Feeling rubbish post asthma attack..

[Melanie1989]

Hi everyone, sorry for the many posts just struggling so much right now...

Last week i had an asthma attack which i attended out of hours for and they sent me to a n e... For the first time ever i had an actual strong wheeze and even though i had good sats was treated seriously and eventually kept in for 4 days. The rHowever looking back on my notes my ABG always shows hyperventilation even though i conciously try and slow my breathing down and dont feel panicked at all, so i have no idea why i have good sats and my abg shows this?? Despite this the drs told me i was having a bad attack?

Attended my g.p today as im struggling and my peak flow has dropped to 250 (personal best is 480). He told me i didnt need steroids as i had no wheeze and cant understand why i dont present like a 'normal asthmatic'. My chest is so tight but im carrying on with ventolin. I would give anything to present as a text book case, although the fact i wheezed in hospital felt like an achievment! Sorry for the ramble, its just so hard being ill and no one getting it!

[Lysistrata Administrator Community Ambassador]

Hi, I know exactly what you mean about wanting to be textbook! When feeling ill it is not what you need to have to fight and argue your corner and beg for treatment because someone isn't aware of more unusual presentations. I would also love a reliable wheeze and a peak flow which acts sensibly.

Re the sats - I believe can often be the case in asthmatics, especially if young and compensating with a high HR (which I believe you mentioned having before in attacks? I get the same so remembered!) A good dr can look at the whole picture, including how hard you have to work to maintain your sats and breathe.

I also get a range of ABGs including the lower CO2 which is sometimes written as hyperventilation. As far as I know this is fairly common in asthma - you breathe fast to compensate for the airway obstruction ans this blows off CO2 - it is not automatically a sign of panic. Drs who don't understand how it all works can have a very simplistic view of ABGs, though glad to hear yours didn't this time. I have been told by a resp cons 2 days after a severe attack that it was all dysfunctional breathing because of the ABG - 2 doctors at the time looked at the whole pattern ie not just PaO2 and CO2 and said I was compensating for my airways, not that it was my breathing pattern! Also had an alarmingly clueless A and E dr who suggested I was doing it all to myself because oxygen was ok and CO2 low so I couldn't possibly have asthma (she was clueless in many ways about asthma).

I think you may need to try a different GP if you can, as you are clearly having problems with what you describe and the one you've seen doesn't understand that wheeze is not the be all and end all - pretty sure it doesn't say anywhere that wheeze is the only indication for steroids or even the major one! So they really don't get it and need to read the guidelines properly.

I am so fed up with this simplistic wheeze obsession! I hope you find s dr who listens and feel better esp at Christmas. Also hope this helps, from a fellow non-textbook type.

[Melanie1989 in reply to Lysistrata]

Hi Lysistrata

Im sorry your in the same boat as me but it is reassuring to find other non textbook asthmatics! Yeah hr always goes sky high which is always blamed on ventolin, which is annoying! I had the most amazing treatment at a n e this time but do wonder if it would have been the same if i hadn't of wheezed. Sad times when you wish for wheezes 😂 Tempted to start my rescue pack as im so worried about getting worse over xmas but dont want my dr to think im taking them for no reason.

I honestly dont understand why dr's are not updated on the no wheeze thing!

[Lysistrata Administrator Community Ambassador in reply to Melanie1989]

Yeah a wheeze often seems to be seen as the be all and end all! I was in HDU in Oct at the start of a 6 day admission - no wheeze. Next admission - less bad, wheeze after treatment. When bad I go quiet!

I get the concern re your dr but they should probably have put you on pred anyway and would have if not hung up on a weird idea of asthma. Maybe call the AUK nurses tomorrow? I find it helpful to talk through stuff with them and see if I am thinking along the right lines. Useful to get advice before things close down for.Xmas.

[Gerl]

My doc told me if my peak flow drops below 1/2 I am 480 on the good days go to A & E i have asthma 6 years or so getting worse on red steroids at the minute they good but not long term