Do I carry on with asthma plan?

[gillbee]

Started pred 4 days ago, shielding on multi inhalers and xolair. Have asthma plan peak flow optimum 470, at mo 310. So continuing plan, resting. However having periods of SOB, racing / slowing heart rate between 130-48, oxygen levels 84-86%, no temp above 36.8 but very dry and very hot to touch skin. Taking fluids, regularly paracetamol and nebs. Then it resolves. Do I just carry on or tell them and ask to be swabbed?

[Js706]

Please do not try to stay home with observations and symptoms like this.

If your sats probe has been discussed with your team and checked that it’s accurate you should know that oxygen levels that low are incredibly dangerous and you should be in hospital.

I know people want to avoid hospital with everything going on at the moment but staying at home like this is dangerous.

Please seek help, preferably by calling 999 ASAP - there’s no point avoiding catching coronavirus if you allow your asthma to deteriorate to the point that it could kill you.

[gillbee in reply to Js706]

I have taken paracetamol, nebs and rest, and it all settles. O2 stats increase, heart rate settles, hot face and body calms down. Since my O2 resolved with nebs and rest this to me seems like classic asthma. Will call hospital today as my xolair injections are due Friday and I don’t want to comprise anyone, because according to my plan My peak flow has to be less than 235 before escalating care.

[Js706 in reply to gillbee]

I know that but please remember that peak flow should only be one part of your action plan and that in hospital they use far more than just your peak flow to assess you.

Asthmatics are normally very good at compensating and can often maintain good oxygen levels until they are very far into an attack so waiting until they start to drop can be very dangerous.

This is one of the reasons they’re often not keen to give home nebs to asthmatics as people choose to stay at home and use them rather than getting assessed properly.

Please at least make sure you speak to your hospital team today and if not I think you should contact your GP and try to be seen by someone.

[gillbee in reply to Js706]

Thank you, I will, oximetry is accurate and as I said it resolves comes in waves. I just didn’t want to waste their valuable time or resources.

[Js706 in reply to gillbee]

Please try not to worry about that at the moment, staying healthy and well is the most important thing for you. Take care and I hope you feel better - let us know how you’re doing.

[EmmaF91 Community Ambassador]

You need to tell someone what’s going on and how often you’re having to medicate etc. With those sats (if probe is accurate) you need hospital, as desaturating with asthma is bad (below 92% is classed as life threatening in asthma), no matter what your PF is doing. Unless you’ve been told otherwise you shouldn’t be doing 4hrly nebs at home, as all that does is mask the symptoms, meaning when you do go to hosp you’re in a much worse state (personally I have to inform hosp when I start using home Nebs, and when I’m at 3+ I’m either sent to hosp or get an appt in hot clinic to be seen urgently).

If you’re taking paracetamol it may be masking your temp. Also please be aware that if you are sick they may delay the xolair as it can make any illness worse (pretty sure that applies to xolair as well as mepo/benra but been a while since I was on it).

It really does sound like you need hospital to get checked out, and get your asthma treated with something more.

Hope this helps

[gillbee in reply to EmmaF91]

Thank you have spoken to my Asthma Nurse at the hospital. My injections have been deferred for a week as the area in hospital set up for the injections is the only clean area for all immuno comprised patients, but is informing my consultant. My oximetry is correct and only desaturating on effort, therefore not moving around much. Continuing pred for 2 weeks and continuing peak flow pre & post inhalers / nebs. Thank you all for your help. I understand I’m Exacerbating, and may have CV, but I know it would be worse for me at hospital at the moment.