HISTORY AND QUERIES OF LATE ONSET ASTHMA

[GYPSYMITCH]

Hi All, My history (sorry this is long). I'm 54 and have never had any asthma or allergy issues until Aug / Sept 2018. In Aug 2018 I started to sneeze a lot and when outside exercising afterwards was short of breath and trying to catch my breath (not all the time intermittently) . I thought I just had the start of allergies after going through the menopause and didn't think do anything about it. I went to Florida for 3 weeks at the end of October ./ November and felt great in the very warm and humid weather. I came home and got what I think was a virus and steadily through December / January got worse. I still hadn't been to the doctors. Eventually after a being on the golf course and really really struggling to breath (the ladies brought me in on a buggy) and a trip to A & E, nebuliser, x-ray (chest clear) , no wheezing the A & E doctor said to go to the GP and say I presented with late onset asthma. I then kept getting ill and visited the doctors 4 times (3 times for an extra nebuliser treatment), I was given a salbutamol inhaler (which has never helped me whatsoever when my breathing is bad). I couldn't walk or go upstairs without really struggling with my breathing. I coughed (dry cough never mucus) constantly and would have coughing bouts particularly in the night. I just kept getting worse and each doctors visit they assured me it was a virus which is / had caused the asthma. Eventually of course I ended up in A & E and Acute Care (this is the day after I'd been to the doctor and told her how unwell I felt and that in the space of 8 weeks I'd gone from being a really fit active person to not sleeping, couldn't walk the dog, play golf, do a 30 minute HIIT session etc, to her saying its just a virus and you do not need more steroids). 5 days in hospital and eventually saw a respiratory specialist who immediately put me on relvar elipta, reducing dose of steroids and 2 types of antibiotics (I'd presented with pneumonia but both he and I both think it was a severe asthma attack). The Relvar Elipta has worked wonders I am back to HIIT training, golf, dog walking, no coughing, feeling great. My one issue is I get very congested nasal passages, Beconase does not work at all, the only thing that works to open up my nasal passages is Otrivine (0.1% Xylometrazoline/Hydrochloride) but I am using this 3 x a day, only when my nasal passages close up, not as a preventer as a "cure". Before I spend the money seeing my private respiratory specialist I was wondering if anyone knew if this is OK to consistently use this product or is my nose going to drop off? And if there is any help / information that springs to mind after reading my post then please do also let me know. Yours hopefully. JO

[twinkly29]

I don't know about the particular nasal spray you're using but have you tried a saline spray or Neilmed Sinus Rinse (which uses saline solution as a nasal wash and, in my opinion, works better than a saline nasal spray)? You may well have done and found you need the spray you use of course!

[GYPSYMITCH in reply to twinkly29]

hi, no never tried a sinus rinse, but will give it a go.. anything worth a try! Many thanks. Jo

[xxggtt]

I haven't heard of the nasal spray you're using, but I'd second trying a sinus rinse twice a day. I also use Neilmed. The other thing to say is that there are other nasal sprays that a GP can prescribe for you (at higher doses, too), some steroid ones (Beconase, Flixonase, Nasonex, Avamys etc.), some antihistamine ones and some combined.

With the amount of nasal and sinus symptoms you've got, I'd also be asking whether you have any allergies? Possibly hay fever, or possibly something else? If you are allergic, then you can take antihistamine tablets as an add on to the nasal spray (again, GPs can prescribe fexofenadine, which is much stronger than any over the counter ones).

There are also decongestants you can use (I think pseudoephedrine is what I use), but I find these don't last for more than a few hours. You also can only take these for a few days in a row as well, but it might be a short-term fix while you try other things. Decongestants work whether the congestion is allergic or not.

It's also possible that you might have a sinus infection (which can be a result of allergies or other inflammation), in which case you'd probably need antibiotics to clear it. Either way, I think you should definitely visit your GP before you pay for a private doctor. Your GP will be able to assess what they think might help you and prescribe accordingly. I think I'd only be paying for a private specialist once I'd exhausted all my options, and when you get to this point your GP would probably refer to an NHS ENT consultant anyway, avoiding the need to pay for private care.

(Edit: I've just given Otrivine a quick google and looks like its a decongestant spray?? So shouldn't use it for more than 7 days, similar to the pseudoephedrine tablets. I'd say visit your GP in the next day or so to see what they might prescribe for you. The steroid nasal sprays they can prescribe are much more effective than OTC Beconase, and they might suggest an antihistamine too.)

[GYPSYMITCH in reply to xxggtt]

Thanks for the response, yes it's a nasal decongestant and of course, I should really go to the GP but given the appalling service I got last time I'd rather pay to see someone, lost trust in NHS GP's (not the hospital teams who were all brilliant). Jo

[Ghoulette]

Hi. I work in pharmacy and I can advise you that are not able to use a decongestant nose spray or drops for any longer than 7 days as it causes something called rebound congestion. This means that your symptoms get worse instead of better.

Hope that helps.

[GYPSYMITCH in reply to Ghoulette]

Many thanks, will book in at the Drs then and see what else they suggest. Jo

[Gazza01]

Might want to try a nasal wash with saline. Look up nasal douche. Wash all the irritants out. It takes a bit of practice and can make you gag a little at first but once you get used to it it's actually pretty easy. Never try any other water though. Saline you are looking for comes in tiny plastic snap top bottles. You can get them on amazon or eBay really cheap.

[Junglechicken in reply to Gazza01]

I love a nasal rinse. Makes me feel so clear and breathing eases considerably.