Two questions about my asthma - Asthma UK communi...

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Two questions about my asthma

Hi,

I have been struggling for 3 months with my asthma ever since I had the flu in February. I've already posted something here a couple of weeks ago but as I still don't feel good and no one around me really understands how bad I feel (not even the doctors) I figured talking to people who had the same problem would help.

I essentially have two questions :

Before I caught the flu, my asthma didn't cause me any issues. I don't even know if I can say I had mild asthma since I didn't even have attacks nor did I take any medication (never used the blue inhaler in years!). But everything changed after I got sick and I went from having almost zero symptoms to having trouble breathing all the time. So my question is: could this be just a flare due to the flu and can it go back to how it was before once the flare is over ? Or does the flu trigger a lasting severe asthma condition that I now will have to live with for the rest of my life ?

My second question is how do you deal with this condition especially when it gets worse? Because I really can't get used to it and the doctors I saw didn't give me any tips on how to handle it and most of them didn't even take me seriously. When I start feeling the oppression and the difficulty breathing I just take 2 puffs of blue inhaler and sit until I start feeling better (it usually takes hours before I'm able to resume living normally). People around me tell me to relax when it happens but it's impossible for me to relax when I feel like I'm going to die! So if you could share any tips concerning how you manage your symptoms it would be highly appreciated!

I should also probably mention that I've been on seretide for 2 weeks and I see no improvement at all. I've also had some nebs at home of bricanyl and atrovent but it doesn't seem to be as effective as the one I had at the hospital.

Thank You

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Morning Hannah, sound like you don’t have much support from your GP surgery...did you get steroids to calm down your flare up? Have you been shown how to take 10 puffs of the blue through an inhaler? Have you tried phoning the Asthma UK nurse helpline for advice? They are brilliant, would highly recommend them, they would arm you with the advice you need to go back to your GP for help. My late onset asthma started just over a year ago during a chest infection & because no one in my family had it or any of my friends I found myself on a lonely journey too although my GP was pretty helpful as was the asthma nurse in my surgery, you will get there but try all the help you can! Good luck!

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I took prednisolone for two days a couple weeks ago although I was very reluctant to take it when I read all the horrible adverse effects it could give. However, I noticed no improvement when I was on it and the doctor I saw back then told me I could stop taking it since it didn't work and it also gave me stomach ache.

I didn't know it was possible to take 10 puffs of the blue inhaler , the doctors I saw told me to only take 2 puffs and I read that the maximum puffs we could take was 8.

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Hi, hard to say if you will have any further problems with asthma following flu episode. For me viral infections do tend to trigger my asthma.

It may take a while for the seritide to take effect. The bricanyl is a reliever if you don't feel better after taking it first say 5/10 minutes try taking 1 puff again. If not getting any relief I'd call doctors.

Asthma UK can be helpful, but you may need to explain to your doctor that although been diagnosed with asthma in past has you have not had any episodes you're not sure how to manage.

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What is your peak flow during the shortness of breath? if the peak flow is ok and as you state you asthma meds arent working then it is probably not asthma.

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Advice is Peak Flow is indicator only it does not mean it is not asthma.

When I saw Respiratory Nurse at hospital after A&E visit referral in Dec 2018 the plan they gave me had peak flow but it said either peak flow or these symptoms.

Peak Flow rate is best used over time using graph as a diagnosis and/or monitoring tool. Again it's not the number but the pattern on the graph that demonstrates issues.

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I stated Peak flow and asthma meds not working, also I said probably.

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What strength is the Seretide? What is your dosage? Did you try singulair?

I’m so sorry and we can all empathize and validate that it must feel so scary! It’s so hard when doctors don’t grasp how awful you feel.

Would an inhaler like advair or symbicort be a better fit? Those tend to be stronger and more long lasting...

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The dosage of seretide is 250 and I take 4 puffs everyday. The last doctor I saw gave me singulair but the side effects scared me so I didn't take it. I figured seretide and nebulizer would be enough but apparently I was wrong.

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I had a bad reaction to Singulair so I understand the hesitation. It gave me terrible crazy nightmares so my doctor took me off it. I just started Xolair. I haven't noticed a big difference yet but I'm hoping it helps as I'm desperate!

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I did some research and found that magnesium could help. Does anyone know which type of magnesium I should take ?

Thank You

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Magnesium Citrate tablets 300mg daily. You can also have baths in Magnesium sulphate (Epsom salts) .... I am in a similar situation Hannah125 so have only just done much digging around for info!

They can test magnesium levels in your blood but most magnesium in the body is not free flowing in your blood (only 10% is in the blood), it is in tissues etc so it is really hard to get an accurate understanding of magnesium levels.

Good luck and I do hope you get some relief very soon.

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Thank you!

Is it dangerous to take the magnesium while being on asthma medication like seretide ?

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I would think not as I am currently having bolus IV Magnesium sulphate every 2 weeks at the moment!! Docs have asked me to try and supplement to see if we can at least maintain or drag out longer before I have to have the next one hence why I had to do some extra research on it!

If in doubt then run it by your asthma nurse or GP, but it was both who suggested it to me and they know I am on preventers.

Hope it works well for you x

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I almost always get given IV magnesium when I go to hospital with asthma attacks. The last time I was on the ward, one of the doctors told me that it doesn’t really work taking it orally but I take it anyway just in case. It also helps with painful spasms I get in response to pain from spinal injuries.

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Hi everyone,

I went back to see the doctor today since I've been feeling awful for the past 5 days and I thought I'd give you an update and share with you what he told me. I told him I was still struggling to breathe despite seretide and ventolin and I asked him if it could be a sign of severe asthma. He said he considered it to be a severe asthma since none of the medication works and despite the breathing tests being normal. He gave me pulmicort when I told him if I could have something other than seretide (he actually told me to take pulmicort and seretide together) and he told me to continue with the nebulizer three times a day. He also told me that he could give me xolair next time if non of this works though he said he wasn't sure if I could have it since my IgE levels are too high. He also spoke about another injection but I don't remember its name, he said it was new but he heard that it seemed to work well.

I was disappointed because last time I saw him I had what seemed to be an attack (with wheezing, tight chest and feeling like I was about to suffocate) and I had to take 2 puffs of ventolin before the appointment. But he still made me pass the breathing tests which were normal (I guess that's because I had taken ventolin 2 hours before). This time I also had a lot of trouble breathing the hour before the appointment but I tried not to take ventolin hoping that he would let me pass the tests again before and after taking the inhaler. However he refused and told me it wasn't necessary since I had done it last time. I was disapointed because it was the only way I could make sure I really had asthma and I could have evaluated its impact on my breathing and the efficiency of ventolin. He told me to come see him again in two weeks.

After going to see doctors who didn't want to prescribe any medication to me saying that I wasn't in a bad enough state, now it seems that this one is ready to prescribe to me all the medicines that exist regardless of the potential adverse effects and regardless of whether I actually need them or not. I really hate taking all these things and the worst thing is that they don't even seem to be working for me.

Has anyone here tried pulmicort ? Do you know how long it takes for it to work ?

Thank You!

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So you came to this board looking for some advice that bucks the trend since you have already tried a bunch of things. I would go pure beclamethasone and drop everything else. Some of the LABAs make you loopy and in my experience don't do a whole lot. In the US we have only Qvar 80, normal dose is 2 puffs twice a day (total 4x80mcg=320 per day). But it is FDA approved up to 320 a day for adults, you just have to take 8 puffs in morning and night. A little tedious but nothing compared to the problems you are having. Be sure to inhale the puff and hold for 5-10 seconds and breathe out slowly after each puff, shake and wait another 10 seconds before the next. Try to space the two sessions roughly 12 hours apart. You can also do it three times a day (same total number daily puffs). In UK I think Qvar/Becotide come in 100 size I don't think it matters whether you get 300,320 or 400. The point is take the higher dose. Give it a full 7 days to start working properly.

Don't worry about side effects, I've taken it on and off for 45 years and never noticed anything, and nor my sister or others I know. Side effect rumors are totally overblown. You can wash out your mouth after as precaution but no big deal. The amount of steroid that gets in your system is way way less than prednisolone even at the top dose. That's the point of inhaler - it goes to the tissue that needs it. Once you are better you very gradually reduce it. Never cease it suddenly, always taper. So that's it - just Qvar/Becotide and Albuterol as needed.

One final thought: Make sure you don't have pneumonia. If you are feeling run down ALL the time after a bought of flu lingering for months sounds like classic pneumonia symptom. Get a chest xray and have a radiologist clear you. Friend of mine (non asthma person) just went through this, she strongly suspected she had pneumonia (she's had it before) GP kept saying "no no" (like 3 visits) finally she insisted on xray GP still said "no" friend said "you're not qualified to read it" then radiologist read it and said "pneumonia". True story.

I don't think being run down constantly is classic asthma as far as I know. While you are wheezing sure it's a problem but once it is over you are back to normal until the next incident.

Yes flu used to trigger bronchitis and asthma flare up for me, more so when younger. But once you get rid of the underlying infection and get asthma controlled it may completely clear up there is hope.

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Thank you very much for your advice!

I have thought about chest infection but I did chest x ray and even ct scan and they were normal. My blood tests also turned out to be normal.

I didn't know about Qvar, my doctor prescribed pulmicort with nebulizer, do you think it will be as strong as Qvar ?

Also, I read that sometimes, when asthma is difficult to control during a flare up it is better to take oral steroids for a few days to get things back under control and reduce the inflammation. I'm seriously thinking about taking oral steroids for at least 3 days to see if it helps but the side effects seem horrible.

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Pulmicort is Budesonide generic. My experience was it's pretty useless. I would say flovent is stronger and qvar even stronger. I don't know how much nebs you are actually taking but if that can't clear you at least for few hours most times then you should take the pred but as you taper try the higher dose ICS. All ICS takes 7 days to work don't miss.

Funny thing is I've got mild bronchitis right now. Started qvar and beconase.

Do you have allergens? Or anything else like hives or eczema?

You got to knock out the inflammation then gradually reduce. Stay positive and calm it will likely improve.

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Thanks for your answer. I'm currently taking two nebs (morning and evening) but I find it only works for 3 hours then the symptoms come back gradually (tight chest, shortness of breath). I guess it's too soon to tell if pulmicort is working so I plan on waiting one more week and then if it doesn't work I'll take Qvar instead.

How long are the nebs effects supposed to last ?

I would do anything to avoid oral steroids because the side effects seem to be very serious.

I do suffer from allergies (dust mites) and I've had eczema almost all my life. But my allergies never caused me any trouble before so that's why I think that my current symptoms are caused by the flu I had back in february.

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Yup, dust mites. That was my number one, I got the shots when I was 16 or so it definitely reduced it significantly (but not eliminate). I just started getting eczema more often recently, first time when I was maybe 40. Everyone is slightly different but common things.

I assume the nebs are Ventolin. If so, it depends on the allergens but a few hours sounds about right. Cleaning for dust mites is very important, it is a threshold effect. So although you cannot eliminate them getting exposure below a threshold can make a big difference. Wash pillows, replace old ones, vacuum mattresses, wet clean baseboards and furniture mainly in your bedroom or other room you spend a lot of time. Vacuum all carpets in the house, wash any pets. Curtains and bed-spreads in your room should be washed regularly - these are another favorite place to catch those mites. I do all of this in early spring as allergy season starts.

To me this sounds like classic allergic asthma you have all the markers. Yes flu can help it flare, and combining with spring didn't help. Try to reduce the allergen and get on the right ICS (as mentioned I'm a QVAR/Becotide fan). I'm really sorry you feel so bad. Please stay positive and continue to try different things I: assure you something will work. A cup of hot tea or hot shower can help if you have some tightness, partly by helping you relax. It's not a nice feeling I know. If you have to take multiple Ventolin nebs every single day that is quite a lot. I would like to mentally prepare you that you may need to go on prednisone for a few days to knock this out. Sometimes that gives you the space you need for the other strategies to kick in. It may make you hungry and a bit hyper difficult sleeping but it's only for a few days and works very fast. It's not that terrible it sounds like someone has overblown it.

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Hi!

Up until last summer I didn't have asthma but did each year struggle and suffer with hayfever. After going back to the doctors a few times I eventually persuaded him to refer me to the respiratory clinic at the hospital who diagnosed that I had asthma. Might be worthwhile doing the same!

I particularly find myself getting very wheezy when the temperature increases and there is a lot of pollen around.

Lynn x

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Hi,

Did you have to perform breathing tests ?

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Hi, I have had very mild asthma for many years but this last winter I had 4 or 5 viruses and each one increased my asthma symptoms. Steroids didn't help and I wasn't crackling so not bronchitis. After 4months and more of this all my back hurt internally from hacking productive coughing but a chest x-ray was clear. I was getting convinced I had pneumonia but apparently not. The GP stopped my ramipril for BP for 2 weeks but I had no improvement. After googling the problem with repeated night time coughing I asked the GP if it could be GERD...silent GERD....and so I tried 20mg of omeprazole instead of the 10mg as agreed by the GP. Finally after 6 months plus of feeling ill I seem to be on the mend.

I told the asthma nurse that my best peak flow is 520 but she put me down as the best I could blow 6 weeks ago of 490. Since increasing the omeprazole I have just recently blown 540 which means I was 20% down for over 6 months.

Not hospital severe but enough to struggle with work etc.

Anyway I recommend you consider all the potential causes and suggest stuff to your GP and keep going back. In hindsight I should have pushed more.

Best of luck and yes you may get better again so hang in there.

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i got flu in april then an asthma attack ....i'm still not breathing properly all my meds have been changed and i'm now on Spioilti that has stopped the cough but i'm still breathless i cant even get to the shops and living in a flat i don't have to exert myself too much but just being alive is an effort ......so sympathies and if you find anything that helps please pass it on........i'm now super depressed as i feel i'll never get well

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