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Newly Diagnosed - advice please

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Can you give me some advice please.....?

I'm 36 and have always struggled with sprays/strong odours. I can't use perfume or spray deoderant, insect repellents etc - they have always made me cough.

History: I have recently been diagnosed with asthma after having a persistent cough for several months. Initially it seemed to be set off by some sort of allergy (sprays etc) and I was given Seretide 250 to take 1 puff twice a day (September). Then I got a chest infection (mid November)and was really bad so I was given 4 days of prednisolone, antibiotics and a blue inhaler which I found I needed to take quite a lot so I went back a week later and the Seretide was increased to 2 puffs twice daily. Within a day or 2 I felt much better. That was about 2 1/2 weeks ago, haven't needed to use the blue inhaler for about 10 days. During those 10 days I had the spiro test - it was fine which was as expected because the asthma appears to be caused by allergens and I was told I may need to have a provoker test at some point.

I have had a cold over the weekend and my chest was beginning to get tight. Yesterday I was really struggling to talk because I was so breathless after walking through a corridor that was being painted (known trigger for me), I had to have 2 puffs of the blue inhaler twice before I felt better. All day today I have felt breathless and have used the blue inhaler 4 times (2 puffs each time). This evening I bumped into a GP at swimming club and she was concerned enough to ask what my peak flow is - I don't have my own meter so didn't know. She organised an emergency appointment for me as she thought I might need steroids. The GP I saw at the surgery is a bit of an idiot. Lots of people won't see him, hence he always has free appointment slots :-( He said my chest is clear and that as I am on the max dose of Seretide I shouldn't be having any symptoms at all. He said that he thought the breathlessness is caused by anxiety because my Mum is seriously ill.

I know that I am not anxious. I'm coughing the same as I was a few weeks ago when I had a chest infection. In that 10 days when I felt good things that would normally have triggered a coughing fit weren't a problem. Now that I have a cold it is a problem. The GP I saw this evening didn't do my peak flow but I didn't remember until after I had left. I don't know what my normal is as it has only been measured twice - both during the time I had the chest infection. The Dr said it was 315, looking at the chart that isn't that low.

Any suggestions?

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5 Replies

Hi and welcome. Our surgery has a GP like the one you describe, always free becuase no-one wants to see him! See if you can make an appointment with the one who organised it for you initially, the one you saw at swimming club - that one sounds much better. Although my asthma is mild, mostly controlled and my triggers are exercise and stress, so very different to yours, I don't know what normal peak flow is either. Whenever its tested at the surgery the GP always says its very frustrating as I don't have very low PF even with a chest infection, its normal for my chest to be crackling a lot anyway, and the cold weather does make that a bit worse. I thought 315 was quite low, I tend to blow anything between 400 and 450, my brother has the same symptoms as me if a bit worse (has been hospitalised in the past) and can regularly blow over 500 (different for men I know). Persevere with the docs and try to see the better GP. Once you have managed that you can then say to the receptionist that its a particular GP managing your asthma so you can't see just anyone. I have had my flu jab and am hoping to ward off any colds etc over Christmas, it always seems that when I take time off work and slow down a bit the infection hits me and I have had several Christmas days on my own as too ill to see family, and end up on pred when the multiple courses of antibiotics don't work. Much as I love Heinz tomato soup I don't want it for Christmas dinner again! Wishing you a peaceful and healthy festive season!

Hi Ginger

Colds are a problem for me too and sometimes chest can be very up and down and sound clear too. Sounds like this GP's no good with asthma at least, it's a bit off to dismiss it as anxiety.

Being on 2 puffs twice a day of seretide doesn't mean that you won't get asthma symptoms and any GP should know that. I'm on double that dose and other things too and I still get symptoms every day, and others are on much more and are still very poorly.

Worth seeing another GP, especially if symptoms continue or get worse. If symptoms get better then it'll still be worth going to see a GP or nurse to get a peak flow on prescription and an action plan.

Hope you're feeling better soon

That GP is being ridiculous! I'm on more inhaled steroids than you, and 30mg of pred and a load of other asthma drugs and at the moment i'm still regularly in hospital with my asthma, you can definately still be having symptoms whilst on the meds that you are on. clearly he doesnt know what he's talking about, ignore him and try to see someone else. some asthmatics tend to have a clear sounding chest, you'll always get some docs who have issues understanding that, for me i only wheeze when im pretty bad, and then it goes fairly quick leaving me feeling bad, but with a clear sounding chest.

also, did you say you had been given seretide 250, but not a blue inhaler when you first went in? that is really strange, seems to be missing a few steps in the standard asthma management meds. (i believe normally you just get a reliever, then a steriod, then a combined inhaler, whilst you seemed to have skipped the first two, dont suppose anyone mentioned this to you or said why - although clearly if you are still symptomatic this was a sensible move, it just suggests that something strange is going on at your GPs) you definately need to get your own peak flow, if you have a naturally higher peak flow then you may be getting good looking readings when you are ill but they could be bad for you (i get this as i used to play flute)

did you find the pred tablets helped? it might be worth trying to see a good GP to get some more if thats the case - it might help you get through this cold, and you should ask about getting the flu jab if you havent already had it, if a cold makes you feel rough you deffo dont want flu! good luck, hope you feel better soon!

in reply to

Thank you to everyone for replying. I really appreciate you taking the time to help me :-)

also, did you say you had been given seretide 250, but not a blue inhaler when you first went in? that is really strange, seems to be missing a few steps in the standard asthma management meds. (i believe normally you just get a reliever, then a steriod, then a combined inhaler, whilst you seemed to have skipped the first two, dont suppose anyone mentioned this to you or said why - although clearly if you are still symptomatic this was a sensible move, it just suggests that something strange is going on at your GPs)

Funnily enough it was the useless Dr who gave me the Seretide initially. He didn't check my peak flow on that visit either and he didn't order any tests. When I went back in November the Dr I saw then was amazed that I hadn't been for the spiro test thing and that I had never seen a peak flow meter. He was shaking his head and muttering that it was strange I had been given an inhaler without any tests.

you definately need to get your own peak flow, if you have a naturally higher peak flow then you may be getting good looking readings when you are ill but they could be bad for you (i get this as i used to play flute)

That makes sense. ""Normal"" is such a huge range when it comes to medicine and the only way to find out what your personal normal is supposed to be is to have tests when you are healthy. Something we don't do for most things. I have exactly the same with my temp - the Dr will take it and say that at 37.5 it is fine, but my normal temp is 36.5 so for me it is high. I've ordered a peak flow meter so I can check it myself on days when I am feeling healthy and have something to compare against.

did you find the pred tablets helped? it might be worth trying to see a good GP to get some more if thats the case - it might help you get through this cold, and you should ask about getting the flu jab if you havent already had it, if a cold makes you feel rough you deffo dont want flu! good luck, hope you feel better soon!

The pred tablets did help. I seem to be coming through the worst of this cold now. I no longer have cold symptoms and my chest isn't as tight as it was although I'm still coughing a lot. I asked about the flu jab on Tuesday (up until then the Drs hadn't told me I was entitled to have it!) and the Dr (who thinks I don't even have asthma) told me that yes I am entitled to it. I have an appointment for next week.

Just one thing about the flu jab, if you turn up with cold-like symptoms (or anything other than asthma symptoms) they won't give it to you. Last year I had to wait ages to get mine as I had a chest infection at the time the letter came inviting me to make an appointment. You may find that next year you get an automatic call up for the flu jab, but make a note to remind yourself just in case you don't. Good luck and hope you feel better soon.

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