When to go back to doctors about Preventer Inhaler? Is this even asthma

[Mattb2449]

Hi Everyone,

This is my first time posting and I could really do with some advice.

So I'm 25, in the past I have become wheezy when running in cold air - which I had a Blue inhaler for and took very rarely - I have also had cases of wheezing because of allergies but an anti-histamine has always sorted them out completely.

Around 5 weeks ago I suddenly became wheezy and this hasn't stopped - it's literally 24/7 wheezy - Taking the blue inhaler does help but it doesn't really help the chest tightness.

Anyway - The doctor gave me the brown Clenil inhaler to take twice a day - which I have for around 4 weeks now - but it has had little effect. I'm still wheezing all the time and am taking the blue inhaler twice a day at the moment. My symptoms haven't progressed past wheezing and tightness, it's just very uncomfortable.

I just have no idea what this could be - in the past it's been an allergy to something very specific, like a cat and an anti-histamine removed any symptoms - but now it's 24/7 in any environment!

The nurses told me to come back in 3 months - but I've read that Clenil effective within 7 days - does anyone have any advice on whether I should go back to the doctors now?

Interestingly, I also had a spirometer, with all the percentages coming back normal - so I don't know if this is even asthma!

Thank you in advance

[Paradigm]

To my understanding, 3 months is the review time if your new inhaler is working.

If your symptoms haven't improved after 2-3 weeks, I would head back. Since it's been 4 weeks, I would absolutely go back. Potentially you might need a rescue pack of prednisolone to knock it on its head.

It does sound like asthma but there are other things that can mimic it. That said, I would try not to worry about it in the early days of clenil - it could be the wrong medication/dose for you.

[Superzob]

Try to get yourself seen by a consultant who can interpret why your spirometry results are OK, yet your breathing is not. Also, Clenil is a single corticosteroid inhaler, whereas you can get dual corticosteroid/bronchodilator inhalers, like Fostair - it would be like taking Clenil and Ventolin at the same time, but with longer duration action. But you shouldn't simply be playing around with inhalers - get yourself seen by a specialist.

[Hidden]

I had an Identical experience, very well controlled asthma, rarely took my clenil or ventolin than about a year ago after a cold I had permanent shortness of breath (sob), it would fluctuate and feel less severe but never went away.

My GP worked out it was not asthma as my peak flow was ok when i had the sob and my inhalers didnt work properly, the tightness you describe is exactly how i feel, it is getting a full breath in that is the problem not exhaling.

[Mattb2449 in reply to Hidden]

Did you find out what the problem was in the end?

[Hidden in reply to Mattb2449]

Not really, top candidates are silent reflux (LPR) or damage to the vagus nerve from virus or reflux. Ive seen a GI and an ENT.

I ride 100km a week and do some gym work and this is really frustrating.

[Offcut]

I blow about 350 on my peak flow meter it used to be 650 but they did not think a lot of it but after a spirometry test and referral I was found to have Emphysema COPD but also RLD which can give a false positive to peak flow. As I have got older I now have been Diagnosed with IPAH and have to go to a Specialist Centre in Sheffield. I have 46% lung function now.

I was diagnosed with Asthma in my 20's I am now 64 I have had and tried many different inhalers and meds some worked for me and some did not it is a case of keeping on to your doctor until something suits you. You have not mentioned if you have had a spirometry test? Well worth having one it can help with treatment.

I must add this is not the usual course of people with asthma I have had lung/heart issues most of my life, plus I worked with asbestos for over 10 years?

Be well

[Hidden]

Hi Mattb2449

I'd definitely go back to your GP and tell them exactly what you've written above. 4 weeks in enough time to know it's not working and there's no point in suffering any longer. If clenil isn't working there's other inhalers and/or meds they can try until they find what's wrong and what works for you.

[Mattb2449]

Hello everyone, thank you for so many responses - it's really nice to know there is such a helpful community I can turn to!

I have booked a follow up appointment with the asthma nurse to ask if I can try the inhaler with the steroid and Ventolin. I've also booked a IgE blood test to see if I'm actually having an allergic reaction.

My peak flow is effected but only slightly. When I had the spirometer, before 4 puffs of Ventolin it was 580 and afterwards 620 (where it should be for my height, weight and age) Day to day it generally drops down to 540-550 before the Ventolin.

I'll let you know what the outcome is!

[strongmouse in reply to Mattb2449]

Good idea to check out the allergy side aswell. It helps to know what you are reacting to so that as far as possible you can avoid any allergens or manage them. A skin prick test isn't 100% accurate but it can be a good indicator. An allergic reaction can exacerbate asthma. It causes inflammation and it is important to know as the reactions can become more severe. Allergy UK has a helpline and so does Asthma UK if you need to talk to someone with expertise.

When I started developing asthma I had ventolin (Salbutamol) and Clenil but had to change onto the combined inhaler and the asthma is well controlled with that. I have a number of allergies including to various pollens, moulds, dog and cat fur, and food ones too. Some causing breathing problems, others don't! Keep asking questions until you get the answers you need to manage your health as best as possible.

Re peak flow if it is below 20% of your personal best the advice is to take a reliever. If you continue to need a reliever on a regular basis then you need to have a review of your medicine to see if you need an additional or alternative inhaler.

[ldrunner]

I'm a runner too. It seems like I have a little exercise induced asthma but it can flare up and continue even when I take a break from exercise. I tested fine neg re IgE and allergies. I get bouts of asthma that don't go away, and don't respond great to most inhalers. I have found benefits from qvar - I think the small particle inhaler works better for me, as well as from Singulair (montelukast). It's been an on and off problem for me for the last 30 years. It also seems like I have silent reflux which can set it off pretty badly, so take Nexium 40mg daily and that helps too.

None of these diagnoses are simple, you have to be persistent about finding something that works and about acknowledging that you need to keep on top of the symptoms with the proper meds. Good luck.