Just another asthma question 😅

[Lee2k182]

You're probably sick of me by now with all the questions lately, but I have another. Sorry.

I was wondering if asthma symptoms can still persist even on oral steroids if still exposed to a trigger. The reason I ask this, is I think I have a sinus and tonsil infection (bacterial) and my consultant mentioned once, that my trigger could be infection. So if it turns out I do have an infection will the oral steroid not work until I clear up that infection?

I believe I may have a chronic sinus infection, that doesn't necessarily bother me as much, to the point that over the years I've not done anything about it. When I had a chest infection 12 weeks ago, I had a lot of antibiotics and noticed after that my nasal mucous was clear and no bits of blood. The last couple weeks or so though it's gone back green and tiny bits of blood (not a lot). I don't feel congested or anything and it doesn't bother me. I'm obviously going to discuss this further with my gp on Monday.

Thank you a again. I learn so much from this site.

Lee

[twinkly29]

My inclination (though not certain) is that oral steroids would help asthma symptoms if being triggered by a bacterial infection as they would reduce any inflammation in the lungs....but the infection itself would still remain if untreated (or might still be lingering, if one had a viral infection) so could still then be triggering the asthma. Does that make sense?! Sorry if not!

Sinus issues can cause or exacerbate post nasal drip which can be a very annoying trigger for asthma - so ongoing sinus issues definitely could be a problem.

It doesn't replace the need for treatment for bacterial infections but NeilMed Sinus Rinse is brilliant. I was recommended it by my respiratory consultant some years ago as an allergy prevention technique but it is good for infection too. It uses warm water (as warm as you can tolerate - too warm and is ouchy, too cool and it hurts like hell!) and the saline sachets to wash out the sinuses - feels like you're drowning the first time 😳 but you get used to it! The idea being that it removes some allergens before they get beyond the nose. That principle works for infection too as an ongoing thing, to hopefully prevent some becoming an issue. I've used it when I've had infections (colds, sinus, or just really congested) in addition to the twice day usuals (say one in the middle of the day as well) and it does help to get things moving. So longer term, if infection is an issue for you, something like that might help - and it sounds promising if antibiotics helped inadvertently before that maybe a longer course might help your sinuses now.

Please don't feel you can't ask questions - we all do it, it's why we're all here!

[Lee2k182 in reply to twinkly29]

Thanks twinkly.

I thought I read somewhere (don't know where) that even on steroids, you should still avoid your triggers. From that, I just assumed that maybe it's because you will still be triggered.

Obviously, if I have a chronic sinus infection, then my trigger (assuming that is my trigger) will still cause me some symptoms.

I don't think I have post nasal drip. Like I say, my nasal issues don't really bother me but I think I've just become accustomed to it, like it's just normal for me. But going forward, I will be looking into methods to reduce any infection, if that's what it is so thanks.

I believe it is infection as I gave a sputum sample in 11 weeks ago (for my chest infection), but I couldn't for the life of me get anything from my chest, so I thought "I'm definitely submitting something", so my whole sample came from my sinuses. As gross as it sounds, I just snorted it all from my nose, (and wherever else it comes from when you do that) into my mouth and into the pot and it came back positive for bacteria.

[Js706]

Infections are one of my major triggers and I would often get really stubborn, lingering ones that took ages to clear.

Generally I tend to find that if I have an untreated infection as a trigger, increasing my steroids and getting extra treatment helps (I take prednisolone regularly as part of my treatment, so am slightly different in that I have to increase my dose rather than start a short course) but I often won't be able to get back to my normal baseline and as soon as I drop back to my regular treatment levels I start to flare again. Then once the infection gets treated I respond much better to an increase in steroids/other treatment and I can maintain the improvement a lot longer!

So in my personal experience - yes I've found that too! Its definitely something you should talk to your GP about to look into further to see if you do have an infection.

I also agree with twinkly's comment about NeilMed sinus rinses. Especially if you have sinus issues - it can help keep them clearer and so infections are less likely to "settle in" as there is less mucus etc (nice I know) sitting there to get infected.

[Lee2k182 in reply to Js706]

Thank you Js706.

So for you, although increasing your steroids help, it doesn't completely resolve your asthma symptoms until infection has gone?

I have just found, over the past 4 weeks or so that I've become a bit more breathless on and off throughout the day, as though I can't fully inflate my lungs. I have found that my wheeze is becoming more persistent even after taking ventolin. I'm on my last day of Pred today and I don't feel like they have done anything.

I've had a CT in march that was normal, 4 chest x-rays in 18 month (last one 4 weeks ago) all normal. Bloods all normal, even arterial gases done- normal, ecg- normal and Dr listened to my chest- clear. The only thing I've had positive is a sputum sample (I gave it from my sinuses as explained in post above)

I had a full lung function test in October 2019 that was obstructive and consultant said I defo had 'small airway disease' and has been treating me for asthma. So it's defo not in my head. I've had ILD, emphysema, BOOP and bronchiolitis all ruled out from CT.

[Js706 in reply to Lee2k182]

Sorry that the pred didn't really help things! If you've had positive sputum from your sinuses then its definitely worth following that up with your GP.

I hope you managed to get an appointment today and get something sorted!

But yes, generally if I have a lingering infection I'll maybe only be able to get back to say 75% of my baseline until its cleared, and then when its sorted I can normally get totally back to baseline (numbers picked slightly out of the air but you get the gist!)

[hilary39]

I’m on a course of prednisone right now and still having symptoms. They can take a long time to resolve.

[Lee2k182 in reply to hilary39]

Finished mine and hasn't done anything. Drs tomorrow.

[hilary39 in reply to Lee2k182]

We've been in sync these past few weeks haven't we? I am finishing a course today too and still very symptomatic. Also seeing my doctor today. I hope we both find answers and relief soon! I am pregnant so quite anxious about how my poor little buddy is coping with all my coughing and wheezing

[Lee2k182 in reply to hilary39]

Yes I guess we are 😅 spoke to my GP this morning and she wants to try a strong nasal spray and 2 weeks of abx just to see if it's a sinus infection triggering my symptoms. I'm skeptical but I'll give anything a go at the moment.

Congrats on Baba. Could it not be your pregnancy that's causing your symptoms? Breathlessness is surely common in pregnancy, as well as your hormones being a bit up in the air.

[twinkly29 in reply to Lee2k182]

Ooh I'm glad anything sinus related might get cleared up though - at least that would rule that out and maybe even improve things for you.

[Lee2k182 in reply to twinkly29]

Thanks twinkly. It's a long shot but it might do the trick🤞

[hilary39 in reply to Lee2k182]

I think the covid + pregnancy + triggers I've been encountering have turned into this terrible trifecta causing a non-stop flare. So glad my pulmonologist could squeeze me ino today. I hope your appt went well too.

[EmmaF91 Community Ambassador]

I agree with all the other responses 😅. It is perfectly possible to still be having issues despite prednisolone, and especially if you have an infection of some kind (viral or bacterial!) that affects either your upper respiratory tract (sinuses/throat etc) or lower (lungs 😉)

And going to support both what Js706 and twinkly29 have said and suggested 😅

Hope things start to improve for you soon!