Uncontrolled Asthma, repeated asthma attacks every day. Do I have bronchiectasis?

[Beach2021]

I am 52, slim, fit, healthy and quite fit with a balanced healthy diet no milk but plenty of bio yoghurt. I supplement with vit c, vit D and probiotics daily. I have had asthma since 4yo, productive chesty cough for twenty five years, chest infections two to six times a year swiftly cleared by Amoxicillin. Pneumonia in 2006.

Until Feb 2020 I had no real problems, but last spring my cough became more violent and uncontrolled. First course of Doxycline cleared my chest infection but not my chesty cough that was causing damage to my chest and shoulder muscles. Three more courses of prednisolone still did not affect cough. Eventually in April whilst feeling rotten was prescribed clarythromycine and Amoxicillin that cleared that infection and my cough gradually vanished completely (for the first time in 24 years!).

My asthma returned last September and was more wheezy and limiting than when I was a child. Soon an uncontrollable, dryish, tickly and productive cough appeared that has been with me when I get up every morning since December and reappears during the day. My phlegm was often thin long brownish and hard, just like a broken 2inch rubber band. Three courses of prednisolone (30mg for 7 days) have helped a little despite dreadful side effects, and I felt fine for a week after a course of clarythromycine on its own recently.

But the cough has returned and I am having bad asthma attacks two or three times each day and now during the night. My phlegm is mainly white but a few times each day I cough up a huge thick lump of dark yellow phlegm. I am awaiting results of this and may give a more recent sample.

I am awaiting results of a chest Xray and am on prednisolone again. My chest is very tight and am unable to take a full deep breath : peak flow is down from 450 best to 370ish. I have been on 4xFostair daily for 9 months replacing fifteen years of Seretide, it is completely useless, but Dr will not let me try another preventer. Ventolin used to be helpful but I need at least three puffs to have any effect and often need more than six with spacer to control my many attacks. Unfortunately I am so susceptible to coughing that small inhalations of an inhaler result in coughing fits that exacerbate my asthma. I try natural remedies when possible, ginger and honey are excellent for calming my cough, and although black seed and turmeric paste helped last spring, they really are having little effect now.

We have lived next to a large wood for twenty years and often have to clean black mould from our bedroom walls and condensation from windows in autumn and winter.

NHS have no natural suggestions but my wife has met people that recommend N-Acetyl Cysteine and quercetin, I have no experience of these.

Apologies for long rant but I am unable to work, swim or even walk our old dog at the moment and everyday is getting worse.

Any suggestions please?

[Hidden]

It does sound as though your asthma is not under control at the moment and just maybe you have developed bronchiectasis ( which is quite common with lifelong asthma, due to repeated infections). You may even have a reaction to aspergilla, a fungus found in mould, wet leaves and as a consultant said to me, any windowsill, anywhere.It is very difficult at the moment but you really do need to see your asthma consultant as a first instance. If they think that you may have developed bronchiectasis it can only be diagnosed by ct scan and interpreted by a bronchiectasis specialist.

GPs, hard as they try, are not trained in the complexities of these conditions and so you will have to be very pro active in finding the right treatment.

[Beach2021 in reply to Hidden]

Thanks very much Littlepom. You have confirmed exactly what I thought. Despite telling various doctors and nurses this story they continue the arbitrary " try" steroids and antibiotics route which may help for a week or three.Things seem to be moving now, but it is up to me to be far more insistent to see a consultant soon.

I am glad I have spoke to someone with experience.

Take care.

[Hidden in reply to Beach2021]

I am sorry that I can't do more than encourage you to put your foot down hard in your own interests. We are here for you. Do let us know how you go on.

[Beach2021 in reply to Hidden]

No worries and thanks for talking to me. I am going to call surgery now to chase up results and make sure they realise I am off work again!

[Bronchi1]

Littlepom has it in one ! I would write the same and add: I know pred is great as an anti inflammatory but I ersonally take the minimum amount cos it suppresses immunity. I developed bronchiectasis after years of asthma. Lots of mucus and infections is typical. Amoxicillin stopped working for me . You need samples of mucus tested so you are taking the correct antibiotic. I have rescue abs at home and before I start them I submit a sample. GP then phones me to tell me if I'm on correct ab or if I need to change depending in what the culture is sensitive to. If it is bronch you would be prescribed other medication too. Good luck.

[Beach2021 in reply to Bronchi1]

Thanks Bronchi1, that makes perfect sense to me. Dr has asked to see me face to face today so will push for CT scan and give another coloured sputum sample. As for medicine, I really dislike taking any so always ramp down the course ASAP to reduce long term effects of steroids and antibiotics. Another reason why I eat bio yogurt and probiotics daily.Hopefully I shall have moved forward later today.

[Beach2021 in reply to Beach2021]

I have just returned from seeing the fourth different Dr in my practice, but he was very interested and proactive. He selected an appropriate antibiotic from my vast history as well as another antibiotic prescription in case that does not work. Still to take Fostair in case it is doing a little something! Not to bother with steroids if they are not working. He (they) will refer me to a respiratory consultant when my xray results return. He did suspect minor/start of bronchiectasis and was surprised that with my history I had not been referred before.

Pretty much what you folks have told me .....

So let's hope to see a significant improvement soon and a long wait to see the specialist.

I called the local consultant's secretary this morning to be informed that there is one that "dabbles" in bronchiectasis! How reassuring.

Thanks again.

[Bronchi1 in reply to Beach2021]

That's more like the response you need !

[Beth1949]

I agree with the comments, you need a CT scan to determine if you have bronchiectasis. Bronchiectasis is like copd but with the weakening of the major air ways. So it is much harder to cough up mucus. The weakened airways form pockets and mucus collects and infection sets in. Your body also produces a lot more mucus which adds to the problem.

Bronchiectasis can be caused by childhood illnesses (whooping cough, measles, etc. or events in your life). Lots of time the doctor will miss diagnose it as asthma, copd or allergies.

In reading your message, mold is a big no no. You need to have it cleaned out and keep it out.

You should see a specialist and if the meds that are given you are not working, have him/her try others. Try alternatives, such as certain vitamins or minerals. I always take Turmeric w/pepper everyday for it's anti-inflammatory properties. I use a nebulizer and have a percussion vest that helps loosen the mucus and open the airways.

Stress is also an issue, I was able to have my bronchiectasis w/asthma more under control when I retired from a stressful job.

Even little things can make a difference. I bought new bed pillows, soon after, I started coughing really bad thru the night. The pillows were filled with goose down. I went out and bought hypo-allergnic pillows and the coughing stopped.

Take care, Beth

[Beach2021 in reply to Beth1949]

Thanks Beth, yes I agree with you.

I have been having my own turmeric /golden paste for a few months but have been advised to greatly increase the frequency of it. I also have been sprinkling black seed (nigella sativa) on my evening meal - this coincided with my cough completely disappearing last summer, but it returned again this winter! I welcome natural treatments, however whilst persisting with them, they have not helped much lately.

Unfortunately I do get unnecessarily stressed over little things.

I need to make more of an effort to move the mucus without coughing, maybe with huffing.

We have replaced our hypoallergenic pillows again recently and try hard to keep the bedroom clean. I may have to get advice on eradicating the mould....

Thanks again for your advice.

[frazwag]

just want to throw an idea in the ring . i take it you had allergy tests ? apart from the fact i also have copd with overlapping asthma it took three years to get me under control but in that time it was me that found my biggest asthma button believe it of not my major trigger was eggs and even sugar . eggs being the worst it is the proteins in the white . i used to eat them all the time but if i had one every day my spirometer readings would gradually go down over a couple of weeks into the danger zone requiring me to take pred steroids to pull me back. i now control my asthma simply by watching my food i also have the usual trigger like dust mites and grass. but what i am say is don't rule anything out could something simple in your diet just a thought. i even changed my milk to lactose free.

[Beach2021 in reply to frazwag]

Thanks for that frazwag. I have never been offered allergy tests.

Interesting that you mention lactose : I was lactose intolerant for many years, drinking lactofree milk and avoiding most milk, cheese, yogurt and cream for over ten years. After the probiotics "cured" my intolerance a couple of years ago I have gone back to normal dairy and eat a lot of bio yogurt.

I shall have to try a week dairy free and monitor the effect.

Cheers

[Ergendl in reply to frazwag]

Yes, my previous husband Bob had severe asthma and COPD. He developed allergies and intolerances to eggs, bleached wheat flour and products, and cows milk. We identified it using exclusion diets after his health dramatically improved while on holiday in Rhodes in the 1980 where, at that time, the milk was usually from sheep or goats and the flour was a lovely golden colour.

[Mrbojangles]

Morning Beachy,Have you asked for a referral to a chest specialist?

If not and depending where you live i can highly recommend the Royal Brompton in Chelsea.

Amazing, dedicated team who eat, sleep and breathe all things thoracic.

I too was frustrated with my local GP’s( they are too general and max 10 minute consultations is woefully inadequate).

Once the Brompton got hold of me i felt “cared for” for the first time.

They organise everything from blood tests, lung function tests etc and the follow up is amazing.

Hope life improves for you and you get the help you deserve.

[Beach2021 in reply to Mrbojangles]

Thanks Mrbojangles,

I have been assured that I will be referred. I am sure the specialist in Devon will be excellent, if not I will consider Chelsea.

My surgery are very good, 20 mins with patient and interested doctors and nurses, although they are not local and I was dozing off in the waiting room after an hour. They always call me when I request and take some action. The last surgery was awful, lucky if the disinterested doctor listened at all then sent me away within two minutes.

[Beach2021]

Update. Four days into a week's course of co-amoxiclav (so far) and coughing less, but still producing dark thick phlegm and feeling tired and short of breath.Dr advised to complete the course, see how next week is and start Clarithromycin if necessary.

Results of chest xray are lots of mucus in lungs "similar to patients with bronchiectasis", to have another xray in six weeks. To be referred to chest clinic ASAP. Give frequent sputum sample for analysis.

Asthma nurse and doctors will monitor me and my progress.

So things are moving forward and I am ever closer to a solid diagnosis.

Thanks for your experience and advice.