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Brittle Asthma exacerbation + pneumonia

Hi, I'm new to the forum! Mum of 3 small children (2,3 and 5) and I've had brittle asthma all my life. For the last 5 years it has been wonderfully controlled on 2 puffs of fostair bd and I've had maybe one or two admissions/steroids a year. Just over 3 weeks ago I was bluelighted in and needed back to back nebs, IV hydrocortisone and IV Magnesium. My peak flow slowly wandered back up to 400 so I was allowed home (normal for me is 520). I was started on 40mg of pred and my fostair was doubled. 5 days later I was bluelighted in again with the same drug work-up needed. A chest x-ray showed left basal pneumonia and I was admitted and started on antibiotics (amox and doxy). I had another attack in hospital the next day after just walking to the loo and ITU needed to review me during this because even the magnesium wasn't helping but thankfully I was able to stay on the ward. I was discharged a few days later, remaining on antibiotics and pred. I then was bluelighted again 4 days later with another attack but again allowed home as that time I didn't need the magnesium (it was one of the same paramedics so he didn't waste any time giving me hydrocortisone) but I dipped down again the next day and needed nebs at my GP. Asthma clinic the next day wanted to continue the steriods at 40mg and added in Montelukast. Last night I was taken back in - I didn't have another attack but my peak flow had gone from 490 (we were winning!) down to 280 so I was taken back. Thankfully just nebs sorted that so I was allowed back home.

I am currently still taking: Fostair 4 puffs bd, pred 40mg (for over 3 weeks now), montelukast 10mg. The pneumonia seems to be steadily resolving, I have been off antibiotics for 5 days now.

I guess I'm just after other people's experiences with brittle asthma with an exacerbation like this, I know pneumonia takes up to 12 weeks to resolve - am I looking at being this unstable for a good while longer yet? Before I had children it didn't matter so much, my husband and I would just muddle through when I wasn't well but I feel so awful that my husband is (willingly) taking the lion's share of the childcare at the moment. I think they want to do quite a slow wean on the steroids now but not until I'm more stable. My peak flow chart is all over the place, I don't think they'll drop them again yet. It's unsettled me how bad I've been plus we live in the middle of nowhere - they scrambled the helicopter for me on one of the attacks until they were able to divert a landcrew because we live 20 minutes from our nearest ambulance station (which only has one rrv and an ambulance) and 30 minutes from a slightly bigger ambulance station but 50 minutes from the main city one where the hospital is. I sink like a stone when I go - I get an itch on my chin and in between my shoulder blades and that's usually when I phone and take 20 puffs of ventolin but even then by the time they reach me I can't talk at all.

Sorry, this seems rambly, any thoughts appreciated. (Apologies in advance if mentioning drugs/doses isn't done on this forum - I will happily edit if I need to x)

1 Reply

What a rotten time you are having, I hope you are feeling better and on the road to recovery.

Lisa' x


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