Really Struggling with Fostair

[mypoorlungs]

Hi everyone, I was diagnosed with asthma last spring after contracting Covid. It started relatively mild, I was prescribed a Ventolin blue reliever and a brown, steroid inhaler (Soprobec) which I took every day with a spacer. My symptoms seemed very manageable and I only had a minor flare up when I had a cold. All of this has since changed dramatically for me this spring/summer. Around May - June I noticed I was starting to get very short of breath after simple exercises or walking. I was also waking up a lot more at night, needing my Ventolin. Also started coughing a lot more too. Dr put me on a week long course of Prednisolone and upped my steroid inhaler from 2 puffs twice a day, to four. I also started taking Fexofenadine antihistamine and a nasal spray every day. I figured it was probably bad hay fever affecting my asthma and it would calm down again. At the end of July I had a very traumatising asthma attack and was taken to A&E. Usual peak flow of 350 was barely at 100. Had a nebuliser and a lots of tests. Everything came back clear, including my chest X-ray, indicating no infection. The dr prescribed me more Prednisolone and advised me that my asthma is not under control and that I need to try different inhalers to manage it. Spoke to my asthma nurse at my GP practice who told me I was overdue an asthma review(I had no idea!) and has now started me on 2 puffs of Fostair twice a day.

My question is: how long did it take you to get your asthma under control? At the moment, I feel terrible. I'm still recovering from the asthma attack I suppose. I've only been on Fostair for a week, and I haven't noticed any difference. I'm still feeling very short of breath and struggling to sleep. I know it takes a while for any new medication to work but I am really struggling. I feel so exhausted. I can barely turn the shower on without getting out of breath. My heart pounds and my hands shake after the Fostair. I'm very headachy too. My chest feels tight whenever I lay down and my back is very sore and tight. I assume it's the muscles? So far all I've noticed are the side affects from the Fostair. I just feel really low at the moment. I'd gone from being in a relatively good place with the asthma to feeling completely lost. I'm signed off work for 2 weeks and I really hope I start to feel better soon. I'm 34 and I feel about 100

*Just want to add, I'm negative for Covid, as I'm tested regularly, including when I was in hospital, and I'm also fully vaccinated.

[twinkly29]

Steroid inhalers like Fostair take about 8 weeks to kick in properly. Initially there can be side effects (like palpitations and shakiness) from the LABA (long-acting bronchodilator) in it but these should subside over the time the inhaler becomes fully effective. It can also take time to recover (physically and mentally) from an acute exacerbation.

Have you finished the oral steroids? Being on these can add to feeling not great (even though they help in other ways) and also affect sleep - and then them finishing can also make you feel rubbish. So all things considered it's not surprising you are feeling pretty naff. It should improve over the next few weeks but do contact your asthma nurse or GP if you're struggling in the meantime. And I hope things improve for you soon!

[mypoorlungs in reply to twinkly29]

Thank you! I am actually feeling a lot better today. I had a really good sleep last night (thank god!) so I feel a world of difference just from that. I know it can take a while for my body to adjust to Fostair...I'm being very inpatient! Not shaking so much today so that's a start. Baby steps. I'm still on the Pred. Got a few days to go on those. I know they can cause insomnia so I always take them early in the morning.

[twinkly29 in reply to mypoorlungs]

That's good to hear! Yes post hospital sleep is important! Even if things are a bit up and down, seeing light at the end of the tunnel helps. I don't think the being impatient ever goes though.....or maybe I just don't learn ha ha! Glad things are improving though 😃

[mypoorlungs in reply to twinkly29]

Thank you! Yeah feeling better mentally today as well. Was very down yesterday but hopefully things are on the up

[PeakyBlinder50]

Sorry to hear your story. I too developed Asthma later in life 4 years ago. I've been on Fostair for 4 years I changed from 100/6 2 puffs twice a day to 200/6 one puff twice a day I also take Qvar and Montelukast. You really need a skin prick test to determine if it's allergic I had this so they determined mine wasn't allergic I had this done privately. Then I had a blood test to determine my type of asthma non allergic eosinophilic. Fostair is a really good inhaler you need to give it time at least 8 - 12 weeks to settle things down. If after 8 weeks you are still breathless you may need another inhaler aswell. It's really important to get the asthma under control and stop OCS it's important for your lung health. Swapping to 200/6 Fostair my tremors stopped this is something you could ask. My heart racing stopped too.

[mypoorlungs in reply to PeakyBlinder50]

Thanks for your reply. Yes I've been thinking about getting allergy tested. I do suffer really badly with hay fever and I have an intolerance to lactose too. I'm actually feeling a little better. Shakes have calmed down quite a bit and I'm feeling less tight-chested. Early days still! Need to give my body time

[twinkly29 in reply to mypoorlungs]

That's great that things have improved a bit even though, as you say, it's early days - and excellent the side effects are already reducing. They certainly do reduce or disappear eventually for most people - some people don't get past a week or so before deciding such inhalers don't work or cause side effects which is a bit 🤦‍♀️ really because all meds of this type do similar because of how they work and, as you're experiencing, do usually settle. So wahoo to progress already!

Allergy testing wise, not sure if it will be helpful but it might be worth asking your GP about it. Normally it would be done (if it's going to be done) by the hospital it one needed to be referred there (for asthma that's not controlled at GP level, which most asthma can be). However, even some consultants seem to say no to getting it done. It can be done privately but not all companies are reliable 8n terms of results so I was wondering if the GP might know of places they consider to be reputable that you could access, such as which companies are good, if that makes sense. They may not know or may not be allowed to advise though.

[Dogruff]

I think give asthma U.K. a call to talk through your treatment. Are you still on oral pred as it sounds like you possibly should be? Took a long time to settle after my hospital visit which sounds rather like your presentation…. On brown inhalers then upgraded to fostair and a month of pred. It took a good few weeks to be able to do basic things again as not breathing properly is incredibly tiring.

[mypoorlungs in reply to Dogruff]

Yes I'm on my second week of oral Pred. Asthma attacks really do take it out of you don't they? My back and shoulders are still really sore and tight I am feeling a little better...I think. The Pred seems to give me a couple of hours of hyperactive energy and then I crash again lol A bit tight chested again today, maybe because of the damn humidity here.

[CharlieLondon]

Just a thought if you find fostair isn't enough you could ask for Relvar high dose. I got put on this after several short courses of prednisolone and fostair. This worked for me.

[Birch_]

I hope you feel better soon. I’m interested about your symptom progression especially in regards to covid; I got “weird really bad flu” at the very start of the pandemic before testing was available and started getting asthma symptoms about 6 weeks later which were mild at first and these days I can hardly walk up the stairs. I’ve just had my fostair doubled but I think I need to ask for a 200/6 instead. I’ve tried looking up asthma and long covid but with no luck. I don’t suppose it changes anything but I’m interested to know if they could be related.

[mypoorlungs in reply to Birch_]

Thank you! I'm feeling a lot better (knock on wood!) Still a bit shaky after the Fostair but on the whole, I seem to be getting better. I think the Prednisolone really affected my mood. I'm (hopefully) in a better place than when I first wrote that post. I think I just needed to vent a little

With regards to Covid, I started off with a cough and didn't think anything of it. This was at the end of April 2020, before the app and the guidance was a little different then. I initially thought the main symptom was a fever, so I didn't think much of it. I then developed a really sore throat which is always a red flag for me, so I called 111 and was told to get tested and isolate etc. Test came back positive and over the next couple of weeks I started to feel like death. Really bad flu symptoms - the most intense body aches, migraines, nausea and then the breathing problems started. Felt very tired all of the time, could barely stand up and take a shower. Had a particularly rough night and ended up in A&E needing a nebuliser. This was at about the 9-week point. There happened to be a lung specialist doctor there that night who saw me in A&E and he diagnosed me with asthma and told me it's pretty common for someone to develop asthma after a bad virus or flu. I do have a history of lung problems in my family so it's not a total surprise...but still. Never experienced any breathing problems whatsoever prior to Covid.... I did wonder if maybe there was a little bit of lung damage?

I think the Covid related asthma is probably a symptom of long Covid and perhaps even a post viral syndrome. I'm guessing here as there's so little help and information out there. When I was initially signed off work (for 12 weeks!!) my doctor said I had post viral fatigue syndrome, and that the breathlessness should get better over time. I think you have to really give your body time to recover. I had a "minor" infection with Covid but the after affects are huge. The inhalers have helped me a lot, and it's only been recently that I had a nasty flare up. I think that was mostly caused by allergies and hay fever. I don't know...it's a bit of a guessing game! I suppose the only good thing with asthma is that there is a lot of help and and medication available in comparison to long Covid which seems like a total shot in the dark at the moment.

Apologies for the essay! I can rant on and on about Covid for ever!

😀

[twinkly29 in reply to mypoorlungs]

Ha ha! Go for it ranting, talking, etc! It's unlikely to be actual lung damage I think. Most post covid breathing symptoms (at the time as well as ongoing after that, and also true long covid several weeks or months later) is likely to be breathing pattern disorder/dysfunctional breathing. However absolutely some people do develop asthma after viruses which it does sound like in your case because the meds have helped. Those who get given asthma meds (acute relief and the likes of Fostair for maintenance) and it doesn't help and then the meds keep getting escalated and it's still not helping are likely to have a huge element of BPD, if not solely that. Breathing exercises are good for that and for asthma anyway. But given how the meds have and are helping it does sound asthma like to me.

But so glad things have improved and yes ugh to pred affecting mood. It likes to do that! Also post exacerbation can do it too and you had the double onslaught as that was a big thing so well done for getting through it!