I’m getting a bit breathless on Fostair MART

[Celie1]

I’ve been on Fostair MART for nearly 2 months and gradually my cough has got less and my breathlessness went away. Yesterday and today I e felt a bit breathless and I took an extra puff on my inhaler, but it hasn’t really helped. Should I take the maximum 8 puffs again (I did this for two weeks when I started with Fostair and then reduced to 2puffs twice a day). I feel that I have some thickish mucous that’s blocking my breathing. My peak flow doesn’t ever change much so I wondered if anyone could give me some advice please.

[Poobah]

There are good physio vids on YouTube on how to clear mucus from the chest. Best to get on top of that. If you clear your chest before taking your Fostair it will be more beneficial.

You should have received an asthma plan when you started the MART regime. This would set out when to increase your Fostair and by how much. If you didn't get a written plan then you could increase your Fostair to the max, but in the meantime make a telephone appointment with your asthma nurse to discuss this and next steps.

Here is a link to one of the physio vids: m.youtube.com/watch?v=bXJkZ...(Not working as expected?)

[Celie1 in reply to Poobah]

Hi Poobah, hope you are doing ok.Thank you for the reply and video link. 😀 I have tried the breathing and ‘huffing’ before but not regularly. I’ll try to do it twice a day and see if it makes a difference.

Strangely I’ve actually been ok with my breathing (I always have a cough) since I posted. I took a puff of ventolin which helped to clear the mucous which the Fostair didn’t - is this usual?

I didn’t get a written asthma plan, maybe because I am temporary patient at the surgery, (having said that I’ve never had a written plan from the asthma nurse at my own surgery either. I had something printed out from asthma uk once but it wasn’t particular to me). I’ve used them when it has been urgent and I’ve needed antibiotics and prednisolone twice, but feel uncomfortable at using them for more general purposes if you know what I mean. 😏

[Poobah in reply to Celie1]

I'm good, TY. If I have an obstinate plug of mucus I find the huffing exercise very good at shifting it. But for general wheeziness I will use Ventolin and that works a treat. I was on MART, using Symbicort, for 6 months - no Ventolin. But it just didn't matter how much Symbicort I took, my asthma just declined over that period. My asthma nurse put me on Fostair and allowed me to take Ventolin, mainly as I have a history of poor response to steroids and long acting bronchodilators.

I have non-eosinophilic asthma and so some meds don't work as well as for other asthma types.

I've had asthma forever but I'm still learning about it. I've found that trial and error is the only way to find which meds are best for the patient.

It's always good to keep your asthma nurse informed of any decline and how you're addressing it. So if you increase your Fostair and take extra Ventolin, just let them know how you're getting on and agree when you need to ask for help with additional meds. You may need some steroid tablets to see you clear this rough patch and also to increase your Fostair for a good period of time.

NB keep a record of Ventolin use as it can be a good indicator of decline in asthma control. If you normally take 3 puffs a week but then are taking it a couple of times a day then you know you need extra Fostair or other meds.

Take care, stay safe.

[Celie1 in reply to Poobah]

Thanks for your detailed reply and sharing your knowledge 😊. What is non eosinophilic ?

[Poobah in reply to Celie1]

Eosinophils are a type of white blood cell and high numbers are an indication of allergy, infection or inflammation (white blood cells are part of the immune system). Small amount of research shows about 50% to 60% of patients with severe or difficult asthma have higher than normal eosinophils present. This can be diagnosed through blood and sputum tests. Sputum can show alot of what's happening to lung cells as we get rid of dead cells by coughing up phlegm/mucus.

An absence of eosinophils just indicates the opposite to eosinophilic asthma.

Research to understand asthma sub types is ongoing and there's much to learn. I do know that non-eosinophilic asthma doesn't respond well to steroids, for whatever reason.

If you see a hospital consultant then it's more likely that tests are run to identify the patient's asthma type or sub type. It can help them choose more targeted treatments, especially if the asthma is severe or difficult.

[Celie1 in reply to Poobah]

That’s fascinating. You never hear about these things in ‘normal life’!