Is this a CVA attack that lasts so long?! Doubting myself...

[Limefime]

I am really confused about what is currently happening to me - is this really an asthma attack, as it is lasting so long? After serious steroids and 3 days and 4 nights, I am still coughing away!

HISTORY

I started coughing quite a bit about a week and a half ago. I initially thought it was a cold coming on but realised by about Thursday morning last week it was possibly asthma. I was already using my inhaler regularly, so upped intake to the amber phase of my asthma plan. However, what I think is an asthma attack, started on Thursday in the night.

I went to see the GP on Friday, who prescribed prednisolone (my first time of needing it). It made an immediate difference on Friday, massively reducing the severity of the coughs. I did find that I still needed my blue inhaler to completely stop the cough for a few hours at a time and continued with the brown inhaler too.

I spent Saturday and Sunday in bed, partly because I was so tired from interrupted sleep and coughing and partly because I thought sticking to the same environment should make it easier to control the coughs.

THE PROBLEM

I have not been able to maintain a completely cough free time for more than a few hours. Even then I often have the urge to "clear my throat", though there is no phlegm at all. Last night was another night in which I coughed myself awake twice and had to use the blue inhaler to stop the cough.

IS IT ASTHMA?

I have been second guessing myself through the night... I know that OTC cough medicines did not have an impact on the cough at all while the asthma medication does help to stop it for a few hours at a time.

The GP checked my lungs and said they were clear and that there was no infection/need for anitbiotics. I've not had a fever, nor any other cold/flu symptoms.

The cough originates mainly in my throat. It starts as a tickle that requires a cough to "scratch" it and then escalates in intensity until it becomes a series of coughs that shake my chest and body, sometimes sounding wheezy (though I don't have difficulty inhaling and exhaling in-between the coughs). I don't feel a severe tightness of chest or lungs.

Did staying in bed make the coughs worse? Should I have been up and active?

Should the oral steroids not have made a more definite impact after 3 doses (though the doctor gave me a prescription for 7 days and said to stop if I am better after 5 days and I have only taken 3 doses to date)?

How long do attacks last? Could it be that whatever triggered the attack is still here? How do I identify the trigger? It used to be cold air but I have not been exposed to that all weekend.

I plan on phoning NHS 111 to get some advice on whether I should go back to the GP (as my DH insists) or hold on for another few days (as my logic suggests)...

#fedupofcoughing

[EmmaF91 Community Ambassador]

Hi sorry to hear what you’re going through.

I’d make another appt with your GP. It could be that the pred hasn’t quite cleared up this flare up, even tho it’s helped a bit. If the ventolin stops the cough, then it usually suggests asthma - general coughs and colds won’t respond so well to it! Infection wise, sometimes our bodies send of warning signals before something hits so it could be what wasn’t there before is there now (I’ve been in hosp one day with only a wheeze, the next with unilateral crackles and then the day after crackles bilaterally, the only symptoms I had were bad asthma and phlegm). I’m not sure how CVA ‘feels’ but the pred, and persistent ventolin could be why you don’t feel tight, it’s dealing with the situation, just not preventing it!

Staying in bed may be a thing to avoid tho as if you have anything brewing it gives it time to ‘spawn’ in your lungs 😷. General advice is usually sleep when you need it, otherwise try and get up and move about.

Personally I don’t have CVA but generally attacks will last until fully dealt with so sometimes hours, sometimes days/weeks if you need more meds than you’re given initially.

If you haven’t been able to Id the trigger and you’re not ill then it could be the change in weather, so try and stay indoors at the ‘right’ temp for you. Triggers can be difficult to identify if it’s a delayed response you can be looking back a few days - from what I remember Wednesday was a cold day so it could be that caused all of this, or it could be a trigger you just haven’t found yet.

Hopefully someone on here with CVA will be able to give you more accurate advice but as it is I’d say go back to your doc! Hope that helps and that you feel better soon x

[Limefime in reply to EmmaF91]

I really appreciate your reply, Emma. It is all so confusing for me. Perhaps I should go back to the GP. I fear that my brown inhaler might be running out soon too and s/he can give me an emergency repeat. I don't keep a spare (never needed to) but I am a bit worried as to what would happen if it does run out.

I think I need to invest some energy into identitying other possible triggers... I do find that there is such a lot one needs to know/learn quickly about asthma in order to manage it!

[EmmaF91 Community Ambassador in reply to Limefime]

I’d definitely order a new inhaler if yours is running out! Ask for 2 and explain you want a spare so there’s no panic when you’re like this and near the end of one, then just order one each time you finish one!

Yes getting asthma (or your asthma deteriorating) is defo a learning curve! The key things to learn are triggers, treatment and when/where to get help. Treatment and help are relatively ‘easy’ - GP and asthma plan (so you know when you need hosp), however triggers can be difficult until you’ve had multiple issues!

Your best bet is to keep a diary and record what you’ve been doing when you’ve developed issues (and any potential triggers the day or so prev) and see if you can find a pattern. Sometimes this will help id other times you’ll still be left in the dark, for example I know a lot of my allergies and triggers however Friday night (4.30am in hosp) I started to have an allergic reaction to something yet I’ve no idea as to what - eaten nothing new, all drugs I’d had previously so couldn’t work it out 🤷‍♀️.

Hope the GP has something which will help you x

[Bucketlist in reply to Limefime]

Hi there

I too have CVA, it only started 14 months ago and , like you I just had a cough, anyway, long story short, I have had 3 ‘episodes’ since diagnosis, my Asthma Nurse has given me Pred each time and they have helped, along with a preventer (Fostair) and Ventolin, which I have just in case, I’ve been told to always take the full course.

Twice the Pred worked within the 5 days and I was cough free after the course, but the third time the Nurse wanted me to have another prescription, but the locum said No, I was unwell for another few days, using the Preventer and Ventolin, and wiped out for about 3 weeks.

I don’t often get a tight chest or any gunk, just a cough and I’m very weak and tired, so I use a PF meter each morning, to make sure that I am ok, I have found that if my PF drops, I go downhill very quickly, in the past I have struggled on for a few days hoping that the cough will just go away with the inhalers, but I asked the Nurse how long I should let it go before I call her and she said 2 days.

So that’s where I’ve been going wrong then!

Hope you get sorted soon, I think once you know what it’s all about (and this site has been very helpful to me,) it helps you to cope.

[Limefime in reply to Bucketlist]

Thank you for that, Bucketlist. I am learning so much! I would have had the same approach as you... wait as long as possible before seeing the nurse or GP. Even now I found myself wanting to expand the 4 hours between my reliever puffs though I could feel the cough getting worse but feeling it was still not as bad as it could be. I then struggle to get it under control, so now I allow myself to deal with it in better time. I am being silly but I guess it is part of not wanting to use medicine if I can get on without it.

[Bucketlist in reply to Limefime]

Hi again, I was told to use the preventer 2 x twice a day, but the Ventolin as and when I needed it during an exacerbation, as they so quaintly called it. So I just use it until I can stop coughing.

Since March this year I have only had a problem once, this time no cough, just woke up shaking like a leaf and sooo anxious, like when you have to go somewhere and you are absolutely dreading it?, I read up on the Fostair and saw that it can cause these symptoms, so called the surgery to get an appointment, Fostair was giving me awful leg, foot and hand cramps too, so I thought the Nurse would just change the medication, at this stage, ( 9 am ) PF was down to 370 from 400 at 7.30, by the time I got to the surgery it was down to 320, I was straight onto Pred and they upped the Ventolin, but still no coughing, yet it was Asthma! How on earth can we control this thing if we don’t know what to look out for?

I’m told it’s probably virus related as I had recently flown back from holiday, but its certainly keeping me on my toes! Hope yours is sorted soon.

[Limefime in reply to Bucketlist]

I am so with you, Bucketlist. How do you fight a shapeshifter?!

I am glad to say that I had a fairly good night as far as the coughing went. It feels like the attack is abating. I only had to get up once in the night for a reliever and one puff did the job. Still nowhere near cough free but compared to the weekend, I feel more in control. Now, if sleep wasn't so elusive and the steroid side-effects not so queer (shakiness, like a nervous stomach, and unless I imagine it, blurred vision) then all would be hunkeydorey!

[mackro]

If I were you then I’d give another 3-4 more days. In between I will also do some breathing exercise like jogging for 2-3 miles. If the cough persists especially in the presence of a phlegm then I’d go and see a GP immediately.

[Limefime in reply to mackro]

I don't have any phlegm, wheezing (apart from when the cough became quite wheezy after an extended bout), tightness of chest or difficulty breathing, Mackro. Thankfully! This was bad enough as it was.

I am going back to the gym today for a pilates/yoga workshop. It gets the heart rate up, within reason. I am not one for jogging but will do cardio again in the gym tomorrow if all goes well today.

It is a good idea about breathing exercises. I shall google some to try. PF is back to normal (even a tad above, thanks to the steroids) so it should be manageable.

[Hidden]

I find that the brown inhaler causes coughs and has given me oral thrush in the past. D

[Limefime in reply to Hidden]

I had oral thrush in the summer, when I was taking the brown inhaler (only needed that to keep the cough under control). I stopped taking the preventer for about 4 days and the cough started back up. It was easier to live with the thrush than the cough, so I went straight back on and the coughs stopped. So I know that, for me, the brown inhaler helps to control the coughing. (My asthma has only ever been a cough and never the traditional symptoms.)

Fortunately the thrush was only in one spot in my mouth and not advanced. It went away fairly quickly.

I have also brushed up on my inhaler technique and make sure to brush my teeth and tongue afterwards. The thrush has not been back.

It is rather disconcerting that the same medicines and treatment can have such different effects on people!

I hope you have a regimen that works for you, D.