Asthma U.K. advice on seeking urgent care

[Wheezycat]

This advice, just posted by Asthma U.K. really worries me!

It says call 111 and tell them how often you use Ventolin and that it is not helping sufficiently. For me this doesn’t work. I am terrible at remembering to use Ventolin. Not totally hopeless, but terrible. I have to tell myself, remember to tell myself, to use it. Yet I have sought urgent care more than once when quite poorly, even having a gp panicking on one occasion, but that doesn’t mean I have used Ventolin. Yes, it can help, but it isn’t instant and a bit vague. So, if I am having a bad time and that is used as an indicator of severity I am potentially scuppered, especially if NHS already are managing a tsunami of need. I have been told this issue I sn’t so unusual, especially in us older folk. How do others manage this? I really dislike that salbutamol usage is used as an indicator. Anyone else?

[Hidden]

I was told by my GP's asthma nurse at a recent visit that in addition to my Preventer of Seretide, I could take Ventolin as often as I felt the need - up to ten puffs a day. I was surprised at this advice as Asthma Uk seems to say that if you're needing to use Ventolin more than three times a week you need to go to your health provider urgently.

[Wheezycat in reply to Hidden]

I think that is when your asthma is playing up, so temporarily not well controlled. I don’t this intended for day to day normal.

[Hidden in reply to Wheezycat]

No, you're quite right. I should have been clearer.

[EmmaF91 Community Ambassador]

If you’re at the point of needing urgent care then you should have remembered to take your ventolin already. And 111 will remind you to try it if you haven’t taken it. It’s not an indicator of severity in and of itself but an indicator of where they signpost you too. For example if you have someone saying asthma flare (and audible sounds mildly SoB to dispatch) with no vent the first thing to do is see how they react to their ventolin and get an OOH GP appt/ call back but if they sound like they are really struggling or report using 20 vent and it’s not working then you’d be transferred to a&e via ambulance urgently. They won’t just be working off of ventolin useage in the triage process but it will be a factor, because they don’t want to send an urgent ambulance to someone who would recover with using their own pump. Lots of things are factored in to severity of attack, salb useage will always be one of them, but as will be how you sound to them, and how you report it’s affecting you. Don’t forget, you are also told to ring back immediately if you feel like you are getting worse, and you can also either call 999, or attend your nearest treatment centre if you feel like it is needed.

Hope that explains things a bit

[Wheezycat in reply to EmmaF91]

You are right I need to learn to use Ventolin. The only time I actually remember is when I go to my circle dancing group and get breathless from the activity, and others comment on it (sometimes). Generally I assume I am just whimpish, and when truly poorly I just don’t think of it, genuinely, to the surprise of both my husband and daughter. But I do need to learn to remember to do it.

I have never gone to A&E so far, though admitted once, nearly twice, from the surgery. If bad I so far have generally managed well enough with urgent care, whether via the hospital urgent care or mostly the surgery. I am fortunate that it isn’t quite that bad for me, still bad enough for comfort. I seem to have learned it is not that unusual among us elderly folk who have been diagnosed late in life. We, many of us, have learned to live with some shortness of breath. To relearn that, to interpret it differently actually quite hard. I am much better at it now, but still don’t necessarily trust my own judgement.

[strongmouse]

Hi Wheezy cat yes it easy to get in habits which can seem surprising. The best way I have found of 'not forgetting' is to stick a post it note in a place where I will see it. Stick one by the kettle, on the bathroom mirror, above the bread bin, on your phone, wherever you will see when you are likely to need to use the ventolin. It might be annoying for other family members to see it but I have found it does work in reminding me to do something when I need to! I expect some people use text messages to themselves these days or calendar reminders... at least it gives the ventolin a chance to work before you need additional help.

Hope you're feeling better

[Wheezycat in reply to strongmouse]

Absolutely! A good idea to put reminders somewhere! I think I am getting better at it before walking somewhere a bit further than just round the corner. The next battle will be when I get my next cold. For that I may need to set alarms. I am fine at present, just regularly caught out when going out. Very irritating and tiring. This winter has been worse for that than previous winters.

[strongmouse in reply to Wheezycat]

I know what you mean, Subconsciously when I feel better I think I want to pretend that there is nothing wrong with me! Then of course when I am really unwell I end up feeling thoroughly fed up.

It has definitely been a strange winter and possibly made the moulds worse with all the rain and high humidity. Stay well as possible.

[Wheezycat in reply to strongmouse]

I have just finished reading a book on psychosomatics. Very interesting! And a very human and humane book. I kind of have had the opposite. When I got worse at first four years ago I truly did not realise something was wrong! Instead I blamed myself for lack of fitness (true) and whimpishness. In the end a friend who is a doctor read me the riot act as she had noticed years before and been tactful, ditto our daughter. In the end I also ended up in hospital for some days . Since then I have battled to learn to listen to nuances of my body, to notice - and take seriously - when I have a problem. I am now learning, but it is still a struggle. I gather there are many like me, according to local asthma nurses, possibly especially among older people, like me for whom this condition has crept up on them from behind.