New to asthma and attacks

Hi, I was recently diagnosed with adult onset asthma last Monday after a couple months with a lingering cough and difficulties with mucus and breathing. I'm actually in the US but this site seems to have quite a lot of good information on it. The symptoms I was having were a minor inconvenience until I saw the pulmonary specialist.

He put me on a Pulmicort Flexhaler twice a day and Albuterol as needed. But within two days of the new treatment my asthma became much worse and I started having attacks. I went back to his office on Thursday for some albuterol breathing treatment which did very little to help. I also started a course of 40mg prednisone.

Now over three days in to the prednisone treatment, and I still do not feel as good as I did Monday starting the treatment. In fact I'm pretty much stuck on the couch and the slightest bit of talking or getting up gets me coughing and wheezing. I've never had anything like this before.

I'm waiting for the doctor to get back to me. They had mentioned doing a CT scan if the prednisone didn't work within a couple days. I also wonder if the new pulmicort inhaler could be to blame for making things worse? The literature says not to use if you have milk sensitivity, and I can't eat dairy products. But I've also read that reactions should be very rare and I don't know if I'm really *that* sensitive.

Is prednisone really supposed to work that fast too? I just worry about going and getting all this radiation without ruling out all the other possibilities. But unfortunately, I know almost nothing about these lung conditions. Any voice of experience would be most welcome, thanks!

12 Replies

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  • Welcome. Sorry to hear you're not well and going through the scary time of being newly diagnosed. You should go back to your doctor to discuss your concerns about the pulmicort making things worse. Prednisolone would normally be working well 3 days into a course, as long as the trigger has been removed (or is being dealt with). x

  • am i right in thinking that albuterol is salbutamol/ventolin? I was wondering if he said anything about why that didnt help? To me (as an untrained medical person) that would ring alarm bells that maybe something else was going on - apart from in my more severe attacks i usually respond really well to salbutamol nebulisers and i thought that was the case for almost all asthmatics. It might be worth getting the CT +/ some bloods i expect (docs are at least 50% vampire in my opinion) just to check that there is nothing else going on, especially as i believe a lot of people do not have a reversibility spirometry immediately after diagnosis, so the asthma diagnosis is less 'concrete'. Im not a doctor so i dont know - but it might be something to discuss with the doc.

    I agree with lou about mentioning the concerns about pulmicort - there are lots of different steroids to try and there is no point being on one making things worse - and given that it sounds like the symptoms were immediately after staring it and its a pretty strange coincidence if theyre unrelated!

    Id get back to your doc asap and talk to him about whether you are on the right treatments etc.

    Hope you feel better soon :-)

    ps. i think quite a few people on here live outside the UK!

  • Thanks for the responses. On Monday, I called the doctor and mentioned my concerns with the pulmicort and he agreed that I should stop taking it. He sent me in to the office to be checked out by one of the nurses. The nurse promptly checked me in to the hospital after seeing my vitals. I was given a CTA scan of the chest as well as an echocardiogram and tons of blood tests including an arterial blood gas. All came back negative, thankfully, and I was released.

    The inhaler is a ProAir HFA inhaler, albuterol sulfate. They were very alarmed that it wasn't helping, as with the nebulizer treatment and prednizone. But after a battery of tests, they don't seem worried any more but I'm left with no answers. I have not had any spirometry test yet.

    I'm trying to work out my next steps. I'm still finishing the prednisone taper. I think I'll ask for a different inhaler without a lactose base just in case that did have some effect.

    Since this likely *is* asthma that isn't being controlled, I guess it makes sense that I have not eliminated the triggers? I guess I'll buy new pillows, get a better air filter, keep fighting the never ending post nasal drip I can't seem to make a dent in either.

    Mostly just taking a deep breath and being glad it's not pulmonary hypertension or fibrosis or some other awful thing.

  • Thanks for the responses. On Monday, I called the doctor and mentioned my concerns with the pulmicort and he agreed that I should stop taking it. He sent me in to the office to be checked out by one of the nurses. The nurse promptly checked me in to the hospital after seeing my vitals. I was given a CTA scan of the chest as well as an echocardiogram and tons of blood tests including an arterial blood gas. All came back negative, thankfully, and I was released.

    Its good news that they were prompt in checking you out. Im guessing by negative you mean that everything was normal?

    inhaler is a ProAir HFA inhaler, albuterol sulfate. They were very alarmed that it wasn't helping, as with the nebulizer treatment and prednizone. But after a battery of tests, they don't seem worried any more but I'm left with no answers. I have not had any spirometry test yet.

    Albuterol is what we in the UK call salbutamol. Do you mean that the inhaler wasn't helping, but that the nebulised albuterol was? The salbutamol/albuterol inhalers make little difference to me, but nebulised salbutamol/albuterol does. I have quite severe small airway disease and I think the smaller particles in the nebulised drug reaches the parts the inhaler doesn't.

    trying to work out my next steps. I'm still finishing the prednisone taper. I think I'll ask for a different inhaler without a lactose base just in case that did have some effect.

    Your consultant should be discussing/working out the next steps with you.. did they say what their plans were to follow you up after all the tests? What did the hospital say about stopping the pulmicort, did they prescribe an alternative?

    this likely *is* asthma that isn't being controlled, I guess it makes sense that I have not eliminated the triggers? I guess I'll buy new pillows, get a better air filter, keep fighting the never ending post nasal drip I can't seem to make a dent in either.

    Mostly just taking a deep breath and being glad it's not pulmonary hypertension or fibrosis or some other awful thing.

    It depends on whether your asthma has an allergic component. To be honest there are so many potential triggers that it would be a total shot in the dark to spend a fortune on air filters, pillows and bedding protectors as you may well not be allergic to house dust mites. I have lots of allergies, house dust mites arent one of them thankfully! Allergies can be to drugs, pollens, moulds, fungal spores, animals.. etc etc. Its best to see if you can have allergy testing to pinpoint if this is a component of your asthma.

    Post nasal drip has a link with asthma, so it might be worth seeing if you can get this under control. My PND symptoms are always worse when my asthma is bad. I didnt realise there was a name for it until the respiratory consultant asked me if I had it!

    The good thing about a CT scan is it rules out other things which can cause breathing difficulties, Im sure its good to have a clear scan :)

  • Hiya, sorry you're not feeling well.

    Hope you are much better soon!

    I developed adult onset asthma too in 2008 and have been on Symbicort twice a day since soon after diagnosis. My asthma has been so well controlled I was cut down from 400/12 to 200/6 last winter. All was going well till I got a bad cold 3 weeks ago. My asthma has been terrible since and I've had difficulty talking, so I gave in and went to see my asthma nurse this morning. She got my GP to ok a script for Prednisone 40mg for 5 days. Taking 8 tablets with food each morning.

    I'm glad I have taken the steps to get extra help with my asthma, but feel a bit down tbh about having to take Prednisone :(

    I guess it's been so well controlled that I unrealistically thought I had 'asthma lite'.

    Has anyone any advice experiences they could share about taking Prednisone? A friend can't tolerate it at all as it makes her manic, so I'm a little concerned :o

    Thanks for reading this :)

  • I failed to mention that this is the first time I've ever had to take Prednisone. It has been a wake up call for me.

  • I really wouldnt worry too much about a short course of pred. The side effects dont tend to be too bad on short courses, its long term steroids that most people complain about. I do find that on higher doses that 40mg i get a ""tad over emotional"" (or completely bonkers!!) but at 40mg/30mg i am completely fine, so i wouldnt worry too much, if you do start feeling unwell then mention it to GP, i suspect the effects wont last long as they'll take a few days to kick in, and then will go soon after finishing! A few people have issues sleeping on pred, my solution to this is to take them at 6am (i wake up, take pred and cereal bar, and then go back to sleep for a bit). You might find you are really hungry on it, not too much of a problem in a short course, on longer courses you have weight gaining issues to think about, but short term its more just about trying to keep healthy and eat stuff that fills you up without being too bad for you :-)

    As i said - i really wouldnt worry about a short course! I, like many on here, am not a fan of pred, but only becuase i take it very very frequently and so have some of the issues associated with long term pred, so when we all complain about it, its not really so much a complaint about the short courses, now that i can at least have a few days off pred in between courses im much happier about it! And as much as i dislike it, it keeps me out of hospital most of the time, so it is good at what it does :-)

    fell better soon!

  • Hey, sorry you're not feeling too good at the min!

    I am with soph on this with not worrying about a short course of pred, it does its job and quietens down the asthma. 2 or 3 short courses a year (according to my gp) is fine and nothing to worry about. I whine about it, but that is because I am on permanent maintenance pred to manage my asthma - 35mg with a view of eventually getting to 20 and remaining there.

    Before the maintenance pred I had a LOT of *short* courses, and the worse side effects I got were a bit of insomnia sometimes and then feeling hyperactive when my flare was dying down.

    Don't worry about them, not taking them is worse than the side effects!! It's better to get on top of a flare up using pred than letting it get out of control.

    Take care

  • Thanks so much for both the replies. Part of my reason I'm a bit despondent today is that compared to many others I know my asthma is nothing, usually asymptomatic. So it has been a bit of a shock.

    But I'm looking forward to feeling much better very soon :D

  • Urghh, I feel worse again today after a slight improvement on a 5 day 40mg course of Pred. I feel pretty bad tonight so I'm going to go back to my asthma nurse tomorrow.

    My heart is pounding so I know I'm getting a bit stressed about it :(

    I really hope my asthma isn't suddenly taking a long term turn for the worse.

  • Crossing fingers that things improve soon!, all asthmatics can go through rough patches, try not to fear the worse! Usually it can be controlled with just the odd blip

    Take care :-)

    Laura x

  • Hi, I'm newly diagnosed too at the grand old age of 48! I'm in New Zealand. It was good to find this forum. Am currently on seretide and respigen. Currently awake at 4 am for some reason (happens a lot). Got aching ribs and pain in collar bone. Anyone else get this? Cheers.

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