So I'm currently been treated for asthma, still not officially diagnosed. I've had a CT scan that suggested early bronchiectasis but I've since had 2 radiologists and my respiratory consultant disagree with this.
Approx 7 weeks ago I had a bacterial chest infection (my 1st ever) that's cleared with amoxicillin after about 4 days but finished a 7 day course. I submitted a sputum sample (after my 7 day amoxicillin) that was positive for haemaphilus Influenzae and even though I felt fine I was advised to take another 5 days course. After this I felt a bit sinusy so called Dr again and they decided to throw a course of Doxycycline at me for 8 days, so finished those. Around week 6 (right after doxy) I was still producing small amounts of phlegm still - clear and thin. So called Dr again who has thrown ANOTHER course of antibiotics at me- 7 day clarythromicin (?spelling), which I'm on day 4, ordered a sputum sample and a chest xray (I feel completely fine btw)- chest x-ray clear and sputum sample clear.
I feel this is absolutely overkill on antibiotics, but with the limited physical interaction from drs, I guess they just want to make sure. However I still produce bits of phlegm throughout the day, not a lot and mainly morning and evening. I seem to be constantly clearing my throat. Sometimes I feel like there's mucus stuck at the top of my breast bone with a congestion sensation, and no amount of huffing and coughing clears it- I've taken advice on here by drinking plenty and exercising etc with not much luck. I've pondered whether I'm over aware of phlegm in chest/throat but then there's times when I talk I physically hear the mucus on my vocal coards- but not much comes out when I clear it.
I guess I'm asking if this is familiar with asthma? Or anything else. Is it possible that me constantly throat clearing and trying really hard to clear my chest is aggravating my respiratory, causing more mucus?
I take symbicort 100/6 turbo inhaler 2xpuffs am+pm.
Sorry for the long post but any response would be great. Thanks.
Lee
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Lee2k182
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Hi Lee, you seem to have been waiting a long time for your diagnosis. Have you tried ringing your consultant’s secretary? Maybe request a letter so that your GP can treat you appropriately or a telephone consultation. Your results will have been looked at by now, surely. At the very least it will remind them that you are still waiting.
As for the phlegm I think clear means you do not have a bacterial infection, but I can’t help you with the cause or the treatment, I’m afraid.
I can tell you, though, that I also have thin clear phlegm at the moment. I am putting it down to high pollen counts of late and lack of rain to clear it all away. My husband, who has never had hayfever is also blowing his nose and sneezing.
Maybe this is affecting you? Hayfever and asthma often walk hand to hand.
Either way, give the secretary a ring. Let them know you are alive and waiting.
My 1st respiratory consultation was 9 month ago and I've seen her 3 times ever. I was told asthma can take years to officially diagnose? So I thought I was still early days. I've had my CT results officially given via a letter that said...
"even though your scan suggests normal, with very mild bronchiectasis, I have held off as I wanted to discuss your scan with dr xxxx, who is another radiologist, and he says your CT is essentially normal and would not have called it bronchiectasis at all"
I've tried calling my resp several times and left messages with receptionist as since that scan I've had that chest infection which she doesn't know about. I dunno if that bit of info will change anything.
I was tested for allergies 6 month ago via a blood test and was told I had no allergies and I've never suffered with hayfever before.
When you say you're producing phlegm, is that from your chest? Or mucus from your nose? Mine seems to becoming from chest and other than that I don't have any other symptoms. Peak flow is the same as always.
I assume mine is coming from my chest Lee. It’s a bit hard to say as I haven’t got a barking cough or anything like that. I feel it in my throat, a quick cough and I can clear it.
It didn’t take me long to get asthma diagnosed. I had a big attack which caused my ecg to be abnormal. At first they said copd, then silent angina. Heart tests were clear. Copd diagnosis remained. Then I had spirometry which showed very good reversibility. All tests done and asthma diagnosed within a month. Getting the medication right is what takes the time. That took about a year.
Have you checked your predicted peak flows, fev1 etc? I know you are supposed to work from your personal best, but I find it useful to know where I am on the great scale of things.
My predicted peak flow has never been 'typical'. I remember 10 year ago I joined the navy and in my medical I had a peak flow that was hitting around 500 when I was supposed to be north of 650 for my height and age. The nurse thought I wasn't trying hard enough and just gave up and passed me saying I probs just have small lungs. I never thought anything of it. I was 24.
My peak flow now is around 540 and my best was probs 550/560ish, taken 9 month ago, now 34. It never really changes as I do it every other day or so.
I did a spirometry as well 9 month ago that shows obstruction.
Fev1- 4.51 (93%)
Fvc- 6.34 (118%)
Ratio- 68%
Residual volume- 127%
Reversibility was 9% and 400ml
These were all taken before I started taking any medication. I'm probs due another spirometry in August time.
I do find that since the symbicort I've had more problems, before it, i only had a wheeze on forced breathing and no other problems. The last 5 month (since symbicort) I've had a urology referral for frequent urination (no pathology found and discharged), hoarseness on and off, slight breathlessness/heaviness top of chest, a bacterial chest infection and now phlegm and throat clearing.
I dunno if it's a coincidence or if the symbicort is to blame. I just put it down to coincidence as surely all or that can't come from an inhaler. I did try the brown inhaler initially which I got thrush from and didn't think it prevented my wheeze (tried for 6 weeks).
My GP couldn't diagnose a sausage. They are useless.
Yes I have ventolin and I've been on symbicort since December 2019 so about 5 month. I believe the bronchodilator is the bit that works the most for me from the symbicort, I feel the steroid part doesn't. I want to try another but I have to give this one a chance apparently. Next review is June so will push for another then.
Are you saying you had repeated infections prior to your diagnosis? I've had about 2 in my life, the 1st was viral that left me with a wheeze and the 2nd was 7 weeks ago that was bacterial, positive in sputum sample.
Looking back now I think I had asthma attacks when I did PE and having always lived around smokers (family/friends and later husband) had attacks when around family and adults that smoked (I have never smoked). I remember one night at my aunt's after she went out and my mum and I were babysitting i struggled to breathe because of the smoke. I stood outside in cold for hours before I could breathe normally. Took deep breaths and stood.
I was in and out of hospitals having tests to try to determine why was getting so many infections (respiratory /sinus/ears) tests for thyroid, glandular fever and so on. Not once did they take a family history.
Suffice to say prior to going to University and changing Drs had 6 infection from March to September 1990.
Following being put on inhalers I was infection free for 2.5 years. Then final year of degree infections started up and had an asthma attack in an exam. Medications changed. Infections lessened.
I have realised untreated asthma led to increased susceptibility to (any kind) infections.
Medication and asthma well controlled = few infection maximum 1 a year. If infections start to increase in a year usually indicates medications no longer working and need to change inhaler.
Example
Late Dec 2017 and Jan 2018 infection severe
March 2018 respiratory staphloccocus infection
2 sinus infections and an ear infection 2018.
5/12/18 to mid Feb 2019 severe -Marcella catarrhalis
Change inhaler just before Xmas
End March 2019 respiratory viral infection (within 3 months of inhaler change).
Been infections free from March 2019
Dec 2019/Jan 2020 and March 2020 first season been free of infection.
So no inhalers or poorly controlled inhalers increases infections in me and indicates new plan needed.
When I get respiratory infections i get them badly.
I don't think looked at Bronchiectasis although I know they think my mum has this on top of her asthma.
I also have OSA and hypoventilation syndrome.
Only started to make connection this year that now had infection since March 2019 and its since inhaler change improved (Note I was on Seretide 500 for 10 years before it was changed late 2018).
It definitely maybe worth discussing with your Dr.
You will need a CT scan to help confirm it though. I had a scan that was reported as "early bronchiectasis" but I've since had 2 other radiologists and my resp consultant disagree and have continued to treat me as asthmatic.
Hi Lee. Your spirometry results are a bit like mine in that my face is above predicted while my fev1 is slightly below predicted, which knocks the ratio. I’m assuming to get a normal result I need to get the fev1 above predicted as well. Problem is, I don’t know how. I have started exercising, so we’ll see.
As for the Symbicort if you don’t think it suits you have a chat with your GO or the asthma nurse at your surgery to see if you can get it changed.
My very first asthma inhaler was Fostair. My dad had been on Symbicort and had been changed to this and thought it was much better. So, when I was prescribed it, I was very pleased and had every confidence in it. For me, it was magic! But, then others have problems with it. This is what I was meaning when I mentioned getting the medication right. What suits one person doesn’t necessarily suit everyone.
The Fostair, or that type of inhaler is also useful to me because I can take it with a spacer, but again some people cannot use this type of inhaler.
As for peak flow, I take mine 3 times a day at roughly the same time. I take the first reading as soon as I get up before medication. I take another at night, just before bed, after medication, as required by my respiratory clinic. But I also take another between 1 and 2 hours after my morning meds. This tends to be the highest.
I graph the first and last reading and make a note of my highest underneath.
Whenever I have to go to clinic or see my GP I take it with me so that they can keep a track of what is going on. ( You can download a diary from the asthma U.K. website)
I have asked my GP and the GP practice asthma nurse to change but they said because I'm under respiratory, they do not want to tamper with anything, especially being only 4-5 month on it, and still no definate diagnosis. I asked my resp cons in march if I could possibly change and she said we will persevere with symbicort for now but to use the MART regime, meaning I can take a puff if I get symptoms, instead of my ventolin. I dunno what she's thinking, I will push for a change next month at next meeting (probs be on phone). It might be as simple as just giving me a bigger dose.
Yea spirometry is meant to be 12% +200ml reversibility for asthma. I was just under at 9% but was told the 400ml was in keeping with asthma, especially with it being so high.
If she has said take the extra puffs from Symbicort it's a good idea to do that see it addresses the problem.. I am on Duoresp Spiramax and mine is 2 puffs twice a day and up to 8 extra puffs in a 24 hr period and only us Ventolin for emergency treatment.
I had lung function tests done shortly after lockdown, and am now waiting to hear from the consultant. At the test, they said they now advise 4 peak flows a day, and have asked me to record 4 until I hear from the clinic. Don’t always remember, but I’m trying!
Haemophilus influenza can have very serious consequences it's a bacteria infection which can cause pneumonia, meningitis and sepsis. It's very dangerous in the very young especially, thats why babies have hib vaccines. Its spread easily as airborne hence all the antibiotics. I'm glad you feel OK as post bacteria infections can wipe you out for a long time. It's a waiting game unfortunately for a real diagnosis and I'm sure when lockdown ends you will be sorted. Try an antihistamine each day incase you have hay-fever aswell won't harm and some of your symptoms seem linked. Reflux can cause some of the symptoms you have too. If your phlegm is clear the infection is hopefully gone. I hope you get sorted soon. Best wishes. 😊
Hi Lee, you do sound like the high pollen may be affecting you as I am much the same and I have put it down to the pollen. I have just had two courses of steroids (10 days) and a 14 day course of antibiotics and just about well again.
I usually get the feeling of mucus every 5/6 weeks and take 5 days of steroid and it clears up, but this time it has taken much longer so I do think it could be the pollen.
Me to, nothing showed up, however something triggers asthma whether you are alergic or not. Triggers are hard to find and believe me I have been trying to find mine for 7 plus years now!
Allergies are not just pollens - they can be food, dust and dust mites, cleaning chemicals, deoderants, perfumes, materials as in clothes furnitures.
Antihistamines work on more than just pollen - Antihistamines reduce or block histamines, so they stop allergy symptoms. Allergies are the immune system over reacting and producing anti- bodies
So when say anti-histamines may work not saying pollen. Allergy testing only cover so many possible sources of allergy.
There have been times when felt had really bad infection but it wasn't it was my hayfever. My point is sometimes allergy symptoms can be surprising and seem to mimic other illnesses.
Don't know if you saw the Asthma UK site earlier on but they had a table looking at Flu, Hayfever and Covid-19 which had comparison of symptoms to help people identify what wasn't
Hi Lee, my first thought is that you have little to concern yourself, supported by your clear sputum, in my opinion it’s quite normal to produce more phlegm at certain times of the year. I had pneumonia and pleurisy little over three years ago and have been producing the stuff ever since. I’ve had mild asthma for as long as I can remember, and take a combo inhaler twice a day. Regarding the phlegm production I wouldn’t be to concerned, not unless it begins to inhibit your daily life.
Thank you robferris1966 for your reassurance. I'm early days with asthma and although I've had a chest infection and have become a little phlegmy since, I'm lucky so far that I don't have a great deal of symptoms with it other than a wheeze now and then.
It's just frustrating as I've never had a chest problem my whole life, and now all of a sudden I do. The irony is I've steered away from smoking and irritants my who life and my friends and family that do abuse their lungs are all fine and I'm not. Typical ey.
Hi Lee, I spent 4 years being misdiagnosed by GPs at my practice. Asthma, COPD I was told. Saw an elderly dour consultant NHS eventually. He wrote them quite a rude letter saying I had neither of those conditions. A little later I saw another respiratory consultant who said he thought it was bronchiectasis but wanted to be sure so did all the blood tests which didn’t confirm any particular allergy but it was the CT that enabled him to diagnose hypersensitivity pneumonitis. Look it up. My symptoms are much like yours, continuous excess mucus especially early morning. Endless throat clearing of clear mucus. Cough stops me going into many social situations especially just now.
I take low level steroids now having started on a high dose that has been gradually lowered. Also carbocisteine helps keep the mucus thin. I wasted years at GP surgery. I went privately in desperation which wasn’t very expensive and now see that consultant at his NHS clinic.
Very interesting story and glad you finally got it sorted in the end. I've had a CT scan and everything was normal, also a spirometry that was obstructive so I have either asthma or copd, but CT ruled out emphysema. Also chronic bronchitis is plausible but I don't really cough and the phlegm is only very small amounts. I have never smoked or been around significant irritants so copd very unlikely, which leaves me with asthma.
I'm still early days yet so hopefully I'll get it under control soon.
It sounds like you have coast nasal drip as well. Try Sterimer it is really effective at helping it is completely natural you can buy it from most chemists including Boots. You could also have hay fever the pollen count at the moment is really high. You could try steam inhalation before bed.
Thanks smoggy, I'm ok with treating it, I'm more concerned with the cause. I do think I have postnatal drip though, every morning I tend to have phlegm in my throat that's difficult to swallow sometimes.
Also, is your name a reference to where you're from? If so I'm not too far away 😁
Like you lee I have a lot of mucus that means I am constantly clearing my throat. Got quite an early and quite quick diagnosis of asthma after second a and e admission and before even ct scan had found mild bronchiectasis. Had been given carbosytine to try it helps me bring it up in the morning and early evening when it seems more sticky.
On another point you would be surprised at the irritants you may of been exposed to. Especially in the navy if you consider that a lot of the soft furnishings and uniform are coated in a fire retardant. And if you consider also matelots are not exactly presice when using chemicals for cleaning.
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