Scary asthma attack

[Emzcat41]

Hello

I just wanted to ask if you more experienced people have any idea what I should be offered to try next as my asthma is not controlled on fostair 3x a day and respimat.

I’m coughing lots (sometimes productive) and in the evenings my symptoms are even worse. I had a very scary attack last night that was resolved by salamol thank fully - but my husband was very close to calling 999. I can feel it building again now so I’ve used my rescue again and it’s helping.

I’m under the respiratory team and I’ll be phoning them when they open at 8 am tomorrow.

I’m allergic to montelukast sadly so that’s ruled out - I also suffer with my mental health with steroid tablets however I can tolerate short courses.

I understand we are all different but I just wanted to ask if anyone similar had tried anything else in this position - just so I can be prepared to ask tomorrow. The respiratory nurse I spoke to before Xmas mentioned me seeing a consultant if I didn’t improve- but it’s actually got worse. Not checked peak flow while having attack (who actually can lol) but in between it’s not really low. About 440 when best is 550.

I don’t have any infection symptoms or COVID symptoms- the cough is very much my asthma cough.

Just picking brains really - this community is lovely and it’s massively helped to know I’m not alone, I’ve also learnt so much on here so thank you everyone.

Hopefully any answers here might also help other readers too

Sorry for long post x

[twinkly29]

It would be worth you doing your peak flow when you're struggling - they would get you to do it in a&e anyway so it's not a "no" just because of an attack.

Why did you decline seeing a consultant? Was it an extra appointment you mean? It would be a good idea actually doing it though as they are the ones who can work out what to look at next based on your history and what you've tried.

If things aren't staying settled I think you need to seek help though as something clearly isn't right at the moment.

[Emzcat41 in reply to twinkly29]

Thanks Twinkly

I haven’t declined seeing a consultant, it’s the next step if I didn’t improve (according to respiratory nurse on phone - I’ve since got worse but they have been shut and open tomorrow)

Next time I have an attack I’ll try to do peak flow but tbh at the time I was more concerned with getting more salamol in - and that was a struggle. I don’t want to go to A and E if I can treat it successfully at home - luckily it started to help after 8 or so puffs. It was the most frightening attack so far x

[Emzcat41 in reply to Emzcat41]

Sorry just re read my original post it’s a bit misleading - my asthma has declined since she suggested I might need to see one if I didn’t improve. So it’s not the same but worse. I would never decline more help I’m terrified x

[Emzcat41 in reply to Emzcat41]

I changed wording to ‘got worse’ not ‘declined’ - duh didn’t read it through properly (me I mean) lol x

[twinkly29 in reply to Emzcat41]

No worries! It's also quite possible I misinterpreted it!

[twinkly29 in reply to Emzcat41]

Oh sorry I totally read that wrong! I read it as declined an appointment rather than you getting worse - sorry!

Doing your peak flow won't change anything in one sense but at least then you've ticked that box - and then once things have settled bit it can be redone which helps show the salamol is working. Also maybe try starting relief treatment when things are beginning to be worse - hopefully then it would start to knock it on the head before needing 8 puffs (unless of course it goes from fine to that instantly - in which case phoning 111 or 999 would probably be sensible anyway).

You're definitely doing the right thing contacting the respiratory nurse tomorrow (is this one linked to your GP?) as that should happen if you've had to use a fair few puffs to control things, plus it's not settled tonight either. If your salamol isn't lasting 4 hours though you may need to seek help sooner. It sounds like you could do with a short course of steroids while waiting to see a consultant.

[Emzcat41 in reply to twinkly29]

Thank you

I think you are right I am sure I’ll be on steroids shortly.

I have used my reliever sooner today and it is lasting so it’s helping. I’ve been trying to hold off using it but I won’t anymore x

[twinkly29 in reply to Emzcat41]

No please don't! 😅 Using it sooner might well stop it escalating. If not, well then the answer is get help. And if it does, that's great. If you find you're regularly or increasingly having to use it for early signs then that's the time to get in touch with your GP/nurse/111 depending what's open at the time. Glad it's helping today - I hope the respiratory nurse is helpful when you speak to her - when it's not bank holiday lol!

[Itswonderful in reply to Emzcat41]

Gish if you need the inhaler use it Emzcat. If you are unsure about it please call 111 for advice and next steps. It sounds to me as if you should be doing this anyway rather than trying to manage it on your own? Please don’t hesitate to call 111 for help.

[Jollygood]

Hi emzcat41. Sorry to hear you’re unwell. Is it fostair 100 or 200 you’re currently taking? If it’s the lower they may suggest it’s worth trying the 200 as it has double the steroid.x

[Emzcat41 in reply to Jollygood]

Hi

It’s 100 so I might ask about the 200 see what they say - thank you x

[Emzcat41]

Thank you

It’s the 100 I’m on I didn’t realise there was a 200 so that’s helpful to know thank you x

[Smegs1978]

I also suffer from severe asthma that has declined rapidly since the end of October, I’ve had 3 attacks in the last week that would normally have ended up in a and e, however they have recently moved on me on to fostair 100/6 on a maintenance and reliever plan.

The fostair works wonders as a reliever, normally 10 puffs of salbutamol wouldn’t be enough to control the attacks but after 1 puff of fostair I can already feel a massive improvement.

However it isn’t great as a preventer due to the extra puffs I’m still needing in the day, so will be asking if they can increase it to 200/6.

I’m also on a reducing steroid dose and managed to get down to 20mg before my asthma starting getting worse so I’m back on 30mg for the time being.

I also take spirvia and uniphyllin, montelukast didn’t work for me as the side effects were worse than the asthma attacks.

You may need some more tests to confirm what type of asthma you have, as the treatment you currently take may need changing.

As others have suggested, take your peak flow when you are having an attack, I’ve been hospitalised about 20 plus times this year and they also get me to do it when I first arrive, my normal is 510 and it’s been as low at 150 in a and e.

I normally can feel when my peak flow is dropping so I then take a puff of my reliever to stop it turning in to a bad asthma attack.

Stress and anxiety make my asthma triggers much worse, so I’ve been referred to a psychologist to get that under control in the hope in improves my asthma control.

I really hope you get sorted soon, asthma sucks especially at this time of year.

[Emzcat41 in reply to Smegs1978]

It really does suck.

I hope it goes well with the psychologist - anxiety is awful never mind when it’s paired with asthma. Mine has definitely got worse since the attacks have got worse.

I will certainly be asking if I can have tests to see what type of asthma it is. It’s certainly not controlled currently so answers would be a great help!

I stupidly didn’t phone the respiratory team today and bang on 5 when they shut I had another bad attack which took a good 30 mins to get control of - I will definitely be calling tomorrow.

Keep safe x

[Jollygood]

Oh no poor you ☹️ How are you feeling now?