Lockdown asthma deteriation

[SteveLondon]

Hi have had standard brown prevention & blue reliever for years with limited real support from GP, just inhaler prescribed etc. However in last 18 months been prescribed steroids three times, as a key worker, worked throughout lockdown as safety manager my general over use of reliever had increased to daily use. I was struggling to get upstairs, my work stress was high and coupled with lingering chest cold, consequently ended up in hospital for 8 days. I had close call on my first night at 5am , disoriented had to find inhaler and only just managed to get briefest quarter inhale, panic set in just managed a second quarter inhale that bought me a few more precious seconds I couldn't shout , it was my about 5 or 6m into the covid assessment ward I was placed initially. ( 2 results came back negative) was promptly moved at 3am next night. I managed a half puff as I opened loo door , followed by full inhale , followed by collapsing into my bed trembling , took another inhale or two , nurse entered fit me back on nebulizer and oxygen. My peak flow was poor 160 to target best 630 & oxygen levels 90%, I had underestimated my condition trying to just fight it with limited knowledge and standard inhaler issue. I did not know what an asthma plan was, didn't know about other inhalers, was prescribed montelukast, increased steroids, nebs, blood tests, chest xrays, allergy tests. In summary, managing my asthma properly just started the hospital was great and now doing daily peak flow tests, FostAir & chamber. I have joined this community as was ignorant, perhaps let down by local GP , certainly pandemic didn't help. I feel confident going forward can manage this condition now, unsure if I am mild, moderate or severe asthmatic to be honest, probably moderate? Should I shield , work from home going forward, I will likely be doing but if both?

Scary experience , so much the wiser now, stay safe everyone.

[Poobah]

Your GP, or consultant if you have one, should have reviewed your records in light of your oral steroid use and recent hospital admission and decided whether or not you now fall into the extremely vulnerable category. If you're unsure, have a chat with your GP about this. They may claim that they don't send out the shielding letters, but they are definitely responsible for ensuring that all relevant patients are included in the right clinical category. As your case illustrates, things change and you shouldn't fall through the cracks.Your experience sounds so scary - but I'm glad you're now being looked after properly. Let's hope you never have to repeat that one!

[SteveLondon in reply to Poobah]

Thanks Poohbah , I have another 2 weeks plus of montelukast remaining so not too sure what plan is after that? GP will advise or via hospital asthma specialist as she seemed to indicate in about 3 weeks? I think on reflection, I fell through the cracks when last 2 GP telephone consultations were just done on telephone and was the practice pharmacist, effectively just authorising a repeat prescription and not addressing the intensity and escalation as such perhaps.

[Poobah in reply to SteveLondon]

My asthma nurse explained that when a patient starts Montelukast they should be reviewed after 4 to 6 weeks, just to check it's working for them. It doesn't suit everyone so good to get that checked and get a repeat prescription if necessary. Definitely get a follow up appointment organised so that your GP can support you going forward. All the best.

[twinkly29]

Glad they got thing under control for you - it must have been frightening to go through.

I agree with Poobah that discussing things with your GP would be sensible. It's difficult with potential new additions to being extremely vulnerable as this lot of letters seem to be the same groups as before (regardless of need or changes in the knowledge about who is actually at more risk than others) - and of course, like yours, people's circumstances do change.

How long have you been on the new medications? Is the montelukast only short term? (It sounds like that from your reply on the other post but I could be wrong.) It's usually a continuous medication.

Regardless of needing to shield or not, having an experience like you did can take time to recover from (physically and mentally) so if it's just happened make sure you don't do what we all do and do too much too soon. On the other hand though, many many people have controlled asthma and don't keep experiencing flare ups like that - so hopefully that will be the case for you too 🙂

[SteveLondon in reply to twinkly29]

Thanks Twinks, see my reply above to Poobah , its interesting you mention recover mentally, something I did not contemplate. I am breathing far better, feel like I have real support now so physically far better shape, my experience has left me feeling little fragile mentally with couple of flash backs and few unexplained teary moments.

I remember thinking in hospital, wow that was close, if this was just asthma I have no chance if covid gets hold of me? I was scared and over-thinking how my youngest of 3 daughters aged 12 would cope etc etc. I am so glad signed off this week from work as mentally don't feel anyway ready mentally ready to resume work as a Health & Safety manager in a stress environment at present. This as you rightly point out, this simply isnt just a case of breathing better as you were, there are a few mental fragility bumps and bruises that need to heal too.

👍

[ccccc in reply to SteveLondon]

Hi Steve

Asthma attacks are an assault on the mind as well as the body so you need to take your time with this as it has been a big shock. You are understandably feeling confused as to what happened and what to do next, both with work and your treatment.

Your GP should've been notified if you've been in hospital and you should be having asthma reviews at least once a year usually with the practice nurse. Also give the Asthma UK nurses a ring 0300 222 5800 Mon-Fri as they have loads of good advice about dealing with the GP/hospital etc. If you're not getting the treatment you need off your GP it may be time to switch.

Regarding work, it can take weeks to recover from an asthma attack so don't be afraid of taking time off, asthma usually fits the criteria of a disability under the Equality Act 2010 as it has a substantive long-term impact on your daily life, so your employer should be making reasonable adjustments to help keep you well including considering working from home during Covid. It might be worth speaking to the Equality Human Rights Commission as there's a section about this on their website

equalityhumanrights.com/en/...

Unfortunately Covid is exposing a lot of the cracks in our health and employment practices so you need to do what is right for you and your health rather than just be fobbed off with telephone appointments and employers who often don't know the right rules themselves, so get all the advice you can and hope you feel better soon.

[B_Asthma]

I know the feeling and I am in a similar situation. I feel let down by my asthma nurse, GP, and chest clinic. Tomorrow, I have an urgent appointment with the Chest Clinic and my expections for anything helpful is low. My plan is to be brutally honest and try to get something done for me.

In regards to shiedling, shielding occurred from March - 31 July. Instead, those who shielded are now being either to work from home or if not able to work at home then they should go on the furlough scheme. Your GP will be able to guide you about working, based on current guidance.