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Managing intermittent asthma - how do I know when to use inhaler?

Hello all

I have cough variant asthma but only when I have a major physical stress in my life. Examples are third trimester of pregnancy (when I was first diagnosed); pneumonia about 7 years ago (hospitalised twice for 4 days each) and chest infections. Colds don't trigger asthma symptoms. I am, I know, very much more fortunate than a lot of asthma sufferers and believe me, I count my blessings!

The problem I have is that due to side-effects, I don't want to continually use the preventer inhaler. I actually only need support from a preventer about every 18 months to two years when I get a chest infection or other big problem. The thing is of course that the preventer takes time to build up, so by the time I know I need it, it's almost too late to start!. I'm using Clenil Modulite (Symbicort makes my cough worse, aargghh!)

I'm beginning to wonder if I should just start using the Clenil every time I start with ""cold"" symptoms (once I've ruled out hay fever, which I occasionally get a little). This would mean I'm using it far more than I actually need to, but on the up side, it would hopefully shorten the nights waking up coughing every two hours when I do need it.

Presently on day 3 of 5 on antibiotics to get rid of the current chest infection, stiff neck from ""sleeping"" on mounds of pillows and pulled muscles in lower abdomen from the cough!

Does anyone have any suggestions of a steroid that starts working more quickly or any other thoughts on how I might manage? I wondered if oral steroids might be the way to go but GP says these are only for emergencies and it looks like they take a little while to get started anyway.

All help and suggestions gratefully received!

3 Replies

hi Pooka,

I used to be just like you! viral/bacterial infections are what trigger my asthma cough variant asthma, and I was often told by my asthma dr & nurse that seeing how I only have exacerbations once every so often that I didn't need to take my preventer inhalers inbetween attacks.

My action plan was always to start meds immediately upon showing signs of a cold or even the mearest hint of a cough. It still means the majority of the time you will be meds free so I really wouldn't worry about taking it unecessarrily, infact I would have thought your drs might say it *is* necessary to prevent attacks.

however, all this went out of the window after 5 exacerbations in a year and 4 hospital admissions and 6 months of pred. I was foolishly honest about my lax approach to taking me medication between exacerbations and it got me labelled as a ""mild non-compliant asthmatic"" which riled me somewhat. I've now been told that I MUST take my asthma meds every day without fail and that I will have to do so until the day I die. A depressing thought, when I can be settled for years at a time, but right now I know I must do as I am told, as I am still on top doses of my inhalers and on several other drugs for my asthma besides. I am a long way away from my usual stable, and able to completely forget I am asthmatic, self.

Really you should probably ask your dr or asthma nurse what they think and draw up an action plan that suits your needs. :)


Hi there! I have a similar issue, I don't have CVA but in between flare ups I barely know I have asthma, as a result I reduce my preventer right down and stay on a low dose until I need to increase it, usually at the first sign of a cold as viruses/bacterial infections are my worst trigger. I can go a few months with no symptoms except when exercising, to upping my preventer to the max and as I am currently, being on oral steroids and still having attacks and frequent symptoms.

I'm not sure if reducing my preventer is the right thing to do, it's still trial and error really, I'm still working with the Gp to find the right course of action. I prefer to be on less preventer but I think it takes too long to build up when I increase it.

Maybe this is something you could discuss?

I know exactly how you feel though, I feel a bit of a fraud talking medication when I'm well, but if it means recovering quicker when you're ill, then it's the right thing to do.


Thank you both. I'll get myself back to my GP to review my action plan. I think I have to accept that I have asthma with periods of wellness, rather than generally being well with occasional asthma.

Germander - all the best in your battle to return to something like normal… will be thinking of you


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