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Ask an Asthma UK nurse your question

Hi all,

Our Asthma UK Helpline nurses are now online and ready to answer your questions. Please reply to this post and an asthma specialist nurse will get back to you within 3 working days.

There’s no such thing as a silly question. The more you know about your asthma or your child’s, the better the chance of staying well, so don’t be afraid to ask. Our nurses are here to help.

The information provided by the Asthma UK nurses is not a substitute for professional care from your usual health care provider and should not be used for diagnosing or treating a health problem or disease. If you have, or suspect you may have, a health problem you should consult your doctor. The Asthma UK nurses provide an information and advice service only and they are unable to access emergency care or talk to health professionals on your behalf.

We are currently not replying to direct messages as part of this service and can also be reached on 0300 222 5800 (M-F, 9-5) or via email bit.ly/asthmacall

We look forward to your questions,

Asthma UK helpline team

162 Replies
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I had an asthma attack on Saturday went to GP yesterday said I have a chest infection gave me oral steroids 8 tablets for 5days,but no anitbiotics could you please tell me why? they did this last time and I had to go back for more steroids and then they gave me anitbiotics.

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Hi there CEC47

It sounds like you have had a rough time lately.

to answer your question, a lot of chest infections are viral and antibiotics are not prescribed as they only work on bacterial infections, though i do under stand your concerns.If you have a high temperature (feeling hot, cold ,shivers) are bringing up green mucous from your chest and feeling generally lethargic / poorly you may well have a bacterial infection and your GP could do another assessment .

Yes a lot of people need more than 5 days of steroid tablets until they are fully recovered.

Lastly each chest infection is different so a bacterial infection may not necessarily follow a previous bacterial infection.

Hope you feel better soon,

Asthma UK nurse team

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Thank you

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My Daughter is complaining of feeling like she is shaking. She has had Asthma for years but never had an attack. She is 12.

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Hi there,

Please give us a call on the nurse helpline as it is very difficult to advise you without more information. Lines are open 9-5 Mon-Fri on 0300 222 5800.

Thanks,

Asthma UK nurse team

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Thank you for your reply. I took my daughter to the Doctor this morning and they prescribed a course of steroids for her.

Many thanks.

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Hi Pat

You mention that your daughter is shaking.I wonder if you could provide a little more information, for instance if she is having asthma symptoms or needing her blue inhaler more than usual ? also is she having disturbed nights.

Lastly is she sensitive to he blue reliever inhaler, if she is needing more it can sometimes cause shaking, temporarily .

Thankyou

From the helpline nurses

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In A&E again the other night, doctors used listening to my lungs and not hearing a wheeze to decide how unwell I was — even though I said “but I’ve never had a wheeze even since I was diagnosed twenty years ago”.

**How can I persuade doctors of this?!**

So many of them don’t believe it’s poasoble to have an asthma attack without a wheeze. I don’t even know what a wheeze sounds like!!

(I’m fine now - but at the time, I was scared and frustrated because I had such chest tightness that the pain was making me tearful and yet to them, that wasn’t relevant.)

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Hi Katie

It sounds like you are having a rough time.Some people don't wheeze and for some people their peak flow doesn't drop very much either, even though they are very unwell.

Many things need to be taken into account. The national guidelines recommend peak flow, oxygen saturation's, heart rate,respiration rate chest exam and general presentation/ history ( colour of lips, work of breathing, speech, how often you are needing your reliever inhaler, is it lasting for 4 hours,night time disturbances and recent admissions)

I would wonder whether you have made an appointment at your surgery to see your GP or asthma nurse for a review as you may need a short course of steroid tablets to dampen down any inflammation in your lungs that may be present.

I also lastly, would suggest that you ask for a written asthma action plan that is individualised to you where it can be highlighted that you do not have a wheeze when unwell when you present to A/E

asthma.org.uk/globalassets/...

Hope this has been helpful Katie and that you feel better soon.

If you did wan't a more personalised chat do call the nurses on the helpline on 0300 222 5800 (M-F, 9-5)

Thank you

Asthma UK nurse team

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I've been in hospital twice over the Christmas holidays with what started as a chest infection then progressed to me being very breathless and tight cheasted. Ive never had a wheeze and my oxygen levels, peak flow etc all seemed 'normal' the doctors seemed to think i was fine and would send me home again even though i knew i was unwell and struggled to talk in sentences and doing simple tasks like having a shower made me soo much worse.

I thought i was getting better but the last 2 days a dry cough has started and gets bad when i go up and down satirs etc.

Im on my 4th week of this :-(

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Hi nic85,

It sounds like you are having a difficult time. You didn't say whether you were being treated for asthma before you got the chest infection? If you are your 4th week of being unwell please make an urgent appointment to see your GP or ask for a GP to phone you?

Or you can contact us on the helpline on 0300 222 5800 (M-F, 9-5) and we can chat about the best way forward.

Thanks

Asthma Nurses

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Hi there i have been on fostair 2 puffs twice a day and before that i was on symbicort. I saw the asthma nurse last week and she has put me on montelukast to see if that makes a difference. She couldn't see any other reason why i was having the symptons i had other than what the doctors thought which was a virus that has followed from the chest infection i had.

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Has the montelukast made any difference? Have you had a course of prednisolone (the steroid tablets)?

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ive only been on the montelukast for 6 days. I haven't noticed a difference yet. In the last 4 weeks i have had a total of 15 days worth of steriod tablets. In the beginning they gave me steriods and amoxicillan. When i was admitted to hospital i had IV antibiotics and was sent home with more amoxicillin and clarithramicin too. They cleared the green mucas and flu like feeling. On my 2nd admission the only meds i had was 2 bursts on a nebuliser. Then they stopped all medication because all my oxygen, sats and peak flow seemed fine so they said i didn't need anything.

I cough more now even though its a bit dry with small clear mucas but it sounds like a straining cough if that makes sense?

I am just about to go out in the snow to take my son to nursery so it will be interesting to see how it effects me as up until today the weather has been quite mild

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Is it the fostair inhaler that you can use with a spacer or the fostair nexthaler which is a dry powder? If it's the spray it can help to use a spacer.

bit.ly/2sJdfws

bit.ly/2rG6qtY

We usually recommend you finish the box of montelukast and if it's made no difference to your symptoms to discuss with your doctor or nurse stopping it. The national guidelines say that for an asthma flare up steroid tablets should be given at 40-50mg a day (for an adult) for a minimum of 5 days and should be continued for longer until the person feels better.

If it's a dry, irritating cough it's more likely to do with your asthma. If you have a blue reliever inhaler using it might make you feel more comfortable, but if it continues see your GP.

Enjoy the snow!

Asthma Nurses

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That's good to know about finishing the box to see if it works. I am going to get another appointment with the doctor tomorrow as ive been off work for 4 weeks now and im due back to work on thursday and im worried if i go back i might get worse as i work in retail and im on my feet and talking to people and that's when i really start to get out of breath. I do use my blue inhaler quite a bit through the day as it is to help ease my symptons. Also going out in this snow has not helped at all.

Thank you for your advise, it has been helpful

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Hi

I wonder whether you can advise me? I bought a new duvet two days ago. I'd had my old lightweight (probably 3 tog) one way too long, although not had any allergy related issues with it. I've never had problems with polyester pillows or duvets, so bought a polyester duvet. However, it is a much higher tog (10.5) and is one of those 'stay full' types from Fogarty - 100% polyester. I moved house and the bedroom is a little colder, although I wasn't actually cold in bed with the old duvet, just the air in the room. It's really hard to get very low tog duvets at the moment.

After the first night, I was a bit snuffly. After last night, I feel a bit tight in the chest but my peak flow is the same as usual. I know that my rhinitis being challenged does strain my asthma, but I'm wondering whether it's temperature related, rather than the content of the new duvet, given it's the same as the old one. I don't want to spend more money on an anti allergy duvet to find the same issue.

I can't imagine it's dust mites so quickly, given the age of my old duvet. Should I change for a lower or anti allergy duvet or persevere a bit longer?

Many thanks

Eva

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Hi Eva,

I think the nurses have answered your post here: healthunlocked.com/asthmauk... so hope it's been helpful,

Thanks,

Dita

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Hi

I have started to become very short of breath and tight chested when exercising or in cold weather conditions. I think this may be asthma (due to family history), but I have a phobia of doctors and so am unsure what I can do.

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Having a tight chest or feeling short of breath when you exercise or go out in the cold can be symptoms of asthma. Wearing a scarf around your nose and mouth may help at the time but it is something you need to have a chat about with either your doctor or perhaps and asthma nurse. Calling our helpline may be helpful as we can discuss it with you in more detail. We can be reached on 0300 222 5800 (M-F, 9-5).

Hope to hear from you,

Asthma Nurses

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Hi,

is there a link between low blood pressure and asthma? I am waiting to see a cardiologist as i have started getting extreme episodes of low blood pressure where i become lifeless etc. I don't tend to wheeze with the asthma but get pressure in my chest and short of breath. Usually the blue inhaler sorts this but when i have had these episodes where the blood pressure floors i'm wondering if it's a severe asthma attack rather than a heart problem which in turn causes my blood pressure to drop this low.

Thanks

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Hi dawnmurray, there is a link between low blood pressure & asthma but only in very severe asthma attacks. If you get pressure in your chest with shortness of breath, it could be your asthma. Don't be afraid to use your blue inhaler because if it is your asthma, the blue puffer will help to open up your airways and relieve the pressure. However, if you faint because of low blood pressure, it's likely that it is not your asthma -fainting is our body's way of making it easier for our body to get blood to our brain. Good to hear that you have been referred to a cardiologist who will explore what is causing these extreme episodes of low blood pressure and how to spot & treat them.

Hope this helps but if you need further advice, feel free to call us on the Helpline: 0300 222 5800 Option 1

Asthma Nurses

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Thank you. I'll see what cardio think and try theblue inhaler if i have a bad episode.

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Hi I have had acid reflux at the beginning of last year and was treated with medication Omeprazole from the doctor for 3 months and then wean off it. My reflux didn't return until last week.

I don't get heart burn just feel sick about an hour after eating. It started up again a week ago.

I am just getting over a cold so have lots of catarrh. I am on two inhalers Flostair Nextinhaler 100 and Flixotide 250 (both 2 puffs twice a day), monkelaust and steroid inhaler for my nasal drip.

My question is that acid reflux can return or is it there all the time? I am thinking of going back to the doctors to discuss my current symptoms but won't be able to get an appointment til next week. (I could go to the open surgery tomorrow but that is for people who need to be seen asap. I don't think I that bad just very uncomfortable) Is there any over the counter medication I can take for this 'heartburn' until then.

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Hi there

It sounds like your having a difficult time with your asthma as i note you are on 2 steroid inhalers and wonder if you are under a respiratory specialist as stated in the national guidelines.

In answer to your acid reflux question i would advise taking all your inhalers and any medicines to your local pharmacist and they could advise an the counter product such as gaviscon to dampen down the acid until you get seen

A lot of people with asthma do take Omepraxole long term so i would ask about that.

Looking at your post you may have already been seen at your surgery.

Do come back to us with any further questions.

Thanks

Asthma nurses

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Hi I am now under a respiratory specialist as of last November. I have had a blood test to check for allergies (turns out I am allergic to house dust mites). I have some breathing tests on Wednesday and then will be seeing the consultant after that.

Thanks for the advice on acid reflux I hoping to go back to the doctors next week.

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Hi, after having several attacks over the past 3 months alone, changing my preventor twice, I am currently on Fostair 100/6 along with antihistamines to see if this helps with my asthma as my asthma nurse believes it is caused by dust mites/allergies ect . I have an action plan stating that if I reach 350 or under peak flow I need to phone 999, but this has been my average most days, I had an attack last night where my peak flow was 150, did not go to a&e though as it was not hours long like usual. I have an appointment with my asthma nurse in 2 weeks but I’m worried that I will continue to have more and more attacks as it seems to be a weekly occurance almost, I have a review to see if Fostair along with histamines is working but I’ve been on Fostair for almost 3 weeks now , should I just stick it out? I don’t want to keep going back to the doctors as it’s difficult being a student, should I be asking my asthma nurse certain questions? I’m fairly new to my asthma worsening

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Hi,

It sounds like you are having a difficult and frustrating time with your asthma. You and your asthma nurse have put together a good plan but sadly it doesn't seem to be working at the moment. We understand it's busy when you're a student with assignment deadlines and things but asthma can be very serious and the advice to call 999 if your peak flow goes below 350 sounds right. You should definitely carry on with the plan but also get an urgent appointment to see a doctor TODAY either through your GP service or a walk-in centre. It sounds like your flare up may need a short course of steroid tablets that you can only get on prescription as this is not something that will settle without further treatment.

Please see the link below with information about what to expect at an asthma review with your asthma nurse which might give you tips on knowing what to ask.

bit.ly/2urXdHX

And here's a link about managing your asthma.

bit.ly/2tBrd2J

Look after yourself. We hope you feel better soon.

Asthma Nurses

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My daughter, age 20 has had a progressive decline in asthma since October and appears not be well supported by her healthcare professionals as she has trouble climbing stairs. She says she is following the GO guidance, but not seeing any improvement. What can she do about this apparent limited or minimal support?

Thanks SnG

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Hi,

It sounds like a frustrating and difficult time for your daughter.

The basis of good asthma management is to use your preventer inhaler (often brown), everyday as prescribed, even when you are well, and to use your reliever inhaler (usually blue) only when required. Inhaler technique is very important too so its a good idea to get it checked at an asthma review often with the nurse or to ask a pharmacist to show you. If you need the blue inhaler 3 or more times a week for several weeks it's a sign that your asthma is not well controlled. GP surgeries should offer people with asthma an annual asthma review often with a nurse and an Asthma Action Plan should be offered at that review so people know what to do if their asthma flares-up. The links below have information about inhaler technique and Asthma Action Plans.

bit.ly/2sJdfws

bit.ly/2rswbf0

Sometimes, despite this, asthma symptoms can flare-up and there may be a need for a short course of steroid tablets for a minimum of 5 days or until the person feels better.

We are not sure what guidance your daughter's GP has given her? The link below gives some information on how to get the best from your doctor.

asthma.org.uk/advice/nhs-ca...

If you or your daughter would like to speak to one of us or contact us via email please use the link below:

bit.ly/asthmacall

Hope this helps and hope your daughter feels better soon.

Asthma Nurses

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9th January I went to doctors as I had a cold for 3 weeks I used my emergency kit of steroids and antibiotics and managed over the festive period but then I ran out so I went to doctors saw the nurse practitioner she said it wasn’t to bad but gave me more steroids and more antibiotics I left the doctors 40 minutes later I was home on nebuliser then asking my carer to just 999 that’s my last memory until the evening the day later which is when I found out that they had taken over my breathing drained loads of fluid from my chest and I was still very poorly I progressed through high dependency then to a ward once on the ward I saw the respiratory nurse most days she said I am going to feel tired and not have energy for a good month and the rest will be the best thing and talk to people about what happened so you can get in your mind what happened I keep forgetting silly things and I keep crying a silly things and the biggest of all I am scared this is the 3 respiratory arrest in as many years and each time they have come quicker and worse I almost feel scared to go to sleep as I fear I won’t wake up is this normal and will it ease in time I did a stupid things discharged myself from the hospital as I suffer with chronic pain and I hadn’t had any pain meds whilst being in hospital and the spasms and nerve pain 9 hours I was climbing the walls in agony and I have very little to no immune system so they said I had to be very careful going anywhere for a couple weeks to give yourself a chance so I had that in My head so then a lady got positive swabbed for Australian flu and with the pain I was in I couldn’t cope panicked and left I was being discharged later that day but I left I have had some contact with the respiratory nurse but I went downhill again Friday and ended up back in hospital with temp and aches sweats etc so I got tested for flu it wasn’t just viral cold then Saturday I came home was told it was to soon to start reducing steroids or treatment to stay on everything and I was given tamiflu to try and help with the new cold I had I haven’t heard from anyone I am doing all my treatments and I don’t know what to do now I know it was my fault but I did panic I did explain this to my unhelpful gp who said speak to the hospital

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Hi Lisacharman,

This sounds like a scary time for you. Do you have a contact number for the respiratory nurse at the hospital as she may be able to advise you on your next step with your treatments? It sounds like you need a plan of action on how to safely reduce your medication if your respiratory doctors and nurses feel you are well enough.

Do you have a written Asthma Action Plan to help you with the day to day management of your asthma? Feeling tired and tearful is normal after such a nasty asthma attack. Do you think your GP might refer you for counselling if you think this would help?

Please see the link below about recovering from an asthma attack with some more information:

bit.ly/2Cv7INK

Please give us a call if you need to:

bit.ly/asthmacall

Hope you feel better soon.

Asthma Nurses

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Hi there,

I am having to take a vile cocktail of Antibiotics, ( Amoxicillin 875 twice a day and Levofloxcian once per day preceded by a strong PPI)at present to get rid of Heilobacter-Pylori , day 3 and and I am waking up at night wheezing and coughing. But in general Peak Flow is good?

Could these medications be causing Acid reflux, which in turn is causing night coughing? I apparently have to suck it up for 14 days of treatment. (Asked the doctor, he really thinks it is the best treatment )

I also am infected with Hook worms, which the doctor wants to execute, but I thought that they were implicated as a possible treatment for asthma. Am I wrong in thinking that they could be the reason my asthma is brilliant at present? Didn’t asthma UK fund some research into this or am I imagining it?

Anyway will have to decide what to do about the hook worms after I finish current course of medications. As doctor is taking a staged approach to killing off these stomach invaders. Any information or advice appreciated.

Thank you so much

Roberta

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Hi Risabel159,

Yes some antibiotics can cause indigestion/acid reflux so this may be the cause of your increased night time cough and wheeze at the moment. Even though your peak flow is stable, we would recommend seeing your doctor to review your asthma as these symptoms are a sign that your airways are inflamed and your treatment may need to be altered.

asthma.org.uk/advice/manage...

Although research into hookworms and asthma shows promise, much work needs to be done before we know if it could lead to the development of new drugs.

asthma.org.uk/about/media/n...

Good luck!

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Thank you

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I started with a viral infection on Dec 5th it was then diagnosed as Bronchitis a few weeks later and i was put on antibiotics which didn't help. I was then put on 2 lots of oral prednisolone which did not help.

My wheezy chest and cough got worse so I was then sent to see the asthma nurse last Friday who put me on a steroid pink inhaler which made my coughing bouts even worse. My chest x rays have come back normal but i am still coughing and my chest is still v wheezy.

My GP is coming to see me on Thurs to listen to my chest and to decide whether i should restart my steroid inhalers. I have never had asthma before if indeed it is asthma. Can a viral infection start asthma off? Thanks WK51 FOD

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Hi there it sounds like you have had a rough time recently and are still quite poorly.

In answer to your question about viral infections causing asthma, yes they can though we don't fully know why.

I note you have had 2 courses of steroid tablets which didn't help it might have been that the courses where not long enough or the dose to low to clear off any inflammation in the lungs if it is asthma.i would advise doing a peak flow diary which is on our website for 2-4 weeks morning and evening best of 3 and this gives your GP a more detailed picture of what is going on in the airways over time as it is a variable condition. chest x rays do not show asthma.

when we look at trying to diagnose asthma we look at low medium and high probability by taking a detailed family and allergic history along side, night time and early morning symptoms being worse and whether you respond to asthma medication.

I would be really good to speak to you for a more detailed chat but i will leave some links below that I hope will be helpful.

If the GP can't get to the bottom of it, it would be reasonable to ask for a referral to a respiratory specialist in the hospital out patients to get a diagnosis, this is not unusual scenario by any means.Respiratory medicine is quite complex and they often do more detailed lung function tests there.

I hope you feel better soon

asthma.org.uk/advice/manage...

asthma.org.uk/advice/diagno...

asthma.org.uk/advice/diagno...

Thank you from the helpline nurses

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The Fostair which i was put on made me v shaky and i could not string sentences together. it was making my breathing and cough worse so i have stopped taking it and will ask my GP when he comes to see me on Thursday. i have had this wheezy chest and cough for 2 months and have never had asthma before can a viral infection start asthma off . it started off as a viral infection and my GP then told me it was bronchitis so put me on antibiotics which did not help. I was then put on 2 lots of oral steroids prednisolone which didn't help either. Thanks WK51 FOD

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Fostair can make people shake and is a known side effect for some people but there are lots of combination inhalers out there and if it is asthma we should be able to find the right one for you that works and agrees with you. they all require really good inhaler technique, with a spacer if it is an aerosol as you get more down and less lightly to get side affects .

A combination inhaler has an steroid ( the same one we produce in the day ) and a medicine that opens out the tubes in your lungs if they are narrow, it also improves lung health.

Thank you from the helpline nurses

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I failed my spirometry (Due to me being too breathless to complete the Forced exhalation part of the test) So my doctor has given me a peak flow and asked me to keep a diary for 4 weeks. I know that normal for someone my size/age is 600(ish), but I'm not focusing on that. My question is what kind of variation would you expect to see for Asthma? Is there a large up/down daily variation? (I hope that makes sense)

I have done one of these before and I noticed that I had a high peak flow on days with bad symptoms, my best peak flow was 560 and worst was 490. The first reading I took was 475 but I put that one up to user error. A lot of the time there wasn't too much variation, 20-50 a day (From morning to night)

Thanks for any help

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Dear TD888

Thank you contacting us regarding peak flow variation. The answer to your first question according to the current asthma guidelines they should see a 20% variation. The nurse at your doctors will be able to work this out for you as she will need to take into consideration you daily changes and the patterns over the 4 weeks. So an example if you have a peak flow of 400 and it drops to 320 that is 20% and if this happening regularly then its a positive indication for Asthma. However peak flows don't always change in people with Asthma therefore its still possible to have asthma even though you no variations in your peak flow readings.

Peak flow explained in more detail: bit.ly/2tBuFdJ

other tests: bit.ly/2sm3ro1

Also more info on diagnosing Asthma here: bit.ly/2qfBfGf

The Asthma diagnosis can be made through other means such as good clinical history of symptoms, using a blue reliever inhaler and it helps and a possibility of trying you on a preventer inhaler and monitoring your response over a period of time.

We hope this provides a general overview and hope your able to get things sorted at your doctors. Good luck.

Asthma UK nurses team.

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My pf said I was normal but still I'm coughing, full of mucus and weak and sick without fever. Though I'm coughing from november and now it's january. And my parents are forcing me to go school tomorrow and there I can't even attend one class like this and get more sick. What should I do

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Hi AlexWatson

It sounds like you are having a tough time.

Although peak flow measurements can be useful, some people’s peak flow does not drop even if they are having symptoms.

If you need your Ventolin more than twice a week on a regular basis we would advise seeing your doctor or asthma nurse for a review as soon as possible as you may need to start/increase your preventers or you may need a course of oral steroids.

It would be useful to keep a diary of your symptoms and Ventolin use and think about what might be triggering your asthma, for example allergies.

Inhalers & treatments bit.ly/2t1P1cb

Asthma triggers bit.ly/2snLpp4

Action plan bit.ly/2rswbf0

Hope that helps

Asthma UK nurse team

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Can I refuse to use inhaled steroids?

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Hi again,

Inhaled steroids are the mainstay treatment for inflamed airways in asthma. If you are having regular symptoms then using a regular inhaled steroid as prescribed even when you are well will prevent your airways from reacting to triggers, reduce your symptoms and your risk of having an asthma attack.

If you are worried about side effects see link below but inhaled steroids are very safe.

Steroids bit.ly/2rIbXkN

Preventer inhaler bit.ly/2t2juqH

Hope that helps

Asthma UK nurse team

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I took inhaled steroids - ventolin - seretide and others, they gave me terrible side effects, migraines, leg cramps, nightmares, fatigue, cough, blurry wet eyes where I could hardly see and much more, the side effects were far worse than the original problem and made it impossible for me to work or live a normal life. so I am not so sure they are safe.

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HI there it sounds like you have had a difficult time . what inhalers are you currently on including doses in mcg and how many puffs a day you are taking ? also how often are you needing your blue reliever inhaler in a 24 hour period . then hopefully i can advise

Every medicine have potential side effects and seretide is a widely prescribed combination inhaler which has been around for many years and is designed to be taken long term.

thanks

asthma nurse

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Hello

I have been on inhalers for over a year, was put on them because of lacking energy and quickly becoming worn out. i.e. hard to walk more than a few steps or go upstairs. I had no proper cough or wheezing or rasping then but often got infections in my throat which would turn into not being able to breath and being taken into hospital for a few days. I have used all of the inhalers, and most of them are fine for a week or so, then I get horrible side effects that ruin any help or pleasure. Blurry vision and terrible eye sight where I cannot read or see properly, lots of pains in my knees and legs, migraines, and much more I often felt too ill to do anything or work. So the respiratory consultant told me confirmed that steroids help me to breath and lung capacity and checked out that my heart was not the problem, which it isnt. Then to try montelukast 10mg starting yesterday. How long will it take before I see if it is working or not (assuming I do not get horrible side effects which make it silly to continue with them) and if that does not work what will be the next step probably please?

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hi there, a trial of montelukast is usually 4/6 weeks and if it doesn't make a difference after that time the Doctors usually stop it.

asthma.org.uk/advice/inhale...

This link to our website shows evidence based led and incorporates the national guidelines for you to look at.

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I had a cough for a couple of months, felt fine (99%) but still coughed, so went to the GP – a few appointments later I was sent to the nurse for an asthma test just as the cough was getting better. I was surprised I had asthma. I had childhood asthma with no problems and I am fit person who is always outside. I have been given a reliever inhaler but never had any problems. Has anyone else been in similar situation? When should I take the inhaler? Is it ok to take before bed? - Been reading around on internet - I do sleep really bad / wake up - no coughing though

Any comments / answers welcome - will discuss the above at next appointment but interested in your experience.

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Hi there , I am curious about blood tests taken during an asthma attack in hospital. I have quite s few admissions, With non allergic asthma, and they are increasing, and more often than not my blood tests come back as normal , I understand on one hand they are looking for infection, and in allergic asthma raised levels of (whatever shows to say your immune system is fighting something it is allergic to, but my question is if the asthma is non allergic, with no infection or virus , is the blood test going to be normal? It just that does seem logical to me and a lot of Aand E doctors seem surprised

Thank you

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Hi, obviously I'm not one of the nurses but I am in a similar position (non-allergic, non-eosinophilic asthma, quite a few admissions) so I will be interested to hear their answer! I suspect a lot of the time A&E just do bloods to be on the safe side and like you say checking for infection. If the staff are good the normal tests don't bother them and it's just to be sure they don't miss anything. I find if they are going to be annoying, they will try to equate infection with attack and say with no wheeze etc and no infection I just have a virus and they won't treat me for asthma - like you say they often seem to expect infection, but I don't get many infections. As I have a high heart rate during an attack usually, if I am really unlucky they will start messing around with blood markers of pulmonary embolism and cardiac markers, which can be raised during an attack but not as much as if I actually had a PE or heart problem. Then they sometimes do another test (which will be normal) and decide I don't have that so I can go home - even though the asthma attack I came in with hasn't been treated.

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My logic tells me that in non allergic asthma the esonphillic levels wouldn’t go up , as I’m not having an allergic reaction : but interested to know from a medical point of view, as I don’t think mine do : I nearly always have a wheeze so asthma gets treated, but once the bloods come back negatively, they slow down the treatment, and I struggle for what seems hours: whereas if they hit the asthma attack fast and hard with the normal stuff ( nebs, atrovent and sal, hydrocortisone and magnesium, it’s attacks the asthma more effectively

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I find the same re treatment ie hard and fast helps, but with me I think it's more the sats/peak flow/wheeze stopping them when that happens. I'll be interested to see the answer here as well! However I have been having discussions with my asthma nurse about eosinophils hiding in lungs and not showing in blood. No good for ED bloods but interesting all the same.

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Hi there

I will try and address your questions

white cell count- yes infection indicators, blood gases are taken from groin or wrist, very painful.. they check how you are doing around oxygen and carbon dioxide.

eosinophils can rise without infection as they are an inflammatory marker and eosinophilic asthma is a known type of asthma effecting around 50% of people with this condition

there are other triggers than allergies and chest infections that warrant asthma attack treatment.

o2 saturations, peak flows and an audible wheeze are not always present so we should be looking at respiratory effort, respiration and heart rate, blood pressure and how you are responding to your blue inhaler (or nebuliser )and steroids..and of course previous admissions.

If you have a written asthma action plan, are on the right step of prevention (including the nose as this is part of your airway ) with good inhaler technique and adherence, these measures should offer sufficient protection alongside a full asthma review at least yearly.

It would be great if you could ring in for a more detailed chat, i think it would be beneficial to you

thank you from the asthma nurses

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My chest is really tight and I can't stop coughing up green flem

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Hi there

It sounds like you are unwell at present , if you are coughing up green phlegm and you are needing your blue reliever inhaler more than 3 times a week you should book an appointment with your GP or asthma nurse for an asthma review as you may need a short course of steroid tablets and possibly antibiotics ( especially if you have a high temperature or feeling unusually hot or cold)

Hope you feel better soon- from the helpline nurses

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Hi sorry this is going to be long

I have brittle asthma and have had so many issues over the winter I was admitted to hospital on Friday and was discharged yesterday afternoon and two weeks before that I had was in hospital with the same problem asthma and I was also in A&E on Boxing Day night too due to asthma and things are coming to a halt due to asthma

My mum got me tickets to see crufts that got cancelled due to it being too risky and I'm a 17 year old college student who with the asthma attack two weeks ago meant an assignment was handed in late cos I was in hospital

My asthma is controlling my life and I'm already under a specialist been under specialists for a year and it's not getting better it's getting worse

I'm struggling to walk up stairs and walking from a to b without getting out of breath. However the amount of nebs I had in the hospital has kept my wheezing so far at bay and walking very short distances is fine but haven't tried going out yet since being discharged but will be tomorrow due to college which is on my mind of how I'm gonna cope with stairs and going to next lesson etc. but I'm not staying off because I've got to try it I can't give up.

I've had enough and I know mine isn't as bad as others and could be worse and to those who have really bad asthma I admire

What can I do now ? I just need a bit of support and reassurance I think

I know I shouldn't be getting agitated cos it will make things worse and I know mine isn't as bad as others I don't know what I need to know just a bit of support from one of your team

Sorry about this

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Hi Erin, it sounds like you are having a difficult time. Even though you feel your asthma is controlling your life you also say you managed to hand in an assignment after being in hospital, even if it was a bit late, so you are staying on top of some things. It can be really scary when you've had an asthma attack and been in hospital and then you have to start to get back to your usual life, like college. Some tips are to always make sure you take your preventer medication as prescribed, always carry a reliever inhaler and spacer (if used), and remember scarfie which is to loosely wrap a scarf round your nose and mouth when going out into cold air. Have you asked any of your tutors at college whether there is any further support you can get from them, perhaps having access to a lift if you need it. Do you know your triggers and how best to avoid them and/or manage them?

Please give us a call if you need to chat it over with one of us on 0300 222 5800 and we will be starting a WhatsApp service later this month so you contact us that way too. Keep an eye on our web page and social media pages as the number for it will be published soon.

Hope you start to feel better soon - helpline nurses

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Hi I have had bad, uncontrollable asthma since Nov 17 with three bouts of chest infections, antibiotics, prednisilone and increased inhaled steroids. My GP now says it is just a viral wheeze. I am always very raspy, I have coughing spasms, my chest goes really tight when the spasms happen. I am down to see a Consultant but the wait time is 18 weeks. Is the wheeze normal, could I do anything to help it? I have lost 1 stone in weight througg diet to see if that helps. Many thanks,

Gary Wakefield

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Hi Gary,

it sounds like you've had a difficult time lately. It can take a long time to completely recover from a chest infection and the cough is often the last thing to clear up. Some tips are to double check that your inhaler technique is perfect so that you are getting the best from each dose. This link should contain some films showing the different inhalers bit.ly/2sJdfws

Wheezing is a sign that your airways are still narrowed and inflamed and you can often get some relief from using your blue reliever inhaler every 4 hours but this should not be a long term solution.

If you are still bringing up phlegm when you are coughing it may be worth chatting to your GP about whether sending a sputum sample to the lab may be useful to check whether there is any ongoing bacterial chest infection.

Overall, it sounds like you are not better yet and you may need more treatment.

Please give us a call on 0300 222 5800 if you want to chat it over in more detail with us.

Hope you feel better soon - Helpline Nurses

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Hi just want to get your guys view...

There is currently a chat going on the site about the correct way to use a peak flow meter, with one person being told by one doc that it’s a ‘fast’ blow, then by another doc that it’s a ‘hard’ blow, which is changing their scores dramatically (something like from 330-550, despite obvious wheeze etc).

A lot of us have been told ‘hard and fast’ but collectively we’re experimenting with our techniques and are often finding no real difference if asymptomatic, but a big difference in people with mild-severe symptoms (especially in those who play instruments!)

We are collectively wondering what your view/opinion is on this topic

Thanks a lot

Emma

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Hi Emma,

It can be confusing when advice is different and it is worth noting that not everyone's peak flow will drop despite symptoms.

The manufacturers recommend taking a deep breath in, placing the Peak Flow Meter in the mouth and holding it horizontally, closing the lips around the mouthpiece, then blowing as hard and as fast as you can. Any coughing or spitting into the meter will adversely affect your readings and should be repeated. There may be some variability between readings and for that reason, recording the best of the three readings is recommended.

Please see link below for further information and video on peak flow technique.

Peak flow test bit.ly/2tBuFdJ

Hope this helps

Asthma UK nurse team

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Thanks - I’ll copy this onto the discussion thread

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Hi,

I have moderate stable asthma on a daily inhalation of Relvar Ellipta 92/22 mcg and Salbutamol PRN. This is coupled with restrictive lung disease of unkown origin. If I exert myself, I get breathless and start coughing and find even the slightest incline to be problematic. The consultant says it’s not my asthma or cardiac diastolic dysfunction and personally, I don’t believe it to be my asthma.

With multiple co-morbidities, how can I ascertain whether or not my asthma is the root cause of my symptoms?

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Dear Mauschen

Thank you for your question. With multiple co-morbidities it can be very hard to confirm which condition is causing your symptoms. Also you mention having restrictive lung disease underlying along with Asthma. We know that people with restrictive lung disease tend to get breathless very quickly and take longer to recover.

I would speak to your GP about maybe getting a referral to pulmonary rehabilitation - this is a programme designed personally for you with a physiotherapist. The programme contain exercises that are known to help the lungs,information regarding managing your breathing , nutrition and much more. This programme from my experience has helped many people with lung conditions to improve their symptoms and breathlessness. Further information regarding pulmonary rehab can be found here: blf.org.uk/support-for-you/...

Further information regarding asthma symptoms can be found here:

asthma.org.uk/advice/unders...

We hope this helps

Regards

Helpline nurses

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Hi as a baby my son was born at 34 weeks , he had a lot of reflux as a baby as well as bronchiolitis. Skip forward he is now almost 4 years old ( June 2018) and has been diagnosed asthmatic by a hospital paeduatrician. He is on a good regimine of inhalers 200mg of clenil modulate in a morning and 200mg in an evening , as well as his salbutamol as required and montelukast tablets. I am told this is the maximum medication he can have to control his asthma dye to his age . However what concerns me is after having yet another exacerbation of asthma involving paramedics and a trip to the gp he is now on his 7th course of prednisolone tablets in 11months. That is a lot and I wonder why he gets sick so often. Surely his age shouldn't be a factor in his health if standard inhalers are not controlling it as well as they should.

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Hi, I agree that things could be better for your son. You say he is on clenil 200mcg morning and evening. It may be useful to double check his inhaler technique. Please see the link below for some films to refer to: bit.ly/2sJdfws When he has taken his preventer be sure to help him rinse out his mouth, for all spacers, and wipe his face, if he is using a spacer with a mask, to reduce the risk of side effects. Is your son triggered by mostly common colds etc or does he have other possible triggers? If he has allergic triggers such as dust or pollen it may be worth discussing with your GP or paediatrician about whether an anti-histamine medicine might help. There is an inhaler called Seretide, which is a steroid and a long acting reliever, known as a combination inhaler. This inhaler is licensed for children aged 4 yrs and above but some paediatricians prescribe it a little earlier if they think it would help. It's certainly worth asking. Here is a link with more info about combination inhalers asthma.org.uk/advice/inhale... We hope this is useful and your son improves. - Helpline Nurses

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Hi, I hope this thread is still going as I have a question for you which I thought others may be interested in. Unless this is just me!

Can you have an asthma attack/exacerbation/flare (including severe ones) without inflammation? If so, what process is causing the bronchospasm?

I am a severe asthmatic with fairly poor control and I'm seen at a tertiary clinic. They are keen on FENO to assess whether there is inflammation that may respond to steroids. If I'm having a flare they will get me in for assessment including FENO. Often this is normal but I will still go on to have a severe attack, or I will be very symptomatic with poor spirometry (but ok peak flow) and Ventolin barely working for several days but it won't become a full attack. Regardless of the FENO, the usual hospital treatments generally work if I do have a full on attack. (Ie nebs, magnesium, seems like hydrocortisone does work at least sometimes).

I thought FENO was about eosinophilic inflammation which I don't seem to have. However when I've asked, they say no it's any inflammation and something else must be causing the other attacks. Except I don't know what!

I am fine with reducing exposure to steroids as much as possible after being on them constantly for ages. However, I'm really confused by what is going on if not inflammation, to cause these attacks. I am also a little concerned that they think attacks with apparently no inflammation are less serious, but it doesn't seem that these 'non-inflammatory' attacks are any less likely to lead to an admission.

I hope this makes sense (it doesn't to me)... Any advice welcome; thanks.

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Hi Lysistrata, thank you your question.

Fractional exhaled nitric oxide (FeNO) testing is increasingly being used to help diagnose and monitor asthma in adults and children. However, a negative FeNO test result does not mean that an asthma flare-up or exacerbation is or is about to happen. If this is the case, further investigations are needed to work out exactly what is going on.

Doctors are understanding more and more about asthma and especially that there are different types of asthma. We now know that asthma can be categorised as neutrophilic or eosinophilic. Neutrophilic asthma is usually late onset as an adult caused by changes such as hormones, stress, colds, flu, exercise, chemicals, fumes, depression and anxiety. Whereas eosinophilic is driven by being allergic to certain triggers such as pollen, dust, house dust mites, animal dander, moulds etc. FeNO testing may be of most value if someone has eosinophilic asthma.

I have put a link here to some of our website pages that explain a little more about tests used to diagnose asthma:

Asthma diagnosis tests: bit.ly/2sm3ro1

Do hope that this is of help, The Asthma Nurse Team

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Hi, thanks for your reply. It seems like they are saying there is no inflammation at all, rather than that it's non-eosinophilic. Is it usual to say that inflammation is eosinophil-driven, and that if eosinophils are not driving the flare, that is not inflammation? That looks like what the link you sent is saying?

It usually seems like there is nothing I can do in this situation when FeNO is normal, given that steroids seem unlikely to work. The other tests definitely indicate asthma.

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Hi again Lysistrata.

Having severe asthma can sometimes be frustrating as there are no clear and easy answers to management & treatment.

If your symptoms do sometimes respond to treatment with hydrocortisone, then this suggests that some inflammation is present which may or may not be eosinophilic. Steroids help reduce inflammation in the airways.

Your case sounds very specialised and while we can provide general advice on asthma management & treatments, sometimes we can only advise that you continue to work with your healthcare team to find the best treatments & medicines for you. We have some advice about the importance of "teaming up" with your healthcare professionals

on these pages of our website: Managing severe asthma bit.ly/2q6r1aR

With best wishes, Asthma Nurses

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Hi, thanks very much for clarifying. It is definitely confusing and frustrating to everyone, and I know there's only so much you can say on here and can't advise on the details. I was just a bit confused by what they were saying about inflammation vs no inflammation, so thank you for shedding some light on that :)

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Hi there. I live in NZ and have recently joined your site. I have found the information posted most helpful and could (if time permitted) spend all day on here,

I was first diagnosed with Asthma in 1972 while pregnant with my son. For many years My asthma had not been a problem and I only required ventolin when I had a chest infection. I would use approx 1 ventolin per year. Since 2015 it has become a real problem and I now have to visit the respiratory clinic every 3 - 6months. I have been diagnosed as borderline COPD. My meds at present are Symbicort, spiriva,and loratadine. My problem seems to be a constant cough. I have had constant courses of Prednisone which seems to help settle the cough (asthma a lot better) but once I finish a 5 day course the cough gradually gets worse along with increasing asthma. I read peoples comments about their peakflow being around 200 & upwards. My best is 150 and has dropped to 60 when I ended up in hospital overnight. I dont appear to respond to asthma treatment as would be expected. My Dr suspects that there are other things causing my asthma symptoms. I also have a gallstone and have acid reflux. These are both controlled by a very restricted diet. I mention my constant cough to my Dr and the respiratory clinic but I dont think they are listening. My concern re the coughing is the long term damage it is doing my to my lungs.

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Hi Bevash thank you for that.. it sounds like you are having a rough time.a few suggestions for you.have you tried a tablet called montelukast which is prescription only in the UK it is very good for some people who have allergic asthma.also if you have a blocked or runny nose or find your self throat clearing this will affect your lower airways.in the UK acid reflux is very coming in the asthma community and we manage it with a P P I . it is a medicine that reduces the production of acid and helps to keep airways calm. i would wonder when last you had a spirometry.lastly the steroid nasal spray has a particular technique after you have cleared your nose in order for it to work if you have nose symptoms it will affect airways lower down hope this is helpful and do get back to us for any further info

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Thank you so much for this information. I am taking omeprazole for the acid re flux and have been for a number of years. When visiting a specialist re my acid re flux and gallstone I asked if there could be a connection between the gallstone and my asthma. He told me that the gallstone will aggravate the acid re flux and the re flux would definitely aggravate the asthma so in a way Yes. I had a endoscopy which appeared normal. When visiting another specialist for the followup results I was told (rather rudely) he could operate and take out the gallstone/bladder but " IT WILL NOT FIX THE ASTHMA"

I would dearly love to get on top of this problem and are now torn between having the operation as I know that any op comes with its own risks. I also have a nasal spray Flixonase (plus the loratadine) for allergies but have stopped taking it owing to the side effect of a very very dry mouth. Should I persevere with this as I understand it could take some time to become effective.

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Hi Bevash i have spoken to our clinical lead and it is unlikely there is a direct link between gallstones and reflux but there is a commonality as some people who have gall stones may have a fatty diet though i know you do mention you are on a restricted diet.i would suggest you speak to your consultant as this is having a big impact on you and your peak flow is permanently low . you could try another nasal spray or if try a steroid nasal mist if one is available. we have Avamys and Dymista the latter is a combination spray as it has a antihistamine in it as well.

It would be good to do a symptoms / peak flow diary for a few weeks making a note of how often you get day night time symptoms and how often you are needing your blur inhaler and if it is working for you....lastly i wonder if you are able to get the microscopic steroid out of the symbicort as it needs a lot of effort to get it down into your lungs where as an aerosol with spacer doesn't require any effort from you.

Thank you

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Many thanks for that info. I will keep a diary as suggested, The symbicort has been prescribed for me (by the respiratory clinic) to use as a preventative. (2puffs morning and nights) and additional puffs throughout the day if required. I have been told symbicort also has a steriod in it and is better than ventolin. I am suspecting you may be right and I am not getting it into my lungs. I do use a spacer with my ventolin. I will also look into Avamys & Dymista and see if it is available and funded here.

Kind regards Bev

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is this only for kids with asthma?

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i guess so nvm

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Hi there, I'm a bit confused, do have a particular questions for us nurses?

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My son is sick a lot with his asthma. He is on montelukast, desloratadine as well as the purple and blue inhaler, but he is still sick quite a lot (at least weekly). Any ideas?

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Hi Katslacey,

Sounds like he needs a review with his doctor or asthma nurse.If he gets hayfever or allergies which can make asthma worse he may benefit from a nose spray

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I have been diagnosed with asthma but I have a normal spirometry and my doctor has never heard my chest wheeze. I do have occasional, mild silent reflux relieved by Ppi’s. Could my asthma symptoms actually be due to acid entering the lungs?

Last year I developed breathing issues. I had a very bad week during hot, humid weather where I struggled to breath out fully. It felt like my lung was sealed off somehow and I was scared to take a deep breath, feeling I would get “stuck” somehow. Every muscle from my waist to my shoulder ached from the effort of forcing my breath out. Throughout the year I also started having short-lived coughing fits when exposed to triggers such as cold, laughter, wind in Spring (possibly pollen) as well as major coughing fits when exposed to deodorant or cigarette smoke (relieved by ventolin). I also had a chronic wheeze when breathing out. My normal breathing using tidal volume was fine but I could not fully exhale. It would take about 15 seconds to fully breathe out - the effort would make my face go purple and I would produce a high-pitched polyphonic wheeze with a coughing fit at the end. I was placed on Symbicort and the symptoms improved immediately. Could reflux do all of this? When taking both Symbicort and ppi’s I have no symptoms of any kind but I wonder whether only the ppi’s are needed.

I realise that I do have asthma symptoms but I have normal spirometry and a clear chest. Would a challenge test be appropriate? I have recently stopped taking Symbicort as a test and have found the wheeze on forced exhale returning.

Sorry for rambling.

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Hi Hildergard 88

If you improved on regular symbicort and PPI that is great. The asthma guidelines suggest thinking about stepping down treatment after a period of three months with no symptoms.The fact that your symptoms have returned after stopping your symbicort suggests that you need to be on this.Acid reflux is a common cause of cough and a common trigger for asthma so your PPI will help.Asthma is often managed using trials of treatment and it sounds like you have found benefit using using symbicort and PPI. A challenge test may not be necessary.

It sounds like you have some allergies which may also be making your asthma worse.If you have a runny, itchy, sneezy or blocked nose then anti-histamine and a steroid nose spray may also help

Hope this helps

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Hi AsthmaUK_Nurse I am due to have a mannitol test at my local hospital in 11 days time. I been told to stop my inhaler fostair nexthaler 200/6, monkelust, and prescribed anti histamine 4 days before the test. Also not to use ventolin 8 hours befor it too.

My asthma is under control at present and my breathing test were normal. (I was on my inhaler when I had it done . There is a definite diagnosis of asthma but the consultant said in his letter to me and my doctors I am a difficult diagnostic conundrum. I have a 5/6 sensitively to house dust mite and a count of 296 on my Ige test.

What I would like to know is ...What will the test show the consultant. A confirmation of the disagnosises if I react. I don't know how da I will feel if it's negative or postive.

Secondly is there anything I can do to protect myself in terms of being off my medication. My husband is decorating the hall and landing at the moment. I been away for some of it but can't be out of the house for all of it. I have asked him not to paint next weekend when I will be off my medication.

If any thing happens in terms of symptoms when I am without my inhaler etc. Any other helpful thoughts and tips. I hope and pray I will be fine.

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Hi elanaoali Firstly, i would clarify if it 4 days to come off prevention i will send you papworth hospital patient information sheet. for your nexhaler it is usually 24 and Montelukast 96 hours and reliever inhaler 8 hours and lastly, anti-histamine is usually 72 hours

You may be sensitive to Mannitiol and this can confirm a diagnosis of asthma.

I would call allergy UK as they may be able to recommend a particular filter if you have to be in the house some of the time.

royalpapworth.nhs.uk/docs/l...

allergyuk.org/

Hope this is helpful thanks from the asthma nurses on the helpline.

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Hi AsthmaUK_Nurses I thought the coming off of all things 4 days before was strange when I looked into it. However this is what the leaflet said with the appointment leaflet.

I needed to ring the consultant medical secretary about the two appointments I have in June a week apart. No explaniation for these was sent with the letters. A mystery?

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Hi There,

This is long, so apologies in advance.

A few months ago I was diagnosed with adult on-set asthma after having this horrible case of bronchitis that lasted for about 2.5 months. It ended up being bacterial (but according to my specialist the initial antibiotics given were not strong enough so the bronchitis never went away). Finally, after what felt like an insane amount of antibiotics later, I stopped coughing but continued to have shortness of breath that would last hours a day.

When I was sick with the bacterial infection I was on Ventolin and some other pills. Then I switched to Seretide (morning and night) and was given bricanyl as an emergency inhaler. I was still experiencing shortness of breath every day and it totally impacted my every day life.

Then about two weeks ago I started having full days where I wasn't feeling tightness. I can't tell you how happy I was! During that time though I was getting really congested. This has now turned into a full-blown cold with more mucus then I care to let on and I am coughing up thick, green phlegm. My doctor told me to take Zithromax (3 day course). I finished it two days ago but am still coughing and occasionally coughing up green phlegm. Is this just normal for people with asthma? My doctor told me because of my condition I will be more prone to getting colds which can worsen my asthma symptoms. I'm also a teacher and she said because of how many germs students carry, I will likely have symptoms like this for the foreseeable future. Is this true?

I've been doing my best to be healthy-- I've almost completely cut out dairy, have barely been drinking for the past few months and have started swimming (about 20-30 laps) once a week. I use my bricanyl before exercising and cough during the swims but am not wheezing.I take walks and try to be as active as possible. I just want to feel NORMAL AGAIN!

When I don't have colds, her plan for be is to be on Seretide twice a day, Striverdi Respimat (olodaterol) once in the morning and Spiriva Respimat (tritropium) once at night. Does this sound intense? Every appointment she assures me I have "Mild" asthma. Does that sound right?

I live in Hong Kong and have been skeptical of the doctors due to a few bad experiences, but the respiratory specialist I'm seeing went to school in the UK and US and came highly recommended. She said we're "toughing it out" right now and that this will take some time. She's not worried at all (which actually makes me even more worried).

My questions are:

1. Given what I've said does it sound like I have "Mild" asthma?

2. How long does it generally take to find medication that works for someone with asthma to the point where they don't feel the tightness? and to feel their asthma is "under control"?

3. Is it true that ideally, someone with asthma can live a normal, healthy and active life? How long does it take to get there?

4. My best peak flow readings thus far has been 500-- is that bad for a 27 year-old- girl? I'm about 5ft 10 inches.

5. I have developed serious anxiety because of this and sometimes it's hard for me to tell if my symptoms are my anxiety or not. Does anyone have any advice about how to cope with the anxiety and that sadness that comes from finding out you have a disease?

6. I have attached a photo of my test-- could anyone help tell me if this looks serious or not?

7. Do people with asthma just have to learn to deal with these symptoms of never feeling normal? I truly hope not.

I would truly appreciate any advice or answers-- thank you in advance!

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Hi kshull13,

Your peak flow of 500l/min is good but peak flow does not always reflect how you are feeling.The aim of asthma treatment is get you symptom free and asthma can be well controlled once the right treatment for you has been reached.Has anyone looked at what might be triggering this? Do you get hayfever as you describe nasal congestion and frequent colds and mucus.This can cause post nasal drip which can result after a sinus infection or as a result of allergy to pollens or pollutants.Post nasal drip and symptoms of the nose can be a real trigger for asthma.

We would recommend making an appointment to see your doctor and they may suggest a trial of daily nasal steroid spray and anti-histamine.

The attachment has not appeared so we cannot comment on your results,sorry, but we hope this has been helpful

Asthma Nurses

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My asthma has been uncontrolled for a while. My GP changed my preventer inhaler from Fostair to Flutiform.

I started the Flutiform inhaler yesterday, I don’t know if it’s a coincidence but I am feeling very drowsy and more tearful than usual.

I was wondering if the new inhaler is causing this?

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Hi asthma-girl,

It is unlikely to be the change from Fostair to Flutiform that has caused this.Do you use a spacer with your inhalers and do you know what is triggering your asthma? Do you get hayfever?

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I use a spacer with the new inhaler and I do suffer with hay fever

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Are you treating your hayfever? A daily nose steroid spray and anti-histamine can really help control your hayfever and help with your asthma

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I’m using Fexofenadine 180mg, sodium cromoglicate eye drops, Nasonex Nasal Spray, Loratadine for my hay fever

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My GP told me that my lung function is about that of someone in their late eighties.

Is there any way I can improve this?

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Hi there that is a big piece of news to digest, can i ask your age and if you had a spirometry test which is the series of blows into a machine that can be quite tiring ?

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I am 50.

I have regular spirometry test every time I attend my hospital out patients asthma clinic appointments.

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ok thank you can you give me all your asthma medicines including inhalers and steroid nasal spray if you use one and also spacer if appropriate it can help me work out what step of treatment your on.

can you also tell me how often you use your reliever in a week ? thanks

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Flutiform. 2 puffs morning and night

Nasonex Nasal Spray 1 dose in each nostril

Prednisolone 5mg tablets (currently on 40mg).

Clarithromycin 250ng. 2 tablets morning and evening (use only when I've a chest infection with productive cough).

Bricanyl Turbohaler (reliever).

Bricanyl nebules.

Atrovent nebules.

Budesonide nebules.

Fexofenadine 180mg. 2 tablets morning.

Loratadine. 1 tablet morning.

Singulair 1 tablet night.

Omeprazole. 2 tablets daily.

Sodium Cromoglicate Eye Drops. 2 drops in each eye. 4 times a day.

Co-Codamol 30/500mg

Tramadol

Rivaxoban. 1 tablet morning

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Thank you I notice you are not on spiriva (works differently to the blue reliever inhaler but can help with lung function for some people) and Alvesco as an add on inhaled steroid it is slightly different than the standard and under secondary care it is sometimes tried alongside your flutiform. It might be worth speaking to your consultant and helpful if they have an email service or a named nurse you can speak to.

If you would like a more in depth chat please do call our nurses helpline it is a bespoke service and we can go things in more detail as respiratory medicine can be quite complex.

Thank you from the helpline nurses

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Thank you, you’ve been very helpful

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I had a very serious asthma attack earlier this year and rang an ambulance. Ended up becoming so critical they couldn't move me without intubating and putting me into an induced coma. I wasn't expected to survive and when I did wake was told "their words exactly" that I'd had some kind of heart attack and had heart failure. Prior to admission I had been growing extremely unwell for the then past 2-3 years with my asthma being so bad I couldn't hardly breathe, move or get up the stairs, and had a horrendous nonstopping cough which was exhausting. My asthma nurse just mocked me constantly when I told her how much I was struggling and my blue ventolin inhaler wasn't working. She said well it should be working if you really have asthma as it's one of the best. Tried explaining constantly that it was doing nothing to help otherthan give me bad headaches and the shakes, but she wouldn't have it could be doing that to me. I was extremely ill and ended up having that horrendous asthma attack because nobody would listen to me telling them I was feeling "and actually looked deathly" Now I've been told my heart failure has gone, but they have still kept me on heart failure medication. The problem now is my breathing has reverted back to how it was prior to coma and the exhausting cough has come back. I am also still in recovery from the coma. My asthma nurse again isn't listening about the blue ventolin inhaler not working, and she's telling me only to use two puffs a day because my preventer should be working meaning two puffs a day is sufficient. It isn't sufficient, I can't breathe well, I'm wheezy, constantly coughing and needing the inhaler a lot to get just a tiny bit of relief from it as per usual it's not helping me. Have been admitted to hospital twice again since my coma because of fast heart and difficulty breathing, but all their tests on me come back as normal, and I know don't know what to do as feeling very unwell again and starting to struggle doing simple things again because I become breathless. What can I do? Why are the tests showing everything is normal or exceptable, when I just don't feel right?

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Hi, this sounds like a very difficult and frustrating time for you. As a general rule, if people are using their blue reliever regularly, 3 or more times a week, then their asthma is not well controlled. The preventer inhaler is very important and needs to be taken everyday, as prescribed, even during times when you feel well. Make sure you rinse out your mouth thoroughly after each use. All inhaled medication needs to be taken with perfect inhaler technique and you can take a look at this page for more information on technique:

bit.ly/2sJdfws

If you get hayfever then it's important to think about whether your nose needs treatment and this maybe the case if you have a blocked nose. This is caused by pollen irritating the nasal passages and results in inflammation making them narrower and causing more mucus production that drips down the back of the throat and causes cough, especially at night. If you think this may be something that is affecting you speak to your GP about a steroid nasal spray.

The tests that the doctors and nurses may offer people with poorly controlled asthma are called spirometry and FENO and these both involve blowing into machines. The results give information on the health of your lungs. You can find more information about these tests through this link:

bit.ly/2sm3ro1

If you have a peak flow meter and a peak flow diary you could measure and record your peak flow every morning and evening, before you take your preventer. Take your peak flow diary along to any appointment with a doctor or nurse regarding your asthma so they can see a written record of what's been going on. Also try and remember the number of times you've used your blue reliever each day and write that in the diary too:

bit.ly/2lFbhH1

It's very important that you have a written Asthma Action Plan as this will give you guidance about what to do when. Your asthma nurse should provide you with one if she/he hasn't already:

bit.ly/2rswbf0

Lastly, as you had such an awful attack your GP may think it useful to refer you to a respiratory consultant if you haven't been referred already. You would have an assessment and possibly further investigations to do with your asthma.

Sorry for the long answer but I hope you get something from it and feel better soon.

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Hi,

I've had Asthma as long as I can remember. But I've always gone through most of my life feeling like I haven't had it because it's been so mild that I haven't even needed a preventer inhaler... until 3 months ago.

I remember being out with my friend and feeling suddenly wheezy. Now, bear in mind that before this day I probably used my reliever 3 times a YEAR. Yeah, that's how good it was. So on this particular day I didn't think too much of it, took my reliever and assumed that I'd wake up the next day feeling fine. That did not happen. The day after I was at work, a normal day at work, I love my job, it's rare that I feel stressed about it, so this is just to point out that no triggers were present at the time. I started coughing, now asthma has never made me cough before, wheezy sure, out of breath, yes, but never coughing. I've never had a cough like it in my life. It's dry and I can actually hear the wheezing with each cough, whenever I've had a cough with a cold it's always been chesty and productive. This cough is like nothing I've ever heard, it scared me so much. I had forgotten to take my inhaler to work on this particular day so I got an emergency prescription from my doctors and picked up my Ventolin from the nearest chemist. It eased it but I was still coughing all day, and the day after. I thought maybe I had a chest infection so I waited it out. I'd have two days of coughing and one day of feeling fine. I was to-ing and fro-ing in my mind as to what it was, whether I should go to the doctors. I eventually went three weeks after the cough started.

They told me exactly what I didn't want to hear, that it was my asthma. The nurse asked if anything had changed in my lifestyle but I wasn't doing anything different. My diet, exercise, lifestyle, work, home, it was all the same. The ONLY thing that had happened recently was that I moved in with my friend 6 months prior to my asthma getting worse. Now she does have cats and a dog. I'm very allergic to cats, but I have lived with one before for 11 years with no asthma symptoms. They aren't allowed in my room and spend most of their time outside anyway and even if it was my new home environment, WHY HAD IT TAKEN SIX MONTHS TO FEEL THE EFFECTS OF IT?

Anyway, the asthma nurse put me back on Clenil Modulite 200 micrograms. It was three weeks til my check up. She told me it would take a few days to start working. Day 3 into taking clenil, I was at a wedding. I tried to dance and sing to ONE song and it was so difficult that I had to keep stopping to catch my breath, this had never happened before. Day 5 was the worst ever. I was due to go to London the following day as my American relatives were visiting, that didn't happen because I was up until 2am, unable to lie down until I could breathe better. I had taken my Ventolin 3 times that night. I was distraught. Finally on day 7 I felt like things were improving but I still didn't feel 100%. When I had my check up the nurse was very surpised when I told her how long it took for the Clenil to start working and to be honest so was I but she didn't question it and so neither did I, she sent me away telling me to continue taking Clenil for the next three months and I could review how I felt myself and if I felt ok then I could reduce how much I was taking and maybe even go back to taking nothing.

Four weeks ago I upped my dose of Clenil to 6 puffs a day because I was needing to take my reliever more and more again. I hoped that this would make things better. It didn't. Two weeks ago I went back to my doctors and I told them that I had upped the dosage and it still wasn't working properly. My asthma hasn't been keeping me up at night but it is now affecting my quality of life. I told the doctor this, and that I was wanting to start going for runs in the evening but was too scared to exert myself because I knew I'd have to take my reliever. I swim every Monday, I have done for the past two years. Swimming now makes me wheezy. Every. Single. Time. I can't do the amount of lengths I used to or go as fast and its so frustrating.

So the doctor has now put me on Fostair, the same one my dad is on. This made me really upset. My dads asthma is terrible, but even he told me the Fostair has basically made his breathing so good that he now doesn't take it at all.

I'm here because I'm angry, and confused. I've now been on Fostair for two weeks and I still don't think its working. I still cough occasionally, I still get wheezy, I have to sometimes take it during the day as a reliever, I still can't swim like I used to. My chest feels heavy and tight and painful every day. My mum keeps asking me if it's actually asthma at all, and it makes me wonder if the doctors have done enough tests. It's like the medication works for a week and then my body gets used to it so fast that it may as well be void. I know other people have it a lot worse than I do but I'm scared at the speed in which this is accelerating. I don't want to move onto whatever is after Fostair. I'm only just coming to terms with the fact that I have asthma after my breathing being so normal for so long. I'm 26 years old by the way, I was diagnosed as a kid but, like I say, I've never had it bad (although I guess I can't say that anymore)

Can you put my mind at ease at all? The Doctors say my chest is clear, but this was so random, could it be something else? Why is the medication not working? I'm so scared and I hate this. I just need some reassurance from someone who understands.

Thanks,

Steph

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Hi Steph

It sounds like you have been poorly now for quite a while and it is having a big impact on you, i will try and cover all the points you have raised.

If the Fostair is a press and spray do you use a spacer? if not an aero spacer chamber can be purchased at your local pharmacy as inhaler technique is really important and you get better delivery with a spacer.

asthma.org.uk/advice/inhale...

I know it must be a worrying time for you as you have not needed to worry about your asthma for so long , however this is not unusual as asthma comes and goes we don't fully know why.

I would suggest you ask your GP for a short course of steroid tablets for at least 5-7 days and sometimes you need longer to clear off the inflammation in your lungs which are recommended in the national guidelines, for a flare up.Fostair is a preventer inhaler (microscopic steroid) it builds up in the lungs overtime to work on a small amount of inflammation the most important thing is that you feel well on your last day of tablets and by then hopefully the fostair will be ready to sit in the background as a preventer offering protection to a known or unknown trigger.. I would also advise you do not reduce on your fostair for at least 12 weeks of being symptom free and not needing your reliever more than twice a week.You mention your father is on it.This particular inhaler is prescribed widely across the UK, it is a newer fine particle inhaler with a better delivery onto your airways.a lot of young people use it as a preventer and reliever to for better self-management and you could ask about this at your surgery(MART regime)

When a GP listens to your chest he is listening for a wheeze(asthma) or crackles(chest infection) what they cannot hear or see is inflammation in the airways.

Lastly, if you have a watery or blocked nose or any throat clearing this is a sign of asthma of the nose (rhinitis) and needs to be treated as it can affect your lower airways(pollen count is high at present) this may consist of an anti-histamine tablet and a steroid nasal spray.

Please do come back with anything else Steph and hope you feel better soon.

From the helpline nurses.

PS you have your 111 service and they can sort out a GP appointment for you if you can't get into your surgery today.

asthma.org.uk/advice/manage...

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Hi,

I was prescribed Spiriva Respimat for my asthma. Can I use it with a spacer?

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Last week I had an asthma attack wholst camping. The ambulance had to be called and the paramedics helped. I booked an oppointment with my GP and she listened to my chest and searched for a wheeze hpwever i dont wheeze unless im having a very severe attack. My peak flow was also okay even when I do have flare ups my peak flow does not drop significantly. My GP gave me some antihistamines and siggested thst a use fostaire but realised i was under 18 smd said she could not do too much more. She then proseeded to tell me to book an appoitmwnt with the asthma nurse.

However i csnnot get an apppintmen for about 2 months amd im getting day to day symptoms and took the asthma uk quiz qhich told me im red alert for an asthma attack.

What do I do??

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Hi, this sounded scary. How old are you as there are inhalers for under 18's. Do you have inhalers already or none at all? If you can't get an appointment with the asthma nurse for 2 months it sounds like you need to call back and ask to speak to a GP as you need some urgent help with your asthma. Explain you took our asthma attack risk checker and you got a red alert to say you are really high risk.

bit.ly/2xvsLej

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Thanks very much for the help. I am 16 and I am on the highest dosage of clenil inhalers and take montelukast as well as a ventolin inhaler as well as prescribed antihistamines in the summer.

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Seretide combination is ok for your age and if you have allergies/hayfever/nose symptoms a nasal steroid spray may help too.

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Hi, I am on Symbicort 160;4,5 and I have been feeling worse lately where my asthma symptoms are as bad as if I am not on medication. In the past 2 weeks, I’ve had atleast 3 asthma attacks per week, I use my symbicort (this is the only inhaler I was prescribed) about 4-5 times a day, but in asthma attack days I can use up to 8 puffs.

In the previous years before I was diagnosed, I had acid reflux, so recently it seems that my acid is acting up again which makes me feel worse.

So I don’t know if acid reflux can make my symptoms worse and if this is worth seeing my GP, or if I should just wait it out.

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Definitely see your GP as soon as possible as you may need a short course of oral steroids to stamp out the inflammation in your airways quickly. They can also review your preventers and treat your acid reflux with a trial of treatment for four weeks. Hope you feel better soon from the Asthma UK helpline nurses.

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Thank you so for your advice

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I had a very nasty asthma attack Monday evening my reliever and nebuliser did not help much. The out of hours came fortunately it was my GP who arrived 22:25 and stayed treating me until 23:55. I had several back to back neb, oxygen because my sats were 80, hydrocortisone and magnesium. He brought a debfib machine in case it was needed. The doctor told me that I was seconds from death and I had silent lungs (whatever that means). This really shocked me because I’ve had asthma all my life and have no problems recognising the signs but on this occasion I didn’t realise that I was that bad.

Since this episode, the realisation has clicked in today (Wednesday) and I’ve been a little tearful. I live on my own and I’m concerned that I might get another asthma attack like that in the future.

Is it normal to be tearful and shaken by something like this?

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It sounds like you have had a very frightening experience and it is quite normal to feel like this, are you in hospital now? Not only have you been very unwell but you have had a lot of medicine and you are probably feeling exhausted. Do you have an appointment with your doctor or asthma nurse for a follow up this week? You may need a full review of your preventers and a revised action plan and a look at possible triggers and a plan of how you can prevent this happening again. Please call our helpline if you would like to have a chat with one of our friendly asthma nurses

The Asthma UK Nurse team

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Thank you for coming back to me.

I’m not in hospital I’m at home but my doctor has arranged to visit me at home later this week.

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Helpline number is 0300 222 5800 Option 1

Get well soon

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Thank you

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Hi - I'm in the process of being diagnosed with asthma and had my spirometry appointment at the GP surgery today. I couldn't seem to do it right, the nurse kept telling me to blow out for longer but I literally didn't have any air left. I couldn't get any usable results and she's referred me to the hospital to get the spirometry done there.

Feeling frustrated because I really was trying as hard as I could and now am feeling exhausted and coughing, tight-chested etc, but it still wasn't good enough. I'm worried this is going to delay me being able to get proper treatment - I'm getting asthma symptoms every day and am using my blue inhaler (all the treatment I've been given so far) a lot, but really want a proper diagnosis so I can stop feeling so rubbish all the time :(

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Hi,

It is not surprising that you found the Spirometry difficult when you are having so many symptoms.People sometimes find it difficult to do even when they are well so please don't feel disappointed with yourself in any way. If you are having symptoms it is recommended that your symptoms are treated even if you do not have a confirmed diagnosis. Prescribing a trial of treatment may help settle things down for you but also will provide important clues as to whether your symptoms could be asthma. A trial of treatment is an important part of diagnosing asthma. I recommend that you contact your GP today to seek an urgent appointment because you are having symptoms and have said that you are using your blue inhaler a lot, this means someone needs to check you. Can I recommend that you download an asthma action plan and take it with you to discuss as this will be a useful tool to help guide you when you are having asthma symptoms as to what to do. I hope you are feeling better soon

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Hi,

My 5 year old daughter has had a vial wheeze every time she gets a cold since she was about 10 months old, she was given a blue inhaler to help which we use on her if shes ill.(about 1/2 times a year) fast forward to last month my daughter woke up unable to breath i gave her the pump and calmed her down and she went to sleep, later that afternoon she had another episode of being unable to breath and running a temperature whilst my parents were looking after her they gave her calpol and her pump and i left work and got her in with her GP. By the time we got there she presented with no symptoms and her temperature had come down. GP said keep an eye on her and if it happens in the night take her to A&E. She was fine that evening and the next day is was fine so she went away to the coast with my parents (summer holidays and i work full time) she woke up the next day struggling to breath again but was given pump and calmed down. a few hours later she had another attack that lasted for about 4 hours and was taken by ambulance to the hospital, She had a chest xray which showed a shadow on her lungs and was given iv antibiotics and we was told she had pneumonia and asthma. She was released from hospital the next day with an orange preventer pump and a chewable tablet to take each night. She has since had a couple of bad turns but by the time we get to a&e she is ok. she has been referred to a pediatrician at our local hospital on a rapid access appointment because she is having very loud, strange breathing at night with severe night sweats. The pediatrician has referred her to the asthma clinic at the hospital (not sure how long this will take? any ideas) also she has taken her medication for a about 4 weeks now and hasnt had another attack but whenever she takes a deep breath in she has intercostal retractions but only on a deep breath is this normal or is it an indication that the medication may need changing. Sorry for the long post.

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It sounds like you have been having a difficult time. In young children asthma can be difficult to diagnose. It is done by taking a full history from yourselves, trying a course of treatment to see if she improves and in older children a lung function test. This can be done in children of 5yrs old and you may find they do this when you see them. Children who have symptoms when they have not got a cold are more likely to have asthma than those who only have symptoms with colds. Your daughter has been given some medication to try and if it is asthma you should see an improvement. You say she is still having some problems and that you can see her chest 'retractions'. I would have hoped that the symptoms would have started to settle after 4 weeks of inhaled medication. I am pleased you have an appointment soon but would suggest that if you are seeing these symptoms that you see your GP as it could be a few weeks until you have a hospital appointment.If you do not have an asthma action plan download a copy from our website and take it with you so that you are clear what to do if she gets worse and you are worried. I do hope that she is feeling better soon.

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Thank you for your quick reply. The doctor at the hospital she was admitted to and who gave her the medication was an asthma specialist for that area and he said she has a clear chest shape (raised breast bone) that indicates she has asthma. She has had no wheeze or crackle at all and she has been seen/listened to by 7 different doctors. she only gets the retractions when she takes a deep breath not on normal breathing and this was seen by her pediatrician 2 days ago when the referral was made but the pediatrician didn't give me much info about this being normal or not.

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Hi,

Chest shape alone is not usually a diagnostic factor for asthma but it can mean that she has been having chronic asthma symptoms. It is great that she has no wheeze which is a feature if asthma when it is not controlled. It sounds as though you will be able to find out much more when you see the Consultant again. If she was seen my a paediatrician 2 days ago they would have examined her and I am sure if they had concerns at the time they would have talked to you about it. I am afraid I am unable to tell you more as I have not examined your daughter but I wondered if it was possible for you to give them a call to ask any questions that may have come up since the appointment?

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Hi I am on Revlar Ellipta 92/22. I find it works fairly well for me. Only thing is that by the time I am due to take it i feel breathless. After i take it I feel my throat sore. This lasts for a couple of hours but by 9.00pm i feel good, breathing normal and this will last till about 10.00 in the morning. Then I will take 1 puff of Atrovent and sometimes before 6.00pm i may need to take another puff so is it fair to say that this inhaler works very slowly in releasing the powder and thats why I always feel so much better after a few hours and a bit breathless a couple of hours before I take it again. I am 66 years old and have suffered from asthma since 5 years old.

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Hello, thanks for getting in-touch. With the Relvar Ellipta its important that you are able to breath in forcefully to be able to get all the medicine down in the lungs. Also, because it contains a steroid its important to rinse your mouth & spit out to use reduce the amount of side effects on the mouth & throat. If you continue to experience this despite the advice above - we would suggest seeing your GP to see if a different inhaler would help. I have also added this link to help show how to get the inhaler technique right as usually this is another reason many people suffer from side effects: asthma.org.uk/advice/inhale...

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Hi Guys Good afternoon

I am Abdul hai Bappy from UAE, I thought i am suffering by Asthma but till now didn't meet with any consultant for this problem actually i face this problem when i am long time in AC room or near Ac i feel Berthing Pressure in my Chest also not able to talk but when i get some hot water then i feel little better. one more thing i am smoker.

Please help.Thanks.

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Hi, Smoking can be both a cause and trigger for asthma. It would be adviseable to see a doctor as they will be able to advise and support you and may be able to offer some treatment.

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If I ask my GP to switch me back to Qvar, am I being awkward. Is Qvar being phased out, and is there an equivalent? I just want a normal style brown inhaler.

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It would be fine to discuss this with your GP if you feel that your symptoms were well managed on this inhaler. There should be no problem. Qvar is an inhaler which has fine particles so it suits some people really well. It is considered to be more potent than the 'ordinary brown' because of the finer particles so your GP will be mindful of this when they decide on the best dose for you.

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Really? They put me on Revlar Ellipter, from Qvar.. And I must admit it is quite effective.. But I don't like all the extra faffing you have to do with it. Like having to keep it dry and using it in such a short time period..

Also whilst I'm here is there a way to recycle the inhalers/canisters?

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I was just worried they'd put me on it to save money... They sprung it on me without asking me.. (I have Diabetes type 2 as well)...

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The benefit of Relvar is that many people like it because it is just once a day. Relvar is a combination inhaler, which means it contains both an inhaled steroid and a long acting bronchodilator (LABA) so it is different to QVAR which does not contain a LABA. Relvar is usually used when a person still has symptoms despite having tried a combination inhaler. I cannot see that this would be to save money in this case. I would recommend that use ask why you were changed? It is always important to discuss this with someone before changing and certainly not great to spring this on you without a discussion. I suggest you have a conversation with your Nurse or GP as if you were well and happy with QVAR I would want to understand why the change? It may being advised locally by the medicines management team that advise GPs.

Unfortunately there is no way to recycle. Hope that helps.

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Hi, just wanted to check on flu jab timing. I'm recovering from a 6-day hospital admission for asthma and have the end of a cold (I got out on Sat afternoon and off work recovering still). I really want to get my flu jab asap to protect me as flu would really mess with my asthma, but also want to avoid feeling too rubbish from the jab (I know it's not flu, but the admission etc is giving me enough rubbish feelings without adding to that and I have felt a bit under the weather/briefly had more asthma symptoms in the past after the jab - unless it was coincidence.) Is there any rough rule of thumb on this, or should I just go ahead whenever? They said 'wait till your lungs are doing better before you get it' in hospital.

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Hi,

Sorry to hear you have been feeling so unwell, hopefully you are on the mend. You are right to want a flu jab to protect you against flu however you are still recovering. Public Health England advice to patients and to GPs is that the flu jab cannot be given until at least 2 weeks after a course of oral prednisolone. Also there should be no active wheezing. It is recommended to have an asthma review within 48 hours of discharge from hospital. It would be a good idea to have a review and to discuss timings for your flu jab at the appointment. The GP or or Nurse will also check that you are well on the day. Hope you are better soon.

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Hi regarding the flu jab not being given until 2 weeks post pred course - what would the advice be for those either on maintenance steroids, or those having to do a reducing regime of steroids over a couple of months?

It’s a question that’s be bounced around a couple of times on the site - when should you get it in these situations. Also if you’re a severe, uncontrolled asthmatic what’s your advice regarding the jab? (Bearing in mind the propensity for wheeze on a daily basis)

Thanks

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Hi Emma

IF you are on maintenance oral steroids it is still recommended that you have the adult flu vaccine that isn't live. If you have active wheezing then this would be about risk and benefit and i would discuss this with your consultant or GP as it would be down to individual care planning and reducing doses again it depends on the individual and how they are coping with their asthma while doing so.

Thanks Helpline nurses

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Thanks for the reply! I am a tricky person to advise I realise because I never wheeze - by that do you mean general active asthma symptoms? Like Emma says it is tricky with severe asthma when symptoms are daily, but it sounds like I should wait a bit longer for the flu jab than I thought so thanks! I am on double hydrocortisone (for adrenal insufficiency and sick day rules) but not pred because it doesn't seem to do much for me now. Maybe I should wait till I can come off the double hydro.

I am seeing my asthma nurse specialist at the hospital next week so have not booked a GP appointment, but will ask them then.

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Hi, you are right. Ultimately it is always the decision of the clinician who is going to administer the flu jab, so it is important that they have all the information. Active wheezing is tricky but it is exactly the term that is used. I feel that this would mean asking if the person has had any asthma symptoms. When you see the Asthma Nurse discuss it with the team and then you will be able to let the practice know what they have advised. Hope you feel better soon.

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Thanks very much! Will do that. (As a side note, I wish national guidelines like this would stop using 'wheezing' to mean asthma symptoms- IMO just reinforces the idea that asthma needs a wheeze, which too many drs already believe!)

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Thank you for your comments, we will certainly take these forward.

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Hello,would a infrared lamp help with my inflammation to my chest for relief.i have had asthma for 20yrs

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Good Morning. I am afraid that inflammation caused by asthma is best managed by the regular preventer inhaler. It sounds as though your asthma may be out of control so it would be best to make an appointment to see your asthma nurse or GP. I am afraid I cannot say that if you bought an infrared lamp for your chest symptoms that it would help you to feel better. I think your GP or Nurse may be able to suggest something to help you.

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I been takeing my oral steroids getting with drawn prombles

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Bit of a strange question for you.

I have a 5 year old with severe eosinophilic asthma.

Why is it sometimes 4 puffs of salbutamol will relieve the asthma symptoms, but other times he is admitted and is still symptomatic after back to back nebs?

Thank you

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Hi there, I think it's probably all down to amount of inflammation present in his airways, sometimes the salbutamol is able to open them up enough, and other times you need a lot more to have the same effect. This is a link to the reliever section on our website;

asthma.org.uk/advice/inhale...

I'm sure that when he is in hospital they are also treating the inflammation part of his asthma.

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Thank you for answering so quickly. I though it would be down to the level of inflammation.

He is on a lot of medications, including maintenance dex (as he can't tolerate pred). They usually up his dex dose when he has a flare up and slowly wean him down to normal dose again.

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I'm sorry to hear you've been in hospital with your asthma. I think it's very hard to tell exactly how long it will take to get back to normal. It's often down to how much extra inflammation there was in your airways and when the oral steroids will manage to get it back under control. I sometimes think it's much harder with asthma because there's nothing to see on the surface ( as there would be if you were in plaster after a broken leg for example!)

So people can often assume that you should be be fighting fit again fairly quickly, when in reality it can take quite some time. You may find this part of our website helpful;

asthma.org.uk/advice/manage...

Have a word with your asthma specialist about your concerns when you have your follow up appointment.

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Hi

I am on Symbicort 200 2 puffs twice a day. I have had several sinus infections which have cleared up but have left my asthma worse than it was. I find I need to use a ventolin reliever as the Symbicor doesn't seem to work for me as a reliever, although i know it should. i also restarted Montelukast because I was coughing at night. This has helped with the night time coughing but I am still coughing during the day particularly first thing in the morning, not coloured mucus. Will it clear up in time or do I need to see my GP? Not easy to do! Thanks

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I would see your GP or asthma nurse for a review if your symptoms are not clearing up. You may have some residual post nasal drip from your sinus infection. Nasal steroid spray can help with this and if your SMART regime is not working for you, definitely time for a review of your asthma inhalers.

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Many thanks I have booked an appointment with my GP

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has there been any research on the use of magnesium to treat asthma

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Hi Robert, The use of Magnesium Sulphate has been a 'hot topic' of discussion for quite a while and there have been various studies. Studies in children are reflected in the guidelines and recommend that nebulised salbutamol is given alongside nebulised salbutamol within the first hour of an attack if the oxygen levels are lower than 92%

In adults guidelines recommend that Magnesium sulphate infusion should only be used following

consultation with senior medical staff. The evidence is less clear with adults but a Cochrane review which has pooled findings of many studies has suggested a place for intravenous magnesium sulphate to be used when first line treatments are not being responded to well in adults in the emergency department as finding have shown lung function may improve and reduce the need for admission.

Hope that helps

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thankyou for your help.

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Hi,

Would it be totally irresponsible to purchase aminophylline without GP or practitioner recommendation?

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Good Morning, Aminophylline should always be prescribed and monitored during usage. The dosage and 'blood levels' are carefully considered. I would not recommend that someone purchases this for safety reasons, hope that helps.

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I have been recently diagnosed with aspergillosis along with my chronic asthma and sleep apnea. They are prescribing a steroid nebuliser twice a day will that help with my asthma symptoms as well as the allergic reaction to everything else??

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Hi,

Nebulising a steroid will help to reduce any inflammation and asthma symptoms. They have probably done this as a short term measure alongside your other treatments. I would recommend that you have a clear written asthma action plan with a date for review of how you are doing. I hope you feel better soon

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I am very confused since my attack I apparently have hyperinflated lung but no one has explained why or if this is dangerous and if my attack caused it. My gp has been so unsupportive actually on a low

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Hi Emily, Its quite common that after an asthma attack your lungs can appear hyper inflated on a chest x-ray. This could be because some of your airways became narrow and more air became trapped in your lungs, this usually self resolves and this is not dangerous and nothing to worry about.

It sounds like you've had an attack not long ago, here are some top tips to help manage your asthma:

take your preventer as prescribed every day

use an asthma action plan

Good inhaler technique

Book an asthma review at your surgery following this attack

Below are some useful links for you

asthma.org.uk/advice/asthma...

asthma.org.uk/advice/manage...

If you want more support please call us on our helpline tomorrow 9-5 03002225800

I hope you feel better soon

AUK nurses

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Thank you first time of being admitted to hospital acute bronchitis as diagnoses..has really affected me mentally very tearful and fearful for my future

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