Looking for thoughts on a better inhaler/treatment

[JGreen42]

Hi

Just looking to learn from others before I go to my asthma review. I have not been able to get the correct treatment and so my asthma has been unmanaged for years.

I am now getting attacks (normally able to avoid with breathing techniques), I am taking to my bed with exhaustion a lot, I am cold a lot and my limbs ache when I need to do anything energetic. I have had quite a bit of time off work.

I have had prednisalone and it really works for me. I gather it's not possible to stay on prednisalone, it's just for when you're bad?

I am on fostair but it's not working. Does anyone have any recommendations I can go into my review and mention?

Despite all this, I have been chest infection free for quite a while. But it does involve a lot of avoiding people with colds and solitary confinement when people around me have bugs. I'm not OCD but it can get a bit obsessive trying to keep my chest from letting me down.

Any thoughts welcome

[Chip_y2kuk]

Yes there are other combination inhales you can take, montelukast and other tablets for asthma and you can take prednisolone long term but only really as a last resort as it causes bone problems and I think lIver/adrenal gland (but some other organ comes at risk of damage)

[JGreen42 in reply to Chip_y2kuk]

Thank you. I just read about the tablets. I don't think I would be prescribed long term steroids and I think I will leave it to a last resort. Although being someone who seems to have allergic reaction to triggers unknown, it does sound an option.

[lakelover]

I was on Fostair for a while. It was brilliant at first but then stopped working. I'm on Symbicort now, which I was on before Fostair, & I'm now doing better. I think sometimes all inhalers stop working & after a break from them they start again.

[risabel59]

There are lots of add on treatments and also depending on what type of asthma you have new Biologic treatments (These won't be available from your GP) . Also there are different combination inhalers. Here are some of the options. It may be that just changing your inhaler to one with a stronger steroid component would help, as it seems that prednisolone works for you.

Fostair is Beclomethazone and Formeterol. Symbicort is Budesonide and Formeterol,

but there are a number of others that are available.

I would ask if you can either try a different combination inhaler, and or have an extra steroid add on inhaler. (1st choice add on steroid in my opinion is Ciclesonide 160, brand name Alvesco, this may be difficult to get on NHS as it is a 3rd line treatment)

You could also try an add on of a LAMA inhaler, like Spiriva, which is a Long Acting Muscarinic Antagonist, this relaxes the muscles in the lungs. A lot of people find this a great help.

Other add ons include, Montelukast pills, such as Singulair, this is a Leukotrine inhibitor and dampens down the body's immune response, which is responsible for a lot of asthma symptoms.

Another option could include a Theophylline, such as Amminophylline or Uniphyllin. These work as long acting bronchodilators , they are old drugs and have a narrow therapeutic window, however they work well for some people. Some doctors are reluctant to prescribe them, as they can have unpleasant side effects and you do need to have regular blood tests.

Hope this helps a bit. Also it may be worth asking for blood tests to check for magnesium levels, and other stuff as these can contribute to feeling exhausted.

R x

[Hidden]

Hi JGreen42

There's some information about different types of treatments on the Asthma UK website bit.ly/2t1P1cb.

If you have specific questions, do give our specialist nurses a call on 0300 222 5800 (Mon-Fri 9am-5pm) to talk through your options before your appointment.

Take care,

Dita

[JGreen42]

Thank you everyone, some very good useful information and links, I have looked at it all. I attended the GP and was surprised to find that the GP was sceptical about my asthma diagnosis in 2014 following a nasty chest infection. He listened to my heart and was concerned enough to refer me for an echocardiogram which has taken just 3 days for them to arrange. I am trying not to be alarmed at how quickly they are arranging it but I gather it must warrant it. I haven't had it yet. The GP did say if they were wrong and the echocardiogram is fine, he will refer me to the chest clinic for a proper diagnosis and perhaps the correct treatment. This site has been helpful as I feel I can discuss the different treatments with the GP with tried and tested information from the people who really know, those with asthma.

[JGreen42]

Just to update. Echo shows all valves have moderate regurgitation and so I am not getting enough oxygen from the heart to the lungs. Everything makes sense now. The diagnosis has shocked me and open heart surgery is major surgery to replace valves. Just waiting on seeing the cardiologist to find out what's next.

I can see why asthma was assumed, the breathlessness with normal blood pressure etc. I am very thank full for a persistent GP spending the time to listen for a murmur thus refer for an echo.