When hospital is needed


This is all new to me. How do you know when you need to go to hospital?

I was diagnosed about 3 years ago but have been doing ok, until last week. Since Monday, I have been on 6 steroid tablets, 4 daily doses of Symbicort and have used up an entire Salbutamol inhaler. I haven't slept for almost a week, I rattle and wheeze, I cough until I think I am never going to breathe again and I really don't like this scary asthma game. I would like to play something else now, like sleeping lions.

When do you need hospital? My peak flow varies from 230 to 400 from minute to minute. Normal is 550 for me.

This its very frightening!

18 Replies

  • Hey Sleeping Diva,

    Sorry your having such a rubbish time, hopefully things will pick up soon for you. The normal thing as to when you need to go to hospital is when taking ten puffs of your blue inhaler hasn't helped. My best suggestion to you is that if your experiencing problems at night and your unsure if you need to go to hopsital or not would be to head to your local NHS walk in centre or contact your out of hours GP service. The problem is on there boards is that we can't see you so we have no idea how ill you are. I would suggest if your ever in doubt then you get yourself seen by a doctor. Hopefully you've seen someone now or are off to see your GP today.

    Sorry this is so badly written - its off my phone! Have a look around this site and get your GP to fill in an action plan for you as these are v good at telling you what to do with different symptoms, and try and find asthma uk's advice on what to do in a asthma attack. One other thing; its actually against the terms of use to post asking for emergency advice on here as you don't know when someone will respond and they don't want you sitting at the computer turning blue waiting for a response. Also everyone on here are fellow asthmatics and not health care professionals (tho there are a couple around) so you mights not get accurate advice, also you might worry other board users posting about being acutely poorly. Best of luck with everything, hope things pick up for you very very soon!


  • Hi Sleeping Diva, sorry to hear that you are having such a bad time with your asthma, from your post I am assuming that as you are on steriods you have seen your GP recently. If you are not getting better then you need to return to your GP asap.

    As far as going to hospital is concerned and may I point out that this applies to EVERYONE, you need to go when you have reached the point where you have used your reliever 10 times and are not responding or when a nebuliser (if you have one) is not working. If you get to the stage where you cannot speak properly or start to panic then dial 999. Also if you need to go to hospital, DO NOT DRIVE, DO NOT GET A BUS/TAXI an ambulance can assist you to breathe as soon as it reaches you.

    I was initially reluctant to call an ambulance when my son failed to respond to his inhaler/nebuliser and took him in the car as it was only a couple of miles. The doctors in A&E left me in no doubt about the error of my ways, as the said that is what ambulances are for !

  • Sorry I didn't mean to break any rules or seek emergency medical advice, but just wondered when I should contact the hospital. From reading through how serious so many others are here, I think I have over reacted. My reliever doesn't work at all. I have seen the asthma nurse on Monday and she asked me to return tomorrow to assess reaction to prednisolone.

    In the evening and night, coughing fits go on for about 30 seconds, stop a few seconds then do the same again. I feel a nuisance but it is scary. I feel I would be a time waster to go to hospital especially as my asthma nurse at the dr's surgery knows my reliever doesn't work.

    My partner says I am wrong to panic when coughing goes on because I always end up ok in the end. I think I need to get a grip. Sorry to get this all wrong on my first posting here, but thanks for your help.

  • Hi Sleeping Diva,

    Welcome to the forum and I love your name!

    I notice you are using an easyhaler, can you use a spacer with that? I have found it works better with one when I am really struggling. Also, if your reliever does not work, have you been tried with a different one?


  • Thanks for all your help and support. I saw my asthma nurse this morning. I am to continue on prednisolone and be reviewed Monday. I managed 3 hours sleep last night for the first time in over a week so that has to be progress. Oh what a wonderful way to spend my week annual leave ~ not!

    So come on lungs, WORK!

    As for my name, well, I didn't know what to pick when joining this forum, was in a panic about not breathing properly, looked down and there it was on my nightshirt ~ SLEEPING DIVA!

  • Hi sleeping Diva,

    Erratic Peak flows are scary. Pred. dose should be strong enough to clear airways completely.

    Then the taper can begin. Have you tried a very very low dose of

    extended release Theophylline? Even as little as 150mg at night

    and maybe 150mg 12 hours later. It is known as the ""Night Time

    drug"" for just what you are going through. It has almost no side effects

    at this dose, just some easily avoided med interactions.

    It smoothed out my airways at night when I had to take oral

    steroids. Nothing else did. Maybe it is worth talking over with your Dr.

    Quite a lot of info on the web about this approach.

    Hope this helps,


  • To cam theophylline has side effects and you shouldn't be recommending this medication as you are unable to assess or know if sleeping diva has any medical allergies

  • I don't know if I have anything useful to add, just that my reliever - at least the Ventolin - tends not to work very well and I've been left wondering what to do with symptoms that don't seem that bad but reliever is not touching them! It can be a tricky one and I don't like feeling like a timewaster but it's best to err on the cautious side and get help if you think you may need it. I did this once as OOH dr on phone told me despite reliever not working and still sounding breathless I didn't need to be seen or need any treatment. I felt like a hypochondriac for doing it but I felt this was wrong (It certainly seems it was against official AUK guidelines!) and I did go to OOH. I was fine so maybe it was doing something but the dr I actually saw was really nice and said he could see why I'd come in.

    re the medication: Gussypoo I can see your point here but to be fair Cam said at the end to discuss it all with dr and besides presumably Sleeping Diva would need to do that anyway to get hold of it? I guess someone might try and buy it online but that goes for anything - I would have thought it's ok to mention medication that's worked well for someone personally, as long as it's made clear that you're saying 'why not mention this medication to your dr and see what they say?' I know I've found it very helpful when people have mentioned medication that's worked for them on here, as I've then known that it's an option to ask about.

  • It is good to hear about the different treatment options, so thank you for sharing them with me. Being well informed can only be a good thing, and gives me more choices to discuss with my asthma nurse.

  • Gussypoo,

    I only suggested low dose Theophylline as a talking point with her health provider. It indeed may or may not

    be appropriate for her. It was tough for me to get it prescribed, but I am glad I did. Nights are so much better.

    High dose Theophylline has Many side effects. Low dose therapy has been around since 1996 and

    has proven beneficial and much safer. It also acts as a steroid sparing drug. Medline has many abstracts on the topic. Or Google: Theophylline

    New Perspectives for an Old Drug by Dr. Peter J. Barnes.

  • It's not suggesting a drug but to state the dose and say no side effects is my concern ..... I'm on 200mg and can't increase any higher due to side effects I get .... Doses of medication should be discussed by the Medical professional and informed of side effects prior to starting Any medication....

    I would say to anyone that if they have concerns over their health that's the time to seek medical attention .

  • It's not suggesting a drug but to state the dose and say no side effects is my concern ..... I'm on 200mg and can't increase any higher due to side effects I get .... Doses of medication should be discussed by the Medical professional

  • Hey sleeping diva and welcome!! I was in the same perdicument when my asthma starting flaring up uncontrollably. And i saw it as go to my gp during the day even if it was an emergency appointment (and i was reasonably ok so talking and walking etc) but at night if i was noticing a down hill spiral then i would just pop along to a and e or minor injuries (dependant on opening time) that way i could get more medicine if needed. Hospitals dont tend to tell you off for being over cautious especially when it comes to breathing. They would rather see you, review you, fix you and keep you or fix you and send you home than not see you at all and you sit and suffer.

    And Sorry but can i just point out that cam said 'almost no side effects at this dose' this isnt stating there is none, but it also isnt stating the side effects it can have hes saying almost...

  • Theophyllin

    Just thought I'd add in - I can't take theophyllin/aminophyllin or anything of that nature due to the extreme side effects I get. Really horrendous headaches no matter what the dose.

    Mentioning medication can be useful but I do think we ought to be a little wary chaps :)


  • Hello Sleeping Diva and welcome.

    There is people here with all levels of asthma from mild through to very severe (often known as brittle) on a lot of medication and in/out of hospital (often referred to as Costa) which is relatively rare given millions of people with asthma. Thus you will generally be always able to find someone who's had similar experiences or able to answer questions.

    To answer your question about hospital, as mentioned before, advice seems to be when not feeling better after up to 10 puffs of ventolin and/or too breathless to speak in full sentences.

    Have a look at the info available under 'all about asthma' along the top and you can order leaflets at the bottom under publications.

    Hope things improve soon, good to hear your asthma nurse is looking after you and wants to see you again. It would be a good idea to get an action plan written up so you know what to do - again available as above. You may find you have to ask several times for this.

    This forum is not the place to ask for medical advice in an emergency. However I do feel it is invaluable for suggestions on different treatment options which can then be discussed with your doctor/nurse in regards to benefits and side-effects for you. I know Atrovent has been useful for myself and others partly due to info on here.

    Cam, shorter courses of prednisolone do not need to be tapered?

  • Im Not looking for an arguement or a fight but I do have a concern .... Theophylline comes In many different preparations and different names . Not everyone knows the names so may have had it in the past and allergic to it .... It was on a dose lower than what cam had recommended . I had vomiting head aches . Abdominal pain and chest pain . And an asthma attack the medicine was stopped . A few years later we attempted the drug again but a different preparation. Tho I had the headaches and vomiting . No chest pain or asthma attacks this time but i can't go higher than 200mg as side effects get worse . I think if recommending medication it's got to be factual

  • Gussypoo,

    Concerns or anxiety over your condition or a 25 percent drop in Peak flows that can't be brought back into the normal range, go for medical help right away. I agree.

    I had bad experiences with Serevent. However, I have learned a lot from people posting specific

    information about their treatments. It's helped me a lot. Books written by Doctors, news articles,

    Med Line studies.......more informed when discussing options with my Physician.

    We will have to agree to disagree. No bad feelings from me.

  • Nice way to end it cam . Thanks

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