How I feel vs. Visible/Measurable Symptoms

I have posted recently saying I'm having a bad time at the moment, needing inhaler every day , constant tight chest, usually I like to run but it is out of the question, extremely out of breathe just walking to shops. Also I'm having an attack a month at the moment, never had this before (in my 3ish years of asthma) but manage to gain control with salbutamol.

Starting taking pred on Sat morn following advice of very helpful AUK helpline nurse. However yesterday I needed inhaler 7 times during day and had attack at half 10 last night, after quite a bit of reliever managed to calm it down but my friends whom I was with at the time said it was scary to watch. Was checked out at walk in today and everything seems fine to nurse but I still have a tight chest, out of breathe walking more than 5 mins and feel rough today. I don't really wanna talk because it is making me tired.

I haven't noticed any PF drop in general, haven't managed to try taking PF during attack, both because I was out and also I don't think I'd be able to do it during. But I don't wanna base how I am on that little device which does not and has not worked for me.

Nurse today said she hears no wheeze but no one has ever reported a wheeze. I tried telling her that even when I had a chest infection last year my chest sounded clear and only knew because of x-ray.

On another note, I don't feel particularly phlegmy during attack/when chest tight, anyone else find this? I cough more than usual but nothing comes up.

To be honest, I don't know what is left to do. Basically feel like I'm having attacks/ constant tight chest but frustratingly I'm not falling into the standard asthmatic symptoms so being shoved off. I don't want to end up having another tonight, my body is too tired for that.

12 Replies

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  • Hi unigirl,

    I think you need to give the pred more time to work. What dose are you on?

    Also, if it was me, I would treat any symptoms aggressively with the reliever and spacer. And reduce your physical activity to the bare minimum. And finally try and relax and give it time as your stress and worry about the situation may be increasing your symptoms. I really feel for you as it is like your life has hit a brick wall. Are you on pred for a set time or as long as you need it?

    I hope things start improving soon :-)

  • Hi JF,

    Am on 30mg atm, I am tiny but it feel like a small dose, I think I was on 40mg last time. I was only given 5 days worse by my consultant for as and when I need it in March, got an appointment with local doc tomorrow but I reckon I will have a fight on my hands which I don't have the energy for. Also I would like to have it as a back up (if I have an attack bad enough I'm supposed to take it whilst waiting for ambulance).

    I don't know whether to suggest antibiotics also just in case, obviously I am not trying to put loads of medicine in me, however if it helps then I'll take anything I can.

    Well I am resting today (apart from went walk in just in case) and have cancelled my plans for the night, however I do admit it can be hard to rest sometimes. I am a lot better at accepting it these days.

    I do feel that I will often use inhaler whenever symptoms start as I know if I ignore them its a rariety they'll go away on their own. However I just feel it is a terrible sign that yesterday was 15 (inc. attack) and other days have been 8... worst of all summer is my ""good"" time of the year for asthma.

  • When I went to the walk in clinic back in June/July, the nurse practitioner I saw said the guidelines for pred have changed back to 40mg for 5 days as it treats it hard and fast and studies have found with 30mg (which I was on then and back in Feb) people need much longer courses, which did happen to me both times. If you are quite small, I am not sure if that applies of course.

    I know what you mean about it being hard to rest, especially if pred makes you mentally hyper, which it does to me! I am fairly used to it after 26 odd years but even I am getting frustrated this summer. Although, I am finally heading in the right direction.

    If you're still not right on the 5th day, I should go back for more before you miss a dose too.

  • Well there seems to be confusion between diff nurses and they disagree. I would rather be hit with the hard and fast and knock it on the head.

    well tomorrow is day 5 so I'll be asking for more.

    I wouldn't say they make me hyper, but my mind is finding it hard to stop but at the same time I'm not making as much sense as usual from the tiredness. I don't really like cancelling plans though but staying in and resting trumps going to friends and having attack any day.

  • UniGirl, I totally get how you feel - been there, done that, not got the steroids etc! I do hope you get it sorted and start feeling better soon as the battle with drs etc to be taken seriously is also exhausting. Having a similar frustration myself atm (said on other thread so won't hijack yours).

    Interesting re the pred - my cons's plan calls for 30mg. He is keen to keep me off pred and I am keen to be off it. but I can't help feeling his plan will either not be effective enough or leave me on it for longer.

  • Interesting re the pred - my cons's plan calls for 30mg. He is keen to keep me off pred and I am keen to be off it. but I can't help feeling his plan will either not be effective enough or leave me on it for longer.

    I also take 30mg after discussion with consultant. Anything more gives me massive cushingoid side effects for no real extra benefit. Back on the old smarties now, with 10 days of IV antibiotics - hopefully its not a six month stint of pred like last year..

  • Philomela, I had a read through, it does sound similar, my plan mentions both PF and symptoms, however it states to do a certain thing (such as pred) if I have such and such symptoms AND PF drop, however I know myself when its getting bad and considering I had an attack... I was right. Like I said, in general PF is normal (especially when at docs which is frustrating). Where my problem seems to lie is that I'm not producing the common recognisable symptoms which sometimes I think would be easier.

    I know exactly what you mean, obviously you don't want to be on it but the other option doesn't sound too appealing either.

    How are you with day to day activities?

  • There was no discussion involved. I guess it may well help at 30mg, I don't know but I don't think I get any more side effects at 40 though I can appreciate I won't notice all of them and the lowest dose possible is best. Not sure if cons's reason is just to try to avoid side effects in general which I do understand (after all I am the one having them!); it's also hard to tell when it becomes effective (GP said it's a bit on/off a lot of the time) - said it could be nothing at 25mg and work much better at 28mg?. I do know 25mg wasn't enough in Feb and it meant I was on it for longer than I would have been if I'd started on 40 and came off it still feeling a bit crap lungwise.

  • I fin dthat if ive been off pred completely, then 30mg is perfectly good for me, and i notice no difference between that and 40mg, but if im alrady on a high-ish dose, then i get more benefit from a larger jump! Had the most bizare A&E cons who put me on three days of 80mg, im really annoyed about it, as i dont feel thats a sensible dose of pred, and i think that for the first time in ages im going to have to do a taper as 80mg to 5mg (my approx hydro dose) seems mad!

  • I must say that I didn't get the crazy munchies and bad insomnia like last time I was on them (last time was 40mg, this time 30mg). However, I woke up at 6am and took pred with a banana and then went back to sleep on the days I need it as I remembered reading somewhere on the board that this helped with insomnia,

    Wow 80 mg is insane, I'd be jumping off the walls.

  • was a tad bonkers at 80mg - although it did work very well! lol! gave me a much needed good day yesterday, although spent a lot of it on the phone to my (amazing GP) trying to get her to get hold of my cons to get me down to 40mg today! so back to 40 till tues when i can see someone! and i deffo find it helps with insomnia to wake up esp early to take it!!

  • Unigirl, I'm pretty small too and have had problems with 30mg not being enough. For a long time I've been taking courses of 40mg, as 30mg was never enough to get things settled. I was recently told to take 30mg for 5 days instead of 40mg (and thought fair enough, my asthma's not as bad as it has been in the past, so thought I'd try it), but I just ended up taking it for longer. Had an exacerbation last weekend, so had pred 40mg a day and I'm glad to say it's done the trick this time.

    I do notice the difference between 30 and 40mg side effects wise so would much rather be on 30 than 40 if the lung would give me a choice.

    Soph, Wow, 80mg, my lungs would be good with that but I wouldn't sleep. Like you if I'm already on high dose pred and still have an attack then I need to jump up but I've only ever been up to 60mg a day, but I'm not nearly as severe as you. I usually go back to 40 and then taper though. 80 to 5 does seem mad. I hope your taper goes well.

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