Suspected Covid, now on Salamol & Qvar, questions

[AirIsUnderrated]

Hello all, newbie here so apologies in advance for any stupid questions.

I'm 51, female, live in the UK's beautiful west of England, haven't had an inhaler since my teens and am not asthmatic. I'm 5'3", my O2 sats remain good, I'm not overweight and I'm a singer (can't sing now!)

I had suspected Covid back at the end of March. There were no tests then so I self-isolated and didn't call the GP until after 2 weeks of symptoms as per the rules at the time. Long story short, I was given a salbutamol inhaler (1 or 2 puffs up to 4 times a day no less than 4 hours apart) at week 4, which sort of helped the horrid, itchy, burning feeling of mosquitoes biting inside my chest 24/7 but didn't do a lot for the breathlessness and wheeze. At week 6 I was given Doxycycline for a secondary chest infection, and at week 8 a Qvar 50 inhaler (2 puffs 12 hours apart) and more salbutamol. It's now week 10.

I understand from the leaflet that the Qvar is intended to replace the salbutamol, but on bad days the reliever only lasts a couple of hours. I'm always better in the mornings then I get worse after lunch, and by the time I've had my evening meal there is no longer enough space inside me comfortably for air as well as food.

I'm also getting "attacks" when suddenly my airways seem to constrict for an hour or two, and the reliever only partly relieves it. I've worked out that heat, exercise and irritants such as cleaning sprays, deodorant, candle smoke and the chip shop can bring this on, but sometimes there is no obvious reason.

I haven't got a diagnosis of asthma. I haven't been seen by anyone. I can't get an examination. I will push for an appointment once the restrictions are lifted. Meanwhile I was hoping someone with experience might be able to advise me.

Is it safe to take salbutamol more often than every 4 hours if it isn't helping?

Could the ache in my chest and back be a side effect of either the salbutamol or the Qvar? It isn't the same as the intercostal ache from overwork.

The wheeze is on exhaling only but is all the time, with or without an inhaler. Could there be more going on here, or is this normal at this stage in treatment?

Thank you in advance!

[twinkly29]

In theory you can take salbutamol more frequently (it might give you a feeling of a fast heart rate,) but the effect should last 4 hours so, if it isn't, it might be worth getting in touch with your GP. They might try a combination inhaler which combines the steroid element (the Qvar) with a long-acting bronchodilator (long-acting version of salbutamol). However, they might want to wait for the other tests - which as you've said is a bit difficult at the moment. Sorry, that's probably not a very helpful answer is it?!

[AirIsUnderrated in reply to twinkly29]

I have a nasty feeling I'm brewing another chest infection. The right side of my chest is starting to burn and I've been coughing today. No fever. I can't tell you how fed up I am with all this. It's been 9 weeks.

Thank you so much for your answer. I hope others will chime in.

[twinkly29 in reply to AirIsUnderrated]

After what you've been through it does sound a good idea to get checked out. You must be so fed up of it all though 😣

[Basil2010]

How many puffs of the salbutamol are you taking when taking it, as you can take up to 10 puffs every 4 hours. Also have they given you a spacer to use the inhalers as this is the best way of getting the medicine into the lungs completely. But definitely agree you need to speak to your GP again as it shouldn’t be like that all the time

[AirIsUnderrated in reply to Basil2010]

I take 1 puff, then if it isn't helping after a minute I take another. I haven't got a spacer. I take 2 puffs before my evening Qvar dose to make sure the airways are as open as possible. That's when things close up. I try not to in the mornings when it feels clear, but maybe I should.

Thank you!

[Basil2010 in reply to AirIsUnderrated]

Something to ask for is a spacer as the medication gets into the lungs better. Definitely use the asthma uk website for advice on using inhaler plus technique etc

[Bu997]

Hi,

I have a very similar story. I had possible COVID at end of March leading to coughing, wheezing, breathlessness and nasty chest pain. My GP has been helpful. After 2 courses of antibiotics for secondary chest infection and a month on Clenil 200 preventer and subutamol, I am now trying Seretide low dose. I was also seen in A & E and chest xray was clear but consultant felt there was localised inflammation of pleuratic tissue.

I have had virtual consultations with GP and nurse practitioner. No previous history of asthma. Similar age too.

Best wishes,

[AirIsUnderrated in reply to Bu997]

You must have been really poorly to get a chest x-ray, you poor thing. I've only had telephone calls, although the GP called me 3 times one week so she must have been a bit concerned. I haven't had much of a cough until yesterday.

Thank you - I hope the Seretide helps. I think coronavirus is going to have unforeseen long-term health consequences for even "mild" cases, don't you?

[Bu997]

Wishing you all the best and hope you get a proper consultation. It will be interesting to do the antibody test when it becomes available

[Poobah]

My sister's first covid symptom started in March and ended up in hospital for oxygen for four days & tested positive for Covid-19. She's still struggling with breathing all these weeks later but has had x-ray, scan & bloods to check chest is clear and to check for blood clots, a complication of covid. Secondary chest infections is another complication and it sounds like you may still have that, given the descriptions that you give.

My sister had two lots of antibiotics from her GP but hospital put her on different antibiotics. She ended up having four courses in all but no inhalers or steroids.

We also had her use Holland & Barrett Vit & Zinc lozenges as zinc is good at dealing with viruses.

I would definitely contact your GP again and sress how your breathing is still an issue, that you have an exhalation wheeze and intercostal pain (& that you're exhausted). If you are happy to have hospital tests such as x-ray or scan, say so/suggest it. It would be good to know if lungs are clear at this stage. Definitely explain that the Salbutamol is not giving you the expected relief and so you have had to take more.

It could be that the GP will prescribe oral steroids plus another course of antibiotics.

Qvar is a steroid inhaler (preventer) and affects build up with full efficacy after four weeks. Salbutamol is a reliever and affects should last about 4 hours. From the description of your symptoms I don't think the inhalers are causing your discomfort. It's another sign that you're working too hard on breathing. Make sure that you have enough of both inhalers.

Eating can affect my breathing so I take Ventolin (Salbutamol) before my main meal. I try and eat smaller meals and eat lighter foods. I also avoid processed foods. With your lungs being so sensitive at the moment it may prove helpful to cut out foods that you think are making you wheezy or just adjust meal sizes until you feel better.

And if you need to seek more support from your GP don't hesitate. You will need ongoing treatment and support until you're over this horrible illness.

All the best.

[AirIsUnderrated]

Thank you all for your replies. I really appreciate the time you've taken to pass on your wisdom and good wishes. What a nice place this is!

Today's update: I've developed what I believe is another chest infection (cough, burning chest on right side, low-grade fever & no appetite) so I called NHS 111 today. Because of the cough and fever as well as the breathlessness, they sent me for a Covid test this afternoon. I fully expect it to be negative, but I have to jump through the hoops. The 111 GP also wants me to have a chest X-ray, blood tests including an antibody test if available, and a different antibiotic. I'll call my GP in the morning. At last something can be done. Watch this space...

[beech in reply to AirIsUnderrated]

Sorry to hear that you’re feeling unwell again, but glad 111 is taking it seriously. Hopefully the tests will rule out/in particular problems and you can perhaps get more appropriate meds and a better regime of control.

[Justahuman]

I’ve been in a similar situation, although I do have lifelong asthma and a mast cell disease. I requested a chest x Ray after my breathing became so bad I couldn’t speak or walk and every breath caused searing lung pain. X Ray was clear but I had two weeks of low dose oral steroids as well as increasing dose of symbicort and that has finally budged it. It was so bad that for two weeks a by speaking above a whisper caused severe lung pain and exacerbation of breathing problems.

I’m now on week 9 and hoping I’m on the mend at last.

I wasn’t given antibiotics as I’m sensitive to them, it was clearly inflammation.

[AirIsUnderrated in reply to Justahuman]

Oh poor you, that sounds miserable. Far worse than me. I agree about talking making it worse though. And everyone wants to call and have a long chat to make sure I'm OK, especially my Mum!

I can't use most painkillers, only paracetamol, but I'm fortunate not to be sensitive to antibiotics, thankfully.

I hope you've found the combination of meds to help you until it calms down.

[ChrissieMons]

Never, ever be fobbed off. Bear that in mind when you see any medic, and insist on seeing a consultant if you get no better. You need a strong will to have asthma!

[mariyn]

You can take 11shots of Salb ... but try to get some medical help ASAP Have you tried phoning Allergy UK nurse ,generally helpful Good luck Marilyn

[AirIsUnderrated]

My Covid test was negative. It only took 23 hours to come back, and on a Sunday too - phenomenal!

I'm on antibiotics for a chest infection and had a chest X-ray this morning. Hoping for the blood tests later this week when my temp has gone down. The GP was discouraging about the antibody test because even if I have antibodies, it doesn't prove immunity. But I really want to know whether Covid has caused all this or if there's something else going on. I'm going to push for it. I'm feeling really rubbish today, but I'm glad things are moving finally.