Bad Flare Up

First of all hi everyone!

I'm back on the forums with a new account after a few years away from the site, i wasn't around much even back then so won't get offended if you dont remember me (used to lurk a lot) but my username used to be getting tired.

I've had asthma since I was kid started off very mild, went away for a few years and came back when i hit puberty. Anyway basically since then it's being getting slowly worse with some periods of control but what my gp describes as a rather fragile chest. Despite this I never really accepted my asthma as possibly serious that is until yesterday.

Yesterday i had what I'd describe as my worst flare up yet, started to get symptoms at around 12 noon and didnt get things under control until around 11pm that night. I suspect pollen and thunderstorm combination to be responsible combined with me not taking it seriously at first I know bit silly but usually it clears up with my usual meds and time.

Eventually went to gp surgery (around 2.30pm) and got seen by a nurse on the emergency walk in service, who got a doctor in, who listened to my chest and told me I was wheezing pretty much given a script for steroids, had a treatment on the nebuliser and was given strict orders to keep a close eye on things, neb calmed breathing down enough to fetch the steroids and get home to bed. Then waking up from nap wheezing again and ended up calling out of hours gp and going in to treatment centre (via taxi) and having 2 more neb treatments before my peak flow approached normal and they were happy to let me go home.

So yeah I'm mostly ok now, exhausted, but resting at home and pretty stable.This is only the second time I've ever needed a nebuliser and I'm a bit scared as seems I need to look after myself a bit better / be more aware of my asthma. I've had it 'properly' for 6 years and thought I could handle it, but yesterday has really shaken me up. Not sure what I'm looking for in this post just wanted to get it out to people who understood asthma I guess and maybe ask for some support?

Thanks for reading and best wishes,


P.s. plan to go back to gp's monday to review things and sort out a proper action plan. dont really want to but know i should.

15 Replies

  • Hiya, Welcome back :-) I only discovered Asthma UK a few months ago!! Its really helpful to get in touch with others in a similar situation to yourself who can sympathise and offer practical advice etc. Its been a bit of a life saver recently!

    I hope you are feeling much better now!! So sorry you had such a bad time yesterday and glad that you eventually got sorted!!

    Bad flare ups are a relatively new thing to me, had a few do's in the past, where I should have probably been treated etc, but been able to manage it at home and not done anything about it. So I can totally empathise with how scary it is and how you are feeling now!

    Its a good thing that you're going to follow this up with your GP/nurse and that they want to help you to develop a management plan. They will probably want to increase the dose of ICS that you currently take because you're not adequately controlled to have such an attack and having a management plan will give you the confidence to call for help without feeling as though ""you're wasting time"".

    After an attack like that it can take time to process what has happened and come to terms with it, but hopefully it should be an isolated event, the preds will calm it down and you can go back to being happy and controlled :-)

    Look after yourself, Laura :-)

  • Sorry to hear of your rough time, just a thought would u have been better calling an ambulance rather than a taxi as they could have given u a neb straight away. Also insist on a follow up and don't leave it like i did then had uncontrollable asthma for a time. i was told to carry on with non steroid medication by my astma nurse of all people after an attack and when my gp found out he went bonkers!! it took me nearly 3 weeks to bring it under control.

    take care

  • Thanks for the replies.

    I am feeling better slowly but still got bit of a tight chest and cough (to be expected I suppose). What I'm really annoyed about is the fact that I was meant to be going to dartmoor on a field course this monday as part of my engineering degree and I will probably have to miss it as middle of nowhere not place to be when your asthma is playing up that and not sure would be up to all the walking, working with equipment etc.

    @Laura i'm already on symbicort 200/6, 2 puffs twice a day + SMART regime so regularly taking 800microgram minimum of inhaled cortesoid steroids a day plus extra when i have to use the symbicort as reliever, as well as being on singulair. So not really sure what they can do next meds wise :s oh well will be ringing up first thing monday morning and asking for appointment (dont think i'll have a problem getting one as doc wanted me to come back i just didnt book it as thought i'd be in dartmoor) and hopefully can get some good advice etc. and yeah like you said can take time to process things like a worse than usual attack dont think I've got there yet. thanks again for the sympathy!

    @Lola I phoned out of hours docs and they thought it'd be ok for me to come in via taxi so followed their advice as it wasnt getting better with meds but also wasnt getting worse. though maybei played it down a bit over the phone... Was reluctant to go get a follow up at first but have come to realisation I ought to just to be safe. thanks for the advice x

  • Quick update things seem to be clearing up. Still a bit rough but managed to go out today with minimal symptoms where as yesterday when I went out ended up wheezing quite a lot and needing my inhaler. we may be changing my medication as not sure Symbicort works for me at least not as a reliever. Anyone here used seretide? it's what doctor recommended I tyr next, just decidd I wait and see how things go for a week. Dont want to mess around with main inhaler right now when I'm planning on going on field trip firday if I continue getting better. Anyways see you around folks x

  • Glad that you're on the up :-)

    I am on seretide and a few other things. I take 2x250 twice a day and personally like it!! I think its making a differnce, but can't really comment on if its totally effective for me because my asthma is playing up at the minute.

    How long have you been on the smart regime? Do you usually find it effective?

    Laura :-)

  • hi Jen G,

    Great to hear your feeling a bit better .

    Take care and rest up xxxx

  • Hello Jen G,

    I'm so pleased that you're starting to feel better.

  • Thanks for all the well wishes.:)Went to gp today for a check up thinking I was doing ok, not amazing as coughing and SOB on and off but ok.

    She listened to my chest and was like you've got a wheeze again and it it's not staying in one place, think you need some more steroids and I'll book you in with asthma nurse for full review / talk about changing your medication. (she said she'd have a chat with her today but that nurse knew more about asthma options than she did).

    Apparently If it's under control I'm not meant to have symptoms every day, oops... I'd kind of assumed that was just the way my asthma was!

    so yeah back on steroids the joy with talk of having to taper off this set.

    I really love my lungs...

    Oh well at least they behaved enough that managed to do my field trip with only minor symptoms.

    Hope everyone else's lungs are being good! Xx

    p.s. Thought i'd replied before now (obviously my mind was playing tricks on me!)

    @ lollie 88 I've been on smart regime since october and i find it usually works ok as a preventer but takes around 10 minutes to feel any effects in an attack situation. Doc today said seeing as i was essentially maxed out on symbicort that we're definitely going to look at changing my meds.

  • Sorry to here things are not great Jen. I hate it when I think I am doing well and then the doctor tells me otherwise!

    I am currently taking Seretide (was 250 but now 500) but have recently tried Symbicort SMART on advice from my consultant. I used SMART many years ago when it was relatively new and it did work well for me. I don't really have big attacks more lingering symptoms and so it made sense that the more reliever I was needing the more steroid I was taking. For many years I rarely needed oral steroids as the extra steroid fought off the symptoms quickly (sometimes before I could even see a doctor). However, my asthma started to get worse and I needed a higher dose Symbicort which couldn't be used on SMART. I never really got control of my asthma after this and was changed to Seretide last year as an experiment. It did improve my control although I am still struggling (which is why I have recently changed to 500). When I saw the consultant in May, she thought my asthma patterns sounded like SMART would be ideal and as I had a good experience of it in the past I was willing to give it another go with Pulmicort to increase the ICS. Unfortunately, a few days later I started to get quite bad hay fever which then made my asthma bad and like you I felt the Symbicort didn't really relieve the symptoms quickly enough (it did treat the wheeze but not the cough). I also regularly exceeded my allowance of reliever and had to top up with Bricanyl which you are not meant to do. I am now back on Seretide (500 this time) but the consultant hasn't ruled out trying SMART again (she just said that it is not the best time to try something new if you are struggling).

    I probably haven't been much help but what you describe sounded very similar to what I experienced a few weeks ago. It is strange (and frustrating) how something can work for a while and then you have to start from starch finding a new combination.

    Take care

  • The steroid portion of seretide sometimes works better for asthmatics who have a certain amount of acquired steroid resistance. Has something to do with the kind of receptors it binds to.

    I also was on Symbicort (SMART) for several years and really liked it. It may have just been good luck and good weather, but for three years colds + follow on asthma exacerbation actually resolved in weeks rather than months when I used a combination of symbicort and a nasal steroid spray. So I really liked it. It literally changed my life.

    But eventually it stopped working for me and now I'm on seretide 500//50 plus 500 flixotide (the inhaled steroid component of seretide). I don't really know if the change helped because a lot of medications changed all at the same time when it was clear at the end of last year that things just weren't getting under control in the weeks that followed a cold.

    I think the only thing one can do is try it and see. way back when (20 years ago) when I was first diagnoses with chronic asthma, we went through several different steroid inhalers before we found one that worked for me.

  • Sorry to here you're struggling too kayla.

    In a weird way kind of glad i'm not only one going through a rough time with pollen at the moment as it means might get better when pollen goes.

    I too am usually symptomatic but not sudden attacks but just had worse/ more lingering/worrying symptoms recently

    To be honest asthma hasnt really been under control with symbicort, could jst be my asthma being unstable but if it aint stopping symptoms then it isnt working i guess. So maybe seretide will help out I always been willing to give anything a try.

    I think it would be easier to handle my asthma if i didnt also struggle with mental health issues (seperate from my asthma the two just dont help each other) struggling with breathing just makes tackling the difficult thoughts in your head that much harder. Oh well got to be positive plenty left to try after all :) Gp was annoyingly right about asthma feels like i got the elephant sitting on my chest again alas it could be a looonnng night.

    Take care x

  • So just back home from an appointment with my asthma nurse. In good news lungs are currently stable and sounding clear after this latest short course of pred but because ended up back on it after a week last time I came off there's no guarantee I can stay off. It's all a bit of a wait and see game at the moment.

    In not so great news, seems there's not much more they can do for my asthma in general practise if it stays like it has been. Nurse said they'll probably end up referring me to a respiratory consultant which I guess is positive as I'm being taken seriously but not really what I wanted to hear. She's goingto talk to my gp and then doc will email me what she thinks the plan should be for now.

    So all in all not as many solutions as I hoped but I can breathe at the moment and hopefuly it will stay that way :)

  • Sounds quite positive :-) hoping you lungs keep behaving and you avoid any more pred :-)

    Also hopefully I won't come to a referral, but if it does then they are nice - my cons is great :-)

    I am currently waiting to see my gp, have a feeling I'm not gonna like what he has to say though :-/

    Laura x

  • I'm glad to hear that you're a bit better and hope it stays that way.

    I know a referral can sound scary (I saw a cons in my late teens/early twenties but then was discharged as they thought it was more allergies and asthma had stabilised). I am now nearly 30 and was referred back a few months ago as it has gradually got worse again. I put it off for a few months and my GP tried everything he could but it came down to the fact that he didn't feel comfortable prescribing increased doses of Seretide long term. My cons was brilliant - there were so many different tests that even though one was fine (my pf usually is when tested by someone official and they probably think I make the other up) they could look at inconsistencies etc, they could confirm it was still allergic asthma and had so many different treatment plans to try. I have got an emergency appointment with them tomorrow so hoping I can have something else. I'm not sure whether it applies for asthma but another cons I see for a joint disorder can also prescribe things which are not licensed for that particular use (I think that is right - I take a low dose antidepressant as pain relief/muscle relaxant for my jaw even though it is not usually prescribed in that way but has be proven to work). I find it reassuring that there are still so many things to try and knowing exactly what is going on helps them to pinpoint treatment a bit more (as I am very allergic they are treating my hayfever a lot more than previously - even though I have always had severe hayfever even when asthma was good).

    I hope this makes sense (I'm sleep deprived and probably waffling).

  • Thanks guys. I think nervousness about possible referral is because it makes my asthma feel more serious, I've always talked it down (part stubborness part trying to ignore it). Took me 6 months to go to the gp about it when it started coming back when I was 14 (had it very mild as a kid 3 - 10) and though over the years (i'm 20 now) I've got better at taking it seriously and going in when it plays up, i still play it down. But like i think said before, until this academic year I'd never needed a nebuliser and had only needed steroid tablets once before so I know it's not right just pfft feel i see enough of the medical profession already due to my other health issues.

    The other thing that makes me nervous with them saying there isnt much they can do currently if it continues to flare is that I'm going home from uni for the summer in 10 days, I havent really seen the gp's at home for two years and they dont know my asthma. So going back without good control is a bit daunting.

    And kayla a lot of that made sense :) It's good to know there is plenty more they can try, just hope that i dont need to! Also glad they're not overly peak flow reliant as I have a pb of 500 (when predicted fro someone my age and height is around 430) and it rarely goes low unless i'm having real issues I can be wheezing and short of breath and still blow 400.

    *cros fingers pollen count goes down*

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