suggestions please

I have kindly been given a cold over Christmas. My usual pf of 550 is down to around 320, however its difficult to measure accurately as it causes me to cough. My cough is dry but once I start I can't stop for ages and it leaves a strange taste in my mouth, however, after taking Ventolin, the phlegm is kind of released off my chest and the cough becomes chesty and productive. I do not normally wheeze but have found myself breathing quite musically especially after a coughing fit. I know medical advice cannot be given here, but I'd like suggestions as to what I am best to do. I currently take montelukast and flixotide 250, 1 puff at night but can increase this to 2 puffs morning and night which I have done for about a week now when the cold started. I am now taking Ventolin regularly through the day too, maybe 10 puffs over the course of a day (dont want to take too much) is there anything else I could or should be doing? Thanks in advance xxx

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  • Hi,

    What a lovely Christmas present...not! Hope it improves soon.

    Meanwhile: did you have a plan telling you to increase the flixotide? I'm assuming it didn't tell you what else to do as you're asking here, but it sounds like if you're already doubling up and still having a lot of symptoms and low PF, it could be time for the dreaded pred - and definitely time to at least see GP. Obviously it's Saturday so more tricky - could you get in on Monday? Or even go to OOH? My 'plan' says that if PF is less than 75% of best, which yours certainly is, and I'm taking more than a total of 8 puffs of reliever in a day, I should consider adding pred. Obviously this is my plan, but at the same time I actually think it's a fairly generic one (I'm asking for a more personalised one as my PF isn't always helpful) and probably a good rule of thumb for most people.

    Hope this helps - maybe not, on a Sat, but I really don't know what else you could do without seeing someone, and if the AUK line were open I should think they'd say the same thing.

  • You sound very similar to me atm. My pf's hovering around 300-330, best 520. My chest is also musical and vibrating. Do you have some emergency pred? I've started mine, as I can't double my inhalers (already on seretide 500 2 puffs twice a day). I'm off to OOH if it gets worse or A&E if much worse. Off to GP on Monday even if I get better.

    So I'd suggest OOH or A&E if you get worse and seeing GP asap. Are you coughing up yellow/green phlegm? As this could be a chest infection.

    I hope you feel better soon and get a better action plan too x

  • so sorry to hear you got such a rubbish christmas pressie ;-) hope things improve soon!

    it defo sounds like you need to see someone. GP on monday or if any worse then OOH or AandE as others have said. i also thought id remind that there is no risk in taking too much ventoline so you dont need to hold back on it for that reason. though obviously if youre using ridiculous amounts for little effect you probs need to get help!

    wishing you a speedy recovery. stay safe!

    Rose xx

  • Thank you for your replies. No, I have no action plan at all, I used to be on the higher dose of flixotide, so always revert back to that when I'm ill, otherwise I have nother options available like having emergency pred.

    Lou - when the Ventolin has released the phlegm is it a dirty thick yellow/green colour, doesn't look pleasant. It also hurts all of my chest. I just feel like I have no lung capacity and am short of breath even sitting still.

    I tries to rung my gp for the OOH number but its not working and tried nhs direct but their call back was hours so thought I'd try again later.

    I hope you get sorted out Lou, its not much fun! Let us know gow you get on.

    I guess I will see how things go, I will try nhs direct again later and failing that, try and fet an appointment with the gp on Monday, maybe if I explain I have asthma they might squeeze me in as I know they are very short of appointments lately.

    Ps sorry for bad typing, on my phone!

  • Lou - when the Ventolin has released the phlegm is it a dirty thick yellow/green colour, doesn't look pleasant. It also hurts all of my chest. I just feel like I have no lung capacity and am short of breath even sitting still.

    Sounds like you have a chest infection then. The reason I asked was because you said you had a strange taste and I know that when I start coughing up muck with a horrible taste that it's yellow/green and infected. Deffinately worth seeing th GP on Monday morning. I have emergency antibiotics so have already started mine as I've ended up in hosptital/HDU with chest infections before.

    Have you had any luck with NHS direct/OOH?

    Like HannahRose has said, don't worry about taking more ventolin, if you have symptoms just take it, through a spacer if you have one.

    I've not changed much, peak flow is a bit lower at times during the night but I don't feel like I'm struggling, so I'm still hanging on to see GP Monday am. Also, my second dose of pred should be having an affect very soon so pf should get better by lunchtime. Let us know how you get on too. x

  • I had a fairly rubbish night, waking up after every hour or so from coughing or wheezing (I'm not usually a wheezer so I lay thinking what's that noise, to realise its coming from me!). I followed your advice of not holding back on the ventolin, and found if I took 4 puffs, waited 10-15 minutes, it would release some of the gunk so then I'd have a good coughing fit, then take another 4 puffs to calm down the SOB from the coughing. This seemed to help, as did sleeping propped up, so I did manage to get some more sleep.

    Today I feel slightly less SOB/tight chested although PF is still only 290-320 ish, maybe this is owing to using more ventolin?

    Lou - when the Ventolin has released the phlegm is it a dirty thick yellow/green colour, doesn't look pleasant. It also hurts all of my chest. I just feel like I have no lung capacity and am short of breath even sitting still.

    Sounds like you have a chest infection then.

    Should I be worried if it is a chest infection? Would it explain why I feel achey and hot/cold all the time? I checked and I don't have a temperature but one minute I'll be hot so strip off, then I'm cold so pile the layers on again! Will I need antibiotics? I know my GP's aren't keen on giving them out, so what would happen if I just rode it out? I will try and get an appointment tomorrow, but wondered how pushy I should be given that I know there's usually a 7-10 wait for appointments.

  • Hi Butterfly, I'm sorry you're feeling so bad and I hope that the advice that everyone has given you helps. I'm a cougher and any sort of cold leaves me hacking away for weeks so I know how dreadful you're feeling.

    The only constructive advice I have is more by way of easing the discomfort than anything else and it's incredibly simple. Buy some Bottlegreen Ginger and Lemongrass cordial and make it up with hot water as often as you want it. You can add some honey and/or extra lemon (and maybe a splash of scotch before you go to bed!)to taste. I find that the heat from the ginger helps loosen the rubbish and, with the honey, soothes the pain in the throat and chest, a splash of scotch at bedtime helps me sleep for a bit and the extra lemon juice hides the taste of the honey and the scotch! I know it sounds mad to make a drink that includes ingredients that I dislike and have to disguise, but it works for me.

    Hope that you feel better soon.

  • Ooo Annista, that sounds lovely, I will be heading to the shops tomorrow for the ingredients! Thank you.

    Stray, thank you for putting that so well, I always worry that I'll demand an emergency appointment only to be told there's nothing wrong or something, silly I know but it always happens. I never worry when its one of the kids, but do for me. I will ring the gp tomorrow and get an appointment with whoever will see me, even if its the cleaner lol! I'll let you know how I get on xxx

  • Hi Butterfly!

    so sorry to hear tjat its rubbish for you at the moment. but glad that you will be at the GPs tomorrow. Stray thanks for that. its very good advice but mpst importantly very clearly put!

    do let us know hpw you get on. wishing you all the best

    Rose xx

  • Well I rang the gp, they weren't going to give me an appointment until I mentioned I was asthmatic and had been having trouble over the weekend, then they were really helpful and gave me the first appointment of the day, she said they often save these for emergency appointments, so worth bearing in mind for future.

    Unfortunately the appointment was with a locum tho. I explained i'd had a cold but now had chesty productive cough, that I'd not been sleeping and that I was using a lot of Ventolin due to asthma symptoms. I did pf which was 310, a bit of tapping on the computed 'thats not too bad he said', I said it is when my best is 570. Ah yes I see he said. He then listened to my chest and said it was clear, but given my symptoms should increase my flixotide to 4 puffs twice a day and use my Ventolin every 4 hours until the cold had cleared.

    So I'm going to see how I go, I was just certain after googling the symptoms, that there was an infection there. In the past when the gp has listened to my chest he's done it direct to my skin and has listened in at about 8 different places each side, this guy only did top and bottom of each lung and did it through my jumper, is that enough? I know I'm no expert but would have expected a thorough examination?

    So its great there's no infection, just can't help worrying that something might have been missed?

  • Well, I'm glad you got an appt but I can't help feeling, as you probably do, that that's maybe not the whole story! I would have thought some pred was called for by now but then I'm not a dr of course, just going on what I've been told.

    I would think it's still possible you could have an infection; my medic housemate said (without of course revealing anything confidential!) that he'd had a patient in the hospital who didn't show the usual signs, clear chest etc but when he sent her for an X-ray she turned out to most definitely have one so it's not always obvious. btw I've been told (by housemate and another dr) that the reason they're supposed to listen on bare skin is that otherwise the clothes make a noise which sounds like something significant but isn't. So am guessing if it was clear through jumper then it probably was clear though it seems that doesn't mean no infection! I might have expected a bit more thoroughness as well if checking for infection but I'm not a medic, maybe it's not necessary and they can tell without?

    Maybe give it another couple of days on the increased dose? The AUK helpline opens on Wed so perhaps you could ring them and ask for advice. Unless of course things get much worse in the next day or two and you need urgent help.

  • I'm glad you got a quick appointment, but I'm quite suprised you've not been given pred with a pf of 310 from 570. I don't think the increase in flixotide will work for a few days. The doctors/nurses have always listened to my chest on bare skin never through clothes. Did he suggest a follow up/asthma review?

    I had an appointment at 11.10 but didn't make it that far. Went in much earlier as finger nails went a bit blue :/. A couple of nebs and I was much better. They listened to my chest and said ""oh, poor you, that's horrible especially the left side"". Pred dose increased and follow up on wednesday. I'm still clutching my ventolin and spacer though :(

    I hope you see an improvement in symptoms soon. x

  • Maybe give it another couple of days on the increased dose? The AUK helpline opens on Wed so perhaps you could ring them and ask for advice. Unless of course things get much worse in the next day or two and you need urgent help.

    I think I will ring them, they usually have sound advice and it I do need to go back, at least I can tell the GP I've spoken to AUK and am not just causing a fuss.

    Interesting about the clothes mimicking breath sounds. So possibly he could have ignored something, believeing it be my clothes??

    I'm glad you got a quick appointment, but I'm quite suprised you've not been given pred with a pf of 310 from 570. I don't think the increase in flixotide will work for a few days. The doctors/nurses have always listened to my chest on bare skin never through clothes. Did he suggest a follow up/asthma review?

    Yes I am surprised, I have had pred in the past with a pf higher than that. I can understand reluctance to give out antibiotics, but I would have though pred would have been a sensible precaution. In the past I've had a 5 day course of 30mg (I think) and it worked wonders with my pf dramatically increasing within days. My GP once before just increased the flixotide but it took about a week before I noticed any improvement and he'd increased it to 6 puffs twice a day, so I'm not expecting any miracles!! I asked him if I should see the asthma nurse and he said that would be a good idea in 2-3 weeks once things had (hopefully) settled down. Mind you she's not all that good really, but hey ho.

    I had an appointment at 11.10 but didn't make it that far. Went in much earlier as finger nails went a bit blue :/. A couple of nebs and I was much better. They listened to my chest and said ""oh, poor you, that's horrible especially the left side"". Pred dose increased and follow up on wednesday. I'm still clutching my ventolin and spacer though :(

    I hope you see an improvement in symptoms soon. x

    I am glad you got seen and are being taken care of, I hope you make a speedy recovery

    xxx

  • I think I will ring them, they usually have sound advice and it I do need to go back, at least I can tell the GP I've spoken to AUK and am not just causing a fuss.

    Interesting about the clothes mimicking breath sounds. So possibly he could have ignored something, believeing it be my clothes??

    Yes I am surprised, I have had pred in the past with a pf higher than that. I can understand reluctance to give out antibiotics, but I would have though pred would have been a sensible precaution. In the past I've had a 5 day course of 30mg (I think) and it worked wonders with my pf dramatically increasing within days. My GP once before just increased the flixotide but it took about a week before I noticed any improvement and he'd increased it to 6 puffs twice a day, so I'm not expecting any miracles!! I asked him if I should see the asthma nurse and he said that would be a good idea in 2-3 weeks once things had (hopefully) settled down. Mind you she's not all that good really, but hey ho.

    Lou, hope you feel better as well soon!

    Butterfly: hmm good point about the clothes though really if he wasn't sure about a suspicious noise he should have checked by listening again under the jumper. My housemate said he thought he'd heard a noise which might be an infection once but he checked again listening under the clothes and it wasn't there so was clearly clothing. Apparently it can sound really similar to 'bad' noises though so they should be checking if they do hear something.

    I am not really impressed with this locum from what you say, would agree going back if AUK says so, with their back-up, would be a good idea if you can hold on till Wed.

  • Butterfly: hmm good point about the clothes though really if he wasn't sure about a suspicious noise he should have checked by listening again under the jumper. My housemate said he thought he'd heard a noise which might be an infection once but he checked again listening under the clothes and it wasn't there so was clearly clothing. Apparently it can sound really similar to 'bad' noises though so they should be checking if they do hear something.

    I am not really impressed with this locum from what you say, would agree going back if AUK says so, with their back-up, would be a good idea if you can hold on till Wed.

    Yeah I was just clutching at straws really, I clearly don't want their to be an infection, but if there is, I want the correct treatment, and if I had felt more confidence in the locum through the appointment I would have more confidence in his diagnosis!

    Fingers crossed things improve over the next couple of days and hooray for Wednesday when I can speak to someone at AUK who makes sense!!

  • Butterfly and Lou so sprry to hear your both going through a rough patch at the moment. i do hope things improbe fpr you soon. sending you both virtual hugs for a speedy recovery! ;-)

    Butterfly was very glad to know that you saw a doc even of je did seem a bot clueless...do get firther help whenever you feel you need ot. same to you Lou.

    Let us knpw how you get on ;-)

    Rose xx

  • Getting better, I'm glad to say. Pred must be doing it's good thing :)

    Rose and Butterfly, I've still got my fingers crossed for a swift recovery for you both. And I hope you're out of intensive care soon Rose. xxx

  • Thanks Lou. Doc came round this evening. did the whole talking about me but not too me. finally asked him how long he thinks ill be in cicu. answer: not long um how long is a piece of string? grrrr annoyed and fed up. sorry for the rant.

    Butterfly and Lou i hope things continue to improve for you

    Rose xxx

  • Rose that sucks!

    Hope you get a bit of energy soon and get out of ICU.

    X

  • Thanks Angelica!

    things are improving slpwly but the figured i.e. heart rate seem to be improving faster than my symptoms of pain and wobbliness/weakness etc. so im a bit worried about how this one will work oit. we sjall see. thanks again! ;-)

    hope youre doin ok(ish?)

    Rose xx

  • Things still no better, spoke to AUK who said I should see someone today, so got appointment this afternoon, fingers crossed xxx

  • Fingers crossed, glad they were helpful! Hope you feel better soon or at least get somewhere - at least as things are now back to normal, it's maybe less likely to be a locum again.

  • Good luck with your appointemnt, I hope you get somewhere with it this time. Let us know how it goes. X

  • I'm very sorry you're all three suffering so much at the moment, think it must definitely be the day for idiot doctors, you would think with a job like that their people skills would be second to none but sadly this is really not usually the case. It sometimes amuses me that they treat patients as though we get in the way of their job, rather than as though we ARE their job!!

    I hope you all make a fast recovery and Butterfly, I hope you get somewhere with your second appointment today x

  • I saw the asthma nurse who jumped the queue for me and got me in with gp. Pf had improved to 400 but he said there was definately restriction and infection in my lungs and I have temperature too, so have prescription for antibuotucs and pred = happy girl!

  • Butterfly so glad to hear that you had a better experience at the docs today. i hope the pred and antibiotics do the trick soon.

    hugs for a fast recovery

    Rose xx

  • That is good news, really pleased you had a better experience second time around :-)

  • Good news to hear Butterfly. Take care of yourself. X

  • In glad ive got the medication I need, just leaves me questioning whether the infection was there the other day or not? How soon should I see improvement? Gp said to get prescription straight away and take them then as the pred would get into my system in 8 hours, just I had a major wobble this evening, the Ventolin kicked in at the last minute but its shaken me up. I was hoping for some sleep tonight but I'm a bit concerned now.

  • Urggg I feel terrible, I'm supposed to be getting better on the medication not worse!!

  • Ugh. That's not nice.

    Do you think you are feeling worse in an asthma way or a URI way? Were you told how long you should wait for the antibiotics to kick in?

    If things aren't resolving in the expected time frame, go back to the GP.

    Antibiotics won't help if the URI is viral or if the bacteria is resistant to that particular antibiotic.

    Pred won't do anything for the infection - it just keeps whatever inflammation the infection might trigger at bay so you don't get a right royal asthma attack from the URI. And of course if an exacerbation has already started, it is supposed to help tamp it down.

    With me, I feel some effect of pred within a few hours, but after that the effect seems more gradual. Then again, I'm not necessarily a good measure of how pred should work since even high doses help but don't seem to completely qwash asthma symptoms.

  • I feel so sorry for you Butterfly! Infection meds always make me feel like death for the first couple of days - hopefully you will feel much better after the weekend.

    I had a chest infection in Novemeber, thought id got over it and got through xmas (although I was exhausted and using my ventolin way too much)....I should have listened to my body rather than feeling I would let people down over christmas and pushing myself - I had an attack on the 1st! My own fault, but defo a wake up call for the future.

    So just a note to say when you start feeling better, take it easy :)

  • Ugh. That's not nice.

    Do you think you are feeling worse in an asthma way or a URI way? Were you told how long you should wait for the antibiotics to kick in?

    I'm not sure what is worse really, my asthma symptoms are no better but no worse. The doc reckoned the pred would need 8 hours to start working, I've had two doses started at 5pm yesterday. He didn't say how long the antibiotics would need to work. I feel achey and have a headache, feel cold then hot and just generally unwell, my heart rate is 90 bpm at rest and my chesty cough is as it was. I haven't eaten all day but tried to eat at lunch and felt suddenly very sick. So I'm not sure if its the infection or a side effect of the medication. I'm just being impatient though really, and feeling sorry for myself!! As you say, the antibs won't work if its viral or resistant so I'll just have to wait a bit and see.

    I feel so sorry for you Butterfly! Infection meds always make me feel like death for the first couple of days - hopefully you will feel much better after the weekend.

    I had a chest infection in Novemeber, thought id got over it and got through xmas (although I was exhausted and using my ventolin way too much)....I should have listened to my body rather than feeling I would let people down over christmas and pushing myself - I had an attack on the 1st! My own fault, but defo a wake up call for the future.

    So just a note to say when you start feeling better, take it easy :)

    Yes I need to take on board the rest thing, unfortunately I have been off work for 7 months due to another medical condition (actually a viral infection!) and am due back at work on Tuesday, I really need to get better by then as I can't take any more time off work!! It's typical isn't it?!?!

    It doesn't help that I only got 3 hours sleep last night owing to the symptoms so I'm not in the best and most rational frame of mind! I NEED more sleep!!!

    Sorry for ranting and feeling sorry for myself, I need to be more patient LOL

  • Butterfly, :(. Hope you feel better soon, this infection really seems to have taken hold! I never feel that great on antibs/pred either though usually it tends to be more specifically stomach upsets - may be that they have a lot of work to get on with though and need more time. But do go back if you still feel rubbish in a few days.

    Crossing fingers about work - but don't push it if still feeling rubbish!

    btw meant to say Rose, if you're reading this - did you escape from ITU? Hope you're feeling better.

  • Butterfly, :(. Hope you feel better soon, this infection really seems to have taken hold! I never feel that great on antibs/pred either though usually it tends to be more specifically stomach upsets - may be that they have a lot of work to get on with though and need more time.

    Yes I do seem to have got myself a stubborn little strain intent in making things difficult for me, good old asthma just adding itself in there to spice things up lol. Yes as you said, maybe it needs more time to battle this bug, I know I'm being impatient :-)

    Rose, I don't understand the actions if the steroids but never though of it in terms of slowing your immune response, this makes sense though!

    I do hope things improve for you soon, sending virtual chocs and hugs xxx

  • Butterfly

    so sorry to hear that youre still feeling so rubbish. as Phklomela said antibs do oftsn cause an upset stomach as a side effect. and the pred although helping with the inflammation in the lungs does actually slow down youre immune system so this.may not be helping in every aspect.

    take care and dont try work if youre still feelinv rubbish

    so i do hope things improve for you soon. do let us know how you get on

    sending virtual hugs for a fast recovery ;-)

    sorry for gypo errors. am on my fone

    Rose xx

  • Philomela yes am still in CICU. my heart behaves if i just sit/lie and do nothing but the slightest effort sends heart rate through the roof :'(

    but hopefully will be moved tonormal cardio aard tomorrow if they have a bed for me

    Rose xx

  • Well I think the antibiotics have started to work now, chesty cough not as bad, temp seems to have reduced and the horrible muscle/hip aches have gone which is good. I'm just still feeling my chest isn't right from an asthma point of view. I don't have anything specific but just feel tight, am still using 12+ puffs of ventolin a day and peak flow is still only just reaching 400 at a push. Is it likely this will take some time to improve? I wake on a night feeling tight too.

  • Hello Butterfly,

    I am pleased that the antibiotics and prednisolone have started to work for you.

  • Glad to hear the URI component is feeling better.

    re: asthma symptoms - do you feel like things are generally improving or getting more difficult?

    I don't know what your action plan is, but if 12+ puffs or PF < 400 is in your yellow zone, it is totally reasonable to call the doctor back and at least leave a message asking for her opinion.

  • Glad to hear the URI component is feeling better.

    re: asthma symptoms - do you feel like things are generally improving or getting more difficult?

    I don't know what your action plan is, but if 12+ puffs or PF < 400 is in your yellow zone, it is totally reasonable to call the doctor back and at least leave a message asking for her opinion.

    They're definitely not getting worse, just don't seem that much better so say I've been on pred for the last 5 days. I have absolutely no action plan so I'm kind of flying blind with it. Yes I think maybe a quick message to the gp might be a good call. I thought that seen as my last pred was today I'd maybe see how I get on over next few days and then call, at least if things get worse, I know the pred was helping.

  • For me it takes a while to get pf up again with a chest infection. I'm still not in green zone even though I've been on steroids for 9 days. Finished antibiotics. Still taking ventolin every four hours and at night sometimes every hour for a few hours. Using much less than I was :).

    If you're worried about still having symptoms get in touch with your GP. Action plans/ventolin use/recovery times etc are all individual, so what's norm for me might not be for you, so ask your GP just so you know, and you can either be reassured that it's what they expect or they can help you out a bit more if needed.

  • For me it takes a while to get pf up again with a chest infection. I'm still not in green zone even though I've been on steroids for 9 days. Finished antibiotics. Still taking ventolin every four hours and at night sometimes every hour for a few hours. Using much less than I was :).

    If you're worried about still having symptoms get in touch with your GP. Action plans/ventolin use/recovery times etc are all individual, so what's norm for me might not be for you, so ask your GP just so you know, and you can either be reassured that it's what they expect or they can help you out a bit more if needed.

    I'm glad it can be normal to have a delay in pf increase. As I said above, I'll give it a day or two, still have two days of antibiotics, and see how I get on. Last time I had pred my pf shot up within a day or two, but then I didn't have a chest infection then so I guess its different. Thank you for your advice e and reassurance

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