Chest Infections.

[Lee2k182]

As a newbie, I am aware that a chest infection is worse for asthmatics but I was wondering if asthmatics are more prone to chest infections? If so, per year, what's "normal" for asthmatics?

Thanks

[twinkly29]

Some may well be more susceptible to them but others won't necessarily be. I think it depends on the individual, as does whatever is normal. Sorry, that's not very helpful though!

[KnPoa]

I think it depends on the person. Both my friend and I are asthmatic, she never gets a chest infection whereas I get them a lot. Winters are normally my worst time any time on from August to April/May. I can have 8/9 in one winter. My doctor said it’s due to my asthma and the allergies I have weakens my immune systems .

[Lee2k182 in reply to KnPoa]

Thanks for the reply.

I'm still early days atm with my asthma. My consultant says I have atypical asthma and I do not have any allergies. I have a small chest infection in January that lasted 3 days with green phlegm and I have one now that's lasted since good Friday with small amounts of cream/yellow phlegm that is persists. I rarely cough and have no other symptoms. Currently waiting for my GP to call me 😬

[KnPoa in reply to Lee2k182]

Sorry to hear. Hopefully you get it sorted! It’s awful feeling to get a chest infection. My doctor told me to try steam (just plain hot water) just before bed for 10 minutes every night. It does work, it makes me cough but helps clear my lungs.

[Chip_y2kuk]

Yes asthmatics are more prone to chest infections and it's a mixture of steroid prevented inhalers dampening down the immune system and asthma causing inflammation and mucus in the airways... all of which are great breeding grounds for bacteria

As to how many will vary greatly by individual and medication at my worst I got one every other week for 6 months needing antibiotics and steroids each time

At my best (now) a few courses of antibiotics and steroids a year (currently on one this year so far)

Chip

[Evie3 in reply to Chip_y2kuk]

I have been suffering with back to back chest infections since November....awaiting appointment for lung function test and to see Respiratory Consultant....obviously wont be soon. Looks like more antibiotics and steroids in the meantime😞.

[Lee2k182 in reply to Evie3]

Sorry to hear evie3, I hope you get it sorted out soon. Are you asthmatic or have any other lung issue?

[Evie3 in reply to Lee2k182]

I have been asthmatic from age 3 however all under control once i got to 15. Then got Rheumatoid Arthritis age 30 and on different meds for that. Now 67.....new meds Nov 18 for RA....chest infections started Aug 19 and Sept. November 19 till now every other two weeks. Was diagnosed as carrier for Alpha 1 Anti trypsen 8 years ago which can cause lung problems. Unsure whats causing this now as been good up until Aug 19. Desperate to see Respiratory Consultant.

[Chip_y2kuk in reply to Evie3]

It's not fun is it... but I do my best to carry on... the Mrs plays hell with me I once went in to work with a probable partially collapsed lung on 2 lots of antibiotics 8 puffs of duoresp and 50mg of steroids for 7 days.... i still went in to work

[Evie3 in reply to Chip_y2kuk]

☹️

[Lee2k182 in reply to Chip_y2kuk]

Thanks for the reply, chip. I've probably had 5 chest infections in my entire life, the one before my asthma diagnosis was the biggest and longest one (dec2018), and was told that's why I now have asthma. Never had a chest infection since and I've had 2 already this year, one in Jan which was over quickly and the one I have now which I've had for 4 days with no sign of shifting. I've been taking symbicort 100/6 2xpuffs, 2xday.

Just been given amoxicillin today, will start tomorrow. I have no symptoms other than yellow blobs in sputum with barely even a mild cough.

[Chip_y2kuk in reply to Lee2k182]

Symbicort opens your airways (formoterol) and the steroid in it is budesonide which they use in tablet form for people with crohn's... so I wouldn't be overly surprised If you did need the antibiotics but the problem is we asthmatics on that sort of medication can be mildly Ill... and then Bamm.... needing an ambulance unable to breathe...

Your lucky having had only 5 your entire life... as a kid I used to get an infection every time the weather changed... so every 2-4 months

As an adult in the last 5 years I've had more than i care to talk about.... infact I phoned 111 once got offered an ambulance... refused and got a gp extra appointment (out of hours doctor Round here)... and got a really good doctor who I went in and said it's a chest infection it's in the left lung (its always the left lung) peak flow is down to xx I normally walk out with steroids and antibiotics but I like doxycycline because in allergic/react to amoxicillin blah blah

He prescribed both steroids and antibiotics and as we where parting ways he said you seem pretty clued up... why is that? .... we had a brief chat about good and bad doctors and parted ways.... shortly after I had to go back to the doctors because I was getting worse and he said.. your left lung isnt filing with air... I ended up on 2 lots of antibiotics and aother course of steroids

The doctors that I've seen before just ask me what I want and sign the prescriptions.... irritatingly they look at my repeat prescriptions and always write a prescription for prednisolone.... which always helps but if I wasnt on so much I wouldn't get steroids everytime.... which by the way stopped me getting life insurance last year

Chip

[Lee2k182 in reply to Chip_y2kuk]

Oh lord, my sympathies to you. I'm belly aching over an infection that doesn't even affect me other than being an inconvenience.

If you're on a lot of prednisolone, would that not be why you get a lot of infections? I know that that stuff drops your immune system right down, so could be a viscous circle for you?

You defo sound clued up to me, I'm guessing you've had asthma a long time. Don't get me started on drs, mine are useless. It took me a year for them to refer me to respiratory! They kept telling me there's nothing wrong with me even though I had a physical wheeze you could hear from the other side of the room!

[Chip_y2kuk in reply to Lee2k182]

I've been under 2 respiratory consultants and an endocrine team... my white blood cell count is lower than it should be (flags red/abnormal on the system) and it's been done many many times and it's always below the low threshold

But its not just the prednisolone the inhaler I'm on is also leaching into my blood stream and that's something I take 2 times a day every day... its also suppressing my adrenal glands my cortisol is not 0 but was 50 at the start of a test... apparently it should be 500 and they say it's the steroid inhaler

And I've had asthma for 33 years minus a 7 year spell I got away with taking nothing.... I'm now in more than ive ever been

[Chip_y2kuk in reply to Lee2k182]

I dont wheeze often I've been heard wheezing 3 times in 5 years.... that makes the "no wheeze, not asthma argument" easy... not all asthmatics wheeze and if they do they dont always wheeze all of the time

The first time I was heard wheezing will have been 4.5 years ago I was new to being back to asthma and i was taking ventolin 4 puffs weren't lasting 45 mins and the gp said come in I will see you once you arrive (it was a friday afternoon).... I was having a slow burn asthma attack.... copious amounts of prednisolone and strick instructions to take ventolin every hour for the rest of the day and if no better by AM... 999 .... anyway me and gp both knew I would be ok... I was 60% better the day after

And the last time was last year when I was advised by a respiratory consultant I didnt have asthma and to stop all treatment so I did.... in the mean time he had changed his mind and wrote to my gp saying it probably was asthma and I should carry on everything as it's working and controlling 'symptoms'.... anyway I was in the gp at that point wheezing in both lungs and had an infection in both..... that would have cost me over £80 in prescriptions( luckily I hadn't yet cancelled the pre payment card)

[Calmcat]

It was explained to me as follows -

As asthmatics we tend to produce more mucus which is then more difficult to clear due to narrowing of airways. This is then a potential breeding ground for a bacteria to come in (often on the back of a cold) and cause a bacterial chest infection. However in theory if our asthma inflammation is well controlled (normal mucus and no narrowing) then we shouldn’t be at much greater risk of infections. The only other thing is if we are on oral steroids or high dose inhaled steroids then these (while doing a great job to suppress inflammation) can also suppress the immune system a bit and make it easier to pick up infections. It’s still more important to keep them to suppress the inflammation as that’s the bigger risk though. Hope that helps

[Lee2k182 in reply to Calmcat]

Thanks for that calmcat, I've only been getting these infections since taking symbicort so maybe it's that?

Hope you're well, I remember speaking to you a month back, how have you gotten on with all your issues?

[Calmcat in reply to Lee2k182]

Hi Lee

Sorry you’ve had so much trouble with infections- I seem to pick up everything going too. I remember talking to you a month ago- thanks for asking- i was very ill then and then GP sent me up A&E - had ct - all thankfully normal but I still couldn’t walk more than a few paces without extreme shortness of breath. Getting better now- have stopped Fostair as that seemed to be making things worse. Went back on high dose Clenil and ventolin (and continued prednisone) which improved things. Was trialled on Seretide Accuhaler- this immediately brought back the shortness of breath on exertion (just like the Fostair) so stopped that. And I’m now just on Qvar, ventolin and prednisone (but reducing). GP wants me to try Tiotropium- but haven’t yet because I’m really nervous of getting another bad reaction and I seem to be improving daily now... she prescribed it a week ago and it’s still untouched- she’s said she’ll ring me tomorrow- not sure what I’ll say....😬 bad patient! 😄

[Chip_y2kuk in reply to Calmcat]

I take a slightly stronger version of symbicort that's cheaper called duoresp spiromax and I can tell you after many tests and various specialists

My white blood cell count is low (technically making me immune compromised)

My adrenal glands are asleep/suppressed as a result of the duoresp spiromax causing blood sugar/blood pressure and all kinds of odd cortisol related problems

And I know that taking all the stuff I take is the 'lesser' of two evils and I've tried to stop taking them all... it ended very badly

As you say poor asthma control can sometimes be the cause of the issue but for us asthmatics chest infections are part of the beast

[Lysistrata Administrator Community Ambassador]

As others have said it really does seem to vary! I have severe asthma and am on high dose inhaled steroids along with other medications, but don't tend to produce much mucus or get many infections. If I do they are more often viral (though of course you can still get mucus with those!) and they cause havoc.

So luckily not that many but almost inevitable admission when I do. Often on the way out when the infection is calming down! I see things online saying oh it's the mucus and other symptoms which causes asthma to flare - well not for me most of the time, as my asthma will flare a bit with symptoms but get worse as the infection goes.

I can also get sneaky bacterial infections which I only pick up because they make me have an attack needing A and E and then the hospital does an x-ray. Often very few symptoms besides the asthma there - no coughing up gunk or fever.

In contrast I have a friend who has mild/moderate asthma who picks up a lot of infections, way more than me, and they set off her asthma (but not to hospital level).

Unsure if my relative lack of infection is because my asthma is very weird and mostly not driven by inflammation (possible, but unusual). I seem to have some inflammation but this does not appear to be the main driver or reason for my poor control.

Meant to add also that I can't use steam to decongest if I do have mucus as it makes the asthma worse - I know not the case for everyone but worth being careful for anyone who hasn't tried it before.

[Lee2k182 in reply to Lysistrata]

Luckily this infection doesn't really set the asthma off thank god, apart from the mucus but it's not that bad. I don't have any other symptoms.

I've been sceptical of my asthma diagnosis to be honest, I'm so atypical that I'm atypical atypical... Lol. I don't have any allergies and my symptoms are persistent with small wheeze everyday and a tiny bit breathlessness so don't really have a trigger, it's just all the time. My symbicort takes the wheeze away but not breathlessness.

I've had a CT that ruled out emphysema, boop, broncholitis etc. It did mention early bronchiectasis but I've had 2 other radiologists that have disagreed with this. So even if I do have that, it's so early it's divided opinion so I'd assume I shouldn't have the symptoms for that just yet.

[Evie3 in reply to Lee2k182]

Is there any family chest/lung issues?

[Lee2k182 in reply to Evie3]

None at all. My mum is suspected COPD but she's 60 and smoked since 14. I lived with her (Smoking home) for 1st 12 years of my life before moving with my dad. I'm now 34 and never smoked, or been around chemicals, dust or irritants.

[Evie3 in reply to Lee2k182]

My Mum had COPD, my brother has bronchiecstasis and me asthma. My son had a routine blood test which showed raised liver reading...anyway he was tested for Alpha 1 Antitrypsen for which he was positive type Z. This condition which can affect liver or lungs is a condition that very few doctors know about...however there are lots of people with it.....but unless specifically tested for it can be diagnosed as asthma etc etc.

[Carolofcambridge]

I think it is very individual. I have had well controlled asthma for twenty years. If I get a bad cold that can lead to a chest infection, but only happens to me every couple of years. Others here have very different health issues and types and levels of asthma so have to put up with a lot more. You will find out your own “normal” over time.

[Hidden]

I've found that it's the severity of my chest infections that makes them most noticeable. If I keep away from my asthma triggers and keep taking my Fostair and Carbocisteine, I don't tend to notice many. Historically before I did this I had lots.

[Babbela]

I always have strep throat I think thats my weakness , very rarely have chest infections depends on how your body reacts to certain infections.