I missed a chest infection??

[gantsdacier]

Ok so basically, my asthma hasn't been great in recent weeks, and I've been waking up increasingly more often with a 'stuffy' chest. I've been getting more of a cough. But I brushed it off assuming it was to do with seasonal allergies or something.

I ended up in A&E on Sunday night because I'd had severe stabbing pains in my chest on the left side since I woke up, it was very very painful to breathe. I have cluster headache so I'm no stranger to extreme pain and when I say I need to go to the hospital with pain it's because I really really need to.

A&E was really struggling so after 7 hours there (they ruled out heart stuff pretty much straight away) I spoke to the nurses and it was decided I would be ok to make an emergency appointment for Monday morning (which it was by that point) to see my GP to try and workout what was going on. What he said was that in my left lower lobe he could hear quite a bit of crackling, so because my temperature and sats were fine and my asthma is stable, he gave me amoxicillin.

I'm using my asthma meds (Seretide 250/25, Spiriva Respimat, Montelukast), I have some saline nebs as usual, and as I have adrenal insufficiency I also have steroid cover at home which I'm supposed to use if I start with a fever, but if needed I can also use it if I'm struggling lung-wise, then make a phone appointment to get some prednisolone which is what I'll probably have to do.

The thing is, I'm wondering if I should have called in earlier to get steroids and kick this in the butt? Did I leave something when I should have got it treated, and because of my own negligence it became a lower respiratory tract infection?

[risabel59]

Hi there,

My first question would be do you have a written Asthma Plan? If not you should get one next time you see the doctor or Asthma nurse. This really helps in making decisions about when to change medications and also when to seek help.

It sounds as though, you were/ are more symptomatic than usual and have been for quite a long time before your chest got infected. So you probably should have taken steroids earlier. However I don't know you, and that is why a written plan worked out with your doc would have helped you make a better decision about when to take Prednisolone.

By the way cluster headaches are awful, my sister gets them. Poor you.

R

[gantsdacier in reply to risabel59]

My action plan is some months old now but it's still applicable (with the exception of my peak flow ranges, which have changed a lot), and I followed it but my chest had been off for a few months. I've mentioned below to someone else that I have some other conditions (the head conditions, plus iron-deficiency anaemia, some other pain condition not diagnosed, and generally a body which isn't happy about heat) and hay fever so I put it down to that really.

I'm on testosterone therapy because I'm transitioning and I believe that increased my lung capacity: I was hospitalised in December with asthma and my peak flow (380 before the attack) never seemed to get back above 310-330. I stopped checking it then had an asthma review about a month and a half ago, at which both a computerised spirometry and a manual peak flow (I requested the latter because I was shocked by the spiro result) showed 435 even though I wasn't doing so great with my asthma at that point..so I can't be sure how reliable my peak flow is as an indicator anyway.

I can't even do a peak flow right now because when I breathe out it hurts a lot. I can't actually complete a breath out right now so I'm doing shallow high breaths which is not particularly comfortable 😭

[gantsdacier in reply to risabel59]

I'm sorry about your sister though! I hope she's getting good treatment, I'm lucky to be under one of the top neuros in the country specialising in clusters

[Hidden]

Hi gantsdacier

Sorry to hear your asthma hasn't been great. Here's some information about the asthma action plan and you can download a version to take with you when you see your GP/asthma nurse for an asthma review. bit.ly/2tBrd2J

A written asthma action plan includes all the information you need to look after your asthma well, so you're likely to have fewer symptoms and significantly cut your risk of an asthma attack.

Hope that helps,

Dita

[gantsdacier in reply to Hidden]

Thanks, I do have a relatively-recent action plan, I think it was probably because I have other chronic health problems that are flaring with the heat and I'm spending most of my life in my bed or at the ice rink so I assumed the issues I was having were part of that, or to do with the fact my lungs have been a bit off for a few months which I also put down to my other conditions. In retrospect I know I should have been earlier but at the same time this came on pretty quickly so I'm not sure if I could have noticed it really. If anything, my lungs actually held out better than usual at hockey on Friday and Saturday. They've gone downhill pretty quick since Sunday morning though.