What do I do first? Sorry, long post.

[KittyB52]

Hello all.

I would like some advice about next steps regarding my asthma and allergies (and possible related ailments). Here's a potted version of my 'history' so far:

1. Asthmatic since childhood, only wheezing when I have a cold, prone to chest infections, allergy to house dust/dust mites.

2. Constant runny nose and sniffing, dealt with mostly by allergy reliever gizmo and low dose loratidine (OTC) as phobia of nose sprays (yes, really).

3. Heartburn (appeared a few years ago, managed with omeprazole daily) until improved, now managed (has recently been a bit worse) with OTC ranitidine or Gaviscon.

4 . GPs nigh on useless - unsure if actually asthma or COPD - not given any advice or next steps. Prescribed Fostair with spacer for asthma taken twice a day

5. Spoke to asthma nurse through Asthma UK, v helpful, recommended monitoring peak flow, but doing peak flow gives me a coughing fit, so have given up for now.

6. For last couple of weeks have blocked left nostril, breathing through mouth at night, dry mouth, headache and slight wheeziness on waking.

I have avoided going to my GP as I dislike one of the doctors who is massively patronising and not too helpful - also don't want to be prescribed a nasal spray that I won't use. However, I think it's time for me to 'face the music' and go back as I am not sleeping well.

I don't feel like I even have asthma (if that makes sense) - I have started walking every morning before work to improve my fitness levels, and I manage a good 40-45 minutes walk at a decent pace with little problem. I feel tired during the day, but otherwise I am well. I don't sleep well and feel pretty rubbish on waking, but make myself get up and go for a walk. So I can't be ill, can I?

I am pretty sure it's all linked together. If I make an appointment with my GP, where do I even start?

If you've managed to get to the end of this epic post, thank you - have a biscuit!

[-Butterfly-]

Sorry I have no advice, just didn't want to read and walk on by.

I hope someone can offer you some useful advice, good luck xx

[Hidden]

The immediate thing that comes to mind as far as the blocked nose is concerned is a decongestant which is not a nasal spray. Have you tried inhaling Olbas oil or used Vicks vapour rub (rub it on your chest at night). They work well for me.

Peak flow metre (PFM) making you cough. You are not alone in that, but you really must persevere and use it. Your PFM will help you to understand your asthma and can act as an early warning device as to when your asthma might be at risk of going out of control. You should do three attempts, and record the highest one of the three.

With regards to the runny nose, do you suffer from allergic rhinitis and if so, do you ever get itchy eyes in conjunction with it? If so, you could always try eye drops.

Walking will not necessarily cause breathing problems. Asthma can affect different people in different ways. I'm known to be an exercise induced asthmatic - but like you I would be able to manage a forty five minute walk, so long as it's not power walking.

Heartburn - you're not alone with that either. Presumably you've been told to be careful about what you eat (avoid spicy or fatty foods, citrus, mint, caffeine, etc). Avoid large food portions, sit upright after eating and don't slouch/bend over for at least an hour after finishing a meal, raise the head end of your bed by about six inches, and don't go to bed until at least three, preferably four hours after you've finished your evening meal.

I think you are right in that you need to discuss this with a GP. You could always ask to see a different one if you're not happy with your current one. Write down the notes you posted on the forum (except for the one concerning the GP:-)) and take them with you to act as a reminder of what you want to discuss.

Hope some of this helps.

[KittyB52 in reply to Hidden]

Hi Maggie,

Thank you for your reply. I have tried both Vicks (on chest/neck) and Olbas oil (on nightclothes and tissue under pillow) but they don't help much. Or at least, I'm guessing they don't if I am waking up with a dry mouth and headache from sleeping with my mouth open.

I will try the PFM again - I confess the last time I tried it was not long after I'd recovered from a chest infection. Maybe it won't cause such a big coughing fit now.

I have never been told I have rhinitis, but I suspect I do. I do get itchy eyes but bizarrely, it's only ever one eye that is affected at a time. I get an itchy, gunky eye which the next day becomes a watering, irritating eye. Then it vanishes. I use Opticrom drops when my eye(s) get bad.

I do try to stride along when I walk, to try to get my heart rate up. I could just about talk if I was with someone - I'm not, I walk alone, listening to music.

I wasn't given much advice about heartburn - as I said, my GP isn't great - so other than testing me for H pylori, they didn't do much other than prescribe the omeprazole. This could be because at one point, even sipping a glass of water could set off the heart burn, so maybe the GP thought it was easier to prescribe something rather than try to figure out what was causing it. It's nowhere near that bad now, I don't take omeprazole unless I wake up feeling 'heartburny' (usually I can tell if it's going to be a bad day if my morning cuppa sets me off).

Good idea about the notes, will copy all this down.

[diana-stoyanova in reply to KittyB52]

You're not alone in any of these, Kitty I've been sleeping with my mouth open for years on end (it only sucks that I snore lightly because of it). I also get the only-one-itching-eye thing. This last one is connected to how your allergy develops. I have allergic rhinitis as well. Anytime I get into an allergic tantrum I get the one itchy eye, the one stuffed nostril, the one itching ear and the only-one-itchy-side-of-the-trhoat. (Currently in an episode like this).

It is also important to notice that some of these things might not even be related to your asthma. E.g. the heartburn. Try to figure out for yourself which works with what problem.

[lakelover]

Could you change GP surgeries?

[KittyB52 in reply to lakelover]

There are two surgeries near to our house, and they 'share' GPs, nurses etc. I am not sure where the next nearest GP surgery is after those. I think I will try to ask for a specific doctor (not the one I have seen before) and see if that makes any difference.

[fallon12]

Hi Kitty, I am sorry your not feeling that your doctor is listening or helping. Its very off putting when you dred going to see doctor but I think you should. I have brittle asthma but at times I feel like I am healthy and as fit as anyone else then I get a cold or a run of chest infections and I know I am sick. Walking is my exercise and like you there are times I can walk for ages with little or no symptoms but then on others days I can hardly walk to my kitchen to put kettle on. Be brave and remember the doctor has to treat you and if your not happy with him ask to see another one until someone helps you work out a plan and gives you the information you need. I wish you well Kitty xx

[KittyB52]

Thank you for your posts.

Just a quick update - I have an appointment with the 'asthma clinic' at my GP surgery on 27th June. Hopefully I can get somewhere with that.

I am feeling pretty rough today - no stuffy nose, but I have heartburn already (despite not having eaten anything today - not feeling hungry, which is unlike me) and am very wheezy. I didn't get to go for a walk this morning, but that's probably not a bad thing. Will be taking it easy today, I think.

[Wheezycat]

Just one thought, on coughing and peak flow. I struggle with the same, but had to find a way of managing it when I was admitted to hospital just within the last couple of weeks with an acute asthma attack. I was nebuliser 4 times daily and had to do my pf before and after. Coughing was definitely a problem. But I found if I breathed in quite slowly, very deliberately starting far down in my body, so using my diafragm and muscles in in that area, I could fill my lungs mostly without coughing, and I could get a good reading. Normally I would pull in quite a lot of air, fast, and that I couldn't do at that time, not sure about now either. I am not sure my description is good enough, but i hope it helps.

[KittyB52]

Just wanted to update on this. I went to the asthma clinic at my surgery and did the reversibility test (which showed I had the lungs of a 63 year old!) The nurse told me to see the GP and asked which one I wanted to speak to. I got chance to see the doctor who had referred me for tests initially, which was good. The results were not clear enough to show whether it's asthma or COPD so the GP referred me to a consultant.

I went a few weeks ago, and the consultant said he thinks I have a fixed obstruction, as I have had asthma since childhood. He gave me some recommendations, and I saw the letter he sent to my GP last week. The allergies seem much better *touch wood*, the heartburn is still a problem, so I may ask to go back on omeprazole. I am not sleeping much better, although that could be due to the start of the menopause.

Anyway, I am going back to the GP to get a flu jab, pneumonia jab and blood tests for Vitamin D levels (as recommended by the consultant). I am also going to ask for my hormone levels to be checked while I am there.

I also have a follow up appointment at the hospital with the asthma nurse who is going to give me an emergency pack with steroids in so that I can cope if I get a cold which turns into a chest infection (as the last few have).

So it's looking a bit more positive. Thank you all for your advice.