3 days of prednisolone and peak flow the same?

[damascena]

Hi. I've had a flare up of inflammation and was truly struggling. Hospital gave me steroid tablets and sent me home as oxygen was ok and peak flow was at 225. I have now taken the tablets three times and have been in bed for two days straight. Though I feel less pressure my peak flow is still at 225. Should I be worried? Is it normal for it to take this long? I did take several days, denying the severity of the situation and didn't seek help so perhaps this is just going to take longer than usual?

[CEC47]

I have had the same just been back to GP my peak flow was 235 didn't change which five day course of steroid tablets have put me on another course of them.

If you feel no better you should go back.

[emmasue]

My peak flow is up and down anyway. I usually go on whether my symptoms clear up or not. I have been bad lately and upped my steroids. I have been a bit better, but was bad again today. I think it is the weather. Anyway, if you have any concerns, go back to your doctor. Don't leave it. That's when things usually get worse.

[Lysistrata Administrator Community Ambassador]

What everyone else said. I usually get told to come back if no improvement in 3-4 days with pred. If your peak flow would usually improve and you're not feeling that much better I would go back as you will probably need to keep going with the steroids for longer. AUK nurses have always told me you stop pred when it's worked and not when still struggling even if things are starting to improve - how many days did they give you and what dose?

[damascena in reply to Lysistrata]

They gave me 5 days 8 5mg tablets a day. I have actually been to hospital and they said if steroids didn't work I don't have asthma as it's impossible... then said go to gp tomorrow. No mercy. I have now that horrible knot in throat to add to my misery and haven been able to eat. I'll go see asthma nurse tomorrow for sure.

[Lysistrata Administrator Community Ambassador in reply to damascena]

Sounds like a good idea to see asthma nurse. Hospital are talking bollocks - I don't expect expertise in every single condition and rare presentation, but they should at least know the basics of common acute conditions! It can take a while to help especially if you've been struggling for a bit, plus steroid resistant asthma is REAL - perhaps they would like to spend 5 mins looking it up?! It's more common than people think too, and if I'd known earlier I was partially steroid resistant maybe I wouldn't now have adrenal suppression... Of all the things they could use to claim you don't have asthma that is up there with no wheeze.

Sorry for the rant but I get fed up with this kind of ignorance affecting people's care like this. I hope the asthma nurse is much better and has some suggestions.

[Wheezycat in reply to damascena]

Last year I had my first encounter with prednisolone. I was given 5 days, but continued to deteriorate in spite of them. I ended up in hospital, where they could administer more stuff. It is not a given prednisolone immediately make things better.

[Wheezycat in reply to Wheezycat]

And, oh, by the way, they did work, just not instantly!

[risabel59 in reply to damascena]

Just so you know, very rarely, in some people asthma is steroid resistant. Are you certain you don't have infection as well?

R

[Hetty123]

I was on steroids tablets for over 2months didn't make any difference

[Hidden]

This is the problem with doctors that don't really understand asthma. Sometimes the inflammation in the airways is overwhelming. 5 days of steroids sometimes doesn't really cut it even if it is 40mg. Its like pouring a bucket of water on a house fire - 5 buckets is not going to put the fire out. I am currently going through an exacerbation at the moment, I have needed four weeks of high dose steroid and its only been this week that my symptoms have improved and peak flow is getting better.

I have a lot of experience with doctors who have no clue about asthma and constantly underestimate the severity of my symptoms. I tend not to get a wheeze (unless I am really unwell) - more very quiet lungs, my best peak flow is 700 and when I have an exacerbation it doesn't go below 480, usually 500 but this is a high number from a doctors perspective.

However, my symptoms are worse at night, constant cough, very tight chested. I have read a lot about asthma and I usually am pushy with doctors because I know for fact I wont get better without adequate doses of steroids. I have been undertreated by doctors in the past resulting in me having high doses for longer as I hadn't completely recovered from last exacerbation. This results in me getting more side effects.

Common misconception is oh your peak flow is only mildly low, you must not be that bad. They can't understand that it is variable airway obstruction and this is a dynamic process. Peak flow is only one marker of airway calibre.

So the course can be longer.

I now do the following:

(1) Document PEFR morning and evening at least

(2) Document my symptoms I have experienced during the day

(3) Make a note ever course of oral steroids I have had and how long I have had it for

I make sure I present this information to my doctor. My GP is really good but the doctors in the ED can be variable. They usually follow a protocol and think with their brains sometimes. It kind of scary think this.

Sorry for this rant. This is my own experience and my opinion. I have had to really educate myself on my asthma as I can't rely doctors sometimes to give me the right treatment.

[Lysistrata Administrator Community Ambassador in reply to Hidden]

I think.you are my asthma twin asthmaguy! Everything you say could be me except the specific PF numbers (guessing you are a man from.username and the PF numbers but mine are high for a woman so get similar problems alongside the no wheeze go quiet thing). I also know what you mean about them often not understanding that delaying steroids may resukt in needing more later. Admittedly sometimes they don't work for me at all but when they do it's better to get them sooner.

[risabel59 in reply to Hidden]

My twin too.

[damascena]

Thank you everyone. I seem to finally be turning the corner after 2 a&e visits and 3 gp visits. Someone finally believed me! My asthma is silent with no wheezing and Drs simply dismiss me with no exams or they roll their eyes. All the best to all of you.