Confused and concerned

[stevec87]

I had child asthma which i thought i had grown out of as it had very little bearing through adolescence or into adulthood. At the age of 31 i rebuilt my bathroom, failed to use a mask sensibly for some of the tile cutting and then it all went to pot.

On the first week of decemeber i developed this dry cough and shortness of breath and the cough appeared to get worse for 4 weeks, at one point i was talking to a colleague and felt as though all the air had been taken from me and i was starting to pass out so an ambulance is called but as with several docs appointments my stats are ok.

The week before christmas my 02 goes from 98 to 92 very quickly and then to 90 and i end up in hospital for a night being nebulized to high heaven and told after a clear xray that its astmah.

Since then i was put on fostair which has seen my peak flow go from 450 to 600 which i guess is good right? However there are some things that are really confusing me:

1 since coming of the prednisone my cough is deteriorating even though pf is good

I am so tired all of the time which is not like me

Hoe do the doctors know that i havnt just go a load of dust in me and thats what is causing an inflammitory response?

My ears pop at least once a day leaving me sounding like im stuck in a well.

I just feel confused as to why despite clearly having better stats (spo2 of 97-98) good peak flow i still cough and feel rubbish

Sorry if this post comes across as very ignorant! Im just very confused and badly informed

Thank you for your wisdom!!!

[EmmaF91 Community Ambassador]

Oh dear - really sorry to hear what you’re going through atm 😔

To answer some of your questions;

Prednisolone is a great anti-inflammatory so it could be that since coming off of it your lungs are starting to get ‘twitchy’ which is why you’re coughing more... you’re PF doesn’t have to drop for you to be having asthma issues

The tiredness and fatigue can come from lots of places... if you didn’t take time to ‘recover’ initially and went straight back to ‘normal’ life than it could be biting you in the butt now. Or it could be that because you’re still having issues your body is working overtime to keep you going so you’re more tired. Or it could be a side effect from the fostair!

Most ‘normal’ people probably would have coughed the dust out by now as it’s been a month. To do this they’ll have increased mucus production for a week or so which may cause asthma-like symptoms. With a history of childhood asthma, you sound like your lungs are taking a little extra time to calm down... it could be that this flare up triggers your asthma to return full time or it could slowly calm down again over the next few months (so long as you behave and use masks etc)! Asthma is very variable and different for everyone - for some kids who have it, it can completely disappear, for others it comes back and others never have it til their adults 😕! It’s also a diagnosis usually made by assumptions - cough/wheeze/SoB/tight/worse at night/obvious trigger/family or previous history/responds to ventolin/age etc etc

Your ears may be popping due to having increased mucus production in your Eustachian tube... hopefully as your inflammatory response calms down this will go away but it’s worth telling your GP if you haven’t already!

In asthmatics sats only drop when you’re really bad so shouldn’t be used as a measure of control, just a measure of severity of attack. Chest X-rays of asthmatics are 9x/10 clear unless there is a very bad infection/lung collapse/rib fracture! PFs for 1 don’t always drop (esp if you’re only having ‘mild’ asthma symptoms but for some they can be in resus and still have an ok PF) and 2 can take time to fine your best. Personally my best is 630 (predicted 440 I think) but for 3 years my best was 500 - as my control improved so did my PF especially with practice! This means that yellow zone boundary (75%) went from 375 to 470 and red zone (50%) went from 250 to 310! Before reaching my new best I often had asthma issues but was told my PF was fine!

If you’re feeling more ‘twitchy’ since finishing the pred (coughing more, tight chest, SoB, wheezy etc) it’s definitely go back to the GP and let them know just in case you need more/different preventer meds. Don’t forget to take your ventolin if you feel like you need it (it takes 10 mins to work so you won’t feel better instantly). Technically having to use the blue more than 3x a week suggests that you’re not fully controlled. Another sign of poor control is coughing up yellow phlegm as this is a sign of lung inflammation.

Have you been given an asthma action plan by your GP? If not I’d definitely advise going back to them or your practice asthma nurse and asking for one! If you see the asthma nurse then they should also have the time to answer any questions you have! Also the asthma UK website is excellent for easy to understand information and when their lines are back open it may be worth giving them a call - they are very supportive and knowledgeable!

I hope that explains some things anyway (in not too a convoluted way 😅). I hope that you start to feel a little better soon

[LDloveslattecoffe]

Ok so you had childhood asthma so already you are prone. You grew out of it that's good. However that doesn't mean it disappeared just means as you became an adults your lungs developed became stronger and managed to cope better.

Asthma can have many triggers which are individual to you ie mine are smoke, dust, cold weather, rarely stress and sometimes my Hayfever and definitely respiratory infections.

So the dust when you were working was clearly the trigger for your asthma. That doesn't mean it will be your only trigger though. You already aware you need to remember to take precautions ie mask.

When you feeling better or after today (as everywhere closed) book appointment with your asthma nurse at the surgery. Explain your history, explain what's happened recently, discuss the inhalers etc and prepare your questions.

If you not satisfied with surgery remember asthma UK has a helpline where you can talked to specialist asthma nurses.

[LDloveslattecoffe in reply to LDloveslattecoffe]

Ps swrote this but hadn't seen EmmaF91, she always gives good advice, what she said!

[Melanie1989]

Hi, sorry your having a rubbish time. Honestly sats and peakflow are not a reliable measure. My sats have been 100 % during an awful attack with a peak flow of 100.. im just a good oxygen compensator. Some peoples peakflow do not drop at all. Asthma is so variable and everyones presentation will be different.

I to had childhood asthma that dissapeared till i was in my 20's, so know how frustrating it can be when it makes an appearence. Many people need a few courses of steroids after a flair as there can still be underlying inflammation, but as most docs go by text books this can be hard to get. I have to agree with emma with phoning asthma uk line, they really are invaluable.

Good luck and hope your sorted soon!

[peege]

Hi, can't add much more, great replies already.

Questions for you:

what dose of Fostair are you on, how often, do you use a spacer and are you taking it regularly at same times each day?

There is much to learn so knowledge is the key since your recent flare up (exacerbation) which undoubtedly was brought on by inhaling tile & building dust. The glaze on tiles is made from powdered glass so I should think it will take a while to recover from.

Drink loads of fluids to keep secretions moist and easier to expel from all your airways - stands to reason the dust went up to nasal passages as well as down.

Fostair is licenced to be increased when needed and decreased to your maintenance dose back to 'your normal'. Ask your pharmacist for the booklet that goes with it for explanations. All the best to you. P

[stevec87 in reply to peege]

Hi Peege

Im on 2x 100/6 twice a day. Feel like such a complete idiot for not wearing that mask!!!

[peege in reply to stevec87]

We all (well the daftest, 'invincible' amongst us)! About 10 years ago unbeknown to me a water pipe had been leaking into the brick wall between bathroom & a bedroom for ages. I got someone to take down the wall, he very kindly decided to clean off each Victorian brick inside my home - without opening the windows or closing the two doors grrrr. My lungs took a nosedive and was ill for years. Prior to that I'd renovated each old house we lived in, including stripping off plaster & very old paint with a blow torch, nitromors or sanding & never wore a mask.

I try to coach everyone to wear a mask, even the carpet fitters. More recently I payed someone to enlarge a chimney breast hole in the kitchen, I bought him a decent mask but he refused to wear it, preferred breathing in 180 year old mortar, brick dust and soot 😁

[stevec87]

I just wanted to really thank you all for taking the time to respond to me. It has been really helpful and informative and i guess what im learning is thatb

there is no magical fix, its about careful management and acceptance

[ChrissieMons]

I know it's not much help, but everyone's cough seems to take forever to go. It may not have been the dust - sometimes the asthma comes on out of the blue - it might have been a virus, or any infection. You're right about acceptance as it is the key to managing it.