Severe allergic asthma constant flare ups

[okkjh]

Hi guys I just did my a levels and in September I went on a trip to Switzerland and when I came back I had this terrible cough. I was prescribed antibiotics and pred. Later that day I had an asthma attack and was admitted to a and e. I spent 24 hrs in resus as I was extremely short of breath and was kept in hospital for 5 days. After 2 weeks of rest I returned to skl and by the end of the day my cough was back. I went to the gp the next day who took 1 listen to my Chest and immediately gave me a nebuliser at the gp then sent me to a and e. After another 4 day stay in hospital I had another asthma attack in November but was fine after 1 nebuliser and sent home. In December I went to my gp again with the cough and chest tightness and yet again he sent me to a and e and I was kept under observation for 48 hours. Since September I have attended a and e 10 times with asthma attacks treated with prednisolne and salbutamol and ibuprofen nebulisers. I have been switched form clenil 100 to fostair, but that caused tachycardia and tremors. Then to flutiform 125. Then to flutiform 250 which caused muscle cramps, headaches and tremors. To relvar elipta and now onto trimbow. I tried montelukast which caused severe insomnia. And spiriva gave me blood in my mucus and jitteriness. I have had nearly 15 courses of pred since September and am just fed up. This cough is still ongoing and I hv a flare up just about every 2 weeks. My gp just gives me pred now as he says I don't know what to do as I am running out of options. My peak flows are at best 450 and are usually around 380 or 360 on the daily. My spirometry is normal. I have high igg Aspergillus but my consultant says I don't meet the criteria for ABPA. I also hv high ige of over 1200. I get chest tightness at times even as I'm writing this now but it's not excessive. I always feel I am breathing really fast and am genuinely exhausted. This has causes me to miss 3 of my a level exams as well as I had an asthma attack just b4 I entered the exam hall and had to get wheelchaired out the scho and straight to A and E yet again. Even the consultant has said he's run out of options of what to do and has referred me to guys for consideration of biological agents for my severe asthma. I still have difficulty sleeping as the cough is always disrupting my sleep. I have many allergies especially grade 3 to grass and a grade 6 allergy to house dust mite. I also have chronic headaches but I am allergic to all the medication and nsaids such as ibuprofen so he says there is nothing he can do. Thank you for making it to the end ans plz share any experience or advice I would be eternally grateful as I hv no options now..

[Shirazmataz]

Hi Okkjh, what a terrible time you have had. Before your trip in September to go skiing did you have asthma or did it just come on? If your doctors are foxed, then it is hard to make any suggestions, but docs tend to use medicine rather than any other practical help. It is making me wonder whether cold temperature has set this off. I have had asthma for many years, a physio friend noticed when i drank cold drinks my lungs clamped up and started coughing.I wonder if swallowing anything cold sets you off too. Then there are the issues of keeping your home dust free etc. Are you living at home. Do you have asthma in your family? I think also your bedding needs to be non allergenic, did you get that sorted out? Any pets at home? Have you been tested for pet allergies? Do you live in the countryside or town, what are your asthma triggers, car fumes, smoke etc in towns, pollen etc in countryside. Since i moved from London my asthma improved considerably.

Those are just top of the head ideas, and i hope others here might also be able to make some suggestions. I can imagine at this stage in your life and especially when your studies are so important for your future, you desperately need to get on top of this. At the mo you need to be near an A&E. You will get a lot of support from people here - it is a very helpful friendly group, with all good wishes to you -Sally

[okkjh in reply to Shirazmataz]

Hi thank you for your reply. I've had asthma since I was 3 and it was really bad in my childhood. Then for the first few years of high school it was non existent. When I was 14 I started having 2 to 3 flare ups a year requiring steroids and now I have this issue and I'm turning 18 in 2 weeks. When I went to Switzerland the weather was so good. It was a physics trip to see a particle collider, the weather was so sunny. I Don't think cold weather started this whole cycle as I mentioned it was sunny but my asthma always flares up with the weather changes. The same thing happens to me with cols drinks I start wheezing and coughing. I have non allergic bedding and no pets. Asthma runs in my family but no one has it as severely as me thankfully. I live in London so you can imagine the pollution and fumes. I've had allergy testing done and am slightly allergic to dogs but this doesn't affect me as I am terrified of them. Thank you for your advice and kind words.

[Beshmeta]

Hi there

I’m so sorry to hear what you’ve been going through. Have you tried calling the Asthma Uk helpline? The advisors may be able to offer some suggestions. As you are highly allergic, can you can ask for a referral to an allergy clinic or specialist?

[Biker88]

Hi if your IgG is high, then as well as ABPA there is SAFS, you can always ask for a referral to the National Aspergillosis Centre (NAC) in Manchester or the Royal Brompton in London. Both offer tertiary aspergillosis consultations and treatments. If you haven’t seen it yet the NAC website is Aspergillosis.org with lots of very good info. Bialogics for asthma are also very good with ABPA so if you get the bialogics your asthma/ ABPA will be better controlled. The prime difference with asthma and ABPA is the treatment, normal asthma treatments won’t be effective so with ABPA an anti fungal is used.

[okkjh in reply to Biker88]

Thank you I will have a look at SAFS, as I'm currently on trimbow and my doctors said I'm on the maximum therapy and it's still not helping.

[Alberta56]

I'm sorry I can't offer any new suggestions, but it seems to me that a referral to one of the top hospitals is in order.

[Gwalltarian]

I don’t think I saw antihistamines mentioned. It would be worth getting some prescribed.

Try and avoid all asthma triggers - including unusual ones hidden in food such as yeast, yeast extract, marmite, wine, alcohol maybe - lots of inhalers contain ethanol, if you react to alcohol, that could be why you are sensitive to so many inhalers.

[okkjh in reply to Gwalltarian]

Thank tou for your reply, I take fexofenadine twice a day which helps with my normal hay fever symptoms liek runny nose and itchy eyes but not so much with my asthma. I do try and avoid as much as I can. I haven't heard of alcohol sensitivity before, I'm muslim so I don't drink. I will dig deeper into it tho.

[Gwalltarian in reply to okkjh]

It’s possibly linked to yeast allergy/ sensitivity. Vinegar? The thing is there’s probably something in your environment or something you consume to which you react strongly so it’s in your interest to find out what it might be and avoid it. I’ve had asthmatic reactions to a lot of inhalers and I know I am alcohol intolerant which is why I think the ethanol content might be - not necessarily- the reason for that. You mentioned something about fungi or moulds - which also cause an asthmatic reaction in me - yeast is a fungus isn’t it? You could try cutting out products with yeast in them in any form for a few weeks and see if there’s any improvement. Spices? It could be whatever preservative is being used in food or medicine. A dietician could advise on a diet introducing one type of food at a time. If you don’t have one or more already an air purifier would probably help, they are not very expensive and are cheap to run. There are different strengths of Fexofenadine. Good luck, I hope you can identify and avoid whatever triggers your asthma.

[okkjh]

I have finally received my referral letter and my appointment which is supposed to be urgent is at the end of September. I Don't know how I'm going to cope the next few months