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Build up of symptoms ?

1974lovejoy
1974lovejoy

Morning all ... hope your all ok during this bizarre period in our lives !!

Quick question - does anyone have a build up of symptoms over a couple of days before their asthma kicks off ??? I seem to take a couple of days after exposure to something in environment before I really start to struggle -2 days ago a local farmer had a bonfire behind my house ( shut windows etc but couldn’t act quick enough as wind changed direction) and the smoke was acrid - wouldn’t say it was normal bonfire stuff, very black and very smelly , yesterday started coughing and today short of breath and coughing with shorter sentences .. managing ok and dosing up on meds .. just wandering if others have these kind of build up to their symptoms - seems to be a pattern for me ...?

Stay well and safe and thank you in advance

39 Replies
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EmmaF91
EmmaF91Community Ambassador

Yeah

I always think of them as delayed reaction attacks. I can get the same (shorter term) with exercise. I might be fine whilst I exercise but 3hrs later I really struggle. Equally I’ve had the same on the longer term... for me usually I’ll have an initial issue, deal with that but then progressively worsen and have a worse issue a few days later (cleaning has done this to me 🤦‍♀️)

I think it’s to do with the response to the trigger... fast vs slow inflammation (for want of a better description). like some injuries will balloon up immediately, whilst for others the inflammation slowly appears over the next day or so.

Anyway, no it’s not just you that gets these delayed responses to triggers/irritants. Hope you start to feel better soon!

1974lovejoy
1974lovejoy in reply to EmmaF91

Thank you .. I guess as an ‘abnormal ‘ presenting asthmatic who is questioned and doubted at every appointment and admission I doubt myself too !!! The only one who works with me and knows how I react is my GP and work colleagues all of which are medics !!! But I guess they see me at my worse !!! I also get delayed reaction with exercise and can take a few hrs to a couple of day to fully react depends on if I’ve added to that exposure as well .. I’m getting better at tracing back each time and it’s good to know I’m not ‘abnormal ‘as well ... thank you for the reassurance x

Hi, you could always take drastic action if you're feeling doubted, record yourself on your phone. That way the doubters have proof of your actual physical condition and they can see & hear how you are. Oh, and it looks like your farmer was burning something with a rubber compound in it, highly illegal & toxic, which could very well have set the seed for your delayed reaction.

Good luck.

Thank you and yes it certainly had a rubber smell to it but didn’t want to jump to conclusions !!! No wander I’ve been struggling !!!

Generally if it's thick, black & acrid it'll be burning rubber. Hellish for most folk, a total nightmare for us sort. Anytime I've been exposed to it, stuck on a motorway with a factory / scrap yard fire close-by, I assume the worst and get ready for a flare up & chest infection. Contact your GP and explain your situation is the best thing to do.

Thank you

Yes, I get what I call niggles. I do now usually find myself thinking hmmmm I wonder, whereas before I'd out the pieces together afterwards. For example I might be coughing intermittently, or might be more easily short of breath. It's kind of ok if it's just one niggle. But lots of niggles appearing is generally not a good sign for me!

Agree with EmmaF91 about response to the triggers - if usual rescue meds or strategies help then my niggles are pushed to the back of my mind/monitored. If they're not helping in the usual way then it's a sign assistance is needed (combined with the accumulation of niggles).

Thank you ... it’s reassuring to know I’m not alone .. people ( including me at times ) just presume asthma attacks are just instant ... I rarely get that .. I get warning signs I guess and maybe I don’t react to these quick enough ??

I’ve increased my Fostair today by adding in a further 2 puffs at lunchtime to see if I can get on top of it .. this fine of year is the start of my admission normally so need to nip it in the bud .. at least I’m not going out to work at mo so can rest more !!!

Thank you for replying

I've occasionally had quicker drops but it's still not an instant thing and is definitely usually a build up (or slow decline!)

Lysistrata
LysistrataCommunity Ambassador

I'm another one who gets a build up - usually! I used to find it would be about three days from the first definite worsening to A&E and admission, but maybe with more subtle symptoms before that.

I still get that, with some very slow slides into a not too bad attack. However, more recently I also get more sudden ones where I think I'm ok in the morning and eg go to work (before all this kicked off) but then get suddenly worse and boom ambulance. This compares to others which aren't even worse attacks but where I definitely become less and less able to do anything in the days leading up and definitely wouldn't be able to get to work the same day.

Even the 'sudden' ones mostly have some slight flare up in the week before - though this is tricky because it's a level which can also settle right down, so it's hard to know what will happen; I am now more careful with that level though knowing it can go from that to sudden bad attack quickly. More recently I have gone from fine to oh vague symptoms to ooh need my neb to resus and 6-day admission...all over about 2 days! That was a definite surprise - the day of the admission I was happily wandering around (admittedly after a morning neb, but not needing much salb otherwise), then all to pot in the evening.

Like Emma I can also sometimes have a delayed reaction to triggers eg next day or hours later.

I am also an atypical asthmatic in many ways (check out my new avatar, says it all lol) so I know the feeling of 'hmm is this just more weirdness, or do others get this?'

Hope that helps.

Thank you for reassurance .. I am the same .. slow build up and then bam suddenly admitted and unwell like you ... it’s so hard to judge what is going to happen ... I often don’t realise I’m starting and my husband will tell me to use my inhaler !!! I don’t always register I’m starting to cough ... and either I’m still in denial or just trying to ignore what I’m feeling !!!!! I had a bad night sleep last night which I know is an indication I’m starting so was expecting it today ...! Frustrating isn’t it no being a normal one 😂!!!!

Thank you, you have reassured me I’m not overthinking it ... x

Lysistrata
LysistrataCommunity Ambassador in reply to 1974lovejoy

I find the problem is I can get surprised too - I think I know how they're going to act and then they change it. And sometimes there is an expectation of how an attack 'should' go which I can't necessarily meet. It's often hard to explain, while very short of breath, to someone in A&E who doesn't know about asthma and how it can build up (I get interrupted sometimes when trying to explain it was meh for a week then worse for 2 days).

Yep I feel your pain !!!

Yep another build up person here! Although my consultant did say that that’s often quite typical of a lot of his patients.

I will pretty much always have some kind of symptom build up for at least a few days (varying combos of more coughing, worse nights or just generally being more twitchy etc) and then it’s the “final straw” that varies - sometimes it’s a really slow drift and sometimes my lungs like to jump off a cliff and bellyflop 😂 but either way I can barely think of any bad attacks etc that have come totally out of the blue

1974lovejoy
1974lovejoy in reply to Js706

That is so reassuring to hear ... I think I’ve had one out of the blue moment after lying in some grass on a meal break at work 🙈 but I guess even then I can trace back some exposure to something that made my breathing organs twitchy 😂( I only relaxed in the grass as I’d been told by consultants at this stage there was nothing wrong with me and it was stress 😂🙈- I followed this up with my colleague administering the life threatening asthma drugs and calling for back up so he could get me to hospital and into resus 😂- funny reaction to stress on a particularly lovely relaxing shift at work !) it’s hard accepting it when as a clinician myself I am still in denial and fighting the consultants for a confirmed diagnosis even with reversibility of 27%! Hence my question today - it’s taken a lot of courage asking you all if I’m honest ... I don’t like being this side of work ! 😂 thank you for making me feel a bit more normal with a special outer layer 😂😂

Lysistrata
LysistrataCommunity Ambassador in reply to 1974lovejoy

Love that description! I think I have a normal outer layer, it's the inside that's special ;)

I've definitely also done the unwise but understandable 'I'm going to do this even though I know it's an issue really, because they told me there was nothing wrong.' A consultant who had never seen me actually have an attack felt more than qualified to tell me what happened and how I felt during it. Amazing those psychic powers, I'm sure she could have made more money as Mystic Meg!

😂😂in which case i need to change jobs 😂😂

EmmaF91
EmmaF91Community Ambassador in reply to 1974lovejoy

Ha. It’s really not just you! My lungs did something similar to being told officially that it was more DB/anxiety than asthma... caught a cold the next week and BAM, 2+ months of struggling whilst my local waited for the spec hosp to see me again and retract said statement (epic reversibility but 0 maintenance/control). I swear tweedle wheeze and tweedle cough were just being stubborn and teenager-y (refusing to show the issue when asked to demonstrate then having a meltdown tantrum when told can’t be that bad) 😂😂. I get frustrated when docs (or any medic) tried to tell me (wrongly) how I’m feeling and how that’s the root of the issue 🙄😒 (if I hear ‘you’re just anxious/stressed’ one more time...!).

But yeah I also do the delayed reaction thing, plus I can have the SLOWEST spirals to hospital ever (my last took over a month so go from ‘meh slight issue’ to ‘yeah need hospital’, and kept spiralling even when I tried to stop it with meds 😒😅), but equally can go from fine to hosp in an hour 🤷‍♀️😅😂

If nothing else at least you have now seen how the other half (ie the patients 😉) live and experienced the frustrations that occur when you’re not listened to/get told it’s nothing 🙄😅 (silver linings and all that, but I bet you’re a better clinician for it!)

Hope the pred helps and 🌟 for asking the question (cause many of us end up with hang ups about asking and being ignored/laughed at/condescendingly spoken to cause of above situation really)

1974lovejoy
1974lovejoy in reply to EmmaF91

Oh yes it’s always me who now deals with the respiratory patients in a shift 😂 I know just how frustrating it can be for patients and also know never to tell them what it’s like !!!

I’ve not yet reached fir the pred- consultant doesn’t like it 🙈 and whilst I can still walk up stairs I’ll give it until tomorrow before starting then 😂 inhalers pretty close to Max but got neb to rescue me now ... ( perks of the job I suppose )!!!

Oh how frustrating "consultant doesn't like it"! Well no, none of us like it. I know the feeling though with other drugs - they work but consultant isn't a fan. So frustrating.

But don't leave it too long!

I won’t ... if it doesn’t settle over night I know I need to do something and my GP is great ... so Ill go that route !! As he said last time - let’s get you breathing properly and we’ll deal with the consultant at a later date 😂

Yes, but with viruses. I also react to smoke etc, and the effects can last a couple of days, but then it seems to go.

Ditto ...

Hi 1974lovejoy

I have a very insipid buildup after being exposed to an irritant. That makes identifying triggers fairly difficult if there was nothing obvious i.e. smoke etc. It can take up to a week or so before the full effects of it, and takes even longer, months usually before getting back to baseline. I can’t have a histamine challenge as I have severe TBM so I literally have to avoid everything and everyone to keep on top of it. I imagine there will be a few people like that.

1974lovejoy
1974lovejoy in reply to Jandm

Hi JandM

Similar at times to me too .. interestingly I was also found to have TBM quite clearly on a CT scan but they didn’t pick it up on the Bronchoscopy- mind you I wasn’t very reassured with the person who did the procedure and I know he wasn’t looking for it -wander if it’s mild they have to look for it or would it just present ?? It was clear as a bell on CT !!!

Jandm
Jandm in reply to 1974lovejoy

Maybe it’s still mild and I genuinely hope for you that it is. The more I coughed due to work irritants the worse it became with the constant trauma. Look after that precious pipe as carefully as you can, the less you are exposed to exacerbations the longer you can hold it off 🤞

1974lovejoy
1974lovejoy in reply to Jandm

It’s scary isn’t it ... I was shocked when they told me and they dismiss it a lot so I’m not even sure of the symptoms of it ???

Jandm
Jandm in reply to 1974lovejoy

I have a really vibratory cough (it’s like a windsock in a gale) I can feel my airway close, it’s permanently uncomfortable now or sore because the walls bang together, my airway is definitely hypersensitive to all sorts of things. I’ve also got eosinophilic asthma, so all the usual symptoms but it’s daily thing. It’s also very difficult to clear your lungs, but my PEP mouthpiece helps enormously with my bronchiectasis. You’ve just got to look after it as best you can, keep on top of everything and stay safe 😃

1974lovejoy
1974lovejoy in reply to Jandm

Thank you ... you too x

Yes I do sometimes tend to get what feels like build of symptons. Early warning a cough, moving into tight chest and cloud like feeling in chest with shortness of breathe and very hard to physically function. It also hurts to breathe. This can take couple to weeks to build up to later stages of attack. I find these attacks difficult to come through without steriods. Other times the symptons of asthma can come on very quickly, and I don't notice build up, but these type of attacks do tend torespond quickly to my reliever. I think reaction response tends to depend on trigger for asthma and how my health is in general. It's the build up type of attack that is so frustrating as I up my Inhalers to dampen down asthma, but they don't work. I then also get very tired as I'm not breathing well. This is why on Montelukast and fexofenadine as well as normal Inhalers. Asthma is so variable.

1974lovejoy
1974lovejoy in reply to Yellow75

I’m very similar and the majority of mine require steroids to recover. I react to environmental and sometimes exercise but, pollen is the one I will get a quicker reaction to and the inhalers usually help quicker, the longer ones I up my inhalers but usually end up on steroids which is frustrating as I don’t want to reach for them every time - my consultant doesn’t like me having them and so always puts a big fat question mark over them !!! I’m on a variety of meds too including montelukast and fexofenadine... !

Thank you for your reply ... xx

Yellow75
Yellow75 in reply to 1974lovejoy

I'm slightly different exercise is one which is quicker reaction for me. Also find smoke, strong perfume too. Virus and pollens bit longer to build up.

I've loved some of the responses to this post. The one that reasonated was the misconception that an asthma attack was an instant thing. My first attack seemed like this, but i always recall a friend about an hour before the attack saying to me my cough sounded bad. Didn't make the connection until 27 years later, and going through a rough patch with asthma. However that attack to me 36 years later was still fairly quick a couple of hours. Was sorted out by Mum who realised quite quickly what was going on and giving me her ventolin.

when I recovered she whipped me down to the doctors. Whilst I was given an inhaler it embedded a misconception of what asthma was.

1974lovejoy
1974lovejoy in reply to Yellow75

It’s certainly opened my eyes in the last 6 years how different it is. I was taught during my clinical training - and they still teach it like this - asthma is quick and wheezy - I never wheeze and I go silent if I am in denial that anything is wrong but never quickly ...although I cross into the silent category quite quickly once it’s established but this can take from a few hrs to a few days depending on the trigger !!!! 🙈ho hum I guess life would be boring if we were all text book normal !!!!

Yellow75
Yellow75 in reply to 1974lovejoy

I'm not a wheezer either, I'm quite silent when I'm in full blown attack. You know somethings wrong because I'm barely off the sofa 😂 or I'm saying to people don't walk too fast when they've taken me to doctors. I found it difficult when I was younger to understand, as my brother and sister were so bad as youngsters and were really bad wheezers. Also as you say when you are seen medically doctors tend to look for the wheeze. I've felt like a fraud sometimes.

1974lovejoy
1974lovejoy in reply to Yellow75

Ditto !!!! I always chuckle when my colleagues listen to my chest and say your not moving much are you ... you can see the look of panic in their faces 😂and throw everything at it ....obviously I’m glad they do !! Unfortunately though they are pretty good at getting it shifting a bit and so when I get into AE they don’t believe them despite me still being unable to complete short sentences or get into a bed!!!!

I've never been to A&E but been close to it a couple of times. Speaking in short sentences that's one I know! Also once I experienced the sensation of double breathing, one breathe hadn't finished when another started that was weird. It's good to share experiences though. As sometimes others have developed better ways to describe things.

1974lovejoy
1974lovejoy in reply to Yellow75

Yes and that helps with the admissions !!!!

Maybe I’m not so weird after all then. When I was young (had asthma since a toddler) my asthma attacks were usually quite quick to come on with very loud wheezing, but easily relieved with my reliever inhaler. Now I’m older (47) I don’t seem to get definite attacks as such just a very gradual worsening sometimes over weeks and often ending up with a chest infection (no idea if the chest infection is a cause or a result of worsening asthma). It’s so gradual that I often don’t even notice at first and usually it’s my husband who is the first to notice. I just get more breathless over time, e.g at the moment, after a period of my lungs being really good after recovering from a chest infection in March, my asthma has been gradually getting worse over the past 3 weeks and I’m now at the stage where doing the lightest chores around the house is difficult and Its difficult to hold a full conversation (currently waiting for results of a sputum sample). Medication (relvar Ellipta, ventolin, spiriva respimat, cetirizine, and carbocysteine) seems to keep things somewhat under control, in that I haven’t needed A&E so far, but ventolin doesn’t really do a lot unless I take loads of it, and eventually I end up on a course of steroids. Measuring Peak flow isn’t much use either, it does go down but not in proportion to how I feel. I assume that this is because I have problems with my small airways (mucus plugging found on CT scan last year). But some doctors will just go by peak flow and send you away saying that it’s fine, so then you tend to delay going to the GP until you’re sure that it’s obvious things aren’t good and then you get moaned at for not coming sooner. I find losing so much time to being not at my best frustrating. At the moment everything has to be paced, with lots of sitting down in between doing chunks of tasks.

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