Help on personal best!

Looking for a bit of advice on setting your personal best. I was only diagnosed last October and ever since my asthma has been uncontrolled. I've had 3 attacks and 4 chest infections in this time. Before the pandemic struck I used to be very active, walking 5+ miles per day on average, so my personal best was relatively high for my height and age. Since March though I haven't been doing anywhere near as much exercise and I've started new medications. My PEF has started to trend MUCH lower (like 100 l/min on average). Now I'm not sure if this is an exacerbation (I am having a lot of issues with cracking voice, extra mucus, bit of coughing - no temp), or my personal best has lowered because I'm not as active as I was. Perhaps it's a mix. Either way, I'm hopelessly lost and because I'm now under the hospital the GP practice is terrified of making new recommendations or doing anything different. With the pandemic picking up where I live, it might be some time before I see my consultant as well.

So please help. I'm not entirely sure what I should be doing.

[Troilus]

Hi Anarcala,

It sounds very much like this could be an exacerbation. It could be that the mucous you explained could be limiting the airflow. Is it clear or green?

Does your blue inhaler help?

I am also under the care of a consultant so I understand that quite often a GP doesn’t like to “interfere” with your treatment. Having said that, he has prescribed prednisone for me, increased the dose of my preventer inhaler and added Montelukast in the past, so they can do things for you when they are unwell.

My hospital runs a nurse led respiratory clinic where you can ring for advice. It might be worth checking to see if yours does the same.

If not, contact your GP and, if he mentions that you are under the care of a consultant explain that you are not likely to be seen there anytime soon and that you know things aren’t right and that you feel you need help.

It might be that you need some antibiotics if it is a chest infection or maybe another course of prednisone to boost you up. The only people who could say for sure is the nurses at the hospital clinic, your GP or the asthma nurse at your GP surgery. And it is within the remit of your GP to prescribe these things for you.

Your PB remains as it was. A sudden drop, or even a gradual drop over a short period of time does not alter that. The fact that yours has dropped is indicative of a problem.

Hopefully, once you get this resolved it will come back up.

[Hidden in reply to Troilus]

Hi there - thank you so much for such a fantastic reply. I'll try and answer as thoroughly as possible.

So the mucus changes colour. Sometimes it's clear, sometimes it has a green tinge to it. My cough is only productive every other week. That's confusing for me. The last few times I've had coloured mucus it's been easy to tell I've had a chest infection (coughing all the time, always productive, extremely tight chest, etc.) and my PEF drops even more significantly (down to around 360-370 from the current personal best of 530).

The difficult part is I've had so many infections back to back over the summer so it's been up and down all the time between March and July. After being put on Spiriva in July, it stablised at 413 in August and September. This is the longest flat line in the trend I’ve ever had. This is why I wondered if it was more of a movement in my personal best. But it's still not even close to what it was in March, which was 442.

The blue inhaler does help, but it doesn't give any lengthy relief. I'm trying to avoid overuse, but I certainly using several times a week at the moment.

I'm still at the very early stages of the consultant pathway, so I don't really know what services are available to me through that. My next appointment isn't until 11th November either (and that's assuming it's not cancelled because of the pandemic), so it looks like I will have to go back to the GP after all.