4 courses of steroids for chest infection

[Manforallseasons]

hi all ,

I’m new to this forum so not sure how to present my problem but here goes.

I’m 73 year old male with asthma and like many of you I suffer during winter months with chest infections.

I’ve taken 4 courses of steroids since beginning of December

In total this is 680 mg.

My doctor has prescribed another 2 week course as I felt breathless and wheezy again.

I’m concerned that this is too much to take considering what I’ve already taken.

Has anyone else taken so many steroids?

Thanks.

[Homely2 Administrator]

I had similar last year. I had three or four short pred courses in quick succession.

I was then given a short notice consultants appointment. He put me on a four week pred course, to sort the issue out. The four weeks included weaning.

So I would be asking if you need to see a consultant to advise re the pred, your long term meds, and to check there is nothing else going on, also with these continuous courses do you need a weaning to come off them.

Ring the asthma UK helpline on 0300 2225800 to go through all this with one of the nurses, office hours

[Manforallseasons in reply to Homely2]

Thanks for reply, it helps to know someone else has taken several courses too.

I’m in Ireland but I think I can ring the Irish asthma society.

I hadn’t thought of that before.

Thanks again for advice keep well.

[Patk1]

It's been a bad winter for viral infections and lingering coughs, even in people without lung disease.has Yr gp actually seen u and listened to chest before giving steroids? X

[Manforallseasons in reply to Patk1]

Hi ,

I’ve had 4 courses already as I mentioned.

All prescribed by GP s ( sometimes I had to be seen by stand in doc )

The 5th course was actually prescribed by my consultant over the phone.

I was concerned as I had taken so many steroids over a 6 week period 136 steroids x 5mg. So I made another appointment with GP before I started the 5th course.

I asked her opinion about taking so many . She listened to my chest and said I have no choice but to take them.

So I’ve started the fifth course 7 days with 4 tablets then 7 days with 2 tablets.

GP said hopefully the new inhaler I’ve started 2 weeks ago should have kicked in by the time I finish this course.

Inhaler is flixotide 250 mg two puffs twice daily so fingers crossed.

Thanks for your message, keep well.

[Patk1 in reply to Manforallseasons]

Hope they help u andsettle it down x

[Manforallseasons in reply to Patk1]

Thanks

[d2read]

What are your peak flow readings and how often do your record them?

You should definitely speak to a specialist, especially if you haven't been technically diagnosed with asthma. If you have been, you should have been seen by a specialist-physician (pulmonologist) or nurse-practitioner to help you identify all the triggers in your home, daily life, and how to eliminate them. They should also help you develop an Asthma Action Plan that spells out what you should do at different points before a problem develops into asthma or a respiratory infection.

Doctors who hand out minimal doses of steroids to patients who have never received proper instruction in managing their asthma, in my opinion, are themselves dangers to public health. Steroids can be very effective, but they also can be dangerous, especially over the long-term and at high doses. But it sounds as if you have been prescribed doses that have been too low and/or for too short a time to effectively treat your problem.

The repeat infections/asthma are warning signs -- pay attention to them.

Remember that you must be your own advocate for the health care you need.

Good luck.

[Manforallseasons in reply to d2read]

Thanks for advice , I agree with you.

I had been dealing with my local GP who can only do so much. He referred me to hospital assessment unit here in Kilkenny Ireland.

To be honest they were so busy they hadn’t time to do proper assessment just send me home with steroids.

So I decided To go private to see respiratory consultant.

She put me on new stronger preventer inhaler and will bring me back for pulmonary tests in a few weeks.

So hopefully this might get to the bottom of this.

With me my chest infections and asthma flare up during winter months I’m grand during the summer.

Thanks for reply and concern.

[Africanleopard Verified User]

Hi Manforallseasons

Sorry to hear this. The advice for doctors in the UK is that if anyone needs two or more courses of oral corticosteroids for asthma attacks, they should be referred to see an asthma / respiratory specialist.

This recommendation was made in the report (2014) of the UK National Review of Asthma Deaths (NRAD). It has also been known for over 30 years that an asthma attack is a risk factor for future attacks and therefore in addition to the treatment of an attack ( ie the corticosteroid tablets) an urgent assessment by a doctor or asthma trained nurse is needed. The purpose of this assessment is to determine whether there are any modifiable risk factors that are causing or predisposing you to these attacks - and to deal with or ‘fix’ these to prevent the next attack. These factors include : not taking a preventer inhaled corticosteroid inhaler, taking too much short acting preventer (ie more than 3 blue inhalers a year, or not using the inhaler correctly or even that the diagnosis may not be correct - there are other factors. Some of these can be fixed by your doctor or asthma trained nurse however 4 courses of corticosteroid tablets indicates that you are at high risk and need an urgent assessment by an expert.

When you see your doctor/asthma nurse- suggest they refer to the NRAD and the UK 2019 asthma guideline where it’s clear that you need to see a specialist urgently.

Finally, of course do speak to the helpline nurse as well.

[Manforallseasons in reply to Africanleopard]

thanks for good advice.

My reply to d2read gives an outline of my treatment to date.

But I take your point I need to speak up for myself during my next appointment with consultant.

All the best for you and keep well.

[Tugun]

Do you know the cause of the asthma? Was it a virus that may then have caused a secondary bacterial infection in the lungs?

[Manforallseasons in reply to Tugun]

With me my asthma normally kicks in during winter months following a chest infection.

On this occasion when I went to doc he didn’t think it was a bacterial infection so no antibiotics. A week later I had to go back and he said it was definitely a bacterial infection and prescribed antibiotics but I think during that week the infection had gone deep into my lungs and Im struggling since.

4 courses antibiotics and now 5 th course steroids

Over a 6 week period.

I’m hoping the new preventative inhaler will kick in soon.

Thanks keep well yourself.

[Tugun]

I feel for you. I had tapered down the prednisolone to nothing and the original antibiotics had run out but I was feeling much better. Two days later the chest began getting worse again. I suspected a bacterial infection. I had both antibiotics and prednisolone with me and decided to try just one. To see if it was bacterial I decided on the antibiotics. Gradually the chest improved - until the antibiotics ran out again. I would use both prednisolone and antibiotics for a better result but I wanted to know if a bacterial infection was a culprit. Luckily my specialist agreed (Saw him today) and has given me a different antibiotic as well as the prednisolone.

[Manforallseasons in reply to Tugun]

Sounds very like my problem.

I hope this course of antibiotics and prednisolone sorts it for you.

[Tugun in reply to Manforallseasons]

Thank you.

[Manforallseasons in reply to Tugun]

Hi all,

Just an update on where I am now.

I was with consultant 3 weeks ago.

She had put me on 250 mg Flixotide 2 puffs twice a day. Still no improvement.Wheezing and short of breath.

So I had an appointment with her yesterday. She changed my inhaler from Flixotide to Seretide 250 mg. Two puffs twice daily.

I started yesterday and feel a little better already. Fingers crossed. I update progress in a couple of weeks.

[Tugun in reply to Manforallseasons]

Glad to hear that it's helping.

The new antibiotics caused extreme cramping in the stomach. After two days, I rang the doctor and he said to stop the course. I did and the chest symptoms came back again and gradually got worse. I saw him again a few days ago and he said to try again but only take them every second day.

The first day I took one and waited for the cramping again - none - and so far none on the second day. Not sure why but I'll see how I go.