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recognising symptoms

this may sound like a silly question but it has been suggested by my manager that I have a very high tolerance level in regards to my asthma therefore may cope longer at a level where I would be better off seeking further advice. Is there a way that I could learn to actually recognise that I need to seek further help before actually getting to the stage where may require admission. Is it just that I am not fully accepted of how I am or can I have a high tolerance level to go with my high pain threshold.

11 Replies

Hi Katherine

Do you have an asthma plan? I don't as yet but from what I understand of them (please someone correct me if I'm wrong) by monitoring your peak flows daily, you should have actions to take if they are dropping. This should help you to identify deterioration early on

Hope this helps



yes do have an asthma plan but if I actually followed it would spend most nights in a and e so tend to go on how I feel which suppose may not be good thing if have a high tollerance level.


Hi Katharine,

Some severe asthmatics can tollerate more a deterioration in symptoms as we live with symptoms on a daily basis. eg I can happily bimble along on a PF of 160 whereas that would floor the average mild female asthmatic of 30 something.

We seem to develop coping strategies more too. Though I would speak to your GP or consultant about your PF and symptoms and get to know a cut off line as to when to increase meds or to get help.

Everyone is different however and always stick to your treatment plans please!

I have an agreement with my consultant about what levels of symptoms I need to get help.

We can learn to live symptoms everyday but this doesn't mean that we should live with it - there is room for improvement most of the time and this should be sought where possible.

Hope this helps a bit




thanks Kate that does help bit perhaps if get to see asthma nurse like at next appt will discuss it with him if not will ask gp. likewise asthma nurse wanted to know b4 last admission why i didn't seek medical attention with pf of 160 told him felt ok ish and didn't want to be admitted.


I think this is a very interesting post. I do have an asthma plan, but sometimes, when | get to a certain stage of Low peak flows, I am functionally not that bad. So f'rinstance, I can reach the point to take pred. 330 for me, but not have night coughing, and I think, I might wait and see... (I get terrible side effects from pred, despite the fact that it works.)...Then I speak to consultant to make sure, and he says well wait and see. Then when I actually go to a clinic, I get really told off by a registrar for not following 'The Plan'. I think hindsight is a gift I would like.

Then it can work the other way around, I can have quite a high peak flow relatively, and know I am going to get really sick...Iike have a virus, and the doctors will say is difficult because sometimes I do get better, but other times I am ill for months. Also I am always relectant to take pred more than I have to . The 'have to times' now work out at about 4 times a year, but if I took it everytime my asthma reached the asthma plan level it would be double....

I think this is very personal for everyone, and I think that is difficult for doctors, even when you have a good relationship with them as every asthmatic is different.

I hope that you find a way that works for you. I think being able to easily contact your own asthma nurse or consultant is the best thing, either by e.mail or them returning your phone call. This is what happens for me in the USA, its meant to happen here in the UK, but it never quite works. Que Sera.

I think this is a great strand to have a discussion about. I do think that everyone has to take it in the context of 'YOU CAN DIE OF ASTHMA', which is endlessly quoted at me.

I have a feeling that I am the patient that the doctors dread coming through the does anyone else feel like that....



hi kath

Speaking as the 30 something year old mild asthmatic that kate mentioned who would be floored by a pf of 160 I thought I'd add my two penneth worth to this debate!

I find that even as a mild asthmatic that my tolerance level has gone up, and in fact i had a long lecture about 18 months ago about not taking my ventolin enough as i was used to struggling - it was only after i had a neb for a reversibility test whilst feeling what i classed as really good that i realised that it was possibloe to feel better! (unfortunately never felt that good since!).

I'm really sorry you're still struggling 18 months on. It doesn't' seem fair that some people like you and all the other brittles on here struggle so much, and I have so much respect for how you all manage whilst still smiling and supporting others.

I think though if you look at where you were about 18 months ago you have come on a long way as regards recognising symptoms and when to seek help, even if it doesn't feel like it - then you pretty much refused to go into hospital ever, and in fact had to be bullied to go, now you do recognise when you need to go in, ok so that has resulted in pretty much monthly lengthy admissions, but at least you are now getting the support you need. You still manage to be in your windband and choir, as well as go to the gym and do up your house, so certainly from the outside, it looks as if you are striking the balance of getting help when you need it whilst not living in hospital

Have you thought about updating your asthma plan if you're not sticking to it at the moment - sounds like it's out of date as to how you are at the moment. That may help? I really hope you can get a better control of your asthma soon, and that you get more help from your consultants to support this - as Kate said - you shouldn't have to live with your symptoms!

Hugs to all

Cal x



I guess i experience the same problem judging by the fact that when i saw my consulant last week and showed him a peak flow chart with numerous peak flow values under 200, and after having minimal effect by the salbutamol, and then listening to him giving me a long lecture about how i should have shought medical treatment when my peak flow was that low (i guess its pretty low for me at least). He even threatened with pred, but i honestly do not think i need that, as my asthma only (to me) gets really bad when im sick, and im not that sick anymore (getting over a minor cold). Anyway, what im trying to get at is that you are definitely not alone out there when it comes to realising how bad bad is, and when to seek medical help. I have moderate asthma by the way. So would my peak flow indicate whether i should seek medical help? like, if it is under 200? or if it is under 200 and the salbutamol has minimal effect?


well after my latest splat have decided that one of my symptoms before I actually go splat is I go very tired but now the question is if and its a big if you know when you are likely to go splat what can you actually do about it?


I have never really been given a proper action plan until now just spent almost 3 weeks in heartlands and came out with posh new laminated card to fit in handbag with all medical conditions and allergies and meds on and also tells medics what meds to give me when having a splatt also a 3 stage action plan and how to up meds in each stage according to pf but to call asthma nurse at costa if need to go in at anytime but living 2 hours away think i would have to go local and be transfered if to bad

kath its def worth asking for action plan review due to your recent splats


first of all im sooooooo pleased they are sorting you out tas,its great that things are getting sorted.

i find it hard to believe that all the doctors and consultants you've seen,

that they haven't given helped you to recognise your symptoms,

dont your asthma nurse help?

dont you use your gp?

i find my gp and the nurses in my doc's surgery are fantastic,

i think you should be asking your doc these questions and try and sort something out .

hope you get sorted

mel xxxxxxxxxxxxxxxxxxxxxx



What to do when you think you are about to splat:

Slow down! Take some time off work and follow your asthma plan. I'm finding the earlier I get on pred the less bad my splats are. I make sure I stay inside and look after myself. Do lots of steamy showers, baths and bowls (with a towel over my head). I take my bricanyl whenever I think I need it and sometimes every four hours just to be on the safe side (as I often feel not too bad sat down resting but feel awful walking round). I try and do the breathing exercises the physio showed me which seem to help to slow my breathing down. I also make sure I'm as relaxed as possible. Get really comfy on the sofa (usually sat up as I can breathe better) and let myself dose off if I need to, read, watch tv and try not to go too barmy. I know its really hard to slow down but to keep the splat less bad its worth it in the end.

When my asthma first went a bit mad it took me a good six months to get better from my first hospital admission and even after that when I splatted I wasn't careful enough so it was taking me a month or two to get better. Now I'm pouncing on it as soon as I can and being more cautious and going with my gut feelings I'm managing things a lot better. The chest clinic and my GP all wanted to me to be cautious rather than waiting until I couldn't cope any longer and it seems to pay off most of the time.


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