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First severe asthma attack (long post sorry)

Carriejen profile image

On Saturday I had a really bad asthma attack. I’ve had a couple before that I thought were bad but with each one it seems to get worse. Although, thankfully they’re pretty spread apart.

On Saturday I couldn’t breathe. My chest was really tight. I took 19 puffs of salbutamol, was taken out of my work for fresh air and an ambulance was called. This all took place within 45 minutes.

When the paramedics arrived they commented on how quiet I was. One said most asthmatics having an attack are loudly gasping for breath. This is not the first time I’ve heard someone say this (a woman I used to work with commented that I couldn’t have ‘real’ asthma as I wasn’t as loud as her granddaughter). I had a nebuliser (for the first time) and felt significantly better quickly. The paramedics also commented that I had no wheeze (I have never had a wheeze). Although the tightness in my chest had eased it hadn’t quite gone away. The paramedics took me to be seen at A&E, and the doctor at A&E checked my peak flow, commented it was ‘normal’ and told me to just go home, and come back tosee an out of hours GP who prescribed pred.

Is this normal? Is anyone else quite quiet during an attack? With a quiet chest??

18 Replies

Hi how awful for you and what an attitude from the medical staff. I have fortunately never had an attack as bad as that but from what I have seen on here many do and are told their peak flow is normal and they are not wheezing therefore they are ok.

This is b*******s and not being able to breathe is a medical emergency. I heard a terrible story on here about someone being told that in hospital just before they crashed and they had to be resusitated. They said the doctor went white and looked very shaken.

No wonder so many in this country die from asthma attacks compared to other countries with this sort of attitude. Why not ring up the asthma nurse on here and have a chat with them. I am sure others will be in soon who know more than me.

I hope you are feeling a bit better now. Take care. x

Carriejen profile image
Carriejen in reply to hypercat54

The paramedics were brilliant, I just felt a little let down when I got to the hospital. The doctor never even saw me I spoke with a nurse. I kind of feel like they thought I was overreacting or exaggerating, or maybe even making it up.

Carriejen profile image
Carriejen in reply to Carriejen

Also I am on the mend now 😬

hypercat54 profile image
hypercat54 in reply to Carriejen

I have heard that so many times on here. Doctors/nurses seem to have this set criteria for asthma attacks. Not wheezing - tick, peak flow fine - tick. It's past time this was changed. I am glad you are on the mend. Don't let it put you off seeking immediate help in future will you. x

Carriejen profile image
Carriejen in reply to hypercat54

It does put me off attending hospital as I get the same thing every time I go. PF ok, no wheeze. Steroids. 2 months ago the hospital missed a chest infection. But I always go to my asthma nurse after and she is just amazing

I have said that I will never have an ambulance called for me again, unless it's from my gp for this very reason, the first and last time I did I was unable to speak more than two words as I was so short of breath but because my oxygen levels were ok and I wasn't wheezing I couldn't be having an attack, I was taken to hospital anyway as the paramedic couldn't figure what was wrong and I was left gasping for breath in the waiting room for over an hour before being spoken down to by a doctor long story short I told them I was leaving and came home to use my nebuliser, I am a silent brittle asthmatic but agree with the other comments about doctors and nurses having a set criteria for asthma attacks. Very out dated and very dangerous. Glad your on the mend xx

Thank you for your reply. This is the very first time I’ve ever needed an ambulance. My managers and colleagues couldn’t have been better. The paramedics themselves were great (this is the first time I’ve needed them and I thought I was going to die) and like I said I generally improved enough that I just wanted to go home. I just felt that going to A&E was such a waste of time. The doctor wasn’t helpful, neither was the nurse and because I was visibly breathing ‘normally’ and had a PF of 450 (my highest is 500) they sent me on my way. It’s hard getting them to take me seriously because my chest and I are both quiet. Thank you for your advice :) xx

EmmaF91 profile image
EmmaF91Community Ambassador

I don’t get ambulances unless I really have too. I’m also a severe unstable asthmatic, and whilst I’m ‘lucky’ enough to wheeze, I improve too much on a neb, so ambulances tend to tell me I don’t need to go in and act as if I’m making a fuss if I insist. I go up 100 on my PF each neb, but it’ll only last a couple hours - I have a home neb which I’ll use to see if it’ll hold before I head in. If I head in immediately after a neb they get a false read and think I’m fine 🙄.

I’ve also got an irritatingly high best PF (630) so when I present at 50% I can be told I’m just having a panic attack cause my PF is ‘high’ 🙄.

Even yesterday when I presented to a&e I told them my best, then they tried to compare to the average 😤. It was only when I told them I was under Brompton that they actually listened!

I’ve also been told that cause I wasn’t wheezing, in wasn’t asthma but I had actually moved ‘through’ the wheeze to silent chest - luckily the critical care nurse picked that up, just before I almost crashed!

I’m always calm in attacks, cause I know panicking/making a fuss will just make my condition worse. I usually worried people but I have also been told that I’m not that bad cause I’m too quiet 😒.

Usually if I’ve been to a&e with asthma they automatically hand out pred, so I’m not sure why you were told to go to OOH GP 🤷‍♀️.

Hope you feel better soon x

Carriejen profile image
Carriejen in reply to EmmaF91

My highest ever PF was 500. Recently it seemed to have ‘settled’ around 450 as that’s what it always is. My asthma seems to be very unstable as at the moment I’m taking montekukast, fostair 250/6 and they’ve just started me on a spiolto respimat. My asthma nurse is amazing, she always takes me seriously and last time I went to OOHGP they missed a chest infection so I have little faith in them. I was still declining the day after my hospital trip and I felt like it was all in my head because they’d listened to my chest and hadn’t heard anything. I think it just concerns me that I’m quiet and that medical people don’t seem to take me very seriously as a result. Although my managers and the paramedics were definitely faultless (in my opinion this is the first time I’ve ever needed a paramedic for an attack usually I just manage them myself). Thanks for your response :) xx

EmmaF91 profile image
EmmaF91Community Ambassador in reply to Carriejen

Yes, asthma is the condition of hypochondriacs or head-in-the-sand-ers. If you go in early (like you’re meant too) there’s nothing wrong and you’re making a fuss, so then you feel guilty and like a fraud. You then put it off and go in later, then you’re told off for waiting too long, and not taking asthma seriously 🙄.

Don’t worry, I’m calm and quiet but also smiling and laughing when I’m really bad/on nebs. There’s usually raised eyebrows as if I’m not bad unless I’m with someone who knows me! Luckily cause I wheeze they can hear that I’m not well - I don’t think I’d get half the treatment I need if I didn’t!

Look after yourself x

Carriejen profile image
Carriejen in reply to EmmaF91

I always feel like nobody takes me seriously and I spend a lot of time wondering if I am over exaggerating or making it all up in my head! Sometimes if I really focus I can breathe better 🤷🏻‍♀️ it’s very confusing. Thank you for your kindness :)

Mogget profile image
Mogget in reply to Carriejen

Hi Carriejen, sorry to hear about your experience! Your asthma sounds similar to mine - I also have no wheeze and have had trouble convincing paramedics I'm having an attack. When my chest is tight I also have to 'focus' and position myself in certain ways to drag a full breath in. It's definitely not in your head!

I've had asthma since I moved to Yorkshire 48 years ago, but I was very "bronchial" when I lived in the Midlands and West Sussex. While it is now largely controlled by inhalers, I've had 3 severe bouts this year, 2 of the lungs clogging up with infected mucus, and the other, for the first time ever a dry bout. That was a rapid tightening of the airways. I also had chest pains.

Fortunately I was in a pharmacy close to the medical centre I use. It was 5 minutes before closing. The pharmacy assistant ran to the doctors. I followed more slowly. I saw a doctor, an ambulance was called and I was admitted to hospital for 2 days. That was only the 2nd time I'd been admitted to hospital because of asthma since 1974, the first time being in 1983 when I stayed for 12 days.

In my case this rapid tightening of my airways earlier this year was put down as an ascerbation of asthma caused by a beta blocker. I had stopped taking the beta blocker about a week before because of an unacceptable side effect, but I assume there was some left in my system.

Lysistrata profile image
LysistrataCommunity Ambassador

Hi, I really feel for you as I'm the same with no wheeze, ok sats and peak flow that doesn't necessarily follow what they 'expect'! I usually avoid ambulances for this reason because I more often get problems from them. I recently had a similar incident at work and thankfully the paramedics were excellent! They accepted no wheeze and specifically commented that my air entry was fine but I was pretty much silent on exhale - which I know I have had before! I almost never wheeze, just sound fine or go to quiet chest, though occasionally I have a wheeze on the way 'up' ie after treatment. I was once told that the wheeze was frankly welcome as it was preferred to a lack of noise (this was a fairly bad attack where blood gases were doing some interesting things - I think my peak flow was still above 50% there but was not responding to treatment for ages which is typical for me when I get worse). I have also been told that I have no wheeze but prolonged expiration.

This last admission they put on my discharge summary that no wheeze was heard etc, though I suspect one of the drs who wrote that may not have noticed that I was still quiet, because the critical care nurse the next day said I was. This dr said I'd never guess, it sounds fine, but I know not all drs can pick up the more subtle signs - luckily he just accepted this was how I present as he wasn't obsessed with that. Wish more drs were like him even if they don't hear/see what they expect - he respected the summary I created for A&E etc. I tend to tell anyone about to listen that I don't wheeze and they shouldn't take that as significant.

Hope you feel better soon and get better treatment next time. I too have a hard time with OOH - they mostly seem to either tell me I'm fine when I'm not because of the sats/peak flow/wheeze, or panic and send me to A&E anyway!

The asthmatic nurse..

dear if cannot breath go straight to hospital. Don't come to the doctor. You are a very serious case. That was about 2 years ago. Since then I do yoga and walking around. Simply breathing in an out. Above all I don't get stressed out. There is always a way out of a problem. Someone told me you worry you die don't worry still die. So no more stress just take each min I'll do what I can. That advice I took on. Now life is good. No more wheezing like a geeewaz. No more that quite asthmatic that no-one notice. Our body is changing everymin listen to it. Change our live style for the better. X

Ah yes, the 'I did asthma in my training so I know it all' approach! A&E doctors are not specialists even though some like to think they are. I have non-epileptic seizures so am quite used to doctors thinking they know all about my 'faked' seizures being 'in my head' (not true and not faked!!) and I was worried that when I turned up at the hospital (where I am well known because of the seizures) they would not take me seriously with the asthma - but they did.

I did, however, get comments about my oxygen levels being ok and no wheeze: when I could breathe I informed the nurse who had said this that not all asthmatics wheeze and that if my oxygen levels are ever low when I go in then please be ready to resuscitate me because that means I am about to crash!

I do agree that there should be better information for A&E doctors re asthma - and maybe we as asthma patients should be the ones to initiate the change? Perhaps we could provide information from Asthma UK - or at least have a letter from our GP explaining how our particular asthma presents and what to do about it?

Let's be the change we want to see! It does work - I have gradually educated the emergency services in my town about non-epileptic seizures and mental health issues, and have seen a welcome change in attitudes and approach :)

Carriejen profile image
Carriejen in reply to Tabitha58

I have wondered about speaking to the nurse about how my asthma presents itself. I just always feel like I’m being a burden or a nuisance! But I am getting a bit fed up of constantly being fobbed off. I only ever attend the hospital if it’s absolutely beyond necessary. Other than that I’m usually good at controlling my asthma myself because usually my attacks are mild and don’t actually last that long and I can get through them with salbutamol. But every time I’ve been to A&E with it they tell me I’m ‘fine’ and to go home, take steroids again and get an appointment for review with my GP. I’m on an awful lot of asthma meds right now and have just had stuff changed and added into my morning routine so there’s not a huge amount more that can be done at the moment 🤷🏻‍♀️

I think perhaps a letter from your GP explaining how your asthma presents would be a good idea. With my seizures, I eventually became so angry that I arranged a meeting with the boss of the A&E department and took with me a full explanation of what my seizures were, how they presented and how to treat them: this is now in a folder at A&E reception so any doctor can access it. This has made such a big difference to my treatment (and to attitudes of staff).

Keep a list of your meds with you too :)

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