Regular seasonal flare-ups

[Tiggertheterrier]

Hello anybody with asthma + bronchiectasis combo!Every year from end of August into December/ January I have a flare of chest tightness, coughing, sinus pain, post nasal drip and fatigue. This has been going on since 2009! Was diagnosed with Bronch after a CT scan in April 2021. Can't get my consultant to take these flare ups seriously, he just waves it away! Current lung treatments; Relvar 184/22, Incruse, Ventolin as needed, Qvar 100mg x1 at bedtime, Montelukast at bedtime, Fexofenadine 180 in morning. I do saline nebs every morning after breakfast then ACB lung clearance ( amount that comes up varies!) . Walk dog at least 4 times a day, have been losing weight ( now 7st 2lbs from 8st 9lbs a year ago). Lost my father in May and my husband then died on 10th September, so been a horrid year. On Mirtazapine 15mg at night to get myself back on an even keel.

I have been waiting over a year to be seen again by my chest consultant and well over a year for Pulmonary Rehab. GP is chasing both secretaries!

Consultant has checked for immune disease, general IGe( not specific!) . he says Bronch was mild and at base of lobes on CT.

GP has just this week put me on steroids 6 x 5mg daily for 5 days. I am then to be tried on Carbocysteine after I complete the steroids.

Latest blood tests were all "fine". Peak flow on the steroids is climbing steadily, but I know it will drop again once I finish.

Is there anything else I can try? All tips welcome. There was some muttering about sending me to the specialist asthma clinic at Wythenshaw Hospital in Manchester - anybody here any experience of that? Thank you for ploughing thru my essay😉

[Alberta56]

Sorry you're having such a rough time. You seem to be doing all the things we broncs are recommended to do. Could you ask for a referral to a dietician to help with the weight problem? I have been infection free since I was put on Carbocisteine, so that sounds a good idea. Obviously the grief caused by losing loved ones cannot have helped. I hope things ill improve from now on. xxx

[B0xermad]

Hi there what a lot going on and I can sympathise with you I have bronchiectasis asthma and copd was diagnosed in 2014 after years of infection this is definitely a pattern of winter flare ups and as the season starts post nasal drip, coughs,fatigue is something to cope with. Having rescue pack of antibiotics and prednisolone is vital to catch it early regularly taking your inhalers through a spacer, using a flutter or acapella device to help clear the mucus every day is a must ,drink plenty of water to loosen mucus is key,I see you take montelukast ,same here .I take mine at 9pm in the evening to give it time to work. There is also mucolyte as carbocysteine or nacsys which will help enormously which you said is about to be prescribed for you and will clear your lungs better,I was prescribed azithromycin by consultant for regular flare ups and take it 3 times a week most of the year after having the same issues as you. Pulmonary rehab is the best thing to get you back to a fitness level and guide to know where you are at .I did that and have carried on with the breathe easy regime and can now walk every day. The weather is very damp at the moment and it's playing havoc with bronchiectasis sufferers right now so scarves are helpful for your breathing outside without other triggers such as wind and log burners fires etc in the mix.I do hope you get all the help you need and push for whatever is necessary for you to be able to cope with your condition. Regards boxermad Julie

[Tiggertheterrier in reply to B0xermad]

Thank you for replying. Azithromycin has been mentioned before, but not actually prescribed - my consultant is a wee bit absentminded, sadly. Am looking forward to getting onto the Carbocysteine on Thursday, the day after I end the Pred course. My surgery are in a bit of disarray at the moment with staff coming and going, locums etc. Nobody is willing to give me a rescue pack, so that's something I need putting in writing by the consultant. I can ask for a Acapella from my local hospital physios I think. Will phone them tomorrow!

[B0xermad in reply to Tiggertheterrier]

Definitely a good idea for the acapella device and unfortunately the consultant see many people and sometimes don't do what's needed. I for one am quite proactive in self preservation where my bronchiectasis is concerned because I am the one living with it on a daily basis, my respiratory nurse at the hospital is a brilliant person to ask questions to at the end of a phone when in between consultant appointments so hopefully you have one at Wythenshawe hospital too

[Nmstoday in reply to B0xermad]

Hi I only have asthma but I get the same type of flare up at the same time each year. I was started on azithromycin last january and it has definitely helped - I have flared again but no where near as badly as usual so I would suggest that you could ask about it. My consultant said that it tends to either work really well or not at all so you will probably know with in a month or so if it is making a difference for you.

[B0xermad in reply to Nmstoday]

Definitely as I have been taking azithromycin for 8yrs

[Biker88]

Hi, I don’t get the flares but but it’s common with a lot of the people on the Aspergillosis groups I’m on. Their flares are seasonal due to all the different pollens and fungal spores that are about. Wythenshaw hosts the national centre for aspergillosis and I know people who go there and are very satisfied

[Tiggertheterrier in reply to Biker88]

Thanks Biker88. Am going to push to be referred there I think. This can't all be ' just a coincidence ' or ' all in your head' - both said to me by various docs recently despite the peak flow diary evidencing to the contrary. Sometimes I come out of consultations feeling like I am banging my head against a brick wall!!!

[GintyFerguson]

I have both but everyone is so different. I'm on incruse and fostair . I take zinc and vit D which I'm sure helps. I avoid the triggers which for me are cold and smoke. I also avoid under 5 kids cos the carry the bugs that get us! I've been offered steroid tablets but don't want them . I hate the side effects . Condolences on such a bad year. Grief will be pulling you down I expect . Stay well hydrated, eat immune boosting foods , rest well and don't have cut flowers in the house. Pseudomonas can grow in the water and you don't want that bug. Hand in sputum samples to your doctor to ensure you are on correct antibiotic . Reduce stress cos it suppresses immunity. It isn't uncommon to go through phases of flare ups. Good luck!

[Tiggertheterrier in reply to GintyFerguson]

thanks GintyFerguson, I am fairly good now at getting sputum samples to my surgery( they have to be there before noon, which can be a challenge sometimes! Last lot came back clear. Wish I could swap back to Fostair, preferred it to Relvar but GP won't change the Relvar " because it was prescribed to you by the Consultant and we can't change it"!!! You need the patience of a Saint sometimes!!!

[GintyFerguson in reply to Tiggertheterrier]

Write to your consultant , say why you preferred the revlar and ask to be changed back? I have written tobconsiltsnt in the past. Oh yes, patience is needed.

[Tiggertheterrier in reply to GintyFerguson]

Its worth a try! Or I will badger my GP to let me go back to Fostair.

[Lutontown]

Are you on antihystamines; do you have mould in your home? You will find Carbocysteine will help, as it thins the mucus and makes it easier to shift. I take Loratadine From February when trees put out pollen, until end of October, as fungi still issuing spores 'til then. Some people take them all year round, as cats and dust and dust mites are around most of the time.

[Tiggertheterrier in reply to Lutontown]

hi Lutontown,yes, the Fexofenadine 180mg are an antihistamine, which I take in ththe morning. There is no mould in the house and I have two air purifiers going 24/7, one in the lounge and one iin my bedroom. It all seems to be getting worse each year! Very frustrating. I live surrounded by woodland and scrubland, so no escape from mould spores at this time of year sadly.

[Patk1]

You've been thro a lot losing dad& hubby.i really feel 4 u.I've chronic rhinosinusitis too +severe E asthma,severe bronch+ loads of other stuff.

I think autumn wiinters worse for lungs with cold+ damp weather.

Yr on gd meds.if u need more steroidscontact gp b4 u finish these.carbocysteines gd - it thins mucous,making it easier to get up.id increase Yr acb to shift any build up of mucous in the evening too,to reduce infections + flareups.do u have an aerobika device? X

[Tiggertheterrier in reply to Patk1]

Hi Patk1, gosh,you have got a lot on yr plate with that combination! I did have an aerobika but it didn't work for me. Often, if I can walk the dog 'briskly' last thing at night before bed I will get some mucous up, but my walking speed is not what it once was. I do get quite a lot coughed up on his morning walk, after the Relvar. These last few days, while on the 30mg of Pred, they are relieving the airways enough to cough some bigger plugs out. I just hate the horrid 'clogged up' feeling when I first wake up, lying in bed with blocked up ears, sinuses, nose, chest, that's despite the air purifier running, hoovering every day and keeping my little dog out of my bedroom completely. All bedding is encased in dust mite proof covers too!! Have inherited my twitchy airways from my grandfather and my dad, there wasn't as many choices of medication back then for them, suppose we are lucky to have the variety, plus the new biologics! Thank you for your encouragement.

[Germantara]

Sorry to hear you're havin an awfull time asthma is just as bad as copd my daughter was 2 yrs old when she got asthma she had an attack for 8 weeks she had inhalers but couldn't get shot off it then everything got better 5 weeks had another ather attack 22 weeks it was frightening I did see children's consultant but didn't do ought great I used use plenty off steam multiple times away I close bathroom door run hot taps and I used to tell her faireys stories as she got older she only has attack with a cold just wondering steam might but I know everyone asthma is different I hope you get sorted

[Tiggertheterrier in reply to Germantara]

Hi Germantara, thanks for your reply, sorry to hear your daughter has had such a rough time. My asthma was diagnosed when I was 19,but had rhinitis as a little girl - constantly snotty nose! Steam sometimes helps me, but on occasion I can feel suffocated by it, odd, but I do keep on trying with it.

[AsthmaandLung Administrator]

Hello Tiggertheterrier

I am sorry to hear what you are going through at the moment, and that you are struggling with flare ups. I have added a link below for you that might be useful and of course you are very welcome to call our helpline on 0300 222 5800 for advice.

asthmaandlung.org.uk/condit...

asthmaandlung.org.uk/helpline

Take care

Helpline Team