Badly controlled asthma help?

[Annika-C]

Hi all, am new to this site but I was hoping someone could give me some advice/ relate to my experience?

I never struggled with asthma at all as a child (despite it running in my family) and was only diagnosed in January 2017 following a severe chest infection. From January 2017- September(ish) 2018 I never really struggled with my asthma, and the only medication I took for it was my ventolin (which I used very rarely).

In October / November 2018 I got a cough and cold and since then my asthma has been flaring up very badly. I wheeze and have a pretty much non stop chesty cough and mucus (ew). I have been to my doctor multiple times since then but he slightly seems at a loss for what to do with me.

First he gave me a 5 day course of Prednisolone and put me on Becotide 250. This did not shift it and I swapped to Seretide 250. My asthma barely improved and I struggled to do simple tasks like walk up the stairs or even laugh without having a bad coughing fit, coughing so badly my back and throat would hurt. I went back to the doctor and was given Singulair and Uniphyllan 200mg. I have been taking Singular for 1 month and Uniphyllan for 2 days now but my asthma does not seem to be improving at all. I am currently taking Seretide, Singulair, Uniphyllan every day and I find I need to use my ventolin atleast once every 2 days if not more.

It is worth noting my asthma never deteriorates to the point where it is an emergency, however it is very uncomfortable and kind of embarassing that everyone thinks im sick all the time from my cough :/

Any advice/ similar experiences would be much appreciated !!

Annika

[Chokit]

Hi Annie’s-C, When I was first diagnosed I too was under a bad flare & the 5 day course of Pred was not enough...I was put back onto it with gradual cutdown for around 6 weeks to help get it settled, I was also put on Fostair 100/6 which did nothing to help so go changed it to 200/6 two puffs twice daily & it certainly did help keep my asthma under control although I had to come off it late in the year because of muscle spasm & cramps...I am again on a flare & lots of different meds, hoping to get it back under control soon, maybe you need a longer course of oral steroid to get it settled, good luck!

[clareasthma]

After many years of my GP not really knowing what to do with me (I'm 61), and my asthma when it flared up, (cold, cough, flu), at last I got referred to the respiratory clinic at my local hospital 2 months ago. At last I found people who would listen to my frustrations and say, let's get to the bottom of this, we'll run tests, we need a new plan, we'll change medication, here's a help line number, here's a dedicated nurse you can talk to with any worries or need to discuss medication. We'll keep seeing you.

It will take time to do tests etc months and I do understand now that my GP practise can only do so much; They say they didn't know what else to do with me, just give me prednesolone and maybe/not anti-biotics to treat underlying sinusitus, or secondary bacterial infection. So I can go back 2-3 times to knock an infection on the head and its disheartening to feel ill and helpless for so long.

I had a bad attack recently (I have sinusitus and a cold right now), and the GP administered the nebuliser which brought me back from the edge of my first really bad attack, but I hated then being palmed off on A & E who ran some tests and palmed me off to a ward for the night with no further medication, needless to say I had another asthma attack in the night and I insisted on a doctor seeing me, but it took over 2 hours to get one to sign off on another nebuliser which again settled it down. It has made me very angry that no one will give you the medication you know you need, even in hospital and that you have to fight for the right medical help. There is a big dis-connect between the nhs services and no one want to commit to doing anything in the middle of the night!

I had an appointment at the respiratory clinic the next day and they were so kind and helpful and prescribed additional medication and will run other tests.

I suppose what I'm saying here is that I know one has to ask for and push for an urgent referral to the chest or asthma clinic at your hospital and let them take care of you and then they can send the prescriptions they want you to have through to your GP, so when you need to see your GP for a flare up, they have the tests, the information on their system and will follow it. GP's just don't specialise in this in my mind and can only do the basics.

I've only just joined this forum, as I've been reluctant for 30 years to accept that I am an asthmatic and I need support and help to come to terms with my changing condition, but I also know when I'm ok then I'm bouncing with life and mainly its a winter thing, but I do follow my medication year round and so I hear your need and think, please don't take 30 years to get on top of this. Make your voice heard!

[LDloveslattecoffe in reply to clareasthma]

You are very lucky your GP administered a nebuliser. Most GP practices don't have this equipment.

I was sent by GP to A&E to get nebulised and from what I have read on here that is pretty much standard practice.

I agree there should be more in GP surgeries as going to hospital is more stressful but I believe it comes down to funding even if you do have GPS who specialises in certain illnesses.

[Matman]

Because NICE can’t even agree a definition for Asthma, the reality is that there are up to several symptoms-sets that any one person’s Asthma may be comprised of, plus, there’s often overlap of symptom-sets.

The standard approach therefore is to attempt to broadly classify suffers suspected of Asthma into allergic / non allergic, and then to experiment on those Patients with a range of treatments until one appears to work.

Some folk, especially long-term smokers, may have COPD rather than Asthma, plus there’s also cross-over syndromes where someone has Asthms and COPD.

The Preventer Inhalers, where effective, tend to take 4 to 6 Weeks to reach full strength, so can’t really be accurately appraised for effectiveness until around week 10.

The best advice (as I see it) is to get as many Tests as possible. These will include Lung Function (Spirometry), Blood (Eosinophils, Neutrophils etc), Allergy Tests (skin prick) and possibly X-Ray or CT (maybe even High Resolution CT) though of course all those imagine techniques carry risks to patients due to radioactivity.

So options are:

Experiment with various drugs

Get lots of Tests

Do both

Keep a Journal / Diary of Symptoms, plus add a Daily Rating (1 to 10) so you can see objectively how you vary, plus - should it be that you are allergic (not all Asthmatics are) - what your trigger(s) are, pet- dander, dust-mite poo etc.

For speed, and to keep costs down, the typical approach is Spirometry Test followed by seeing how patients react for a minimum of a couple of months, to each drug tried (drugs need time to work and desensitise / repair damage).

Know you may well appreciate all this stuff already, but its the reality of how things are.

[Hidden]

A constant cough and coughing up clear mucus with shortness of breath are a few of the symptoms of Silent reflux (LPR).

It is commonly misdiagnosed as asthma and doesnt respond to the asthma medication.

There is quite a lot of online information if you want to investigate yourself.

[ChrissieMons]

A GP is a general practioner, and cannot be expected to know everything about every condition. Insist on seeing a specialist/consultant, (take someone with you to take notes) and find out what tests you might be having and ask for those.