Had a really bad night and was on the nebuliser 4 times with 2 x 5mg so quite a lot (probably a record for me) and not much better at the end of it. Then took prednisone in the morning which has helped my breathing but my chest is rattely and my husband worried... partly because the last time I had a chest infection I ignored it and ended up in hospital with double pneumonia in Feb 2019. But apart from the rattling (and a bit of a temperature) I don't want to rock up to A&E and be fine on a Saturday night with all the really sick people. On the other hand I don't want to have another night like that. I think although my breathing now is not as bad as it has been in the past (no blue lips or not being able to talk or anything) I probably need antibiotics. Could these wait till Monday when I can see an asthma nurse or GP maybe? or should I just phone 111? I am not usually so indecisive but I am tired. I should add that my asthma has been very good for a long time until around Christmas.
Chest infection and Asthma .. should ... - Asthma Community ...
Chest infection and Asthma .. should I call 111
Oh, I really feel for you on this! But yes, definitely call 111 - that's what they're there for, and an out-of-hours gp appointment will probably be better than going into A&E (having just had experience of both in the past 48 hours 😂)
Thanks for your reply. An out of hours GP sounds good. I have spent a lot of time recently in hospitals with my Mum who fell and broke her shoulder and arm and has dementia so I am just so hospitaled out atm! Were you in with asthma in the last 48 hours? Hope you are feeling better.
Aw, that sounds like you've been having such a miserable time - and I'm sure the stress of your Mum's health can't be good for your asthma either. I hope your Mum's injuries are getting better and that it hasn't impacted too much on her dementia.
Yes, first A&E visit for a while... fun times!! Thanks for the good wishes - and I hope you're feeling better soon too 🤗
Fun times indeed.. I am guessing not!? I have not been into A&E since Feb 2019 for myself and it is nice to feel that there is hope and my asthma has improved so much since being on the Fasenra injection. I had really started to think I could even put the nebuliser on eBay! So it is disappointing to be back at the beginning again (for now). I always thought my asthma was simply a physical thing and not a stress induced illness but how do you prove that/work it out? When you are stressed adrenalin kicks in and later when you seem relaxed it could still be underlying stress... who knows? I do think though this is a chest infection that probably can't be caused by stress. Mum is much better although, as you said, it certainly did impact her dementia. It has been a long journey already as she was diagnosed in 2016 so it feels like we have lost her in stages already but we are calm, kind and well read and deal with it mostly well. Thanks
I hope you had a better night.Sending lots of good wishes to you and your family as you continue navigating your way through your Mum's illness 🤗I don't find stress is a trigger for my asthma but I do find that when I'm having a flare-up they feed off each other. Yesterday, my resting pulse was 144 at the dr's and he asked if I was anxious, to which my reply was, "Well yes, I'm anxious because I can't get my breath properly!" 🤨
Yes ...not breathing would make you somewhat anxious! 😜 Yes I think that nails it... stress may not cause it but it sure as hell does not help when you are in it. Like most long serving, severe asthmatics I imagine.. I have had some close calls and consider myself lucky to still be here and swing from thinking this to being oddly complacent because you do have to just get on with your life.
Hi Porthos
As a doctor, in my view you should go directly to A&E and when ther ask to see a doctor or nurse with asthma expertise/ training:
I) Your asthma is clearly out of control and there are signals that this may be a life threatening attack - failure to respond to high doses of nebulises salbutamol; significant drop in PEF, and waking at night due to asthma
II) I assume you are using the nebuliser without oxygen. If I’m correct, this is extremely dangerous - because when you use a nebuliser without oxygen, your bills oxygen levels ( sats/ABGs) drop down to dangerously low levels - because of what’s called ‘ventilation/perfusion inequality’ - in plain English, that means that tge blood and the air in your lungs are not in the same place- so the oxygen you breathe from the air doesn’t get into your blood stream and so your vital organs( heart, brain and kidneys) don’t get enough oxygen and this is potentially life threatening. The bottom line is that home men’s should not be used unless you have specific advice from an asthma specialist- the difference between home men’s and hospital nebs is tgat hospitals use oxygen to drive the nebuliser ( which is in fact the small plastic container that you put the salbutamol into).
Iii) so in my view you should phone 999 tell them that your asthma is out of control, that you have been using very high doses of salbutamol, tell the call taker that your PEF was 70% of best, and explain how your breathing has been affected and at A&E insist on seeing a doctor/ nurse who is trained in asthma care. You could also add that according to the U.K. Sign guidelines, you have an asthma attack that needs specialist attention ( as detailed in I) above.
sorry for the typo’s .. should read blood oxygen… and home nebs..!
Hi. I think you meant this for me and not Porthos. I wtote the original post. Thank you for taking the time to send such a thorough reply. I am at the hospital now and the Dr is very thorough and knowledgeable about Asthma - so lucky. I did leave it far too long to phone 111. Lesson learnt. Overall my asthma is well controlled so it is unusual for me to be in this situation and need to go to Hospital luckily. Thanks again.
So pleased you're getting seen and supported! And Africanleopard was absolutely spot on - just the wrong person they were addressing!
sorry!
apologies. Just glad you’re in a safe place.
I would definitely not wait till Monday - call today and get something sorted. And of course, go to A&E if you need to. I used to use 111/out of hours when I really needed A&E so I didn't feel like/couldn't be told off by my consultant for going to A&E directly. But I was told off a few times for not just going to A&E and to be honest they were right.
I do get the urge to avoid it especially on a Saturday night, but your chest will probably get worse at night so it's best to be on top of it as much as you can.
Thank you for this. Really appreciate it. I have only had good experiences of 111 for other people so I am not sure why I am holding back. I think I just need a bit of sleep first and then it will seem clearer. Why would your consultant tell you off for going to A&E. I used to go a lot in my 20s and 30s and it was a little hospital very near to my house. Often couldnt talk and the nurse would say - your usual table at the window? Then having a nebuliser and prednisolone at home made it much easier.
I get what you mean re sleep but obviously do be careful - it's not your first time I know, but it's very tempting to want to stay home I find and not deal with it all, when you should be getting help. I have to be really strict with myself sometimes, especially after bad past experiences.
My asthma is atypical so I tend to present without wheeze, low sats etc - but can still be having a severe attack. Added to that, the paperwork is very confusing and will make it look like my post treatment state is how I turned up! The consultants I've seen are most of the time at best unhelpful and at worst actively (insert word of your choice that I can't use on here). I have had one who was lovely and supportive but the rest second-guessed all my and the A&E drs' decisions and told me I shouldn't have gone because I look fine now, 3 weeks later, or because my peak flow wasn't low enough for their liking (I can have a bad ABG at 60% best (edit: best peak flow)), or because they know better than me etc etc
I also have a neb at home which definitely helps with not wrestling with 'but you have no wheeze', if a neb will fix it. Obviously I'm careful with it and get help if it isn't working or is wearing off.
I hear what you are saying, thank you, and I will phone them. OMG 60% sounds nearly dead!!! What a shame you have had such s..t consultants. I think I have been quite lucky... only two in my life... one for ten years! But they were both excellent, clever and sympathetic. I guess it is the luck of draw.. there are some shining stars in the NHS and some dazzlingly sh...te ones I have experienced lately with my Mothers care and you have to know your onions.. and/or have someone there with you to fight your corner. 3 weeks later.. most people will be fine by then! I have an old peak flow which is currently not a great reading and a new one that shows an excellent one.. how is that possible? Have they changed the make? I feel much calmer now and breathing seems better but underlying rattle not so good so will take your advice and call 111 if things go awry tonight. I tend to be better generally in the day and always have been but in the early hours struggle... I think that is quite common. Thank you for your thoughts and experiences.
60% best peak flow - sorry for confusion - not 60% O2 sats! But my ABGs were pretty rubbish even though from peak flow I looked not too bad. I had an asthma consultant who was obsessed with peak flow and would go on at me every time I went to hospital about what it was, and that I shouldn't be getting any care if it was over 50% best (good job I didn't listen to him - for anyone else reading this, even asthma specialists can give terrible advice).
I'm glad to hear your consultants have been good. But sorry to hear about your mum and her care - I saw in another reply she has dementia which must be very stressful, especially with less than ideal care sometimes. I had to fight my corner for my parents with cancer and it was hard - so a lot of sympathy there.
I know what you mean about the early hours - the witching hours I call it sometimes! Often I can guess pretty accurately what time it is if I wake up with asthma (though I don't always wake up properly, which is annoying as it means I can't sort it with inhaler etc). I hope you have a better night and get some sleep.
Re the peak flow meter - are they different brands? Or is one of them digital? I always get much better readings on digital meters and have a higher personal best on them! But as I'm sure you know, don't wait for it to drop if you feel worse (sorry for telling you the obvious but I find I can still need reminders even though I know).
Oh I see. It does sound like your asthma specialist has his head up his bum! Yes it has been hard with Mum at times but she is now in a home, which I really did not want, but it is a good one and she is happy and sociable. She does seem to have spent a lot of time in hospital in the last year though. We saw awful homes (before the good one).. I would come out and just cry. Generally it seems old people are not respected in our country even though these places make a fortune. I can only imagine how impossibly hard it must have been to support both your parents through cancer. Yes it is odd but a good way of describing it.. the witching hours. I have not tried a Digital peak flow metre. .. oh I have as part of the study in Oxford for the biologic injections... very interesting.. they take you to the brink breathing into tubes and it is all on screens but someone else did that for me for 5 years so putting a little back was a good feeling.
Oh and thanks for the reminder and yes I will go if I feel worse again.
Ha yes I say he has incurable craniorectal problems 😂 so does my current one sadly but then current one used to work under Dr Peak Flow.
I'm glad your mum has a good home now - that sounds like a very stressful process trying to find one! It was hard with my parents yes - I didn't have to do that with both at the same time.
Hope you're managing some sleep!
Incurable craniorectal problems - love it and will steal it! I did sleep on and off but finally phoned 111 after struggling. They sent me to A&E. Triage nurse couldnt have been less interested and said it’s up to you if you want to wait 5 hrs or you could just go home. The Dr was good though. Took bloods. Listened to my chest and said oh dear. Then nebuliser but with an added med I have not had not heard of before - Ipratropium bromide. That really helped my breathing and quickly. Antibiotics next. Thank you for taking the time to reply and encouraging me not to be a f…nny for too long!
Ahh I thought they might do that! Sorry about the triage nurse, that's really not on, they should know more about asthma! But glad the Dr was good and you got to see them (hope not too long a wait). Ipratropium (Atrovent) is amazing in nebs isn't it! Are you home now or admitted? Hope you got some sleep either way.
Thanks Lysistrata! Quite speedy. I didn't even get to finish my book. Dr was everything she should have been. I am home now and fell asleep in the car. I don't think you sleep well when you can't breath.. obv 🙄 so catching up. I was AMAZED at the difference the Ipratropium (Atrovent) made. I wasn't quite swinging from the ceiling but much less flat on the floor. Thanks again. 😀 You have all been GREAT and it was so good to feel supported and know that there are others like me. It is something you learn to live with but it does have quite a profound effect on life at times and can mean my judgement is out of whack (clearly). I still have that Catholic guilt and Dr's being up there with the Priest a bit... from childhood - that says.. don't be a bother and waste the nice mans time!
Once I rang 111 and they organised a paramedic to visit me, which is what I wanted, as I needed a nebuliser. The paramedic said he was just going from asthmatic to asthmatic.
In january they organised an ambulance and a and e for me, which again was the correct decision.
I find them useful because it helps to have somebody logically working out what I need.
Going from asthmatic to asthmatic is a scary thought. Yes logic isn’t in my thinking right now but my husband is sensible so he is saying food, shower, pack a bag, get some sleep and if its the same tonight we will phone 111 or just go. Thanks for your reply - really helpful.
How are you today and what did you decide to do yesterday?
At the hospital after phoning 111. Chest infection. Feeling bit better already after steroid in nebuliser but do feel like I have had the stuffing knocked out of me. Breathing shallow rather than an attack. Won’t be going on any brisk long walks for a while. I imagine when the antibiotics kick in I will feel improved further. Thank you 😀
Great to hear you are in the right place now. All the best for your recovery 🙂
Thank you 😀
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