What are your triggers for asthma att... - Asthma UK communi...

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What are your triggers for asthma attacks?

AirIsUnderrated
AirIsUnderrated

I'm new to all this. I've been on Qvar for nearly 3 weeks and I'm still needing my salbutamol, 2 puffs 4 times a day with wheezing and shortness of breath in between doses. I've worked out that my triggers for sudden constriction of airways includes; heat, aerosol cleaners, smoke (candles and bonfires) and the fryers in chip shops.

The last couple of days I've had 2 "attacks" with no obvious triggers at all. Both times I tried a puff of the salbutamol, even though I had taken it less than 2 hours prior, but it didn't help and I was gasping for around 3 hours, then it subsided.

Do you get attacks with no obvious trigger, or do you usually have a pretty good idea what's brought it on?

ETA: no asthma diagnosis, no recent history of chest issues, currently 10 weeks post-viral with breathing difficulties that won't go. Definitely NOT controlled at the moment!

39 Replies
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Pollen, smoke and viruses :-)

Cleaning products for me especially dettol also pollen dust ice cream kicks mine off also lots of other things.

it sounds like you need more salbutamol when an attack happens. Speak to your GP but my sense is that you could have more puffs. I am still working out my triggers but think pollen and weather changes are mine.

Mine are very similar to yours. Sometimes I get tight chested for a couple of days with no obvious reason, and then cough up coloured mucus at the end which points to a mild chest infection. Sometimes suspect hay fever as well.

I have the common ones, pollen, some perfumes and aftershaves ( not all) some room sprays, humidity. And I have some odd ones, frying food, boiling food, domestos, ice cream. I’m also debating chocolate - it makes me cough!

Frying food is one of mine, and bleach! I'd forgotten about bleach. I've always reacted to it with soreness of airways but it never comes to anything. I just stopped buying it.

Dairy in general thickens mucus, so anything milky might be bad, including chocolate. Does dark chocolate do the same?

I don’t eat dark chocolate. I’m just beginning to draw a connection with chocolate. As a general rule, in normal life, I don’t eat much of it. I first wondered about it at Christmas. One of the chocolates in a box from Hotel Chocolate set me coughing. Yesterday I had chocolate ( a feast of Kit Kat!), then last night my peak flow was a lot lower than usual.

I had a chocolate hob nob ( or maybe two, or was it three?) this morning and again my peak flow was a bit lower, but came back up a couple of hours later.

Guess I’ll just have to keep eating chocolate to see if it always happens.

I wonder if I react to trifle? Maybe I should try that next.😊

Let us know!

Yup, sometimes you can't win. Milk and white chocolate make me congested. Dark chocolate gives me headaches. Thank you menopause for that. 🙄 🤦‍♀️

I forgot to mention red wine, sherry etc. That makes me congested and headachy. When offered it I used to say no, sorry, it gives me a headache. Nobody believed me, they inevitably told me I just shouldn’t drink so much of it. I now just say I don’t like it, where in real life, it doesn’t like me.

Why do so many people have the opinion that "a little bit won't hurt you". Yes, it does. Trust me, it's my body and I know it better than they do.

One glass of French red wine, however expensive and superior, gives me the hangover from hell. Australian, Spanish, Chilean, Italian are all fine. I think it's something to do with the way they're processed.

1974lovejoy
1974lovejoy in reply to Troilus

I changed to soya milk in cereal and in my tea and it has stopped that mucous thickening I was getting ... I’m not strict with other dairy but I’m careful .. I notice the same sensation with a bar of chocolate especially Cadbury ( it’s very milky) but I like dark choc lots so I make sure I get my fix that way !!

Wine often makes me cough but lucky for me Prosecco doesn’t 😁and Gin is also good !!!! 😁

Good luck with the taste testing xxx

EmmaF91
EmmaF91Community Ambassador

Hi. It sounds like you need to get back in contact with your GP and tell them what’s going on, because you are still using a lot of ventolin (a controlled asthma rarely if ever uses ventolin. An uncontrolled asthma is classed as needing more than 3 doses of reliever a week). It could be that you need a stronger preventer or a short course of steroids. It may also be worth asking about getting a asthma action plan if you don’t have one already (you can download them from asthma.org.uk/advice/manage... ).

Most of the time I can identify my trigger, however not always (in which case I usually blame the weather/air pressure 😅😂) or ‘trigger jenga’ (I have written previously about that so here’s the link if you want to read it 😅healthunlocked.com/asthmauk... )

I hope that helps and you get to the bottom of what’s going on soon

I'm so sorry, I forgot to say that I have not been diagnosed with asthma. This is post-viral (probably Covid) breathlessness that began in March and has been up and down, mostly down, ever since. I can't get an appointment to see anyone because of Covid, although I've been in touch with doctors most weeks. No respiratory nurse. No examination. No spirometry test. No Covid test until day 65, which was negative of course. I did have a chest x-ray on Tuesday and it was clear, but that only shows infection not inflammation, so last week's chest infection has gone thankfully.

I completely agree about trigger jenga (LOVE that expression!) A bit of dust I can cope with. Trying to clean up that bit of dust on a hot day with spray cleaners = attack. Cleaning sprays in work is manageable with salbutamol. Stopping at the chip shop on the way home = attack.

It's the non-obvious attacks that are getting me down. I need to get labels on those elusive jenga bricks.

Thank you for your advice - all good. :)

Lysistrata
LysistrataCommunity Ambassador

I agree with Emma - this doesn't sound like you're well controlled currently and you need to get back in touch with your GP.

Like Emma I know my triggers, but often find I can't pinpoint what triggered a specific episode and suspect 'layering' or trigger Jenga is the case. It can also be difficult at times because not all triggers act immediately; there can be a delay with some allergic triggers but also with something like exercise or even weather.

I do find the worse I am the more sensitive I am to any trigger I can identify and also those I can't - so to me this also supports you talking to your GP again.

I also agree with the action plan. When you're better it's worth working out what your best peak flow is so you can figure out where you are in relation to that. However, peak flow isn't helpful for everyone by itself; it's also important to pay attention to your symptoms and reliever use, like you are now. Worth discussing with the nurse or GP what works for you. It's all a learning process getting to know your asthma, but like Emma says you should be aiming for.good control with minimal reliever inhaler use - and that is possible for most asthmatics even if it involves some trial and error!

Thank you! Please see my answer to Emma. I definitely do need an action plan.

Others have given sound advice.

My known triggers are drinks like orange squash but I'm ok with elderflower cordial. Some alcohol like acidic wine and champagne is a no go. Pollen, viruses, exercise, strong perfume, dust as in decorating. Fat from frying or roasting. Smoke including people who are vaping and people who are smoking joints in public. Weather changes, such as cold air and humid air is a massive trigger for me.

Asthma trigger Jenga that EmmaF91 mentioned seems to be a factor too. I hadn't heard of it before reading about it on here. 😊

An interesting one for me has always been laughter, I have to watch comedians like Lee Evans in small doses, if I laugh too much I have to reach for the inhaler and calm down. Never met another asthmatic with the same trigger

EmmaF91
EmmaF91Community Ambassador in reply to CornishGent

🙋‍♀️🙋‍♀️🙋‍♀️

To quote the Face of Boe “you are not alone” 😂😂😂

Lysistrata
LysistrataCommunity Ambassador in reply to CornishGent

There are some things I have to ration when I'm already struggling. Otherwise I would have to explain to some A and E doctor that yes I am here partly because I was wasting time reading DamnYouAutocorrect compilations (for some reason they really set me off). I nearly sent myself back to hospital after a set of those when I came back from an A and E trip once.

Or there are certain YouTube videos that really make me laugh...then I would have to explain that too 😂😂

Oh goodness yes! But laughter has made me cough all my life. I thought that was just me. I also remember my chin constantly itching as a child and my Mum saying she had never heard of that as an asthma symptom. And 35 years later, it's accepted.

CANINE12
CANINE12 in reply to CornishGent

Laughter is a trigger for me, trying to explain in A&E what triggered the asthma attack got some interesting looks. 🤣🤣

Too much laughing sets me off coughing and spluttering - which is a shame as I find myself to be hilarious 🤣

Aerosols (particularly deodorants); cold weather; hot weather; cigarette smoke; sawdust; strong perfumes and aftershaves; some wines: these are my main ones. Then, sometimes there appears to be no obvious trigger at all. And often I just wake in the night wheezy from lying down.

Lying down - I remember that from when I was little, but not in this episode. Yet. In fact, lying down is the only comfortable position for me, especially on my front, and at night I don't cough and hardly wheeze. The first few minutes of waking up though, even if I don't move, I can feel my airways getting "itchy" and tight.

Oh yes! I'd forgotten that my husband's antiperspirants set me off. My own are OK. Even when both are made by Sure. Go figure. I'm still not convinced that it's the fragrance though, as all his are a problem and all mine aren't, and I haven't had any other fragrances bother me. That's an anomaly.

Paint, a lot of different cleaning products, heat, Smoke,damp, wine, infections/virus, strong perfume, hay fever, oh and ice cream makes me cough weirdly 🤷‍♀️ Something new always catches me off guard too.

I have been monitoring my asthma and peak flow quite closely which has shown some triggers I wasn't aware of. Exercise was already a key trigger and nail polish remover. I have now discovered that oranges/clementines, sardines and soy appear to be strong triggers. A lot of other foods seem to trigger more mildly. Another mild trigger was my preventer - Flixotide. I stopped taking that (after talking to my GP). Interestingly, my peak flow improved by about 40% over the next few days (it had been getting worse and I was generally at about 50% of max peak flow - this is now around 70% and about to start on new preventer).

Interesting. How do you know what your peak flow ought to be? I have sung all my life and have always been able to blow well over the maximum for my height and gender on the charts. Is there a way of working out a personal "target"?

Lysistrata
LysistrataCommunity Ambassador in reply to AirIsUnderrated

As someone whose personal best is also well above the charts, probably due to years of singing and oboe, I also had to work out my best, and it has actually increased slightly despite my asthma still being severe.

I tried doing it a few times on good days and after reliever medication. My view is that the medication returns me to what I would be at if I didn't have asthma, so it's valid to take it after medication to see what the best I can possibly do is.

I still periodically check to make sure that best value is still valid. Sometimes I have been told to use my 'normal' which I find vague and unhelpful - I spend a lot of time sitting in my amber zone but it doesn't mean I can't get more at times, or that you should use that as my target. The last person who said that also just made up numbers for the normal which I think is much less helpful as it can vary a lot more. Just use my best and acknowledge peak flow is only part of the picture.

My high number does sometimes cause problems with healthcare staff who don't believe my best can be that high and/or that I must be fine because it looks good (I have a high personal best and also don't drop as low as expected in attacks, though I do drop). I think too many people don't understand that those charts are just population average values for someone of that age, height and gender.

Just a note that if you use digital peak flow meters the number appears to be different from manual meters (the classic type most people are given). I usually find on a digital meter my numbers are higher than on a manual one, so since they usually use manual ones in hospital I give my best value from that.

Thank you, thank you.

As per Lysistrata's response, my "max" is literally the highest peak flow I have recorded. I my case, not just after taking my reliever, but also after significant aerobic exercise. I find running opens up my lungs considerably.

Mould, damp, diesel fumes, smoke, wind and cold air for me. Avoid strong chemicals, aerosols , strong ones will always set me off

Thank you so much, everybody. I really appreciate all your answers. It's helping me to understand this whole, new, unexpected journey and all the related baggage that goes with it - I've done so much Googling! My GPs have been amazingly patient and helpful, but they simply haven't got time to answer all my questions, most of which I don't even know to ask until after I've thought things through and done some research. You've all been incredibly kind and generous with your advice and personal experience. I'm very grateful. 🥰

Cat, dog, horse hair; dust; mold; certain heavy duty cleaners like bleach

Have you considered trying a daily antihistamine? If it's possible your breathlessness is due to covid, hayfever could just be the icing on the cake (I've never had hayfever issues and this year it's a nightmare). I've read some comments and I was wondering - is it possible for you and your husband to swap to roll on deodorants?

Also I would recommend more than 2 puffs of ventolin if you're struggling - it sounds like perhaps your original puffs of ventolin arent helping (as they should help for at least 4 hours), so maybe it's the triggers from your previous attack instead of new ones? Although I will say I am 3 years diagnosed and still finding new triggers for me! My big ones are laughter, mold and damp, weather or temperature changes, spray aerosols are a hit or a miss, sometimes I'm fine sometimes I'm not, exercise is a big one for me too - I can walk for miles but anything faster than a walk or uphill is a no go. Viruses and cold set me off, smoke is sometimes a yes or no, beers, wines and ciders have been known to set me off too. I would recommend trying a piritom to start with if you're not already on one, and call your GP and ask for an aerochamber to take your ventolin through :) hope you feel better soon

Thank you! I was given a prescription for a spacer and desloratidine antihistamine last Friday. I got the spacer (BIG difference but still getting tight in the afternoon) but I haven't had the antihistamines dispensed yet. I was waiting for a blood test for eosinophils and if I had taken the antihistamines before that, it would have defeated the object of the blood test. I had the blood test yesterday and I'm still thinking about it, as that family of drugs never worked for me as a child, and the side effects list looks scary! I haven't had hay fever badly for years and years. Lime pollen can set me off but I've hardly been outside this year and my nose is completely clear and dry.

Yes, your list is similar to mine. As for deodorants, my own doesn't bother me at all. DH now puts his on in the ensuite with the fan on, bless him. We both hate roll-ons but will consider them if it becomes a problem. 🤞

I went back to work yesterday after a week off with a chest infection. I got through the shift pretty well - until the pub across the road had a black, billowing bonfire and the fire brigade were called. That wasn't too comfortable but I closed windows and kept away from the drama and it cleared. I actually didn't need my evening Salamol at all. Then I was awake half the night with my right lung itching and now I'm getting wheezy and tight again one hour after my lunchtime dose. I just don't get this.

You can take salamol as and when you need it. If you find you're still struggling after youve taken it, take some more. If you're still struggling you can take up to 10 puffs with a spacer, and if after this you're still having problems you should be looking to call for an ambulance. Dont just take the blue inhaler 4 times a day, it's an emergency reliever. Just be careful you're not taking too much of it

Thank you - yes. I have been taking it to open up the tubes before my twice-daily Qvar dose so that's 2-4 puffs a day. Even when I don't feel tight in the mornings, my peak flow goes up from 380/90 to 450 with it. I always need it for the evening dose. I try not to take it in between but with the chest infection I've had to, but I don't go above 8 a day. It just doesn't always last the 4 hours. I'm uncomfortable and tired, but I'm definitely not at the ambulance stage, thankfully.

If you're still uncomfortable then you need to go bac to a doctor. The salamol should open up your tubes and you shoudnt be feeling bad again after a couple of hours. Try an out of hours gp or your gp, you might need a different steroid inhaler or aomething else

👍 I was told to give the Qvar 4 weeks to take effect, and it's only just 3. I haven't actually "seen" a GP at all yet, in 10 weeks of this. Only phone calls. I have a follow-up call scheduled for today, and the poor doctor is going to hear it all!

Thank you so much for taking the time to help me. 🥰

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