111 - argh!

Hiya,

Finished pred/amoxicillin combo on thurs, started seretide on mon.

Today feel really tight chested, coughing loads and feel breathless. Using my blue a fair bit.

Rang our MIU, who told me to ring 111 as they couldn't prescribe, as I'd already had treatment?

Well, 3 hours on, still waiting for call back - chest really tight and hurting :-(

Sorry, rant over!! X

23 Replies

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  • If you are still suffering and your reliever not helping much maybe you should phone 999 or OOH Doctor.

  • Still waiting, don't feel any worse, but certainly no better. Beginning to get a little angry now :-(

    It's not bad enough to call 999, but not good enough to not be seen

    Chest hurts - I reckon it's still the chest infection which was why I was on the pred/amoxicillin

    X

  • It is really frustrating when it is like that, you poor thing. I do hope you start to feel better soon.

  • Heyy,

    111 finally rang me at 7am this morning, after ringing goodness knows how many times.

    They booked me into an out of hours appointment, who saw me after abusing my Salbutamol big time!

    Saw them at midday, they really told me off for not dialling 999, PFV was 340 (up from 250), PB 520. O2 sats were still down, which they were worried about because even in a bad attack they rarely go below 98% and they could hear audiable wheezing, when I'm not a wheezer.

    Was given yet another dose of prednisolone (for 3 days) with an order to have a review with my GP in the next 48 hours.

    She has recomended at least doubling the steroid component of the Seratide, plus another add on possibly?!

    I don't even know whether I am mild, moderate or severe asthmatic? GP seems very ambiguous! Though had 4 REALLY bad attacks in the last 8 weeks?! Confusing!!

    Though I am actually feeling better than earlier thanks to the pred - just worrying that I have been given it A LOT recently! Sorry for ranting!

    Laura x

  • Hi Laura!

    Are you under a respiratory consultant? If not, after 4 bad attacks your gp should be thinking about referring you.

    X

  • Hiya,

    No I'm not, but my GP practice is a bit dense!!

    Had ""suspected"" asthma for years ... but no official diagnosis.

    Been constantly ill with it since september ... no preventors etc given wil January when I went to the walk in centre, who said they couldn't treat me cos I hadnt got an official diagnosis and to book an emergency GP appointment for the next day which I did. If it got worse to go to A&E - this was in Jan.

    The GP said then that I was definitely asthmatic (as PFV was below 50%) and put me on QVAR 50 and Pred, telling me that it was obviously mild and that it was the type ""that never causes any problems"".

    Since then gone on to have 3 more lots of Pred and Antibiotics (at times antibiotics just for precaution - I have issues with this?!)

    Seretide dose been increased today to 2x2 puffs of 125/25 a day - over the phone. Put back on pred yesterday. GP said they dont require a follow up appointment?

    This is despite 2 lots of pred in the last 11 days (2 days between courses) and 2x being nebulised in this time too.

    They haven't referred me anywhere and dont seem very concerned ... but I can't do anything at the min without feeling like death!!

    Sorry, I feel really ranty at the min!!

    Laura x

  • There is a stepwise approach to asthma managment, and currently on step 3 with the drugs youve said. The next step would be singulair. I dont think a referallal is needed just yet!

  • When you see your GP ask for a referal , they can take a few months to come through the sooner you are seen by a proffesional in this the sooner it will be under control

  • Rang AUK today, cos finish pred tomorrow and still not feeling great, the person I spoke to was great, said I needed to go back to GP and be on the pred until its totally under control. In the meantime to be put upto max seretide with a view to reducing my intake!!

    She also said that the next step would be montelukast? Which may be worth enquiring about? Any experiences?

    She also felt that it is getting to the point where referral is necessary due to the number of attacks recently, but to first see if there is an asthma nurse at my surgery.

    Was very impressed by them actually. Was very helpful and informative and was nice to hear that I am not just being a hypercondriac, which my mum seems to think I am being :-(

    Do you reckon I need a referral? Asthma seems to have deteriorated soo badly and quickly this last few months ... I am off work with it at them min

    xxx

  • Montelukast (aka singulair) is a pretty good anti-allergy medication. Its quite commonly used in asthmatics who are a bit harder to control. I personally haven't noticed any side effects from it, and i think there has been some improvement in my asthma since i've been on it. If your triggers tend to be allergens then i think you are more likely to get a lot of benefit from montelukast, mine tend to be more cold air, exercise type things. Its just one pill before bed (in most cases) so its pretty easy to fit in and like i say, i know a lot of people on it and not heard anyone complain about side effects although im sure like all drugs there must be some!

    I personally was reffered when in your kind of situation (i was given montelukast by a consultant and not my GP, but i was already in hospital at the time) i know some GP practices like you to be on pretty much everything that they can give you before reffering you. it might be worth giving montelukast a few weeks to work (as this is likely to be the first thing a consultant would do anyway, they'd probably give you montelukast and tell you to go away for a few weeks to see if that helps - you might as well try it first cause then you'll get the benefit now!) But i don't think it would be ridiculous for you to ask to be reffered now, as i say, i was!

    I agree that it might be worth going on a stronger dose of seretide, if you are having a lot of attacks i guess it would be more common to be on 250, 2x2!

    Hopefully its just a temporary blip while the weathers been so dodgy! :-) shame your mum isnt being supporitve, family can really make things easier if they are supportive!!

    Good luck :-)

  • My mum (bless her!!) used to ba a nurse, and has decided that I am being a hypercondriac!!

    Dunno what my main triggers are now ... everything seems to set me off! whether its cuddling my dogs or going for a walk, hoping that this is just a ""bad patch"" :-/

    what are specialists like? Its a scary thought asking for any referral ... think I would rather bury my head in the sand :-/ though I am signed off worok at the min and pred not getting rid of symptoms ... grrr xxx

  • She also said that the next step would be montelukast? Which may be worth enquiring about? Any experiences?

    Montelukast has been great for me, deffinately added some control. Lets hope the top dose seretide does the trick for you and you don't need montelukast.

    She also felt that it is getting to the point where referral is necessary due to the number of attacks recently, but to first see if there is an asthma nurse at my surgery.

    Do you reckon I need a referral? Asthma seems to have deteriorated soo badly and quickly this last few months ... I am off work with it at them min

    If there is an asthma nurse or GP interested in asthma at your surgery then go see them asap. If they're proactive and you feel confident with them then maybe you could wait and see what happens before being refered. If you don't want to hang around before being referred or you don't feel confident in your surgery then get the referal. I have a fab team at my surgery, so I didn't feel like I needed to rush into a referal as I was confident they were doing the right thing.

    Was very impressed by them actually. Was very helpful and informative and was nice to hear that I am not just being a hypercondriac, which my mum seems to think I am being :-(

    In my teens my mum and dad used to think I exagerated my asthma (my dad has asthma and i'm sure he thought mine was mild like his) but then I ended up in hospital quite a few times, then they took it more seriously. I don't know what you can do/say to convince your mum though, going to hospital is not a good way of convincing her, but maybe you could take her to the asthma nurse/GP appointment with you. It's different for me now though, my mum worries like mad about my asthma, my attacks, amount of time I have off work and amount of meds I have, although my dad's pretty much the same, ho hum.

    I hope you're feeling better soon

  • Hey, thanks for the replies and advice :-)

    I decided not to go back ti the gp and see if I could manage myself and try to get though it - very bad idea though !!!!

    Ended up back at the gp yet again today as the pollen count has made me really bad on top of already very badly controlled asthma at the min. Should have just gone straight back on weds!

    Anways .... he has put me back on pred, yet again!! This time for 10 days, the worrying thing is that over the last 3 weeks, there has only been 3 days where I havent been on i- and then been really bad!! Its 40mg ..,. Am I going to have to taper off of the pred when I am eventually taken off it?

    He also made me book an appointmernt to see him on tues so that we can come up with a plan, have a look over the meds that I am currentky on and probably try going up another level!

    I just want it to bahave now - its quite scary when it flres up like this !

    Hiw is everyone else? Xxx

  • Hey, thanks for the replies and advice :-)

    I decided not to go back ti the gp and see if I could manage myself and try to get though it - very bad idea though !!!!

    Ended up back at the gp yet again today as the pollen count has made me really bad on top of already very badly controlled asthma at the min. Should have just gone straight back on weds!

    Anways .... he has put me back on pred, yet again!! This time for 10 days, the worrying thing is that over the last 3 weeks, there has only been 3 days where I havent been on i- and then been really bad!! Its 40mg ..,. Am I going to have to taper off of the pred when I am eventually taken off it?

    He also made me book an appointmernt to see him on tues so that we can come up with a plan, have a look over the meds that I am currentky on and probably try going up another level!

    I just want it to bahave now - its quite scary when it flres up like this !

    Hiw is everyone else? Xxx

    Are you on 40mg for the next 10 days or does it include a taper? If you've already been on pred for the last 3 weeks (bar a few days) plus the next ten days then I would normally expect a taper.

    I remember you saying that you have seretide at the 125/25 dose. I'd have thought you might go up to the 250/25 dose and see how that goes. Montelukast might be a good idea for something to try as it helps allergy type asthma, I got given it because of being uncontrolled on top dose seretide and having hayfever, it's really good for me. Also worth trying to sort out a stronger antihistamine (if you don't have one already) as you say pollen affects you. They quite often try fexofenadine for this. They might not up seretide and add montelukast at the same time as they'll want to see if one works without the other.

    I've been pretty good recently, thank you. Just a short blip a couple weekends ago. Cons was pleased when i saw him yesterday, don't have to see him again for 2 months, hooray.

    Let us know how you get on on tuesday x

  • Also trying to work out how to thank people!! I'm new to auk, and haven't figured it out yet!! So not being rude :-) xxx

  • Hi Lou,

    Currently I am on 2x2 seretide 125/25 a day. I've been told that I will probably have to increase this though - but it takes a few weeks to achieve how controlled you'd be on it?

    The prednisolone 10 days doesn't include a taper: I was on pred 4-12th April, 14-17th April and now 19-29th April - no taper at all.

    The montelukast, I've been told that this will probably be the next step because allergies are making me worse - I have both hay fever and eczema.

    This flare up is really beginning to get me down now though, I'm signed off work at the min. Also a good friend and I met up yesterday (she's 50 and I'm 25) and walked up to another friends house. Normally I can happily do this, but was really wheezy and coughing/ going blue by the time I got up there - she wanted to ring 999 - she wasn't happy that at the min my salbutamol is working for 10 mins and then I start again .

    Cheers guys :-) xxx

  • Sorry that you are having a rough time of at the moment I do hope you start to feel better soon.

  • Hiya all,

    Saw my GP today following this flare that I am in the middle of at the minute.

    He was pretty good actually, and I felt as though he was taking me seriously and not dismissing me - he seemed a bit concerned that my PF wont go above 400 at the min even on pred ... PB is 550.

    I finish the course of pred on sunday, I have been on it more or less constantly for 3 weeks, but forgot to ask him about whether it should be tapered off from there? Any thoughts?

    Due to the lack of control I have at the min, he has decided to put me up a stage of meds to 2x2puffs seretide 250 a day and 10mg montelukast. So hoping that it stabilises things.

    I do actually feel better today though than I have for ages - not had to use my salbutamol at all today ... hoping the pred is doing its job :-) and the other stuff gives me more control.

    I haven't been referred to a specialist, though the GP has said that I am on the max meds before that point - and he wants me to have a good period where I don't need pred.

    Sorry for rambling!

    Hope everyone is well and enjoying the sunshine :-) xxx

  • He was pretty good actually, and I felt as though he was taking me seriously and not dismissing me - he seemed a bit concerned that my PF wont go above 400 at the min even on pred ... PB is 550.

    I finish the course of pred on sunday, I have been on it more or less constantly for 3 weeks, but forgot to ask him about whether it should be tapered off from there? Any thoughts?

    Lol, my PB is 550. He should be concerned that your PF is not going above 400 on 40mg pred for a few weeks, so it's a bit odd he's not told you to taper/given you a plan with pred or arranged for you to see him for a review on Monday. I'd suggest phoning to see what the plan is, but deffo go see him Monday if PF not better by then. My asthma flared in January with a chest infection and took ages to get back above 400 even with 40mg of pred for 2 weeks (which included 5 days 60mg to get pf above 300), this was partly because my trigger (chest infection) took a little while to go. Have you managed to get rid of your trigger(s)? If you've still got triggers around it may be difficult to get pf's up.

    Due to the lack of control I have at the min, he has decided to put me up a stage of meds to 2x2puffs seretide 250 a day and 10mg montelukast. So hoping that it stabilises things.

    I do actually feel better today though than I have for ages - not had to use my salbutamol at all today ... hoping the pred is doing its job :-) and the other stuff gives me more control.

    I'm glad to hear you're feeling better and I'm impressed that you've not needed your reliever today. Hopefully by the time your pred runs out the extra ics in the seretide will be working. I found the montelukast was more gradual, but after about 6 weeks my peak flows were generally quite a bit better, i was sleeping better and using less reliever, so I saw some really good benefits but it did take a while.

    I haven't been referred to a specialist, though the GP has said that I am on the max meds before that point - and he wants me to have a good period where I don't need pred.

    I think that once you've been on the extra seretide and montelukast for a couple months, if you have good control and you feel happy with GP then stick with them, if you're still uncontrolled then get a referal.

  • Thanks Lou :-)

    I have been flaring since september off and on tbh, not been properly stabilised since then, just unfortunately over the last month its been a nightmare when I got yet another chest infection, I come off the pred and within 48 hours I'm readmitted to hospital cos of an attack ... not fun :-(

    My GP wasnt happy about the peak flow, he feels it should be higher, although he also advised to go on symptoms as to when salbutamol is required, not only when PF drops, which has always confused me! I have also been told that if it goes to 330 I need pred, which helps hugely!

    I will give him a ring to see whether he wants me to come straight off the pred or taper. I really want to come off the pred, but it worries me a little that I will end up at square 1 if its not time!

    I have had a good day today though ... not had to use my salbutamol until I took the dogs out this evening, its the longest I've gone without in ages :-)

    Are you feeling better from the last flare up?

    xxx

  • Thanks Laura, yes I'm feeling better from flare up in January. When I was tapering pred I got put onto Uniphyllin and it has made lungs behave better, although I nearly had to have more pred 2/3 weekends ago when I had a couple of patchy days and rough nights, luckily things settled and the pred can stay in the cupboard for a while longer. Before that, like you I'd not been well since mid September, I had a couple weeks pred, then off for 2 days then doubled my top dose seretide, 6 days later another 5 weeks of pred, then off pred for 12 days and then more pred and then off for 4 weeks before my 3/4 week course in Jan. So I'm over the moon that I've been off pred for so long, it's a record for the past 18 months :).

    It seems to me that you end up in trouble when coming off the pred quickly so I would have thought it'd be best to try a taper to ease back into being pred free, I recon you might be more successful and less likely to end up relapsing. Your GP's right, your pf should be getting to 80% so 440 and above, so another good reason for tapering the pred and coming off gently. It's normal to be worried when coming off pred, well it is for me anyway, you just feel like a ticking time bomb.

    Very good that you didn't need your reliever 'til later in the day and doing something active too. I was doing well yesterady and hadn't needed my reliever so thought I'd go out for a run (I walked half the time, but feel so lucky I can go out and do this), and even though I spent the first few hours of the night not being able to sleep it was worth it as it's been good for the soul to get out and do something.

    I hope your days keep improving xx

  • Cheers Lou,

    I have had yet another good day ... had to use my reliever 2x4 puffs, but been teaching pe outside :-) recently I would have been 10x that!!

    I am hoping that I am on the mend then and the new and upped meds will make a difference!!

    Do you have pred at home for if you have a flare? My gp is good in that I phone and explain my pf is low and he prescribes pred, but weekends worry me if I'm ill, which seems to happen at weekends!!

    Do you struggle to come off it and go backwards? I have been recently l, but now on max dose of seretide and montelukast, so I hope it will become more controlled!! I also hope this will make I easier to come off the pred!! I don't want to appear as a hypercondriac though!

    Another weird one is my gp hasn't diagnosed me as mild, moderate or severe?! A job app asked me!!

    Glad you're going through a good patch and hope it continues :-) xxx

  • Thanks. I'm hoping it continues too.

    Glad to hear you've had another good day, Hopefully down to a combo of pred working and new/increased meds, which should make it easier to come off the pred.

    I have emergency pred and antibs (as chest infections are my worst trigger) at home, 3 days pred so enough for a weekend then I see GP for more and get checked out.

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