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Really worried - new to this Asthma stuff - PF 150 morning & night

Hi there, apologies for convoluted explanation but I’m wondering whether anyone has experienced the same. I’m really not sure what I should be doing. Mid Nov I had a dental abscess flair up and the following week have had symptoms of severe breathlessness for the past 6 months. I was given 5 rounds of differing antibiotics which didn’t help. During the 3rd lot of antibiotics I was given prednisone which more or less helped to get rid of the symptoms! Or so I thought. After a 5 day course of 40mg a few days later my breathlessness came back with a vengeance. Chest X-ray was clear. Sputum sample clear. Bloods show raised platelet count. All in all I’ve had about 5 or 6 courses of steroids (one of which was tapered although from what I’m reading on the forums it was too quick!). I stopped the last prednisone about 1.5 weeks ago and now I’m really suffering. My peak flow is coming out 120-150 morning and night. I have some nights where sleeping is impossible. I also now can’t walk a few metres without being severely out of breath. Met with a consultant who prescribed me Montelukast 10mg. The first of which I took last night. I’m just wondering whether I’m being really naive and should actually be taking myself to a&e. I’ve never had asthma before and the rapidity of the breathlessness makes me think something is causing it than can be reversed (please god!). I don’t really want to go back on the steroids after reading all the withdrawal effects. I also wonder whether what I’m experiencing now is a withdrawal symptom? Anyone been in this boat? I’m actually getting quite scared. I’m 34 and have two young kids 🥺

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Hi

The number your PF is doesn’t really matter, it’s what % it is compared to your best. For example my best is 630 so for me 210 would be really bad as 33% is classed as a life-threatening asthma attack.

At this point of time work out your PF %. If it’s 50% or below and ventolin isn’t working to resolve the problem you need to head to hospital. You can take up to 10 vent at once (1 puff at a time of course). If this solves the issue you need to see your GP today, if it doesn’t you need hospital. Equally if the ventolin isn’t lasting 4hours you need hospital. Ignoring the PF if you’re feeling like you can’t eat/talk/walk normally or if you don’t feel safe to sleep you need the hospital.

It sounds like for whatever reason your body is rebounding when off the steroids so the underlying problem hasn’t been address. Monetlukast might help this but can take a while so you may need another pred course to calm it til the Monte is in your system.

Steroids are a pain, yes, and come with a whole load of potential side effects, but breathing is kind of essential so takes priority 😅

From the sounds of it you may need to head it for more help. If you have an asthma plan my advice is to follow it.

Good luck and hope you feel better soon

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Thank you for responding! 🤗 I’ve never measured my PF until I started suffering. The best I’ve ever done is 410 so I guess I should head to hospital. I may try 10 puffs of ventolin first and see if that works. And you’re right breathing does trump the side effects of prednisone withdrawal 😂 I genuinely wonder whether the dental issues are part of what’s going on. I know it’s not likely but there have been some cases reported of asthma symptoms disappearing after the removal of troublesome teeth. Already had one removed and now waiting on getting the other out. Sounds drastic but dammit I’m to the point where I’ll do anything if I thought there was the remotest possibility...

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Sorry to hear you’re in such a bad place at the moment. You’ve had some excellent advice from Emma, our expert helper on here. So follow it and see how things go.

I had dental problems last November too, funnily enough, resulting in a lot of toothache and eventually an extraction. It sent my asthma haywire for a few weeks. I decided it was all the codeine I had to take. Paracetamol wasn’t enough by a long way, and ibuprofen is an asthma trigger for me. All my perfume triggers were hugely magnified, and my asthma got worse and worse. Managed to keep myself out of hospital, probably stupidly, but once the codeine was finished, well after the extraction, all went back to usual daily meds and reasonable success. I take montelukast too, but as Emma said, takes a while to impact on your triggers. Sounds like you need medical help just now, don’t delay any longer 🌹

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Thanks Yatzy! :) I've avoided Codeine as I previously got a little addicted to it so avoid it at all costs! I'm just taking Paracetamol which takes a small edge off the pain. I was also taking Ibuprofen which did help and also was the reason I delayed taking the Montelukast (a contraindication I believe). I wish I'd have just stayed with the Paracetamol and started the Montelukast sooner, doh! Well we live (hopefully) and learn. I've just taken the 10 puffs of Ventolin which has helped a little although not entirely. It's my sons first parents evening tonight, I really don't want to miss it but looks like I may have to :(

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You may have to miss it, Catia, but tell him you’ll talk to the teacher about his lovely work another time. Your health really is the priority just now. Maybe ibuprofen exacerbating your asthma, as it does with me? Sends it of the scale, never dare take it now.

Anyway let the medics reduce what you’ve got now, then think again 🌸

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Thanks Yatzy :)

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Very helpful reply for me too! Thank you.

I'm understanding now why my nurse isn't at all worried about my PF - nor the fact that with side effects from other medications, Ventolin is the only that works for me without problems some days.

She's been more concerned with trying to find something that doesn't had an adverse effect for me. (Currently gradually getting my dose of Uniphyllin higher).

Pollen has been partially masking any good effects of it lately though.

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I should also mention I have never been given an asthma plan...I didn't know that they existed until moments ago!

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The information page from AUK about asthma plans, and where you can print off a plan:

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

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It’s never fun having to head in for more help but it’s always better to do so sooner rather than later!

It’ll be much easier for them to treat you and hopefully will result in a shorter stay for you (also heading in during the day time means that hopefully they’ll be able to discharge you from a&e if the treatment is effective 🤞). They’d much rather we turn up earlier on than at the point of collapse!

But I often find that anything illness wise can set my asthma off (it doesn’t necessarily have to be a cold or chest infection) as your body is having to work harder generally so it’s often tougher on your lungs. And then unfortunately once you get stuck in a flare it can take a lot to solve it (as you’ve been finding with the repeated courses of steroids). As Emma said, steroids are really not nice, but they are a necessary evil!

I hope you manage to get help ok and feel better soon 😊

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Thanks :) Because I'm new to all this it's so tough to know what to do!

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Yeah it’s always difficult! My asthma has been worse for about 3 years and I still struggle to decide what to do about it sometimes.

This is a great place to come and ask questions though, as there are lots of very experienced members! The phone lines are also really handy too if you have any more questions once you’re more on top of this flare 😊

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:) :) :) Thanks

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You sound like I was a few years ago and stress def makes it worse ! I was great (or better)for about two years but all got worse again after my son had health scare and a few other things ! I take one puff of Relvar in morning and montelukast at night along with two puffs of Respimat! The respimat made a big difference when I started it and allowed me to virtually cut out ventolin. As I say my allergies got much worse about 8 months ago and I’ve spent a fortune on supplements to help. Only about 10 days ago I started taking kelp! I took more than the recommended one a day and took three! I’m now down to two. But it has made a marked improvement in my symptoms and my cough has abated and my sinus problems and post nasal drip. Might start a thread to see if anyone else has benefitted from kelp?

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That’s really interesting! I’ll have a google around later about Kelp. I ended up going to a&e and have been admitted 😔 after 3 nebulisers my PF only went up 50 to 200 🙄

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My PF has always been really low! Not tested it lately mind you! Get better soon!

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Sorry to hear this. Hope you feel better soon and aren’t in for too long 🤞🏻🤞🏻

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Sorry to hear they're keeping you in! Hope it isn't for too long

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hello please research magnesium deficiency and symptoms of magnesium deficiency also research benefits of d3 k2mk7 try to eat lots of fruit and vegetables take care

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You’re i the best place good luck cx

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Just to keep you guys updated they’re actually thinking a Pulmonary Embolism is the cause of my breathlessness 🙄 In hospital for a few more days 🤞🏻 it all gets sorted

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No PE! Phew! 😅 Now looking at a cousin of TB and aspergillosis! Really wish I’d come to hospital sooner! I always thought I’d just get better. How naive was I!!!!!!!! I could’ve saved myself 6 months of this 🤦🏻‍♀️🙄

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Eek! Hope they find out what it is soon!

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As already stated PF is relative, saying that 120 - 150 sounds very low (you mention walking is difficult). My gut feeling is if the pred is relieving your symptoms then something is seriously aggravating your airways and you should be seeing a specialist I would harass your GP you cant live your life with a PF of 150.

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I have very similar symptoms to yours and have been suffering for about 9 years now. What I would say is with a peak flow of 120-150 you should definitely be going to A&E, that is the only way you will get the attention you need. Don't rely on Montelukast I have been on and off over the past few years and never really had any improvement. The only thing that works is Prednisolone - yep I don't like taking it because of the side effects, but there is no choice. Exercise does counteract the effects of prednisolone.

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Just thought but have you tried an antihistamine has after the infection could have triggered other allergies, worth a go, also don’t want to alarm you but tooth abscesses infections can enter the blood stream and affect your heart as it did my dad. Personally I would be taking myself off to a and e especially as your peak flow is less than half your normal numbers

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I haven't been on here in a while but I'm so sorry your having so much trouble, my Dr finally put me on Montelukast 10 mg and that was a godsend, all my breathing got better almost over night, so I hope that will help you also and mabe so inhaled steroids would be better then prednisone is. Not so hard on you😎.

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