Why is my breathing suddenly so bad?

[Daxigal]

I have had asthma for years but although I admit I generally haven't taken my preventer regularly I have felt very comfortable. Suddenly my symptoms have become severe. No cough, just tight and unable to breathe easily. When it first started it was terrifying as my chest, diaphragm and ribs felt exhausted from struggling for every breath. I had it like that sitting up all night every night for ten days. It then eased some where It now feels like my lungs capacity is much less, when I exhale I feel and hear a congested type of wheeze which is uncomfortable, I'm constantly aware of every breath and am breathing more frequently to try and compensate. It's hard to sleep comfortably as I wake up congested and constantly trying to force myself to cough and clear my throat even though I don't have the urge to cough. My covid test was negative (which I'm not surprised by as I literally don't leave the house and garden).

My doctor prescribed prednisolone (30mg per day) which helped a BIT (may be made it improve by 25%).

I went to A&E they did ECG, listened to my chest (said was clear), took 4 vials of bloods, chest x-ray (clear and normal), oxygen monitor finger test (perfect levels), peak flow (three times and all 500+), my bloods normal except for showing an infection. I was prescribed amoxicillin for 10 days.

It helped a bit. But my symptoms are still extremely uncomfortable and to be honest distressing. I finished the course and two days after that rang my doctor again. I was prescribed 7 days of Doxycycline and more prednisolone (this time 40mg per day) and said that if these don't work it will definitely be asthma that needs reviewing. I'm three days in but no better yet.

I'm thoroughly fed up and confused as to why this is happening.

My inhalers are flutiform (2 sprays twice per day which I have been taking during all of this time - I even tried doubling, tripling and quadrupling the dose to no avail) and ventolin (as needed - sometimes 8-12 sprays per day) which of course does help but not like it helped me feel normal prior to all of this.

Any suggestions or anyone had similar experiences? I feel very alone and distressed by it all. Sorry this was long. Please don't scare me with horror stories.

[twinkly29]

Unfortunately steroid inhalers need to be taken all the time even when well because they can take 8 weeks or so to kick in properly each time they're stopped and restarted. Apologies if I've misunderstood though. But, if you restarted when you became unwell they probably haven't been doing much yet. Of course it may have happened anyway but, had the inhaled steroids already been on board, maybe the first lot of pred would have done the job? Obviously I'm just guessing and, as I said, apologies if I misunderstood!

I hope things start to pick up for you now though - it's miserable when it drags on!

[Idreamedadream]

Hi thereI’m sorry you have been having a lot of problems....you are not alone.

I got diagnosed with asthma 2yrs ago and had been using clenil preventer am/pm and ventolin.

I suppose looking back the ventolin didn’t seem to be working as well as normal as my asthma became worse and I jst put it down to the masks we have to wear during this awful pandemic.

4 wks ago my chest was becoming heavy altho I felt well in myself and carried on working but about 1 week later I woke up suddenly with sharp pain in my right side of my chest and feeling like I couldnt breathe and weighted down and tightness, wheezy cough too.

I was taken into hosp and given all checks all seemed ok and I was discharged with the conclusion it’s my asthma not under control.

Since then I have been suffering with the worst viral infection ever(not COVID..had 3 negative results) and awful asthma.

Doc changed my inhaler to fostair and subsequently stopped my ventolin(seemed to make it worse)...

Had antibiotics and steroids but cos viral not helped.

I am now on montelukast and taking co codamol, throat spray and am really hoping it does the trick...I’m off work with this and jst wanna feel normal and get on with life.

[Daxigal in reply to Idreamedadream]

How awful for you. I really hope you get well soon. Thank you for your reply. It's comforting to know I'm not alone in all this. The situation with the pandemic makes things so much harder as it almost feels like there isn't much help available as no drs etc really want to see anyone.

[Poobah]

It can be so perplexing to have an unexplained and unexpected flare up of difficult asthma. The first aim is to get it under control but when the first plan of treatment doesn't work we can feel very vulnerable and stressed. I'm glad that the hospital has done the necessary tests though and that helps rule out other stuff.

Why did this happen? Sometimes it's a fruitless pursuit trying to work out what went wrong as asthma can be so unpredictable. Sometimes there's no answer. In an age when we know so much, or have access to a vast amount of knowledge, it can be bewildering to have very few concrete info. Asthma research continues, but there's still no cure and mainstream treatment remains steroids.

You certainly did the right thing by going back to your doctor to assert that you're still struggling. I think that it's time to go back again and ask for stronger dosed inhalers and maybe a LAMA inhaler too, to address the ongoing inflammation. Or the doctor could change your combo inhaler to Seretide as it has a different longer acting bronchodilator to Flutiform. And discuss using Ventolin as a maintenance treatment while the flare up continues - is it better to take 4 x 2 doses throughout the day rather than in an ad hoc fashion? Is your Ventolin strong enough? Definitely get this nailed down in order to get the maximum benefit.

Given that your inhalers were good while your asthma was under control, it makes sense to up the anté while you're in the middle of a flare up. While it takes a while for the oral steroids to work it's important to get ongoing relief from bronchodilator inhalers (both long & short acting).

If you get to day 5 and there's no improvement, definitely speak to your doctor.

Wishing you all the best and I hope you start to feel better very soon.

[Daxigal in reply to Poobah]

Thank you so much. It's been over three weeks now. It came out of the blue. I haven't felt ill or unwell. Just my breathing awful. I used to get some dreadful chest infections as a kid thanks to asthma etc but i'v never ever had anything as awful as this. I will definitely get in touch with my GP again and see about some of the things you suggested. I'm terrified of what will happen when the course of steroids runs out as they are the only things that give me any decent relief. They don't clear it 100% but I take them before bed which allows me to sleep as if I take in the morning they have worn off by night time.

[Alw75]

I had a similar problem some years ago after a chest infection. I kept going doctors and they said my asthma was fine, but (but was this initially) after around 3 months of this a doctor I saw (who was a locum) ask me to tell him everything from the beginning. I had been through a fair bit, chest xray that showed up shadow, so then CT scan, (showed damage to my lungs from smoking, I know not good, but shadow did disappear) this was all drawn out. After I told him, he said I was suffering from anxiety as a result of it all and having continuous panic attack. He told me how to breath to try to control it. Once I knew the problem and controlled my breathing, it took a whole but gradually I was able to control it and the attacks went from constant to a few times a day, then a few times a week etc. When I'm stressed it does flare up again, but I can control it much better now. It does feel exactly like my asthma though, just my inhalers don't help, that's the only way I know.

[Alw75]

Just as another thought, once you get through this awful time, and you will. Please take your preventer as you should, it is really important. A couple of years back mine ran out (it has a counter and that's the only way you know its empty as still feels full unlike ventalin) I didn't notice the counter was on 0, must only have been a few days tops though, my asthma got gradually so bad from the Thursday that by the Monday I had to have a course of prednisone, still didn't know why, on the Wednesday I realised what had happened. Even with the prednicalone it didn't properly improve until I was taking my preventer again, missing out on my preventer caused in total around 2 weeks of struggling. So it is vital even if you feel fine, like I did before this happened.