newly diagnosed - good peak flow but with a wheeze

[hygge]

After admission to hospital with a very fast resting heart rate and suspected blood clot on my lung I came away with an asthma diagnosis.

10 days prednisone and 2x symbicort 2x daily I am finding that my 'normal' isn't normal at all and that I can exercise without 'being unfit and dreadfully out of breath! I have a new lease of life and in 2 weeks I have lost 5lbs.

I'm writing in the hope you can help me learn a little about myself. My peak flow when on the steriods was 440 tops. My peak flow now (a week off the steriods) my peak flow ranges from 380-410. I recorded my pf, as I do nightly, and found I had a wheeze at the end. I have also noticed that sometimes I also have to have a cough too, after putting effort into the pf exhale.

Does the wheeze and the cough mean my asthma isn't as well controlled as I think it is or just expected because I do have asthma?

[WheezyAnne]

You should not have any wheeze, that is what the blue reliever inhaler is for. Blue inhaler is Ventolin\Salbutamol. You don't mention this, or how often you are using it? Symbicort includes both a reliever and preventer, and it is possible that they are trying you just on that to see how you go. Either way, you need to get rid of any wheeze. Speak to your GP, as it sounds like you need to change your treatment plan. Let me know how you get on. I have over 50 years experience and may be able to give more advice, though Asthma treatments are evolving all the time, thank goodness.

[hygge in reply to WheezyAnne]

Thank you so much for taking the time to help me understand. There's no wheeze when breathing and everything consistently feels open and ok (although a little tighter upon waking but soon loosens up with my symbicort. I take 2 puffs symbicort upon waking and another 2 puffs 12 hours later at about 7pm. I do have a salbutamol inhaler but was told not to use it unless it was an emergency as the symbicort is a better reliever anyway.

I have just taken my pf, blew hard, hot 400 but there's a definite pronouced wheeze at the very last second of exhalation.

I now realise I should go back to the GP to talk about this but in the mean time should I take the salbutamol now as that noise is there?

[WheezyAnne in reply to hygge]

Sounds like Symbicort is doing its job. It would do no harm to take one or two puffs of Ventolin\salbutamol to see if it clears it, particularly as your Peak Flow To down a bit. Yes the idea is that the preventer controls your Asthma, and that you only take the ventolin\salbutamol when you really need it. On the whole your peak flow is good. Mine is around 200, but that is after many infections over the years. Hope all that makes sense.

[hygge]

I think I have been experiencing an asthma episode. Throughout the day my chest has felt tighter and tighter. Walking my children home from school at 3pm I struggled with my breathing and noticed I was out of breath walking on the flat. I took a double puff of salbutamol. Come tea time I felt my chest tighten even more with an awkwardness when swallowing. My voice became horse at that point too. I took my pf which had dropped to 350. I took my double puff of symbicort a little earlier at 6pm and have only just felt at ease now having a total of 4 salbutamol. The horseness has eased as has tbe awkwardness when swallowing.

Given I was hospitalised with pleurisy, suspected blood clot on my lung, tachycardia etc, this is the first time I have experienced symptoms of what I expect is my asthma. It's all very new. Is it possible that the wheeze last night was a warning of what is to come? I'm learning about myself a great deal... for years these episodes have been attributed to anxiety and panic so to be able to have some control, treatment and knowledge is an immense feeling.

[emmasue in reply to hygge]

I wpuld call your GP or asthma nurse asap! Also, the asthma Uk helpline is a great resource. You shouldn't be feeling breathless snd I wonder if they nave explained how to use the symbicort smart regime to you. I hope you get some answers. x

[WheezyAnne]

As Emmasue says, get to GP NOW as your PF is showing a downward trend. Sorry only just seen your post. Also speak to your Asthma Nurse about an action plan. They will advise on your PF measurements, and what meds to take when it shows a downward trend.

[hygge]

thank you both so much. I took your advise and only just back from GP.

Ok, wasn't given enough information when prescribed symbicort and actually told wrongly to cease the blue inhaler. The GP explained that it takes time for the symbicort to build and that I most probably struggled because I have only been on it for a short while and not using the blue inhaler to help out in the short term I have had a relapse. So for the next 2 weeks I am to use the blue inhaler when ever I am doing anything that gets me out of breath or suffer from the effects of triggers (for me it seems to be strong smells, wood burning smoke, BBQ smoke and cigarette smoke, exercise and stress)

I am also to take meds for anxiety as GP believes they are interconnected with one effecting the other and vise versa. The GP thinks that some of my symptoms yesterday were me panicking at 1) asthma not very well controlled and 2) not having a plan in place for when O do have an episode. Because anxiety has always been on my periphery he thinks we should treat it.

Also the hoarseness and my difficulty swallowing with my acid reflux symtoms and heart burn issues could be down to Heliobactor bacteria so I'm to provide a sample for that.

It seems that there's a fair bit going on with me and one has been brushed off as another for years. It's nice that the asthma isn't panic, my anxiety is recognised as a condition other than just panic and my acid reflux isn't just a new diagnosis of asthma.

I want to thank you both for taking the time to help me understand my asthma and prompt me to get further help.

One thing I still don't have is an action plan but I'm to go back in 2 weeks so will ask then.

Thank you so much because with you I would have assumed it was asthma and allowed it to just continue as 'just asthma'. I've come to realise that poorly controlled asthma is very dangerous... and very frightening thinking I was actually being very responsible following advice with my meds.

Thanks again

[WheezyAnne]

Glad to help. Let me know how you get on. Once you and your GP have got your Asthma under control with the right meds, as there are a few to choose from, you will find that you do not need to use your blue inhaler so much. I still have to use mine sometimes during exercise, and early morning. I am on the Symbicort Smart Regime too. I also have anxiety and depression so we have lots in common. Best wishes.