Asthma Appointment

[Lilmix03]

So I went to see the nurse at my practice today because my asthma has flared up and although my chest is clear she's told me to finish my course of steroids because my peak flow is low (270 usually 450) and I'm tight chested and a little breathless and she's changed my steroid inhaler from Flutiform to Fostair. The worrying thing for me was that she told me I'm taking steroids too often and that I could develop diabetes and is refusing to prescribe me another rescue pack. I have noticed that I'm going to the toilet at night a lot more and I've been a lot more tired recently but I don't know if this is just coincidence so should I make an appointment to get a blood test.

[Bevvy]

Sorry but I would make an appointment with the gp. Is this nurse a specialist practitioner or a general nurse who has some responsibility for asthma? Steroids are nasty evil little tablets which can cause seriously side effects. Yes they can cause diabetes and nasty bone issues and so on BUT they do the job of treating inflammation. Changing your inhaler is great as a preventative medication but that can take a number of week to be fully effective. If someone presents with a low peak flow then they need some form of treatment. If that is steroids then so be it.

If you are needing steroids on a regular basis then yes it is sensible to consider if preventative is now not keeping asthma symptoms and also to consider (by your gp) whether or not you need referral to respiratory department at hospital. However to deny you steroids if they are required is totally irresponsible.

[Lilmix03 in reply to Bevvy]

This is just the nurse practitioner not the actual asthma nurse. She was reluctant to do anything in the first place because my chest is clear but I've never really gotten wheezy with my asthma flare ups. She only changed my inhaler after I brought it up but she's given me the wrong dosage because the Asthma nurse wanted me on 200/6 not 100/6 so I'm hoping they can change that. I have a appointment to the respiratory department at the hospital coming up in a few weeks so hopefully they can help with something

[Nanto4]

In the same predicament here, been diagnosed as borderline type 2 ,believed to be because of repeated use of prednisone due to many flare ups this year and a bacterial infection that lasted from March to May which had me on a high dose for 3 weeks .Now on a tablet to thin phlegm which seems to be helping but a flare up started this week and i was told stay away from the rescue pack if possible .Strangely i can sort of tell when my sugar going high as i get pins and needles in my foot and hand.

[Poobah]

Definitely see your GP. There are other add on treatments available that can help you through this stubborn flare up and you want to get the Fostair 200/6 sorted. The doctor can order blood test but I think a urine test can check for signs of pre diabetes and diabetes. You're smart to tackle this now and there is a push in the NHS to help prevent diabetes in the first place, despite needing oral steroids - if you need them, you need them. england.nhs.uk/diabetes/dia....

All the best

[RACrally in reply to Poobah]

I didn't know this. Ive just looked up whether an asthma inhaler can cause diabetes. I was expecting to find it's only tablets (which I don't have to take thankfully)

but it's inhalers too!

[Poobah in reply to RACrally]

I think it's what can happen over time and some people are more susceptible to certain side effects. If we know the risks we can make adjustments to our lifestyle to get better odds and outcomes, to some degree. I'm trying now to look after my eyes, bone & teeth health. Inhalers are wonderful but they're not without side effects. And I've been on Inhalers for over 50 years.

[Homely2 Administrator]

I think the key is to avoid seeing medics who do not get asthma, I do not wheeze my chest just stops working, which confuses some medics.

I would concentrate on working out how you can get regular access to a proper asthma nurse. I have access to a part timer who can prescribe at the gp surgery and a full timer at the hospital, between them they sort me out.

[ReedB]

I often find myself in a similar situation. Not often wheezy and seem to always present with a clear chest so I often get the look from health professionals that says are you sure you're not taking too much steroid? As others have said, if you need them then there's not much can be done. Sometimes, despite all the prevention asthma can be stubborn and if you get a bad run of viruses or pollen etc then steroids are the only thing to calm flares down. The key is knowing what works for you. Good luck

[Mary2267]

Hi lilmix03 I would go and see a doctor and ask if a blood test would help and the nurse should give u a Rescue pack so if u go ill u can Catch it Early so you don't land in hospital hope this helps u

[ForestFreda]

Hmmm 2 courses of steroids in a year should be an automatic referral to secondary care as the GP practice are not managing to keep your asthma well controlled. Steroids cause lots of problems including diabetes and osteoporosis, but I would be wanting a referral and proper work up including blood eosinophils when you are having an asthma flare. If you need steroids you need them but secondary care should be assessing and offering differnt treatments

[Patk1]

No wonder yr tired with asthma exacerbation.rest up til yr well and if u need steroids again,ring for same day appointment. Hope yr soon better x

[JezB]

hi, I would get blood test. I have exactly same symptoms but also joint and muscle pains. Blood tests showed nothing but I think it is fostair making me feel unwell so be careful.