I have been using Seretide 250 as a preventer for a month and I still feel the same. I know that it can take several months to see the full effect but I thought that I would at least start to feel a little improvement. I still have to use ventolin several times a day and my nebs three times a day. I use seretide with a spacer and I take 2 puffs in the morning and two others at night.
So, could it mean that this drug has no effect on me and I should try another ? Or should I continue using it for a few more weeks ?
Also, I've been reading recently that an asthma attack poorly or not treated at all could last for several months. And if so, how do we put an end to it ?
Thank You!
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Hannah125
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Hi Hannah 125. I started taking Seretide 500 6 weeks ago, after months of ignoring my badly controlled asthma (unbelievably reckless on my part) which lead to 3 asthma attacks in a month. It’s only now starting to have some effect but still have chest tenderness and a slight wheezy sensation. I do feel less at risk of another attack though (last attack was 4 weeks ago). It’s been 2 days since I last took salbutamol which at the start of July I was taking every 2 hours. You might want to explore the possibility of another condition effecting your control. I was diagnosed with pneumonia and chronic sinusitis as a later complication which seriously messes with your control. I was at medium risk of attack even before the pneumonia came along. I would certainly recommend talking to your GP/specialist ASAP if you are concerned about your treatment as they know your medical history better. Nobody wants to see you very ill in A&E! I’ve now become a massive advocate of getting everyone to monitor their blue inhaler use and how they are feeling. If I had gone to my GP as soon as I started to notice the chest tenderness I could have avoided months of illness, a lot of distress/ anxiety for both myself and my family. My usually relaxed dad was shaking so badly when he took me up to the hospital. I thought he was going to need treatment too. I felt so guilty for putting him through that.
I read it takes up to 8 Weeks to reach maximum effectiveness. If after that period it’s not helping, you may want to ask to try a different steroid inhaler.
If so, mention you’d like it to try one of the newer steroids. It may be if the next one you try does not help, you’ll need to consider a duel / combo inhaler that not only delivers a preventative steroid, but also a long acting (12 Hour) reliever drug, so that AM + PM usage keeps your airways open 24/7. Better to try and fix things with just a standard preventer inhaler first if you can though.
If you do progress to the duel / combo inhaler, you’ll probably find that you rarely need your blue inhaler, because the duel inhaler will be delivering a similar (but longer lasting) reliever drug to your lungs twice daily.
Non of these inhalers fully tackles the cause, they just deal with / reduce the symptoms. The steroid element may - over a year or two - get you to a point that you can reduce dosage or even discontinue. Ideally, know you need to try to figure out what’s causing your problem, and then see if there is anything you can do to tackle that.
One of the most recent ways of looking at Asthma is to see it as what’s now referred to as United Airways Disease. This means it’s seen as an issue not only with the lungs, but the entire Respiratory System, including nasal airways, sinuses etc. For example, it seems apparent that my own ‘Asthma’ issues are triggered by Chronic Sinus Disease and Post Nasal Drip, so I’m constantly looking at ways to tackle that issue, rather than Asthma.
There’s not even any agreement on what constitutes Asthma. NICE haven’t even agreed a definition for it. More useful, I feel, to avoid the Asthma Definition, and to instead think in terms of undiagnosed Respiratory Disease, that’s typically made worse when you pick up any virus or other rhino infection.
I've been thinking that maybe there was some sort of infection in my lungs that prevented the medicines I take from working. But the problem is that aside from the tight chest and stuggle to breath I don't suffer from any symptom that could indicate infection (I don't cough, I don't have fever) and more importantly chest x-ray and blood test are normal.
Is an infection still possible even when x-ray and blood test are normal ? Could an infection last for 6 months ?
I’m not sure about infections lasting that long but certainly post nasal drip can last for a very long time and irritate the lungs. I’m being treated for sinusitis and the inevitable post nasal drip. The use of a steroid nasal spray, antibiotics at a low dose for inflammation and saline nasal rinses has made a real difference to my breathing.
Some infections are very illusive and hard to detect. For example, I understand standard blood and sputum tests, can be improved on by more advanced ones, if a GP sees fit.
Persistent Viral infection (as opposed to bacterial) cannot, I gather, easily (if at all) be revealed by a standard sputum test.
With the NHS, you’ve often got to become the proverbial ‘’Pain in the Ar**’’ In order to get to the bottom (no pun intended) of what’s happening.
Essentially, that’s what an NHS Doctor told me!
Some imaging, such as various forms of CT, may indicate that something like bronchietatis (think I may have spelt that wrong) is present. Sometimes, only when something like that is revealed by imaging, will your Team go to the time and cost of delving deeper to try to identify ‘harder-to-pinpoint’ infections, BUT as you know, imaging does, itself, carry radiation risks.
The easiest / cheapest approach for the NHS, is to keep trying different Meds on you, to see if one works. (e.g. The Suck-it-and-see approach). Often, for Bacterial infections only, more expensive or restricted-use Antibiotics will work wonders, where more common ones fail. (I love Clarythromycin) Likewise, a different inhaler may do the trick.
One problem experienced by asthmatics, is that - where a non-asthmatic might take (say) a week or two (following an infection) to recover, the asthmatic’s immune system (often less robust) might still be trying to cope with the ‘aftermath’ (e.g. irritated airways, mucus production etc) for ages later, even though the original infection has long-since departed.
Maybe ask your GP if there is more advanced Sputum and Blood-work that might shine a light.
It’s true what you are saying about asthma sufferers and recovery times. My GP believes it could take as long as a year for me to recover from Pneumonia where for non sufferers it’s usually about 6 months.
Thanks for these informations,I'll definitely ask the doctor for a more specific blood test. I also heard of something called a Feno test which could show if it is eosinophilic asthma or not. It is true that in asthmatics it takes ages to recover from an infection but I never would have imagined that it could last that long. I've been wondering if my symptoms are just caused by the infection I had (flu) and thus will eventually settle or if the viral infection has triggered my once very mild asthma and now I'll have to deal with sever persistent asthma for the rest of my life. Do you think there is a chance for asthma to go back to being mild after a flare up or does it remain severe ?
Right now, I'm feeling like my right lung is blocked and itching. My lungs feel very sore and it's a real struggle to breath in and at times even breath out. I also feel like my chest is congested but I don't cough. Sometimes, I force myself to cough but it irritates my airways even more making the tight chest worse. I really can't imagine living like that for the rest of my life as I can't even leave my house! And actually I've been really concerned lately about having a severe attack as I've read that it happens a lot after an exacerbation that cannot be controlled.
Feno can be associated with eosinophilic inflammation in the lungs but it is falling a bit out of favour now as it doesn’t always match up with inflammation or symptoms and is quite variable. So the 2019 guidelines that just came out are no longer recommending it for routine asthma diagnosis and monitoring.
The best way to find eosinophilic asthma is just a basic full blood count - as the eosinophil count should be reported on all of these
I too find that it takes a long time for these meds to fully kick in. My experience is that it takes several months before I feel the full effect. It's very frustrating. Hang in there.
If you’ve now had poorly controlled symptoms for several months, and Tests administered my your GP / Nurse (such as Spirometry) are inconclusive, it might be worth asking your Doc about being referred to an NHS Respiratory Consultant (assuming this had not already happened).
Trouble is, unless you and your GP considered that you are ‘serious ill’, any Consultant Appointment could take 8 Weeks or longer to come through.
Think you might have said you have a non-productive cough (no sputum being coughed-up). While that doesn’t rule out infection as an underlying cause, typically, chest infections seem to include sputum production when coughing. So (possibly) something other than infection is in-play in your case. (e.g. Allergy, other etc).
Another chat with your GP seems to be the best way forward. If you’re monitoring you’re own peak-flow, you could take along a couple of weeks results, plus details from a Daily Health Journal (if you’re logging stuff on a day to day basis). If you’re not already keeping peak-flow plus a Daily Health Journal, would highly recommend you do. Detailed Records from them can help persuade others you require increased attention.
If you end up seeing a Consultant he / she might do a FeNO Test to check on you're nitric oxide lung output, but (as js706 indicated) this might not be considered appropriate.
If you and your doc feel it’s time for you to see a Consultant - but you don’t want to wait for an NHS Appointment to come through - the only other real option is to see one as a Private Patient. Not cheap, especially if you don't have existing Private Health Care Insurance. I paid £350 x 2 (£700) for two appointments. Also the cost of Tests done privately are usually extra. Private Imaging in particular can be ‘very’ expensive (many hundreds) e.g. CT Scans etc.
If you decide to go private to try to speed things up, strongly suggest you get price-info ‘in advance’ for both consultations and tests. (A buddy of mine paid a lot less for his private ‘cardio’ consultations - about £200 Per Visit - so ‘shopping around’ could be worth it ‘if’ you want to consider private treatment.
It took me 4 different inhalers over 5 months to find the right one, and lots of badgering my GP.
I felt different effects to the different ones immediately and with the one I am on now I felt more in control pretty quickly, although still not perfect.
I've tried Fostair but I only used it 4 days as I noticed it made my symptoms worse right after I inhaled it. I don't know if it was because it was under the form of powder and it irritated my airways but I didn't want to take any risks. Then I tried Seretide for more than 2 weeks but it didn't work (I took it only once a day and sometimes I would forget taking it). I later resumed taking it for a month because my asthma was becoming worse. Seeing as it was still not working I tried Pulmicort for 2 weeks but my asthma kept worsening so I stopped everything and took oral steroids. Now I'm back on Seretide and I've been taking it for a little more than a month and I still feel awful.
Is there an inhaler that is more effective than seretide or Pulmicort ?
You poor thing! I'm afraid I have no idea as it all seems to be personal for each of us. Just have to tell your GP you need to try a new one. The asthma UK nurses are great to speak to for advice as well. Good luck.
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