Antihistamines

[Carriejen]

I posted a couple of weeks ago about a nightly cough, and varied peak flow of between 380 and 500 (best is 500). I finally got a GP who believed it wasn't covid and was prescribed fexofenadine and dymista (plus a saline nasal spray). I am also on Fostair 200/6, montelukast, and spireva as well. These have helped with the cough, but the last week or so since I started taking the new stuff I have been waking up in the morning with a weird feeling in my chest. It feels like its brusied. Breathing is painful. My peak flow is also on the lower end too (420 - 460). Ventolin usually sorts it all out, but I'm not sure if its a virus, or if its the new tablets, or if its something else triggering me? I haven't been out apart from running my other half to and from work, and nothing new has changed in the house (smells etc). Don't really want to bother my GP at the moment as my breathing is only getting bad if I'm over exerting myself and they're not really interested in anything other than COVID just now

[Gwalltarian]

I have been prescribed spiriva and some other inhalers - long term bronchodilators and/or anti muscarinics and after a few days or so they have caused me to feel as though my lungs are raw and sore so I don’t take them. I think you should phone your doctor.

[Carriejen in reply to Gwalltarian]

I've been on the spireva for quite a while now with no real issues. Oddly enough I've woken up today feeling fine just a little bit like I'm catching my breath. Maybe I will give them a ring.

[Poobah]

Do you take the saline spray in the evening before bed? I wondering if you have post nasal drip feeding saline to your lungs. Even in small amounts saline can be quite irritating for the lungs, hence the morning discomfort.

Looking at the patient info for Fexofenadine it does say to contact your doctor if you suffer chest pain. Just on that I would call your doctor today.

[Carriejen in reply to Poobah]

Oddly enough today uve woken up feeling fine. Just a little bit like I'm trying to catch my breath. I was advised by the GP to use the saline twice a day - perhaps I should take it a bit earlier than bedtime. Thank you

[Gilly100 in reply to Poobah]

Hi Poobah I have post nasal drip which could be making my problems worse. Besides having asthma, aspergillosis and bronchiectasis, Vocal Chord Dysfunction is now a possibility. I have been given exercises over phone to do but can't have an endoscopy because of covid. Was told post nasal drip could also be affecting my VCD. Do you have this and if so I would appreciate any advice.

[Poobah in reply to Gilly100]

I don't have VCD however I do occasionally get PND. I use Beconase steroid nasal spray if I get a stuffy or runny nose, it takes quite a few days to work as it's a steroid, but works very well for me. After taking a dose it's important to lean forward and move the head from side to side, this ensures that the spray is swished around the sinuses otherwise it just escapes down the throat.

Never use Sudafed or Otrivine or similar, they are for short term use and if used more than for three days can actually make things worse as they end up causing inflammation.

If you don't like the sound of a steroid spray then you could try a saline spray - however this may irritate the lungs if it drips down the throat.

[Gilly100 in reply to Poobah]

Thank you!

[Birthday60]

Firstly - you should check what your Peak flow target is - age , gender and height. My target was 450 but as Ive grown older it has reduced to 390. Its not the absolute figure that counts but the % of target.

[Carriejen in reply to Birthday60]

My target is 416. My usual best is 500, I cant see how it would have dropped permanently in a couple of weeks?

[Birthday60 in reply to Carriejen]

Fabulous - I’ve never been better than my target and am as close as I’ve ever been . To be honest stress reduces kind to silly low levels as does Chinese takeaway!! It’s only if you are low For a full week and increased steroid Inhalers don’t work do you step up to a 7 day course of Prednisaline - your asthma plan should have your step up and down drug regime clearly marked

[Carriejen in reply to Birthday60]

I'm on the highest for all my inhalers already, and my GP isnt wanting to prescribe me steroids. I'm not sure if I've had some sort of viral infection as I've been ill for about 8 or 9 weeks now but it's a weird ill. I had an on and off cough for the first 6 or so weeks. No temperature, tiredness, shortness of breath. Reduced peak flow. I tried piriton for a while and it really helped and then I developed a nightly cough. I dont know if maybe my nasal spray is causing the issues. I've stopped taking it at night and my chest no longer feels bruised but it still feels stiff. It's an effort to get a full breath in and I know it's not as full a breath as I usually get. Maybe I am just unfit as I've been 'shielding' for 8 weeks now. I'm due back at work in 3 weeks though

[Lysistrata Administrator Community Ambassador in reply to Birthday60]

Didn't see this when I replied before due to timing - would add that as well as using personal best not predicted, peak flow isn't the only consideration - not everyone drops it neatly in line with symptoms and a plan should also reflect symptoms (well in general it should be personalised) - so wouldn't say waiting a week based on PF is a blanket rule.

[Lysistrata Administrator Community Ambassador in reply to Birthday60]

It's true re the percentage being more important, but also important to know your actual personal best and use that once you do, not the predicted value. My actual personal best is way higher than my predicted, probably due to years playing a wind instrument, so I use that (and have to explain it a lot).

Carriejen - not sure if I can be much help but am wondering how you use the spray? I spray it in then blow my nose to clear it out before using my Avamys spray. I find saltwater can be irritating so like Poobah wonder if you may be swallowing it at night.

Alternatively, I do find some triggers can be hard to identify and I am often set off by subtle (and less subtle) changes in the weather and my bedroom environment. Could it be anything like that?

[Carriejen in reply to Lysistrata]

I've been really bothered by hayfever this year, but that's all sort of settled for now. I use the saline spray, just a little bit, and then blow my nose. Then use my dymista. I've stopped using them at night (just to see if theres a difference) just in case its being swallowed at night. My peak flow has been all over the place this week. The best I've had this week was 490, but its averaging around 450. I didnt really have any 'normal' symptoms this weekend. I had a slight shortness of breath daily, but nothing like my usual symptoms. My chest doesnt feel tight. I'm a lot more tired than usual but I'm not sleeping properly and im not sure the two are connected. I feel, and am well aware, that I am not getting a full breath when I take my inhalers/give a peak flow reading. It's very strange. The weather where I am has been wild. In the last 4 weeks we have had everything from clammy sunshine, to snow and hailstones. Maybe its connected to me shielding as I have been off work for about 8 weeks now