Asthma

I had an acute asthma attack Wednesday which nearly landed me in ICU. When I finally recovered I got sent home with a 5 day course of prednisone and got told to go back to my local GP even though I'm under a consultant. So I did what they said anyway and went to my GP today and they gave me more pred. My peak flow on a very good day is 460 but normally about 350 but for the past couple of weeks it has been 160-210. Why does nothing seem to help anymore? I have my reliever quite a lot throughout the day and seems to help for about 5-10 minutes or so but then after that it doesn't seem like I have had it at all... Anyone else in the same boat as me? Many thanks.

21 Replies

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  • Same is happening to me. My asthma has been bad for a year. You need a new plan and maybe new treatment. Have. You been sent for a lung function test?

  • Thank you, What other kind of meds are there? They don't want me to have a neb at home because if I get that bad then I need to go in is what they say...

  • What? Every asthmatic who's severe enough to need several meds should have a neb at home. I'd question that again, strongly.

  • Actually home nebs are not indicated unless a person cannot use a pMDI/spacer combo.

  • Very surprised at that; I've had a home neb for years and can usually get an exacerbation under control by myself without needing to take up space in A&E.

  • Most consultants won't prescribe home nebs unless the person has an underlying condition such as bronchiectasis where nebs are indicated, or they cannot use an MDI/spacer combo. Some brittle asthmatics might get nebs for home just because of how easily and suddenly we can crash.

    The problem they face is mainly people thinking they're fine after using a home neb and not going to the doctor or A&E, as well as people assessing the severity of their own attack and using the neb instead of calling the ambulance first when they really really need to be in hospital.

    The general consensus in the medical world is that if you are ill enough to need nebs then you need to be in hospital.

    Of course, everyone is different, but that's only a decision the doctor can make.

  • I have to say, this is fascinating. I moved here from Ireland last year and I really didn't expect to find such a huge difference between treatment of asthma in the two countries. I have actually never been hospitalised for asthma, because I am a) stubborn and b) have a home neb. It's been years since I've had an asthma management plan because I am on the max doses of everything and there's nothing I can increase, except Ventolin; but reading info on this forum I can see that, by NHS standards, I would have been in hospital almost every month! That's scary for many reasons. I've a lot to process.

  • I'm guessing you have brittle asthma too? Which doesn't really have indications for anything much, so you being on home nebs doesn't surprise me as much :)

    It's also quite common in the USA, I think, having nebulisers at home.

  • No, I don't, I have severe allergic asthma. I also recently discovered, through this forum, that I have what is called Cough Variant Asthma. I've honestly learned so much on this forum, and I thought I was well-informed before!

  • Ahh sorry :)

    So did you get the nebuliser in Ireland?

  • Yes. Over there I'd been scolded for not getting a nebuliser sooner! :)

  • They're not giving me one because if I'm that bad I need to be in hospital but yet if I have one I feel that I can prevent so many hospital trips... I've heard they wont give a lot of people here where I live one either

  • I'd talk to your consultant; that's a worryingly low peak flow. Your GP is great for emergency prednisone etc, but your consultant needs to get to the bottom of this. Hope you feel better soon.

  • Thank you.

  • Yes , my peak flow has been averaging 130. I am using the reliever more and using the cpac for longer. I am losing count of the courses of prednisone and antibiotics I have been having . I really wish i had something positive to say to you. I have recently seen the consultant who says I have bbronchiectasis so that would explain frequent infections. You really do need to see your consultant so they can start finding out why this is happening to you. Take care - you only have one you.

  • Thank you.

  • I have bronchietosis and have been taking preds for nearly two years they are working wonderful now i have to wean myself off slowly . Have you had a CT scan and all the tests GET THEM DONE!!

  • Thank you, I haven't had any CT scans no.

  • My peek flow never goes above 190! I have Brittle Asthma, which is controlled by permanent 20 mg of steriods daily , I also use my nebulizer or inhaler when needed! But my asthma has not been since Christmas! But I know when I need help! I have a excellent action plan of things to make sure I make it to hospital, without needing to have to go into intensive e care! It's a shame because I'm well-known there by my first name! But its a relaxed atmosphere when it does happen! But I have a big problem, I'm allergic to Ventolin! Which cause's massive problems how to treat me!

    I think you need an action plan! A few tests done! Check it out with your Consultant/ GP talk and don't hold back about your worrie's.

  • Thank you, My consultant was talking about putting me on pred daily but I'm not keen on the idea as I don't fancy putting anymore weight on... but I guess it will help me.

  • Daily pred should be a last resort as it has long-term health implications as well as side-effects like weight gain, mood swings, trouble sleeping, etc. Have you been tested for allergies? That should be done if not. If your main allergens are controllable/avoidable that will help. You might be much better with daily antihistamines, for example. Alternatively there's a medication called Xolair which inhibits IgE, the part of your immune system that over-reacts to allergens. Only a very small proportion of asthmatics are candidates, but it's another thing to talk about with your consultant.

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