Hi. I’m new to having Adult Onset Asthma/ Long Covid/ Covid-induced Asthma/Allergies? (Doctors unsure of diagnosis)
After several attacks over 3 weeks and two big attacks, I’ve been put on a 5 day course of 30mg Prednisone along with Clenil 4 times a day and an antihistamine every day.
My doctor told me I absolutely will not get another attack whilst on steroids and if I do phone 999. So I was really pleased with this news.
All has been well for 2 days, however on day 3 of my steroid treatment I needed to use 4 puffs of Ventolin at lunch time due to breathlessness. Then between 6-8pm when resting it became worse having to use Ventolin every half hour. I had used a total over 12 puffs over the day- I lost count if I’m honest. I did a lot of tidal breathing and tried to ignore it (it wasn’t a full on attack and came and went in waves, but annoying and made me irritable) so didn’t feel unwell enough to call anyone- even though I had probably had 10 puffs by then. I went to sleep and woken up much better.
But I wanted to ask people’s advice, what do we do in this situation? Not a bad attack but having mild symptoms requiring 10 or more puffs of ventolin to get comfortable? Also, is it possible to still get these symptoms when on steroids? I thought it would of stopped so was surprised.
Sorry for the long message!
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It's important to discuss your experience with your asthma doctor if your Ventolin use continues to be in the 10 puffs a day range. It's an indication that you may require further days of oral steroids beyond the 5th day.
Steroids can take at least 3 or 4 days to have the desired impact on asthma exacerbations. And sometimes a 5 day course is enough, and sometimes a longer course is necessary. Ongoing discussions with your doctor are important to ensure seemless treatment. In the meantime, our dependency on Ventolin can remain high. It's a good indicator on how well the steroid treatment is going.
Are you on any other inhalers? It can be necessary to increase any combination inhaler as well, as these contain a long acting bronchodilator (Ventolin is short acting and is only effective for about 4 hours). If you're not on a combo inhaler (like Fostair, Symbicort, Flutiform) it maybe an idea to ask your doctor about having one. They include inhaled steroids aswell as the long acting bronchodilator. While the bronchodilator takes about 30 minutes to kick in and lasts for up to 12 hours, the steroids take several weeks to build up their full effectiveness. Regular maintenance is key.
So don't be worried about your Ventolin use during an attack, just be aware that by day 4 your steroid tablets should be helping you decrease the Ventolin use back down to normal levels. And always seek early help from your doctor, and don't hesitate to go back to them when things aren't getting better.
My reply will be far less helpful than Poobah's but erm just no to what your doctor said. If being on pred stopped attacks people would never need further escalation! And those of us on permanent pred still end up in hospital!
Thanks for your replies and sorry for my late reply I ran out of internet data! Lol
Thanks for this Poohbah that’s interesting to know. I am much better today and it is day 4, I had some breathless but tried a different tactic of taking an antihistamine and not had any further breathlessness at all- so I am wondering if this is working because it is long Covid and recent research says antihistamine could be a treatment? . Or it is an allergy and antihistamine worked on the allergy? Or is it just day 4 steroid working? It’s all guess work!
I have just started on Clenil as a preventor I am on 8puffs a day as Gp wanted this to get in my system for next week when I stop taking the steroids. She will be reviewing me after day 5 I just hope it works and I don’t start getting attacks again next week when I’m back at work!
Twinkly I have read some posts on this website and how unfortunately so many people are on long term Pred and struggling which was upsetting and shocking to read!! And also very confused about my doctor saying I wouldn’t get an attack on them.
I have a feeling she thought some of my symptoms are anxiety and so said that to me to give me a ‘placebo’ effect or to reassure me, which it did until i got symptoms yesterday then just felt confused so came on here for knowledge.
I also feel like even if I were to have an attack and call 999 paramedics or doctors would not prove it scientifically. As my chest is always clear, my oxygen always seems to be 100% and the ventolin use pushes my peak Flo right up to green zone (I am constantly in yellow zone without ventolin use) so when it is happening there’s nothing to prove it! I suppose other than my symptoms.
However- my symptoms are real- tight chest, nasal congestion, sneezing, shallow breathing, sob, very physical symptoms often triggered by dust and cold and definitely not just anxiety.
I have read other posts and have seen other people have similar issues there stats are all fine in attacks too.
I suppose it’s a new world to adjust to but sharing with each other gives us empowerment and knowledge.
The big boost initially sounds a good plan and glad they're keeping an eye. Even if, in time, it becomes mainly not asthma, but some asthma, some anxiety, some long covid, some something else, medication can be altered as needed. But for now trying to hit it for any asthma sounds sensible!
If you do need 999, give them some notes on a bit of paper - I don't usually wheeze, my sats can be good, GP is treating as asthma, advised to call 999 in this situation. Might help?!
Yes brilliant advice thank you! I have just wrote myself an asthma plan with my triggers and symptoms so yes I will write your suggestions too, I feel better already about that thanks!
Thanks for the insight. I do feel better for having that written down at least it gives a logical and medical account if I do get into trouble.
So, ( i am not trying to advocate not calling 999 after 10 puffs ) but it seems basically this can be a condition which does need a lot of ventolin- more than 10 puffs to keep us comfortable. And not necessarily need to go into hospital but we just take a lot of ventolin temporarily while we wait for preventers to kick in?
So, is there an absolute limit to how many puffs of Ventolin in a day without over dosing?
I think of one has to use the likes of 10 puffs they're meant to contact GP to discuss , eg next day or something - was it a one off or is it ongoing etc. But definitely in your case needing more at the moment is common because it could take a while for the clenil to kick in properly. I would say if you need 10 puffs and it works and holds for 4 hours you're "ok". But if it doesn't work or isn't lasting then more intervention is needed. And if you didn't want to do 999 you could do 111.
Not sure about the limit. There isn't one but again if you're needing to repeatedly do 10 puffs at a time then I would say you need seeing.
I hope you have had help since you posted this but I was very similar to you so I did my homework reading posts o health Unlocked and then asked my asthma Nurse for atimos modulate and I’ve been fine since. I know it’s steroid and not good in that respect but it works and a lot of people I’ve noticed complain about palpitations but I found holding it in my lungs for a shorter period than told works and I cut down on my caffeine dramatically which also helped. I’ve had little help from my doctors practice due to covid so I just read, read , read , what people say here and learn 👍🏻👍🏻👍🏻
Thats good to know I have just had a google of that medication!
I have been ok thank you I am lucky that I began to feel a lot better, but then accidentally missed 1 dose of clenil, and the next day missed 2 doses (I am on 4 doses a day) and then had more attacks the following 2 days needing loads of ventolin again- the attack didn’t stop until I took an antihistamine and then it stopped!
I was so surprised how quickly I deteriorated just by missing a few doses or even if missing the doses was the reason or it would have happened anyway?
Does anyone else find antihistamines stop attacks when ventolin doesn’t? I just wondered if this is a ‘thing’.
My inclination would be that if antihistamine clears up symptoms then, at that point, it's an allergic reaction to something but not actually asthma related/triggering the asthma as ventolin is not needed or helping.
I’m pleased you’re feeling better. I’m not sure of the answer re the antihistamines and attacks but it’s something I’d be interested in knowing too as I’m fairly new to this and recently thought of taking antihistamines. I tend to sneeze and cough a during the day and other members have said they also take antihistamines alongside their asthma treatment. It’s all a learning curve isn’t it!
Thanks Twinkly! Yes that makes sense I will mention it to my doctor. That maybe why at times ventolin just doesn’t work on me!
Leiley I also have a fair bit of sneezing and coughing too and wondered if I have allergies, but also read that this can be just asthma too as in ‘the first signs of a cold’ are asthma symptoms.
It’s very tricky to work out! I am also new and trying to put it all together! I feel like mine could is asthma most of the time but then I have attacks which now I am thinking could be allergies.
I also found when I feel well with no asthma symptoms at all I don’t get any ‘allergy’ type attacks but when I am unwell with low peak flow and general breathlessness- this is when I seem to be more sensitive and get suspected allergy type attacks as well as the general type asthma. I don’t know if this happens with you?
Maybe speak to your doctor about trying antihistamine and if they work when you’re having an attack maybe it could be allergy like twinkly suggested?
Hi yes I will have a word with the asthma nurse or gp about antihistamines, I have some left from a biggish box the gp prescribed a while back (for hives from an allergy) so I thought I would try those, as twinkly said time before - a lot of people here take them daily.
It’s interesting about the possibility of your asthma and allergy symptoms, I also get hay fever for a few months of the year. So far I’ve worked out that my triggers seem to be dust, smoke (cigarettes and oven burning etc), aerosol deodorant and exercise. I haven’t actually worked out if the general breathlessness is linked to the allergy type symptoms yet, it’s a lot to work out isn’t it 🙈
I have found that some days I can get more breathless quicker doing the same activities/housework as other days so maybe that’s when the lungs are ‘sensitive’
Yes I have all of those things as triggers too- deodorant, perfume, strong cooking smells or smoke, and definitely dust! And yes some days I can go up the stairs fine and other days I cannot breathe at the top! Maybe this is ‘typical’ asthma and when we feel ‘sensitive’ it’s when it’s not well managed that day. I went for a few days after my course of steroids where I felt great, nothing bothering me at all and not breathlessness- fully in the green zone! But it didn’t last long.
I have spoken with my asthma nurse today following a couple of asthma attacks on the weekend. I thought this might be helpful/ interesting.....She has told me to take an antihistamine every day for the time being while we wait for my clenil to start working. (Have only been on clenil for 2 weeks and so while this gets to work she says I will be prone to attacks from all sorts of triggers- pollen, dust etc) she also said that the antihistamine can also act as a preventive! As well as the clenil.
She has said the fact that the antihistamine works doesn’t prove I have allergies and like you and twinkly have said - lots of asthmatics take a daily antihistamine.
I feel a lot better and safer knowing the antihistamine is another layer of prevention. Just a tip- I am taking mine on the evening as have been tired having it in the day today!
Yeah it's such a minefield. Symptoms could be allergy only, or intolerance. They could be asthma. They could be a combination of both. Or they could be neither. Why can't stuff be obvious 🤣
I guess in a few days if things suddenly have jumped up in feeling better then the antihistamines are maybe helping.
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