Advice on asthma as I have run out of options !

[4127]

I recently visited someone with a cat for about an hour and ended up having a big asthma flare up. I went to hospital twice for nebs and one of these I required magnesium. I didn't have a big wheeze but was told they thought that was likely as I couldn't get enough air entry. 1 week later and I'm still struggling. The wheezing has subsided as long as I don't exert myself too much but I'm continuing to cough a lot on exertion and my chest feels tight. I'm struggling to sleep through the night and haven't wanted to eat much which is very unlike me but am aware can be an asthma symptoms! I'm also coughing up mucus plugs (white). I'm currently on 40mg steroids (due to the reaction) and will start weaning tomorrow, fostair 200/6, spiriva respirmat and ciclesonide. I can't take montelukast as it causes anxiety.

[twinkly29]

Do you take antihistamines? Taking them regularly might help guard against allergy triggers.

[4127 in reply to twinkly29]

I take fexofenadine 180mg minimum twice a day my allergies just seem to have gone mad and no number of antihistamines stops them and I'm not sure why !

[twinkly29 in reply to 4127]

It's tricky because if it's a particular trigger then asthma can otherwise be well controlled but no matter how good something usually is, it's not a guarantee that particular meds will protect against everything. So then the answer is often to avoid the triggers. Some it's more difficult to of course but some people do genuinely have to avoid cats (or other animals) which is rubbish or not ideal but if the reaction is as you experienced if you don't then that's quite significant.

One option might be to try adding in piriton (chlorphenamine) the day you're visiting somewhere with a cat to give extra protection - but you should check with your GP before doing so in case that wouldn't be sensible for you as you're already on a high antihistamine dose.

I assume you're under a consultant for your asthma? If so it might be worth specifically asking about allergies in light of things being less controlled. If you're not under a consultant you definitely need your GP to refer you.

[4127 in reply to twinkly29]

Hi! Thank you so much for your help. Usually I am okay if only around a cat for 1 hour but not anymore, in hindsight I shouldn't have seen them at all. My allergies have been in overdrive and seem to be having bad allergic reactions even when I can't find a cause which is unusual! I'm quite allergic to dust/feathers which can be hard to avoid at times unless I want to avoid sitting on any sofas etc 😂 I am under a resp consultant but we haven't done much in terms of my allergies so may be worth seeing if there's anything that can be tried there?

[twinkly29 in reply to 4127]

How much help it will be I don't know as it seems to be a particular and avoidable trigger - so it's not an everyday all the time issue which indicates your current meds are probably right for your day to day asthma control - but that you need to avoid a particular trigger, ie cats.

On the other hand they might be able to suggest something so worth asking.

[4127 in reply to twinkly29]

Unfortunately my asthma isn't great day to day and I take salbutamol most days. However only taking salbutamol once or twice a day is a big improvement from where I have been! The cat allergy just set it off to using 10 puffs 4 hrly instead of only using the salbutamol twice a day

[twinkly29 in reply to 4127]

Oh sorry, I misread your reply above! I read the "I'm normally ok" as generally speaking instead of meaning around a cat for that time - sorry! Definitely worth a discussion with the consultant then if allergies seem to have worsened.

[runcyclexcski]

My most recent allergic asthma exacerbation took 2 weeks to start feeling a bit better, with all the usual meds. Exertion-induced SOB took the longest to feel a difference. Hang in there! I would never go to house with a dog. If I must go, I put on a respirator. It looks "impolite"/extreme, but it's better than AE.

[hilary39]

Just wanted to say I totally empathize. If I were around a cat for an hour at this point (as opposed to when I was younger and my allergies weren't as bad), I'd be in the same exact situation as you. How long were you on 40 mg of steroids? Do you think you're ready to taper? Do you have super strong antihistamines? When this happens to me sometimes it can take weeks for the inflammation to fully go down which can be really frustruating.