Not sure what to do

[alexanderosman]

Typically, I’ve got to Friday evening and my asthma is bad. If it wasn’t Friday I’d probably see my gp in the morning but obviously can’t do that.

I’ve had some sort of virus for the past few days - first had a sore throat, then turned into a tickly cough. Yesterday I was coughing from midday, couldn’t really eat my lunch and was very breathless in the evening. Didn’t eat any dinner, went to bed and fell asleep quite quickly after 4 puffs of ventolin. Woke up at midnight, then again at 4, had six puffs and went back to sleep for about half an hour before getting up for work. Was breathless for a while but then settled down and wasn’t so bad, had 2 puffs ventolin every 3 - 4 hours during the day. Had 4 puffs at 6 as was coughing a lot.

Just had another 6 puffs as was very tight again. Peak flow was 280 before inhaler, rises to 310 after, personal best 420. I don’t wheeze and know from experience that if I was seen like this would be told nothing was wrong. If this continues will probably need pred but don’t want to see ooh gp unless absolutely necessary. At what point should I be considering this?

[emmasue]

If you are needing your reliever less than 4 hours between, you should think about going in. Have you tried using the ventolin with spacer 10 times in a row? This is supposed to be like using a nebuliser. If you still need ventolin less than 4 hours after that I would consider ringing the out of hours service. Stay firm and don't let them push you around about not having a wheeze. Not everyone with asthma has a wheeze. Hope you feel better soon.

[alexanderosman in reply to emmasue]

Can’t find my spacer annoyingly. Some of the ventolin is going in as I can feel the difference. I’m not sure how much is due to the virus and how much is my asthma if that makes sense.

I’ve had bad experiences of going in and them not believing me, and am not good at communicating when stressed so want to avoid it unless absolutely necessary.

[emmasue in reply to alexanderosman]

I know how you feel. I am the same. I burst into tears once because the A&E doc said I didn't sound too bad. He couldn't understand that I was upset.

Take care and don't leave it too late. Try a chemist in the morning if you are still bad. They may be able to provide a spacer. Try to sleep propped up and don't hesitate to call for help if you need it. xxx

[Lysistrata Administrator Community Ambassador]

I totally understand this dilemma. I have the same where I know it will get worse but they won't do much at this point.

I have found that creating a summary for myself listing medication and how I present (no wheeze, sats ok, PF ok, fast HR) can really help with all but the most block-headed dr. May be less effective with OOH drs but worth at least having in your head.or even written.down for you. I use it also for when I can't talk though at that point you definitely need A and E not OOH!

I agree with trying the spacer thing and seeing how that helps. It might be worth pointing out that reliever not helling or lasting is listed as a sign of an attack by Asthma UK.

Hope this helps and don't leave it too long!

[DotPro]

Another Perspective:

The feeling of a sore throat is not always a virus.

Consider Acid Reflux and LPR Larypharangeal Reflux (Silent Reflux) in which acid and stomach contents irritate the throat.

Watch diet... Do not lay flat on bed at least 3 hours after meal. Watch portions. Look out for foods that irritate and can cause reflux.

LPR is also common in hard to manage asthma.

[Minushabens]

Good morning - hope you're feeling better today. If not, I'd definitely give 111 a ring or pop up to A&E. Look after yourself!

[alexanderosman]

Thanks for replies. I slept through to 6am on the 6 puffs so not too bad. Very tight again now and peak flow down to 250.

Thanks for suggestion of reflux but don’t think it can be that, as my asthma has been well controlled for a year since I last had a cold. I almost never need ventolin usually. It’s just that on the occasions it does get bad, it can be slow to reverse.

[Minushabens in reply to alexanderosman]

I really think you need to get some advice today - just give 111 or your surgery emergency number a call & I'm sure they'll either send a doc or tell you to go to A&E.

Or just go there anyway. Don't just put up with it!

[alexanderosman in reply to Minushabens]

Thing is I know this will subside in about an hour and I’ll be much better during the day so long as I rest, hence my dilemma. I’ll try more puffs of ventolin but if that doesn’t help or last I’ll decide what to do.

Unfortunately our local out of hours switched to going through 111 and from experience they usually just want to send an ambulance which is not needed so that doesn’t help. I probably do need pred to calm this down though.

[Minushabens in reply to alexanderosman]

Whatever you decide to do, I hope you feel better soon - but please don't mess about. If you need help, get it.

[alexanderosman in reply to Minushabens]

Yes I will thanks. I’ve been worse than this and dismissed by ooh before which is why I prefer to wait and see my own gp if possible.

[Lysistrata Administrator Community Ambassador in reply to alexanderosman]

My surgery does the 111 too with similar results. Infuriating! I also get these kind of in between episodes where it's clearly not good but you know it will be tricky to get help. I would definitely advise getting help if any doubt at all but also do appreciate the problems here.

Would you be able to get to a walk in centre at all? Sometimes this has got round the issue with 111 for me - it's not your GP but at least it's not someone with a computer telling them what to do (I know 111 has actual nurses who can advise in some areas but not mine!)

Maybe try emphasising that you definitely have asthma and pred has definitely helped before in similar circumstances.

[alexanderosman]

Went to local minor injuries who say they can deal with chest infections - of course by the time I got seen I felt better so all exam was good. They didn't do peak flow though and this didn't occur to me until after I had left because my peak flow has been consistently low since this started. I told her I'd been waking up in the night coughing, had been finding it difficult to eat and had no appetite and had been using a lot of ventolin.

All I was told was that I don't need antibiotics and I should wait 7 - 10 days for the viral cough to go away, there's a lot of it around! Apparently it's common to lose appetite with coughs and colds despite the fact that I told her I never do unless my asthma is bad.

Got to be the worst emergency appointment experience I've ever had. Waited over 2 hours for nothing!