How long should I give it?

It's 9 days since I saw the asthma nurse and increased the Symbicort (2 puffs am, 1 lunchtime, 1 teatime, 2 bedtime). So far, I've not noticed a difference. I'm still waking between 4 and 5am, it still takes me a good few extra puffs after getting up before my lungs feel properly functional.

How long do you think I should give it before going back? I think I'll see the GP who deals with respiratory stuff (each GP at our practice has a ""special interest"" and extra training in that area).

As an aside, I also find that I have to get up and move about to clear my chest of the goo that settles in it overnight, is this normal with asthma? It never feels totally clear, but until I've been up and about a while it doesn't lift at all.


8 Replies

  • Hi piglet,

    The morning goo is normal for asthma, my consultant told me it is partly where everything settles at night and partly where the lungs are 'preparing' for us to get up and move around. He did say it was to do with a surge of natural steroids in the body during couple of hours before we get up.

    Are you also using a ventolin inhaler with your symbicort? I used to be on Symbicort SMART (It suited me perfectly for almost 3 years.) But when my latest flare up started I was using up to 12 puffs a day and needing more. I was given a ventolin inhaler with pred.

    I would probably go back if it was me or after 2 weeks if no improvement. Are you still on the Symbicort SMART? Can you take up to 12 puffs? Also, are you on the 200/6 inhaler?

  • I'm on Symbicort SMART, on the 200/6 inhaler. I think my asthma nurse said I could take up to 10 puffs a day? I'm finding it hard to remember how many puffs I've take each day on top of my regular 6.

    One weird thing is that my PFs are almost always normal, even when things are misbehaving. The only time it really changes is if I have a chest infection or the couple of times I've been to A&E (I've been told off a couple of times for not going to A&E, but I'm never 100% sure when it's necessary and when I'm making a fuss about nothing). I don't understand how that can be, when all my asthma symptoms are being a pain in the arse?

    I'm feeling a little confused tbh.

  • I would probably go back and clarify the maximum you can take and get checked over. Whenever I used to reach 8 puffs a day, I would start recording it, as you are meant to only have 8 or more puffs for up to 14 days before seeking advice anyway.

    I can't help with the PF I'm afraid as my asthma is atypical and mine only changes when I have an infection.

    Other people on here may be able to help with deciding when it is time to go to A & E. I know when I was on Symbicort SMART you could only have max 6 puffs at a time so I guess when you have had that it is time to seek help.

  • Also, just out of curiosity Piglet, are you on antihistamines? Because the tree pollen started last month and may affect your asthma.

  • Thanks.

    I'm not on any antihistamines, but it's something I'll speak to the GP about - I'll see if he'll prescribe me some since I have a pre-payment certificate. I think I'll see the GP rather than the nurse. While she was very nice, I sort of felt like she was a bit too unsure of herself for my liking.

    You know, if I have to have long-term illnesses, why do my 2 have to be so damn hard to control? :-/

  • I would deffo go back as there is no set answer to how much symicort on smart, it is up to dr/cons to decide depending on patient and how their asthma responds for example my new cons has just upped mine to max of 16 puffs in a day, with 10 being my maint dose, so pls go back and get it checked out

    Hope you get it sorted and some relief soon


  • Asthma can take a lot of patience! Let us know how you get on Piglet.

  • Not much to add but just to agree you should go back. Also that I completely understand about symptoms not matching the numbers - I've been told for ages 'oh your PF is above predicted so you must be fine' (yes but you don't listen when I tell you my best value is over 200 above predicted!). And even when it's in my personal 'green zone' I've felt rubbish so I never know - plus I find reliever can push it right up without actually relieving symptoms much. I've never actually blown my personal best without a lot of reliever...don't know if that means I shouldn't use it as my personal best.

    Never actually been to A&E because feel like they'll say I'm a timewaster and never sure when to go. I'm reasonably sure I've pushed the envelope out to breaking point sometimes and it's 'been ok' but I suspect I shouldn't have.

    So go back to GP asap, hope they can sort things and give you some advice.

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