Sudden Stress induced asthma condition

Hello everyone, I am new to this so treat me gently! I have had a peak flow of around 400 since my 20's. It goes up and down with virus' etc, but I never had an asthma attack. Never needed to take the inhaler I was given as a precaution.

This Autumn I was diagnosed with stress - bad time at work with a weak headteacher with a reputation for distressing his staff... but that's another story.....

So, I got what I thought was a virus - coughing in the evenings until I was sick. Wouldn't go away, and 2 weeks later I saw another GP at the practice who said I had stress induced chronic untreated asthma.

Have been on steroid pills for 6 weeks, although have been coming down from 6 to 1 over the past 3 weeks. Have the red inhaler, plus a ventolin nebulizer 4 times per day. I no longer cough at night, but I cough up a good amount during the day - especially in the morning when I go out to let my animals out. What is worrying me is that the doctor feels I should have improved, and has sent me for a chest x ray. I am so scared of my next doctors appt because I dont know if there is something I should be scared about. But reading your great stuff on this site, it appears that 6 weeks isn't a long time to be coughing. How scared should I be? He put poorly responding asthma on my referral slip. I assume it is normal for asthma to take this long to respond to treatment? Any kind words would go down a treat. As I am still stressed and upset about situation at my work ( I have left now), I assume the stress induced asthma is likely to be lingering? And I feel like I have a cold all the time - is this asthma or do I have a cold???

Thanks for reading this - the first time I ever did a forum. :-)

13 Replies

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  • Welcome, before we go any further I must ask: nebulizer? do you mean a electric machine into which you put a solution, switch it on and breathe the mist either through a mouth piece or a mask . Sorry to ask but handing out one for a 1st attack is very odd and potentially dangerous for you. However, I have heard inhalers refered to as nebulisers by people before.

    I am not surprised you are scared, honestly with the right treatment almost all asthma is controllable. It is slightly skewed here on AUK as many here have difficult to control asthma however, rest assured that the vast majority of people do get control and for them their asthma does not interfere too much with their daily lives. Stress plays a massive part in your asthma treatment and control however recognising that your asthma getting so bad maybe stress related is good sign , if you know what is causing it you are half way to getting control!

    I would ask for a referral to the local chest consultant ASAP. Where in Devon are you? There are quite a few of us here who live in lovely Devon.

    Again sorry to question the nebuliser bit but either some GP has lost the plot or it is just name confusion either way worth clearing up.

    Bex

  • Hi there, Stressed Chick, welcome to the boards and I'm sorry to hear that you have been diagnosed with asthma and that you have been having problems with stress. I know that things might seem very confusing and frightening at first, but we are on hand to try to answer any questions that you might have, and I am sure that you will soon get the hang of things.

    Like Bex, I am also a little puzzled and concerned at your reference to a 'nebuliser' - a nebuliser is an electric machine, usually a mains operated air compressor, that aerosolises a concentrated solution of medication. It's essentially the same medication as is given in a blue 'reliever' inhaler such as salbutamol (Ventolin), but it is much much stronger. This means that it can have quite unpleasant side effects, especially if you are not used to it - commonly a racing heart, shakiness and jitteriness. It can also be a dangerous treatment, especially in someone who is not used to asthma and asthma symptoms, as it is so strong that it can often give people a false sense of security about how they are. The vast majority of people who are unwell enough to require nebuliser treatment rather than inhalers should really be in hospital so that they can be closely monitored; it is usually only a very small minority of asthmatics who have very severe disease who are given nebulisers at home, and then usually after review by a hospital respiratory consultant and strict rules about how and when it can be used. The worry is that people can tend to sit at home when they are having a severe attack, thinking that they are okay because they are getting some response to the nebuliser, whereas in fact to be safe they should really be going to hospital.

    I hope that it is just a question of confusion over the terms involved, and that you have not really been given a nebuliser at home as a newly diagnosed asthmatic, because that would probably be very inappropriate and potentially dangerous treatment. Please don't let this worry you too much, I don't want to start your first experience of a discussion forum by scaring you completely, but it would be irresponsible of us not to mention that this is not the usual or safest treatment.

    That said, I hope that you are finding that the treatment is having some effect. There are many different medications available for asthma, and it can sometimes take a while to find the ones that suit you and get good control of your asthma. For the vast majority of people, though, about 95 - 97% of asthmatics, once they find the right combination of medication they can be almost completely controlled with minimal symptoms or interference with your day to day life. As Bex has said, this site inevitably attracts a disproportionate number of people who do have difficult asthma, and you might read references to people having a lot of problems, recurrent hospital admissions and even Intensive Care admissions, but these experiences really do occur only in the very small minority of asthmatics - it's just that most of us who have these problems seem to find our way here!

    Stress undoubtedly has a very important part to play in asthma in most people. Most of us have experienced worsening of our asthma due to stress, and indeed worsening stress due to asthma problems! Stress does not cause asthma, as such - there does need to be a pre-existing asthmatic tendency - but it certainly has a large part to play in making it worse. Reducing stress in your life and trying to control things that are causing you stress undoubtedly can help to control your asthma. It does sound, though, from your description of your peak flow going up and down with viruses, and having been given an inhaler as a precaution, that you have probably had an asthmatic tendency for a while.

    I can understand why you are concerned that your GP is saying that he would have expected things to settle before now, and that he wants you to have a chest X ray. You are right that six weeks is not very long, really, to gain control over asthma, and it can take a trial of a few different drugs before you find the one that works for you. So it is not necessarily worrying that you are not completely better after six weeks. Your GP probably just wants to do the chest X ray as a precaution, to make absolutely sure there is nothing else going on that would require different treatment, such as a persistent infection.

    You say that you feel like you have a cold all the time - by this, do you mean that you have a stuffy/blocked/runny nose? Do you also have itchy eyes or an itch at the back of the throat? This could be due to allergies - allergic rhinitis or 'hayfever' - which is often seen in combination with asthma. You mentioned going to let your animals out - I wonder what animals you have, whether you could have developed an allergy to any of them, and whether you are also exposed to grass pollen and other pollens, hay or moulds.

    I know there is a lot of information to take in at the moment, but do gradually try to find your way around the discussion fora and the AUK board - there is a great deal of useful information on here. To begin with, I would take a look at 'What to do in an asthma attack' under the heading 'All about asthma' on the green banner above - it is important to be able to recognize the signs of a severe attack and know what to do, especially given the concerns I have already expressed about the dangers of ignoring symptoms if you do have a home nebuliser.

    Hope this hasn't overwhelmed you and that you settle in here - do feel free to ask any questions you might have. I hope both your asthma and your stress problems are much better soon.

    Take care

    Em H

  • Stressed chick on a Nebuliser

    Hi Em and Bex, Thanks for taking the time to counsel me :-) I do have an electric nebuliser. I use it routinely 3 -4 times a day. My doctor tried steroids (6 per day), and a becotide plus a blue (not ventolin), then a red inhaler 2 puffs three times a day, but none of them have eased this at all, except that I don't cough at night any more, and I don't cough until I am sick any more. Still I have this persistant cough - and persistant wheeze. I am so fed up that every day, especially since the nebuliser, I expect to feel better, and every day is the same. I have chickens, horses and the children have guinea pigs and rabbits. Mostly outside, and we have 2 outside cats so I don't get too near. Since I got ill my husband has been feeding the horses - and I keep away from the hay as much as poss. I just thought that just before I got ill we cleared a huge amount of loose hay from a field. The baler had not picked it up. But that was all outside. And I breathe through my jumper when I go into the hen house. In fact recently I try to open the door and run! I have moved into a bedroom on my own and have new bed clothes regularly and keep the window open to air the room. I have always had a tendency to asthma, but no attacks - just peak flow. I feel like I have a cold, especially when I wake up - need to blow my nose. But not sneezing. I feel good doing the nebuliser - and no side effects- funny thing is that I never had ventolin in an inhaler because it made me shake too much. But the nebuliser doesnt! Well just a little - but I was shaking a little after the inhalers I have already. No noticable difference after the nebuliser.

    I just have a deep chesty wheezy cough - can't comfortably breathe in deeply but never cough up anything nasty coloured etc (yuck!). I just want to get back to normal. To laugh without erupting into coughing fit.Thanks for your concern. I feel less isolated now. But I know on Monday my doctor will be less than pleased that I am not showing signs of improvement. He is a great doc. Oh, and I do suffer from awful hay fever most years - but not this year - in fact not so much since we moved to Devon from Suffolk 4 years ago. We felt the pesticides and intensive farming was harming my health - used to rub out all my eyelashes! Now I don't remember having much of a bad time any Devon summer. We live in the Teign Valley. On the top of a hill. Amazing view and good fresh air.Thanks for caring ;-)

  • Hi

    Can I ask where you got your nebuliser from - was it from the hospital or on the advice of your Gp? As Bex and Em have already explained, having a home nebuliser is a huge step in home asthma management and you don't sound as though you have been tried on many alternative medicines before having to resort to nebs.

    Sarah

  • Hi Sarah

    The nebuliser was given to me by my GP. Have never been to hospital with asthma - just for a chest x ray yesterday which really freaked me out because I immediately thought ""what else could be wrong with my lungs"" and I will be scared until I see my GP to get the results. You see I am stressed about a horrible time I recently had at work - and it brought all this on. I try to be calm but always seem to have something to contend with - I have 2 primary aged children, lots of pets and I run the local Brownies single handed - so as you can imagine I never get to sit down! LOL, chick.

  • Hi Stressed Chick,

    I am really very concerned by the fact that you have been given a nebuliser to use at home, by your GP. It really is not recommended or appropriate treatment at all. There are very clear-cut and evidence based recommendations of the steps that should be taken, in terms of medication, to manage asthma, and your GP does not seem to have stuck to them. There are many other treatment options to explore before considering home nebs. The way he is treating you could be dangerous for you.

    If your GP feels that your asthma is severe enough that you require home nebs, he should be referring you to a hospital respiratory consultant for assessment, or even sending you in to hospital as an in-patient. The fact that you have not responded particularly well to either oral steroids or nebulised salbutamol does suggest that perhaps asthma is not the problem, or not the only problem; this is probably what your GP was getting at when he said that you should have responded by now. You are right to say that asthma can often take a while to settle, but six weeks of steroid tablets and nebulised salbutamol are both pretty strong treatments, and one would expect to see some improvement.

    There are many other conditions that can mimic asthma or co-exist with asthma and make it difficult to treat, and without seeing you it is impossible to really know what is going on in your case. You need to be assessed by a respiratory consultant fairly urgently so that further tests can be arranged, if necessary, to try to get to the bottom of this. I know this probably sounds very frightening, but it doesn't necessarily mean there is anything seriously wrong - conditions like post-nasal drip, gastro-oesophageal reflux and vocal cord dysfunction can all produce this sort of effect, and they are not usually serious conditions and often respond very well to treatment. You do need to have those investigations first, though, to find out what is going on here.

    Do please go back to your GP and ask for a referal to a respiratory consultant. You deserve better, safer treatment than this.

    Take care

    Em H

    PS Just to explain in a little more detail why we are so concerned about this nebuliser business, I include a quote from another recent post of mine on the subject - apologies for quoting from another thread, but it does save me typing it all out again!

    ""There are two main reasons why someone would be given a nebuliser at home:

    1) If someone has attacks that are so sudden onset and severe that they need to be able to use a neb while they are waiting for the ambulance - this is very rarely the case as the vast majority of people will get as much benefit from 10 - 15 puffs of salbutamol inhaler via a spacer. If someone has a neb for this reason, they should only use it when they have called an ambulance and are waiting for it to take them to hospital, and their GP should keep a close eye on how many nebs they are getting through to make sure of this.

    ""2) Occasionally, someone with very severe asthma who is already on pretty much maximal other treatment will find that they respond so poorly to inhalers that the only way of keeping their airways open is to use nebs fairly regularly. In order that they are not in hospital all the time, for quality of life reasons, they may be given a neb to use regularly at home. This usually happens after many hospital admissions for asthma, and after attempts whilst in hospital to get the patient off regular nebs by adding in other medication. No-one should have a neb for this reason unless they have exhausted all other treatment options without success.

    ""In both these cases, the patient will have very strict protocols about when they can use the neb, how frequently, and how often they can use it before they have to go to hospital. Giving someone a neb at home is always done with a lot of thought and caution on the part of the doctors, and has to be very carefully considered.

    ""There is a very real danger that someone who has a neb at home will have a false sense of security about how easily their asthma can be treated, and will keep nebbing when they really should be getting into hospital and having other treatment. In a severe attack, nebs will often not work alone, and other treatments like IV hydrocortisone, IV magnesium and IV aminophylline may be needed, or even, in an extreme case, intubation and mechanical ventilation. By the time someone gets to the stage where nebs aren't working, they are usually extremely unwell and need to be in hospital very quickly.

    ""A good proportion of the deaths that occur in this country due to asthma occur because people have undersestimated their symptoms and have not got themselves into hospital quickly enough - and a lot of these are associated with the use of nebs.

  • When have you got to go back to your Gp? I can hear from your replies that you are extremely anxious about possible results and this could be exacerbating your current symptoms (easy for me to say I know). You have said that you use a nebuliser 4 times a day, is this as a preventative measure or due to symptoms? Have you tried using an inhaler instead? 10 puffs usually sorts me out, I only need to resort to nebulisers when they don't and I know then to contact resp nurse.

    Take care

    Sarah

  • Just a thought,

    Others here have said that your symptoms may be caused by another condition.

    I noted that you were collecting up loose hay from a field just before all this kicked off. As it has been extremely wet this summer there may have been some fungal spores in the hay that you may have breathed in or something in the animal bedding. This can cause allergies and infections and therefore symptoms similar to asthma. Please mention this to your GP as well - It may or may not help to pinpoint what is causing your symptoms.

    I hope this helps a bit and please try not to worry - I know it is difficult not to.

    Take care

    Kate

  • allergies and hay

    Hi Kate

    I did wonder as I typed the word 'hay' - as I have had bad hayfever ever since I went to Kew gardens years ago. Came home with itchy eyes and have had hayfever ever since. As it got better (not completely, but much better compared to the severity suffered in the past) when we moved to Devon it slipped to the back of my mind. I am someone who carries on regardless, and tries to ignore illness - too busy! But I have always found cut grass to be a trigger for hayfever - so all that hay on the field - and in the van in plastic sacs with me driving (5 mins or so, but still shut in with it because it had started to pour with rain...)

    And I looked up the symptoms for post nasal drip - and I have had a runny nose/cold type symptoms for about 2 months - and even before - often a cold that never goes which I put down to hayfever. Also I have a history of sinus headaches and since I have had the asthma I have had this feeling that my ears are blocked - keep trying to make them pop by holding my nose and swallowing! And it all started after the hay episode and with what the doc thought was a virus which made my throat itch and made me cough and cough until my throat went into spasms. Then I went back, saw another doc who diagnosed untreated asthma.

    So the great people who have talked to me on here over the past 24 hours have led me, like a detective, to a possible answer. Seeing the doc on Monday and will have a serious chat about all this.

    Many thanks for your help and interest.

    Take care, and let me know anything else that occurs to you.

    Not so stressed chick ;-)

  • Hi,

    Hayfever is not usually caused by allergy to hay itself, despite its name - although grass pollens can be a trigger. Other common allergens causing hayfever are tree and plant pollens; also house dust mites and animal fur, although this would more properly be referred to as 'perennial allergic rhinitis' (as compared to hayfever, 'seasonal allergic rhinitis') as it would not have a seasonal element.

    The important point about hay, though, as Kate says, and the reason why I asked about it, is that damp hay can have certain moulds and fungi in it which can be breathed in and can cause a range of diseases which may mimic asthma. These conditions can mostly be treated pretty effectively, especially if caught early, but they do require slightly different treatment than asthma, which is why it's very important to get referred to a respiratory physician so that you can be properly investigated.

    I understand what you're saying about wanting to ignore medical conditions and carry on with your life - I think most of us here feel the same - but early diagnosis and treatment makes so much difference to most medical conditions. If you get diagnosed properly and get treated, hopefully you will be able to get back to a full and active life, free of coughing and wheezing, as soon as possible.

    Do please push for respiratory referral, and do mention your exposure to all your different animals, and especially to hay.

    Take care,

    Em H

  • Stressed Chick, I am so glad you are searching out answers. Sorry about the nebuliser questions, as you have read GP's handing out nubulisers is rare and dangerous. I don't suppose your GP is australian is he? I know they use nebs a lot more than over here! Good luck seeing him ask for a referal to your nearest local chect consultant preferably one who has an ""interest"" in asthma"" and please seek help if you are getting no relief from your nebuliser.

    Bex

  • referral

    Hi Bex

    Thanks for your concern, this site is really great - I had felt alone for a long time. Funnily enough my husband and kids just don't seem to think I am ill! I sometimes wish they would tell me to take it easy! We have such a great life here on Dartmoor, that it is never convenient to stay in with your feet up!

    Today I have a real cold, courtesy of hubby (who has had 'man flu' for a few days!), and to be honest, I feel OK. My cough is not so bad today believe it or not - but the sinuses are taking a hammering and my nose is streaming or blocked at all times. So when I see the doc tomorrow I need to tell him that although I have a cold today, the cold I thought was a cold over the last few weeks wasn't a cold at all!

    He isn't Australian BTW, so I don't know what posessed him to give me the neb. It does make me feel better - but how much is psychological I don't know.

    Will let you know how I get on.

    Chick :-)

  • Stressed Chick, good luck for with the GP. Keep us posted. I know what you mean about Dartmoor I am in love with it but I dare not move further out onto the moor. Where are you based. PM if you would rather not let the world and his wife know. I suspect others here will vouch for my being real and not an axe murderer although some have used the term ""a little mad"" I am sure they did not mean it :)

    Bex

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