Hi,Has anyone had infrequent (twice in 2 years in my partners case) severe asthma attack where the inhaler does not work?
What causes it? What do you do? How do you manage it? Paramedics put it down to anxiety attack as she was fine by the time they turned up. Is there a chance of it happening again?
If your partner is fine by the time the paramedics turn up, could this be because the inhalers did work, albeit slowly.
My inhaler for attacks is salamol, while my inhaler for every day is fostair.
It can easily take me 10 doses of salamol to stop a severe asthma attack, and be an hour or two before I can walk again. So for a while I think they are not working, so persist.
Some people find salamol does not work for them and prefer ventolin.
In terms of how to help stop severe attacks in future
1. Make sure your partner discusses this attack with their gp or asthma nurse and has a review of their medicines. Go with your partner so you understand it. Pre the appointment, ring the asthma UK helpline to discuss, so your partner knows what they are talking about, especially re the anxiety suggestion.
Once the medics have checked it out and altered the medicines if necessary, practical advice is:
1. Back off early when something is causing your partner asthma difficulties, do not persist. All my hospital excursions have been caused by not backing off. So prevent the attack.
2. Look up some basic breathing exercises for asthma to do daily, it helps mentally when you are having an attack to have something familiar to concentrate on, and it helps the asthma. It also helps with anxiety.
3. Never go anywhere without spacer and asthma drugs, so your partner can treat the attack early before it goes out of control. Hit attacks early.
4. Have the biggest spacer you can for attacks at home, when your ability to breathe has nearly gone, I find a larger spacer to take the salamol through very helpful.
5. Most importantly understand how to follow your partners asthma plan, it will tell you what to do in an emergency, eg when to ring an ambulance. Have a copy on your PHONE and the plan on the fridge.
My wife has saved me a number of times when I do not follow my own advice.
I am now off to clear the shed out with a phone, an inhaler and a spacer, and a chair to sit on.
Wow, thank you for your amazing response. Wish you the best in the whole wide world.
Hi it is always possible to have an attack when the rescue inhaler isn’t working properly or slowly … that’s medical emergency… it can’t be anxiety if it relieves with inhaler and usual symptoms like wheeze, tightness, cough etc are accompanied… I would suggest speak to asthma uk and make sure the preventer is helping to control the asthma and get your asthma reviewed …. If inflammation is high it can make rescue inhaler stop working in attacks … If it keeps happening then it needs to be prevented but asthma attacks can happen out of blue even when it’s controlled … wish you best of luck
Hi! And yes, it happens occasionally. I use the paramedics and go to the ER. They get me fixed up and I’m released to go home. It can b brought on by emotional issues, or maybe no reason at all. The more you gasp, the worse it gets. Scary. The hospital will give you a shot that eases your breathing, also perhaps a Colonzapam to relax you. Try not to worry. Happens to asthmatics occasionally. Good luck!
You have my sympathy. I suffered a similar misery when I was younger. I'd suggest you ask your doctor if it is ok in such situations to have additional doses of whatever medication you take. I found my inhaler provided at least a tiny amount of relief and the relief did not last so long, so extra doses helped somewhat (with no side-effects whatsoever in my case) - but you should check with your doctor first. Also ask at what stage should you call an amulance, etc.
I learned deep breathing exercises, keeping still, and keeping calm (REFUSE to panic, just mentally shake your head, say "no," to fear by keeping your mind on calm thoughts) helped me endure. All physical action needs more oxygen. Strong emotion (fear, anger, even laughing, and even a heavy meal, and even wanting emotional sympathy) all need more oxygen so you need mature discipline to remain strong.
Makes sense to let your body get as much oxygen as possible and consume as little oxygen as possible, right? Search the internet for simple meditation techniques that can help you relax (you don't necessarily need to get involved in complex religious studies for this - choose what suits your outlook on life.)
Doesn't stop the difficulty in breathing but gives you a little control. My last moderately bad attack was 15 years ago so it is possible to get past it - but don't ask me how. It's a mystery what causes these bad, ongoing attacks compared to normal slight, easily managed attacks.
Best wishes and good luck. 
Is your partner taking one dose after another without waiting 30 seconds between each puff? If he is then this could be why it seems not to work. S/he could be just inhaling the propellant. MDI inhalers need 30 seconds for the medication to 'drop down' (a medics words, not mine) between puffs.
Hi MrCABG
Few things to add to the comments from the others:
Sorry to hear your partner has been having this trouble with their asthma. Two severe attacks in a year should trigger a referral by your GP to an asthma specialist. I suggest you request an urgent referral and you could cite the recommendation that was made 10 years ago by the National Review of Asthma Deaths( NRAD) the report is online ( search RCP NRAD to find it - RCP= Royal College of Physicians).
You say the inhaler doesn’t work. While salbutamol ( salamol, ventolin- they are the same) only contains a reliever drug - this helps to relax the muscles around the air passage walls. The problem is that an asthma attack involves two processes- the underlying inflammation- which causes swelling of the air passages, collection of mucus/ phlegm AND spasm/tightening of tge muscles around the air passages. The salbutamol only treats the spasm. So during an attack , that drug alone cannot stop the inflammation and that may be the reason it seems to ‘fail’. Corticosteroids are needed to treat all three processes causing the airflow obstruction.
Fostair has a licence to be used for so called MART therapy ( Maintenance and reliever therapy) - this is a 2 in one inhaler with inhaled corticosteroid plus a quick acting, long acting reliever ( Formoterol). Formoterol works as quickly as salbutamol to relieve spasm of the muscles in the air passages ( and works for 12 hours). The idea of MART is that you take the Fostair regularly and also use it for relief of symptoms instead of the blue inhaler ( ie salbutamol, ventolin, salamol which are all the same drug just with different names). If during an attack, this doesn’t help or you have used 6 extra doses then medical assistance ( or A&E) should be sought.
By using Fostair in an attack ( instead of salbutamol) there is the possibility that the attack may be stopped in its tracks.
The specialist, after assessing your partner would advise on the best medication for you. In the meanwhile I agree that you should ring the asthma helpline for advice while waiting for the specialist appointment.
Hope this is useful.
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