Asthma during respiratory infections

[OldCatLady]

Hi,

I've been asthmatic since I was 2 years old and am now considerably older than that. Despite 45 years of experience I really don't have a good understanding of what to expect from asthma management.

I use a low dose Flixotide preventer inhaler every day and salbutamol when required. Day to day you wouldn't know that I have asthma, and during the summer I can get away with halving my preventer dose with no problems at all. However, in the winter I get the usual colds that fly about, and this is where my asthma really kicks in.

I have been advised to increase my preventer dose at the first sign of a cold but I still end up needing to use my blue inhaler several times a day and often in the night.

My question is, should my preventer inhaler prevent this, given that my asthma is very mild when I don't have a cold? Or is it expected that I will have to use salbutamol during a cold? I would ask the asthma nurse at my annual asthma review but it's done through an online form now that only asks about the last two weeks. When I answered the form last time to say that I didn't have an asthma action plan they just sent me a blank template 🙄.

Thanks in advance for helping my understanding.

[Homely2]

I would have a chat with a nurse on the asthma UK helpline. They are very helpful and will give you ideas of what to ask your asthma nurse for.

Personally I am on fostair 100 mart, so can have two doses a day when my asthma is good, and can increase it up to eight doses a day when my asthma is bad.

So I like to have an inhaler that you can use the mart regime on.

[OldCatLady in reply to Homely2]

Great idea, thank you, I'll give them a call

[Shirazmataz in reply to Homely2]

I feel very disconnected from any asthma care from my practice now - and i have not heard or been told what a Mart regime is, Could you explain it please Homely2! thanks

[Homely2 in reply to Shirazmataz]

Mart is just a posh name for a dosing regime.

So I had my fostair200, two times a day, two doses, so 800 of steroids in total, this was to make my lungs better longish term. While my blue inhaler, salamol was used for attacks.

I asked to switch to a mart dosing regime as the above dosing regime did not work for me, as by the afternoon my asthma was out of control and the blue inhaler was becoming ineffective through overuse

Under mart, I use fostair 100, for up to 8 doses a day, including one in the morning and one at night, and six spares, so still a max of 800. However I take the six spare as and when I have attacks, and in theory do not need the blue inhaler.

This different spread of doses means that my fostair covers the whole day much better for me, and also means when my asthma is happy, eg in August, I only take two doses of fostair a day, so 200, rather than the 800 of my old system, which is also good.

So to me it is a win win, though in practice I still need some blue inhaler but much less.

Only certain inhalers can be used under the mart regime.

[Shirazmataz in reply to Homely2]

Thankyou so much H2 for that most illuminating description, that really all makes sense. I need to get something similar agreed and am on Fostair 200 too, so will get onto the practice and try and see someone who knows about Mart regimes. 😁

[Yumz199725]

I find that when I have a cold my inhalers don't touch the surface and it definitely aggrevates my asthma which makes my cold get even worse. I agree there not very helpful with asthma advice anymore I'm lucky if I can get a face to face appointment and I noticed they don't do your peakflow or see how your asthma technique is??? It's weird right.

[Patk1]

Welcome to the forum OldCatLady.That's poor care..id request an appointment with the asthma nurse.

Most of us have flareups triggered by viruses, which need acting upon asP.ru aware there r nose and throat sprays available to help stop / reduce viral infections eg vicks first defence. Many of us also find colder temps and damp Weather of UK autumn/winter don't help either.

There's an Aluk helpline no mon- Fri if u want to talk to them

0300 222 5800 x

[Shirazmataz]

I am rather in the same boat as you and have been told the same. I dont use the ventolin regularly, only when i have a respiritory infection coming on. Can you ask to make an appointment to see your practice asthma nurse to agree your plan. It is very difficult to see any health professionals these days, but you really do need to have a face to face conversation to set you on the right treatment. Filling in a form is pretty unsatisfactory.

[SuziElley]

See if you can make an appointment for a face to face with either the asthma nurse or your GP. Otherwise go with what has been suggested and contact the helpline on Asthma UK. I would think you really need a face to face appointment though

[peege]

These online review forms are absolutely useless imo.

My last one was last February, I'd just spent almost 4 weeks in bed with a very bad infection (looking back it might have been pneumonia). I couldn't get through to gp surgery at all..........so I filled in the form in the worst case scenario mode ie couldn't sleep from incessant coughing, high temperature of 40°, wheezing & using Ventolin 20 times daily as well as more than doubling my Fostair MART. There was no reaction whatsoever 😳!

I haven't had a face 2 face review since 2019 and only two of the on line reviews My asthma was always similar to yours in that it was worse during the winter and very susceptible to any cold going which absolutely always became a bacterial chest infection. Nowadays I take vitamins to boost immunity and lucky enough to have got prescribed prophylactic Azithromycin 250mgs for Mon Tues Fri, November to April. It's really helped enormously.

Back in 2010 I started to wear a Buff (fine wool or synthetic snood) over my nose and mouth on the Tube and seasonally to keep cold air out of my lungs - that really helped too.

Do please see your respiratory nurse or gp, insist on it. It's well known that asthma can get worse in later years. Personally, I went from extremely mild to mild in my 50s then to moderate in 60s..

[Pwkav1]

Hi im on Fostaire 200 and if my chest is bad in winter i up it to double the dose. Your preventer inhaler is meant to stop you from using your blue salbutamol one and i have used my blue one much less. Which means your asthma is then more controlled. And if i get a cold and it affects my chest i just up the dose on the preventer more which works for me. Sounds like you need to speak to someone. Good luck. Karen xxx

[Maximonkey]

Hi Oldcatlady, I would stick with your preventer inhaler as prescribed and only use your reliever when your asthma flares up. If you find you are relying on your reliever inhaler then you need to see the doctor or asthma nurse as your asthma is not under control. I like you usually suffer more in the winter months when any cold, or infection will make my asthma flare up. This year has been particularly bad for me as I have had an allergic surge (I do not know what has caused this) but it has been pretty bad as I have suffered on and off since March, with infections, asthma and sinusitis. Thankfully new information in the ENT world means I can have a CT scan and they will be able to tell me whether I really have had sinusitis for the past 50 years. Looking forward to finding this out. Your name suggests that you love cats, are you allergic to them as this will make your breathing very much worse. Take care and I hope you get your inhaler needs sorted out soon. Maximonkey

[watergazer]

hi and welcome. I have asthma with bronchiectasis. The first asthma nurse I saw at my gp surgery was brilliant She gave me a detailed plan. The new nurse isn’t so good and my plan given at my review is somewhat lacking so I tend to stick to the first one I got. It gives me advice when to increase inhalers and which one according to my peak flow I do have an inhaler that can be used on the MART regime but as it will increase my steroid intake I prefer not too. X

[Ergendl]

I have COPD with asthma overlap, and avoid catching colds like I would the plague! I avoid crowded places where I can, carry a mask to use when necessary, plus hand gel. If I have to be in a close packed crowd, I use NasalGuard Cold and Flu Block beforehand and breathe through the nose while I'm there. Afterwards, I rinse my sinuses out with a saline solution from the local chemist. If a cold starts, I use Vicks' First Defence.

Hope this helps.