Not sure what I should do...

I saw my gp before christmas about issues at night and a chesty cough that had lasted 3 weeks/ a month. I was told to increase my inhaler and then go back if I wasn't completely better a few days later. The night time symptoms eased up a bit, but the cough remained so I went back. He listened to my chest and said it was clear so I should just ride out the cough, then gave me a lecture about how a cough doesn't have to be asthma and I'm sure he thought I was wasting his time. He ignored the fact that I still had some symptoms at night. I didn't point it out since he made me feel so rubbish I just wanted to leave!

Anyway, I'm not sure that I have just a viral cough. I went back home over christmas and after a few days of barking, the cough had virtually gone. I live i the middle of the countryside where no one smokes on me and there's little pollution. I got back to uni last friday and the cough, and symptoms returned. I live in the middle of a city where everyone smokes whilst I'm at uni. Surely that doesn't make it just viral?

The problem is, I didn't take my inhlers home (oops!) so haven't used my preventer for 3 weeks. I found an old reliever at home so at east I had that. I'm not sure whether I should go an see someone now, or wait until I've used the preventer for a few weeks first. Maybe it'll go away once I get some control back?

Just wondering if anyone can give me any advise on what to do!

Thanks :)

22 Replies

  • Hey :) not sure I can offer much in the way of advice, just want to say I have had a very similar experience. I've had a chesty cough and night symptoms since October that were originally put down to a chest infection, although antibiotics didn't help that much. Then I went home from college for christmas and got a lot better, now am back at college and the cough is back with a vengeance!

    As to what to do, I think if I was in your position I'd make an appointment in the next week or so - like you say, it can't be coincidence that it got worse when you returned to a smoky city! I hope you start feeling better soon, sorry I'm not much help :)

  • The problem is, I didn't take my inhlers home (oops!) so haven't used my preventer for 3 weeks. I found an old reliever at home so at east I had that. I'm not sure whether I should go an see someone now, or wait until I've used the preventer for a few weeks first. Maybe it'll go away once I get some control back?

    In the past, when my asthma wasn't particularly active and easier to ignore, I'd often go long stretches without preventer with no ill effect. If I'd only restarted using it (e.g. to keep a cold from turning into a long exacerbation), I often waited a week or two after I started using it again to see what happened. If all was well in two weeks, I'd never call the doctor.

    My logic was that the main reason to visit the GP is because the current plan isn't working as it should. Why call or visit, when all I'm going to be told is stick to the plan?


    My thinking on this presently is a bit different for two reasons.

    First, it could be that the doctor will say, ""well, duh, take the preventer"" but it could also be that the doctor will want to jump start the process of getting the lungs back to where they ought to be with more than the usual amount of medication and then drop back to the normal amount.

    Perhaps a phone call for guidance? Just be honest that you've only recently restarted reusing the preventer so that the doctor doesn't think this is an exacerbation that happened despite the preventer and you get more medication than you want or need long term. The worst that could happen is that that the doctor will give you a polite lecture about the importance of regular use of preventer. That's not pleasant I know, but still better than not getting the right help because you stayed silent.

    Second, monitoring frequency of symptoms and exacerbations is part of the general monitoring process your doctor needs to be doing. Treatment levels can be both stepped up or stepped down based on whether or not your asthma seems well controlled.

    If you never call in about exacerbations that go away when you stick to plan, then he or she might eventually think it is time to try a step down in asthma meds when in fact it wouldn't be a good idea. That is, if your coughing at uni after a cold is due to asthma, then one way to look at your three weeks without preventer is as a failed step-down experiment.

  • Thanks for the replies :)

    Well, after a 40 minute walk uphill in the cold today (to see the most amazing student house ever that is unfortunately too far away :( ) I think my flatmates are starting to wonder why it sounds like thre's a dog in my room! Going to have a quiet night and hopefully an early night. Was up until 2 coughing, not good with a 9am exam and a flatmate who didn't shut up untl midnight! My ventolin is next to me, though for the moment I'm managing without :) I think I'm happier just knowing it's there!

    Beth, that's exactly what's going through my mind. All they'll do is tell me to take the inhaler. I know the nurse won't shout at me but the doctor will and it has to be one of the doctors who messes with my inhalers. I'm not too bad atm so am tempted to wait a bit. I think if nothing's happened by monday then I'll go. It will have been a week then since I got back. Ideally, I'd like to see the nurse since she' so lovely and sympathetic but it would mean waiting a week whereas I can see a doctor that day. Maybe I'll see one of the other docs if I have to, all my friends ay a certain one is amazing! I uppose I don't really notice it being uncontrolled since I've never been controlled (diagnosed a year ago but always had symptom ).

    Thanks :)

    Sorry or any issing letters, my keyboard is havin issues!

  • Hi,

    I can't add anything to the advice you already have but just wanted to say, I have a clear chest about half the time I go to the GP about my asthma and it drives me crazy how they can make you feel like you're exaggerating/imagining your symptoms just because they can't hear anything at the specific time you visit. The worst culprit for this at our practice is oddly enough the GP who is the asthma specialist! I find the asthma nurse much better for talking to about symptoms, she is much more clued up! If only she could prescribe prednisolone I don't think I would bother with the GP at all!

  • Thanks :)

    The problem is that the nurse can't prescribe and she was the one who sent me to the go to have my chest listened to, so I'm assuming she doesn't do that either! I'm starting to think it's all in my head though, my pf is around 420 and my best is 450 so not sure why it's bothering me. The coughing was worse today, and led to me feeling dizzy but then I could be stressed!

  • Rachel, once again I'm feeling exactly the same as you are! Coughing makes me dizzy and is constant throughout the day but my pf has only dropped from 500 to 450. I would still say if it's bothering you then you should get it checked - although maybe leave it a week to see if your preventer gets rid of it? Coughing is always the first sign of a flare-up for me and I'm sure you want to avoid that where possible! May not be the same for you though :)

    I hope it starts clearing up for you soon :)

  • Rachel - your symptoms also count.

    Some people, especially it seems those of us who have studied instruments that rely on breath (voice, wind instruments), can maintain a peak flow even after symptoms show up. In theory, for my age, sex, and height, I should have a peak flow of 420, but that is actually the point where I become noticeably symptomatic. At or below 400, I'm often too tired to function and my lungs sometimes quiver like gerbils at silly triggers. 420 to 400 isn't a big difference and it certainly isn't 80% of 420 or even my best so far with this peak flow meter (460).

    Listening to your body is important. It isn't overreacting if you are being level headed about it and just noting ""hey, this isn't the way I am when I'm functioning at my best"".

    (Note to self: re-read above several times and apply to self)

  • Hiya Rachel,

    I'm not a great fan of the ""it must be stress"" argument I have to say. It's a particularly sore point wirh me as it took me months to convince my GP that I was ill and not just stressed when my M.E started to manifest itself! That is, if you feel you are stressed and stress usually makes you cough, then clearly who am I to question it! But if you aren't prone to coughing whilst stressed, then I would say the cough coupled with the drop in your peak flow - even if it is only a fairly small one - is classed as a definite symptom of asthma and something you should definitely pay attention to. My peak flow has reached 470 (that's my best over the last 2 years) but at the moment it's hovering between 350 and 400; however I can get symptomatic whilst it's still at 450. So I'd sat definitely, get it checked out - always better safe than sorry!

    Ps - don't forget, emotion can be a genuine asthma trigger - so if you DO have something going on in the background your asthma can be triggered - either way, it still merits investigation! Xxx

  • Thanks for replying :)

    I wasn't convinced about the stress either, but the nurse always goes on about so I thought maybe she'd noticed something I'd not. I do have exams right now but I'm not felling stressed about them at all (well, no more than anyone does with an exam!) I've never had a cough with stress, I don't really get stressed, but since I don't have a clue about triggers I was clutching at straws.

    Today was the worst day so far :( But I think I can blame that on the snow. Why can't it snow and be warm?! I had an exam so unfortunately I couldn't avoid venturing out. I woke my flatmates again with my coughing last night, however one of them had been smoking various legal and illegal things all night in his room with some friends, so it's only fair that he got woken up!

    I'm using my symbicort 3x a day as opposed to the usual 2x. The doc told me to keep at it for a few weeks, but didn't say how long, so I've just carried on until I stop coughing :P I know I've said this before, but if it's not gone by next friday then I'll make an appt with the nurse. I'm not really sure they can do much though if it's just the cold and the pollution.

    Thanks for the replys, now excuse me whilst I tell aforementioned flatmate to stop shouting down the corridor to his friends (who have invaded our kitchen and are making a mess >:( ) and to turn the music down!

    Beth, did you take your own advice? :P

  • Ok, I think I should maybe make an appt

    Incredibly breathless and my chest aches. Took my pf out of interest and it's 350. Given that I can hear myself wheezing I think it's safe to say that this cough is asthma related!

  • Aw Rachel :( yes sounds like you need an appointment! Hope you get some sleep and start to improve soon x

  • Hope the GP appointment went well, Feel better soon!

  • I actually decided against an appt this morning since I was better than last night... I'm amazing at putting things off! I have an appt on Monday for something different but equally annoying so I'm debating which thing to mention. I haven't had to go outside today which has helped. Just bad in the evening and my pf was 400 after my inhaler which is ok.

    Out of interest, does anyone know if weight affects asthma? I'm very slightly underweight (bmi 18 ish) and o put weight on so I'm just about a normal weight. It's since putting the weight on that I've got worse. Could just be a coincidence since it's overeating for the past month whilst it's been cold that's caused it.

    Thanks :)

  • Out of interest, does anyone know if weight affects asthma? I'm very slightly underweight (bmi 18 ish) and o put weight on so I'm just about a normal weight. It's since putting the weight on that I've got worse. Could just be a coincidence since it's overeating for the past month whilst it's been cold that's caused it.

    Thanks :)

    Absolutely it does! I've gone from a BMI of 14 to a BMI of 18 which is still considered low (Im still very slim) and it has hugely affected my breathing. Its no different to me physically carrying another two stone after all!

    Lynda :)

  • Weight does affect asthma in that the more you weigh the more work lungs have to do. However i thought the problem only arose when one os actually over weight so notsure if being normal weight has the same effect?

    Hope you get sorted and feel better soon.

    Rose xx

  • I'm sorry you still aren't feeling well.

    I think when things don't go as we wish we tend to reach out to things we can control, among them food, to explain things. Sometimes though it ""just happens"".

    My understanding also is that only outright obesity is a factor - normal or low-normal BMI is not. But note:too low BMI causes a raft of health problems as well.

    Do make sure you are drinking enough and not just eating - with the cold weather you are likely breathing in a lot more dry heated air indoors and with coughing and rapid breathing from the asthma, breathing out a lot of moisture. Dehydration might lower your weight, but it won't help asthma or general health one bit.

  • Rachel, one thing I wanted to add before you go to your appointment (and don't cancel it this time!)... coughing can sometimes be the 'first step' before the real wheeziness begins. At least that's how it seems to be with me and I've had to tell medical personnel quite firmly to pay attention to the cough, because it is only the start.

    If I cannot get the coughing under control, it can very quickly spiral into wheezing, tight chest and all the 'classic' asthma symptoms. Unfortunately it took A&E staff a while to realise that, and it wasn't until they got my blood gases back that they realised my O2 was not 100% as the finger probe was telling them. They moved me straight into resus after that and within minutes my oxygen levels started to plummet.

    That's why I no longer tolerate people saying ""have you got a cold?"". You can normally tell the difference between an asthma cough and a viral one, so be firm with the doc. Sometimes it helps to write down beforehand what you want to say, or even to say it first thing when you get in there (before he has a chance to make you feel like you've lost your confidence), but he needs to be told.

  • Hi,

    I definitely agree with the above - for me, a cough is usually the way things start to deteriorate, definitely not something to be ignored!

    Definitely don't cancel this doctors appointment xx

  • Thanks for replying everyone :)

    I promise to keep the appointment :P. The doctor I've booked it with is one who I've not seen before, so maybe he'll be ok. I couldn't get to any times with the one I last saw (what a shame :P). I started off better again today, but then I had to go outside and I've barked through the rest of the day. I think the person next to me in my exam was ready to murder me by the end! I tried to stop myself but that just made things worse! Also, my ventolin has stopped having any effect for more than 5 mins so now when it gets bad I'm on my own, which really scared me last night!

    Re my weight, I know it's bad to be underweight but I just prefer how I look that way. I am careful though to eat a balanced diet and I'm not sure my bmi is that accurate in that I don't look underweight. I have lost about half of the weight I put on so I'm almost back to normal. Didn't really think it would have an affect, but like Beth said, I'm just trying to find a reason in anything.

    I'll use the appt to talk about asthma, partly because I can't work up the courage to talk about the other thing I made the appt for (nothing serious, just irritating!) but mostly because I want some sleep! Fortunately I'm going back home for a few days tomorrow so back in the fresh air and countryside :) Just hope I don't get snowed in.... what a shame it would be to miss all my lectures...

    I think part of my problem is that I've spent my whole life ignoring asthma symptoms because my parents told me I was overreacting. I was only diagnosed last year so have had to force myself to notice what's going on. I don't really know what my triggers are or how bad I should be to get help. I'm also bad at remembering the existence of ventoin until I get to the point where my chest stops me from doing anything! It would be so much easier if it could just go away!

    Thanks for the replies :) Hope you're all well :)

    Rachel :)

  • I think BMI is pretty inaccurate for a lot of people, and i think its improtant to 'look healthy' as long as no-one is lookig at you and thinking you look really skeletal you're probably ok! i am right at the top of 'normal' but my ribs and hip bones really stick out, so i dont think i am going to be 'overweight' if i gained a little bit. but any extra weight will mean more for you to carry about. if you are properly underweight then it will also be bad for your lungs in that you wont have the reserves to fight infections, work hard when your breathing is difficult and things like that but as long as you are a healthy weight for yuor shape and size it shouldnt make a huge difference.

  • Sorry I haven't been on in a while, no idea where the last few days have gone!

    Now, I know I promised that I wouldn't cancel that appt, but I went home on friday and then discovered that I don't have any lectures until thursday so I'm staying at home for a while :P Tbf I'm a lot better than I was, got some kind of weird dizziness thing going on right now, but it's better than the coughing!

    I read something in the news the other day that said BMI generally labels shorter people as more underweight than they are, and taller people more overweight that they are. Since I'm a shortie maybe I'm ok after all :P

    Thanks :)

  • Glad to hear you are feeling better. Enjoy your holiday at home!

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