When to start taking "emergency meds"?

[y_not]

Hi All, during Christmas I had an exacerbation (although I didn't know at the time that that was what it was called!) and after spending 36 hours in bed I contacted the NHS direct helpline because something clearly wasn't right (I was convinced I was on the way out!).

A couple of hours later I was being told that I shouldn't have left it so long, that people as bad as I was don't always make it back (think this was the shock tactics) etc, etc.

A few days later and part way through a course of antibiotics & steroids , as instructed (and feeling a lot better) I visited my GP. He supplied me with "emergency antibiotics & steroids" to keep at home and "use as necessary".

I know I should have asked what he meant by "as necessary" but I didn't.

My Christmas infection started on the Friday last afternoon with feeling very cold, shaking, headache and by Saturday morning I just couldn't get out of bed. On Sunday I made the call (didn't want to waste A&E time). If I'd had the meds then when should I have taken them? How do I know that it's not simply a bit of a sniffle and is going to develop into something serious?

To complicate the issue I also take another [powerful] drug once a week which, because of reactions, I HAVE to stop if I take the antibiotics, so I don't want to just start a course of antibiotics/steroids unless it's necessary.

Can anyone offer a suggestion, many thanks

[copdliving]

When you feel that bad you should take your temperature. I also have a peak flow meter that I use a few times a week to keep track of my lung health. If I am starting to get an infection I notice the peak flow readings are lower than normal for a day or two before I get sick. Normally you will feel more tired than usual a day or two before as well. The most important thing is to prevent the flare up by keeping your lungs clear. You might not always have a fever but usually your breathing worsens. When you are at the point of being bedridden you you have [probably waited too long and need to start ASAP..

[Hidden]

My husband has been told that if the two of the following symptoms get worse he should start taking the emergency medications:-

coughing more, more breathless and mucous/phlegm changing colour

It is really difficult actually to find the right time because if you do leave it a bit too late, then it can takes much longer to get better and does more damage to your lungs. My husband tends to monitor it when he is feeling worse. Last week he thought he might have to start on the antibiotics again but the following morning his symptoms had subsided. Although he was coughing more the phlegm hadn't changed colour and he was more breathless but the weather is so cold.

I think it is about learning to listen to your own body. BUT if you are in any doubt start the emergency meds. Far better than getting ill. TAD xx

PS the BLF have a helpline it might be useful to chat to them, they could have some practical advise.

[libbygood]

My doctor always says 'sooner rather than later', there have been times when I've jumped the gun and taken meds when I didn't need them, but so what if I panic and take them unnecessarily.

Lib x

[Hidden]

I know when an infection is starting as my temperature rises and I develop a cough which produces green gunge. Ugh. Each of us is slightly different I think and we each need to get to know our body's reactions. Then hit hard with the antibios when necessary. I agree with others that sooner is better than later but you also need to be careful not to take them too often - i.e. whenever you have a cold rather than an infection - as this will reduce their effectiveness. You will develop knowledge as you go along.

[Hidden]

When prescribed emergency supply for home I was provided a chart on what action to take and when. That includes when to take the anti biotics and when to start prednisolone. I understood all medical professionals supplied this when they prescribed emergency anti bios and prednisolone for patient's to keep at home. If you have lost your copy of the action plan I would say the best thing for you to do is phone your doctor and ask. As mentioned above we are all different and what your doc advises you, may not be the same for each and every patient.

The suggested action plan I was issued with indicates symptoms, action, cautions and warnings. It also includes extreme symptoms and when to contact emergency. Printed on my suggestion action plan is "COPD self management plan from GPIAG" (search that).

The link below shows very similar to the action plan I was issued except my information is all on 1 page. The document link below is a pdf, a document issued by scot.nhs.uk, scroll past the first page, view pages 1 through to 5:

lothianrespiratorymcn.scot....

Hope that is of help to you.

[Hidden in reply to Hidden]

I have never had a written plan Zoee. I will follow this up, thanks.

[Gordon57 in reply to Hidden]

If plans like that exist, and are issued in some areas, why not the whole NHS ? I've never seen that document before either.

[Hidden in reply to Gordon57]

Its something you should take up with your own GP Gordon, I think all docs are suppose to do this for patients who are prescribed for self medication at home, how else is a patient supposed to know? Do another web search for

"COPD self management plan from GPIAG"

the link I provided above was just the first one I clicked on I am sure there are others that you may want to print and take to your doctor to fill out or your doctor may have one that the surgery uses and had somehow overlooked not giving you one (I am sure some docs think if they discuss it with patient that is adequate but we know its not because we do need something on paper to refer at those times when we may be deciding what we should do, short of phoning NHS Direct).

[Gordon57 in reply to Hidden]

I'm amazed. I've not known anything about these documents yet it seems Doncaster has an extensive one, now I've searched around and found it - goo.gl/hJXUD (had to shorten URL, it had funny characters in that would not link)

I will be having words with my GP practise, the hospital and even the local PCT as things like this seem essential to anyone like myself.

It would be nice of GP's even discussed things like this wit patients, I had a brief talk from a nurse once about when to take the antibiotics, based mainly on being very SOB without any physical activity.

Just goes to show, we're always learning and picking up on each other's treatment etc. to further educate ourselves

[Hidden in reply to Gordon57]

thanks for the link

[y_not in reply to Hidden]

Zoee, many, many thanks for sharing this information.

There was (like other comments here) never any mention of an action plan!

Guess that might have been very helpful - I'm reading it as I write.

[rememdium]

What a brilliant pamphlet when I was told 6 years ago I had severe copd no one told me anything about how to cope with it fortunately I was able to use the Internet to educate myself and spent hours browsing and gleaning information .It was only 4 months ago I was given a home pack and like others no instructions only to tell practice nurse I had used them so they can be replaced I also have not used them when maybe I should have as been unsure and told they should not be used willy nilly. I found a good website amongst a few others called COPD ABOUT.COM it is written by a journalist RN nurse which I did find very helpful and combined with pamphlet I am sure it can help others as it goes more in depth on some of the advice.3 30 am wide awake after 2 hrs as usual nothing else do do might get another 2 before 9 if I am lucky.