a long time ago and things were different then. 

So, back to my question: if I am due to walk up a hill I now do take ventolin. Likewise if I do anything that I know brings on coughing fits. And so on. But what if I am sitting in our sofa, minding my own business, but notice that my airways feel irritated (not unusual for me) and as if my breathing isn't as comfortable as it could be, without it being really bad? I can manage fine, but now I notice it - or pay attention. Should I take ventolin? My peak flow at present ranges between 290 and 330 generally, though once I managed to hit the dizzy height of 360. I am trying to also link it with other activities, like cleaning a very dusty room, but that is work in progress at present. 

Any advice/learning from others is welcomed. 

[Beth_19]

Welcome to the forum.

If it were me in your situation and I noticed my airways getting irritated for no apparent reason I would firstly try changing position and some breathing exercises. If that doesn't settle it after a reasonable time then I would take a puff of ventalin. 

Irritated airways can happen for any number of reasons and sometimes do take a little bit of medication to settle while other times simple techniques like changing position and breathing management can work.

If you see the asthma nurse, maybe ask them about the various breathing exercises you can try to help open up your airways when things feel a little irritated, then it means you can leave the ventalin for when things get tighter.

[Wheezycat in reply to Beth_19]

Thank you, Beth. That sounds like sensible advice. And I hadn't thought of it.  I have just re-started yoga (I am a beginner anyway), and last time I found that I felt better for it. I suspect that is the influence of the focus on breathing. So, yes, breathing excercises sounds good. And I thought I was good at that........so much to learn! I also do plan to go back to the asthma nurse, but want to gather some more 'evidence' first. I last saw her a couple of weeks ago. It was useful. 

My follow on question is: if I am feeling only slightly challenged breathing wise, but it isn't really getting in my way as it were, does ventolin do useful things other than just make me feel better? Is it useful for my lungs to open these airways? Remember I am the person who got very adept at noticing very little at all!

[freefaller in reply to Wheezycat]

Wheezycat, I find it difficult to advise you on when to take your ventolin.  Only you can tell and you are doing the right thing by being aware and observing yourself.  Personally,I would not take ventolin before walking up a hill say when you are out mooching around town just take it slower and easier but if you are attempting a nice long walk then yes maybe take a puff before you go out and the same goes for any exercise until you find you can do it without taking it as I have done.  Quite often I find I feel wheezy or sob I take my peak flow and find it is really good but then within a couple of days it has gone down as I have a cold coming on.  Then I up my ventolin starting at morning and night and upping the dose if that has no effect and getting to the GP.  Am sure you will get used to this it just takes time.

[Beth_19 in reply to Wheezycat]

No problem. Only you can really decide if you need to take medication because we are all different and have different limits. 

My rule of thumb is about functioning as I have other medical conditions to take into account. I take the least amount possible which allows me to function, meaning when things get bad I have more options for increase. However that is just me and that is what works for me.

Its a good question to ask the asthma nurse as they know more about the medications and the benefits/cons of them. 

[Wheezycat]

Thank you both for your responses. It all helps. I am getting more aware and recognising symptoms, I hope. 

The 'bizarre' thing is I sort of felt generally better, except when I really didn't (like walking briskly up a hill, or briskly anywhere with someone and attempting to talk. Recently, before getting so I'll, I have found myself telling friends I am not prepared to walk briskly!) Now, becoming aware, I am noticing when it isn't so OK - which leaves me less comfortable! Sometimes ignorance is bliss! Or at least nicer! But not necessarily better, as I have learned to my cost.

[Hidden]

Hi, like you, I must have lived with asthma for many years. I was diagnosed as a child, but never felt the need to take anything and assumed the diagnosis was wrong or I grew out of it. My whole life I've had to constantly clear my throat and I've always found exercise hard (who doesn't, I thought), but until my lung collapsed last year, I was very fit, although suffered chronic fatigue, which I put down to weather changes.

I have had the same dilemma. When do I take the blue inhaler and why? Ive never had a peak flow test, but after 9 months of being medicated, I've come to notice more when it actually does me some good. Before, if I was starting to cough I would ignore it, as I was used to it happening, but taking the inhaler actually puts a stop to the coughing pretty quickly, so rather than an emergency medication, I see it as being convenient. I've also noticed that since I've been getting better at spotting the times to use it, I'm actually needing it less and less.

I really think that you will get to know your asthma as time goes on. I'd suggest to take it out of curiosity if you think it might be of some use and see if it really helps. If it does, then you might as well use it in that same situation next time. 

[Wheezycat]

Interesting! Definitely similarities to me! You could say I normally cough as a hobby. I frequently wake myself up at night with coughing paroxysms. Add to that that I have been aware that I often have a slightly sore throat, which always seems to spread downwards, and other small irritating symptoms in my airways.

Just now none of that, but then I doubled my dose of clenil with this chest infection. I was encouraged to do so by the nurse. So now I take 4 X 200 each day rather than 2x200. I won't reduce it until I feel more 'stable', and no longer feel the need for regular daily ventolin. It is going that way. And perhaps with the clenil, it is currently unusual that I wake up coughing. Interesting! I don't miss it!

Also wheeziness and breathlessness going uphill. There is one hill I tackle regularly as it is on my way to work ( so I aim to walk briskly) I can never do that without getting breathless, and needing a breather once I reach the top. I always put it down to my feebleness and lack of fitness - except I did try to improve on it. It never made any difference. 

Just now that I am just still getting over nasty chest infection it feels as if my life has turned 90 degrees. Neither better nor worse, just that I am not quite the person I thought I was. Odd! But I think I am slowly learning. And the pf meter has become my friend. 

....

[Hidden]

Hi Wheezykat 

I was told to take ventoline 2puffs 15mn before exercise or cold weather or heatwave or pollen spell..use an aerochamber for all your inhalers it penetrates down the lungs better and avoids dry throat or thrush.

Up to 6 times a day I learned this week from the consultant if not the lungs get used to the vento and it's useless.

Hope this helps xxx

[Hidden]

Wheezykat..i too cough during the night, I was told its post nasal drip causing it.

[Wheezycat in reply to Hidden]

Hi! Yes, I have been aware of that possibility, but then it wouldn't have miraculously disappeared in the last few weeks, since I have been recovering from my chest infection. Thus I now believe that has something to do with increased use of clenil. Also, could post nasal drip be linked to sensitivities (highly likely) which is then also linked to asthma symptoms? Obviously I don't know, but my current suspicion is that it all links up. Also I often cough in the daytime, even when I am fine. There is a lot of learning for me to do. In time I will reduce the use of clenil again, once I feel more permanently stable (it is moving in that direction), and if my night coughs then increase again it should tell me something. And,and it was bothering me, it would be good to understand it better, and know how I can manage it. 

[Hidden in reply to Wheezycat]

I am only recently diagnosed aged 55

.Although called post nasal drip, I have it almost constantly so think its allergy causing it, I have a cat and dog and I smoke,a nasal wash sterimar does seem to help.