Confused

Hi there! I'm new here. As the title says really, I'm confused. I'm 59, took early retirement nearly two years ago and live with my husband and an assortment of animals, including 10 cats (soon to become 11). We also have llamas and a pig on our 2.5 acres. Over the past 10 years or more, I had what I thought were attacks of bronchitis. After coughing like mad for a couple of months I would go to the doctor who gave me antibiotics. They didn't work, I didn't go back, but the coughing eventually went.

Then 8 months ago it started again and I would be up all night sometimes with a cough that felt as though it would break my ribs. I eventually went to the doctor (I had also come down with cellulitis by then) and was put on 3,000mg antibiotics/day. The cellulitis cleared, but I still had the cough.

Then I was given a 5 day course of prednisolone (I know this steroid well having used it for our cats and ferrets). It worked. The doctor didn't explain why, but suggested I try an inhaler. Still under the impression I had bronchitis, I declined. About 5 days later I began wheezing again, so back to the doctor who gave me Symbicort. I felt like new.

The only trouble is that I've had umpteen cases of very painful oral thrush. I rinse and gargle very well, brush my teeth afterwards and recently kept gargling with salty water through the day. I'm sitting here now unable to eat and it's even painful to drink. I still have some Nystan left over from a previous episode, so fingers crossed it will improve soon.

They tried me on Qvar, but after 5 days I was wheezing again. After 10 days the cough was getting bad, so I gave up and returned to the Symbicort.

My normal doctor left recently and I can't seem to get on with the other one. In over 20 years I have only been there a couple of times and don't know any of them well. They haven't (or won't) give me a diagnosis, only saying it might be asthma.

Apart from the cough, I also get bouts of sneezing and about once a fortnight I can't breathe through my nose at all. Cue another sleepless night sitting downstairs in a chair. I'm on Loratadine for that and so far (about a week), there has been no sneezing. (The episodes were odd and would often start around 1.30 in the morning. No idea what I was suddenly exposed to that I hadn't been earlier).

So now I've taken myself off Symbicort and don't fancy another trip to the doctor. I have little trust having been let down when I had Septicaemia a few years ago. The hospital put me on pills that I couldn't keep down. Hubby rang the doctor, but she didn't call back all day and he rang back to catch her leaving for home at the end of the day. Things could have turned out very badly.

Sorry for the long post. So I think I may have asthma and perhaps it's allergy related, but to what, I don't know. I've not been offered any tests to find out, although I guess it's something I can't avoid. I have no idea if I can continue on the antihistamines alone. I don't know whether to change doctors and if I do, what should I be asking for?

[Hidden]

You have been given the runaround haven't you. The normal test for asthma is the peak and flow test where you breathe into a machine and it measures your lung functions. They could also give you a spirometry test which is similar but a bit more complex.

You need to go back and ask your doctors for the P and F test. This should determine whether or not you have asthma. The fact that symbicort worked well means that is probably is asthma and not other lung problems too is a good sign.

I have copd as well as asthma and at my last review with the nurse I was taken off symbicort and put onto qavar and clenil as according to the new gold standards I was being 'over treated'. However my pharmacist did tell me it was mainly due to cost cutting! Tell your doctor/nurse what you have told us and ask to be put back onto symbicort. .

I hope this advice helps a bit.

[Hidden in reply to Hidden]

Thank you for the reply. One of the doctors did give me a simple puff test. I had to blow hard into something and that gave a reading. Apparently it was improved by 50% after 4 weeks on Symbicort. The problem is all the outbreaks of oral thrush. I can't keep on not eating, so I've taken myself off the inhaler.

[Wheezycat in reply to Hidden]

Hi! I have also had a lot of problems with oral thrush, something I had never encountered until I ended up with a chest infection, and antibiotics, last year. Since then I know it well. Mine doesn't hurt, though, or not enough to stop me eating.

Last summer I was on very high levels of Symbicort, so it was a constant struggle to avoid getting thrush. Now I still keep an eye (inspect my mouth and throats for any sign of give-away white spots) so I can nip it In the bud. I take half of Symbicort compared to last year.

What I find works well is Oral Dactarin which you can buy over the counter. I did also once have Nystan, but with the wrong instructions (a manufacturer's mistake) so I used it up too quickly, and now I just find it easier to go with something I don't need to make an appointment for. I don't need to use it often now.

Last summer when it was really a problem I also got into the habit of gargling and rinsing my mouth with water mixed with a little bit of salt and a little bit of vinegar, an old home remedy, or just salt. Though it didn't cure it I do think it helped to keep it down.

Symbicort has really helped me too, and still does. It is worth hanging on to (or some other medication that helps). Asthma is more serious than oral thrush, however unpleasant the latter is. I do hope you can find a gp, or asthma nurse, who is more effective and helpful.

[Hidden in reply to Wheezycat]

Thank you for the tips. I've been gargling with salty water for the past few weeks - every time I pass the bathroom and it still hasn't helped. This is now the fourth day of not eating and sadly I think the cough is preferable...

[esthermoroney14 in reply to Hidden]

Just use a spacer for your inhaler that will stop oral thrush

[Hidden in reply to esthermoroney14]

I don't think you can use one with Symbicort, but I'll ask for another and give it a try. Thank you.

[Damon1864]

I would be asking for a spirometery test if I were you.xx

[Hidden in reply to Damon1864]

Would that give a definite diagnosis? (Goes off to Google the test...)

[Damon1864]

Not necessarily, but it may help to xxx

[thewheezyone]

Hi, poor you! Try corsodyl for oral thrush.... keeps it at bay for me. Have you tried beconase? I have to use that twice a day to help with post nasal drip, which could be making you cough.

I've tried lots of inhalers and the best for me turned out to be duoresp. Keep speaking to, or make an appointment with the asthma nurse at your surgery. There are lots of things to try... good luck xxx

[Hidden in reply to thewheezyone]

Thank you. We have Beconase at home, but it doesn't work for me. I haven't been told about an asthma nurse. It doesn't help that they haven't diagnosed asthma.

[Beth_19]

I am so sorry to hear you have been given such a run around by our health service. It certainly sounds like asthma could even be allergic asthma (you sound similar to my mum when she is around animals), but the only way to know is to have the lung function and allergy tests, which unfortunately means going to the doctors.

If you don't trust your current doctors then it may be prudent to try another surgery if they have spots available (so hard to find a good doctor these days). Or you can ask at your own surgery if one of the GP's specialises in respiratory diagnosis. Not a lot people realise that even GP's have their areas where they are more specialist but with a general working knowledge of medicine.

If it were me I would be asking for clarification on why they have you on inhalers and if they say maybe asthma again, I would ask for the tests or a referral to a proper Respiratory Specialist for a proper diagnosis and medication.

I hope you get sorted

[Hidden in reply to Beth_19]

Thank you for the reply. The problem is our surgery is only very small and opens just four days a week. One doctor has just gone on sabbatical leave. I find the other one won't let me finish a sentence, so I never really get to explain my symptoms. The last time she said to just "drop her a note" about how I was getting on with the anti-histamines. Now I have oral thrush again, I don't want to go back. It's not supposed to be that painful, but at the moment I can hardly speak. I'm self medicating with salt water. I cured my own eczema with vinegar because they were only offering steroid cream. It cured one patch, but would just break out somewhere else.

We are quite rural and it was hard to find any doctor to take us when we moved in some 20 years ago, but I do think it's time for a change. The surgery did score very badly not that long ago, getting just 1 out of 5 or 6. Sadly I think the episode when I had septicaemia ruined any trust...

[Beth_19 in reply to Hidden]

Some doctors really need a course on how to deal with their patients because some of them really suck at the whole kind, compassionate and caring. If changing doctors is a course of action you can undertake it may be worth looking into, trust is so important and if they have lost your trust then their treating of you isn't going to work so well. If you can't however (as in nowhere else is taking patients) then you need to ask to be referred to a respiratory specialist. If they refuse you can write a complaint to the Surgery Manager for failure of care.

I know you don't trust doctors anymore but it is worth having the investigations and seeing a specialist even if it is to rule out causes of your problems. If it is asthma then the Specialist maybe able to recommend another inhaler or even another medication to help with your oral thrush.

Your quality of life is being affected and doctors have a duty of care. I hope you get sorted. Keep us updated and hopefully we can help.

[Hidden in reply to Beth_19]

That's very kind of you.

[Thompson_2009]

With the Symbicort do you rinse your mouth as soon as you have taken it?

[Hidden in reply to Thompson_2009]

Absolutely. Like a thing possessed. Then I brush my teeth. Then I gargle with salt water.

[risabel59]

It's very tricky when you don't have good primary care. I also have a couple of hints that might be helpful for you. But Symbicort is a really good drug for Asthma so you are lucky to have it prescribed.

For Oral Thrush, everyone has made good suggestions, but I would add. Don't use any alcohol based mouthwash, such as Listerine, as it kills all bacteria in your mouth and allows the fungus to move in. Better to rinse with warm salt water, or just water.

As you have animals and are outside a lot, another thing I do is use nasal rinsing. It takes a while to get the hang of but can be really helpful and is worth persevering with, as it washes away all the gunk in your sinus's. You can buy a neil med kit from boots. If you are coughing from post nasal drip this can be a real help.

There is simple basic test that you can do for Asthma at home, (This is best done if you are not using the symbicort, but if you are using symbicort do the test before you take symbicort.)

It's not a guaranteed diagnosis. You need a Peak Flow meter, You can buy this from boots, or your gp can prescribe one. You also need a Reliever inhaler, (the blue one) which hopefully you have at home. Take 3 peak flow readings, write down the best one. Then take 2 puffs of reliever inhaler. Wait 20 minutes. Take 3 more peak flow readings, write down the best one. If the difference between the two readings is 10% or more, then it is quite likely to be asthma. (i.e. the second one is 10% or more better). I would stress, that this is most basic of a myriad of tests that doctors do to confirm a diagnosis of Asthma. Also there are different types of Asthma. Allergic and non Allergic, Eosophillic and Neutrophyllic, to name a few. As well as lung conditions that mimic asthma.

Blow into the Peak Flow meter 3 times (as per instructions) Write down the best reading

I find that communicating with bad G/P's is a real problem. Mostly they stare at their computer screens trying to remember who the hell you are, and don't even look you in the eye. I have resorted to writing letters to them, in order to explain my symptoms, what is happening at present, and what outcome I would like. I.E. a referral to a specialist centre. I ask them to read the printed letter before we start talking. Then at least I know I've said what I came to say. It also helps if you keep a symptom and peak flow diary.

I do hope you are feeling better soon

R

[Hidden in reply to risabel59]

I'm not sure about home testing. I'm competent enough, having looked after a diabetic cat for ten years. I can also do sub-Q fluids. Not so great with my own health though.

The letter is a really good idea. I wrote one a few years ago when my Mum was in hospital. She had dementia and needed a carer three times a day. However, when they asked her questions on the ward she told them she could do everything herself. I felt like a rat, but I had to set out what she was incapable of doing.

[healthwish]

U need to see a respiratory consultant who will carry out tests to see if u have asthma. Your gp will have to refer you. Hope I get well.

[Hidden in reply to healthwish]

Thank you.

[Bridin]

You need to see a respiratory consultant i was bad with my chest for a long time going to gpand getting nowhere going to respiratory consultant was the best decision that i made

[Hidden in reply to Bridin]

I'm glad you are sorted out now. We're going to find a new doctor after Easter.

[Hay1234]

Hi and welcome do u get itching in the ear when attacks coming on or a few days before

[Hidden in reply to Hay1234]

Not that I've noticed.

[Hay1234]

Does your throat feeling strangled and coughing alot

[Hidden in reply to Hay1234]

No, thank heavens.

[Hay1234 in reply to Hidden]

Im out of ideas hope u get better soon xx

[runnerwithasthma2559]

Dar Zooey1,

Perhaps you are allergic to animal hair. My asthma improved when I no longer had a cat.

Wishing you the best, John Terry McConnell, author of "Running with Asthma: An Asthmatic Runner's Memoir"

[Hidden in reply to runnerwithasthma2559]

That would be unfortunate seeing as we rescue cats. We currently have ten and another one is arriving from Bulgaria in a week.

[Madoug]

I sympathise with all you have been thro. Please please stamp your feet and throw a tantrum if you need to. Keep asking and pestering any gp for a referal to a respiratory consultant. You have rights, and getting the proper treatment is one of them. Dont give up.🙂

[Hidden in reply to Madoug]

I won't, but for the moment things seems to be holding up with just the anti-histamines

[Mary06]

Hello. I've never answered in one of these forums but I feel your pain! Last year at age 54 I started to get dry cough that I thought nothing of until it wouldn't go away. After three months I went to The dr and had the run around to many different drs - allergist (no allergies) pulmonologist, gastroenterologist and ent as well as primary care. My spirometry test showed possible asthma. Felt relief at times from the different inhalers I tried but the side effects gave me other disagreeable symptoms. I've gone off 90%dairy, pretty much gluten free, unless I get glutened by accident, cut back on coffee, lost ten pounds just from this and started taking iron and other vitamins. (My ferritin was very low and I swear this started all of my coughing and fatigue). After about 10 months I started feeling much better. I don't have a cough nowa year later, but get a throat clearing thing that gets annoying. I take Flovent with a spacer if it gets worse but for the most part take nothing. My throat cannot handle these inhalers. Symbicort was brutal on my throat but helped get rid of the cough.

Good luck to you. I know how frustrating the whole thing can be. That coughing is exhausting and for me was depressing. I hope you find relief as I have!

[Hidden in reply to Mary06]

I'm sorry you had a problem with Symbicort, but it sounds similar to the problems I've experienced. Currently on day 8 with no inhaler and just the Loratadine and (touch wood) I feel fine