Asthma Myths (apparently)

[Matman]

Asthma.net has published a short article on what it says are common Asthma Myths.

asthma.net/living/myths/?ut...

[strongmouse]

Interesting about the oxygen levels not necessarily dropping with an asthma attack. Also the bit about not wheezing. I wish all GPs knew this...

[Lysistrata Administrator Community Ambassador]

I wish that came as a poster! Would put it up in A and E and respiratory clinics as well as GPs. I have met more than one respiratory doctor who genuinely believes that you have to wheeze and drop sats or it isn't asthma, and enough acute medics and A and E drs who think that to be nervous about going. (To be fair, many don't but none of them should buy into these!)

Oh and I'd add to that: 'all heart rate increase in asthma is due to medication' as an annoying myth too many healthcare professionals believe.

Poster with the myths should also be in ambulances. In London the official protocol actually says asthma is wheeze and dropping sats and you're not supposed to treat for asthma without that. Means I feel I can't call one unless desperate ans better to make my own way to A and E.

[1974lovejoy in reply to Lysistrata]

Unfortunately ambulance guidelines nationally I believe state salbutamol treatment nebuliser is used if wheeze is present .. I am fully aware of the fact a wheeze is not always present as I am one such asthmatic .. I’m lucky I work for an ambulance trust frontline and my colleagues know when I need help and know I don’t wheeze ., but it’s taken a long time for them to cross guidelines to treat me ., I urge all asthmatics to have a plan stating if they don’t wheeze in particular to allow us to treat appropriately....

[Lysistrata Administrator Community Ambassador in reply to 1974lovejoy]

I do have one but didn't think it would make a difference- will try that, thanks! To be fair I have been given nebs still quite a.few times, but have also had inaccurate lessons on why nebs will only help if I wheeze. Some paramedics do get it but because I know what the official line is I am still nervous.

[1974lovejoy in reply to Lysistrata]

It’s always hard as at a time when you can’t hold a conversation you need the treatment and you can’t go into whys and what’s with crews .. ! We work from guidelines called JRCALC and this is our medicine bible !!! Salbutamol is indicated in their for an audible wheeze but it also states for use where usual inhaled therapy has failed .. so you shouldn’t be refuse it .. add into your plan you don’t wheeze and you require salbutamol nebulisers if inhaler therapy hasn’t been effective .. some Drs don’t give salbutamol unless you wheeze also .. but we all know everyone presents differently with asthma and many are starting to catch up !!!

[Lysistrata Administrator Community Ambassador in reply to 1974lovejoy]

Oh yeah drs can be just as bad! Like I said good paramedics think outside the box anyway but yes when you can't talk etc it is not fun to have the ones who won't (or doctors). I do think it doesn't help having official guidelines emphasising wheeze and sats. Dr ref guides can be just as bd as they are not clear enough and while wheeze is not actually required if you read carefully, they encourage a simplistic view of asthma for the average dr in a hurry.

[emmasue in reply to Lysistrata]

Interesting about the heat rate. The last time I was in A&E, the reason they took me so seriously is because my heart rate was sky high. The cardiologist said my heart is fine but I am on a tablet now to lower my heart rate

I don't know if my heart rate was high because I had the flu, because of the asthma flare up, or medication or what, but it didn't come down after. I am better on the new medication but I still wonder if my heart is truly ok.

[Lysistrata Administrator Community Ambassador in reply to emmasue]

If you've been ill a lot that may be why. Mine was constantly high and jumping at the slightest thing when I was untreated and they were faffing around with the diagnosis.

These days I don't have to be having an attack for it to get twitchy but it does tend to correlate with me noticing lung issues, though the sky high rates are reserved for bad attacks and it will freak everyone out (except me lol. The worse I am the more inappropriate my sense of humour). I posted on here another time about being treated entirely for HR not asthma one time in A&E, but luckily mag sulph being actually of more use in treating asthma than sinus tachycardia. Of course they thought it worked because my HR did come down, but that was because I could breathe.

Sometimes I may not even notice - at a clinic appt in April it was 120-130 even after sitting in the waiting room and the nurse keeping me sitting there for ages to wait for it to go down (and freaking out - I was totally calm and telling her it was fine!). I felt ok but my spirometry wasn't optimal ie FEV1 44% predicted, which is lower than even my crappy usual (my FEV1 isn't unexpectedly high like my PF), so I think my lungs were moaning at me making them hurry to get to the appointment!

It was not ideal timing as they were muttering about side effects of aminophylline, but I managed to persuade them the HR wasn't normal and I can do a perfectly respectable 70ish when I'm ok, even with Phyllocontin, and I'd be higher if I came off it as I'd have more flares. I'm not sure they linked it to the lungs but I was pretty sure it was that.

[emmasue in reply to Lysistrata]

Thanks. Maybe it is just my lungs then. My heart rate at the moment with the Biopropolol (or however you spell it!) Is between 95 and 120. Without, it was between 140 and 170. I didn't really start tracking until after I had the flu in March. At least it helps me get seen when having an asthma attack! 🙄

[flossiew]

Interesting reading... My sats have never dropped below 96% even when I can't hold a conversation; I have only ever been told twice in three years that I have a wheeze despite having several asthma flares/year and having followed a locum's advice last year on what dose of ventolin to take I ended up with a very rapid pulse which left me feeling very weak and shaky. Rather worrying 😕

[Lizzie1956 in reply to flossiew]

Totally agree with you. My stats the same! No matter how ill I am!!!

[flossiew in reply to Lizzie1956]

I just hope those with the responsibility of looking after folks with a bad asthma flare realise that they can't expect everyone of us to fit all the criteria - wheeze/low sats etc...