Action plan conundrum

[Wheezycat]

Sorry, this may become a bit long.

After an flair over Christmas I realised I had no up-to-date action plan. My Symbicort/Smart was changed to Fostair a year or so ago due to thrush issues. And it has been ok, but I got no new action plan, and then Covid hit, and I just didn’t think about it.

Anyway, since Christmas I have been asking for one, and it took me until March to finally get it. Having cast a glimpse I put it to one side, and only today I have looked properly. It leaves me with a couple of questions.

First, over what period do you decide what is your best peakflow? Bizarrely, the one on the AAA is higher than I can remember blowing for at least 2-3 years, if ever, so it needs adjustment.

Second, also bizarrely I am down as MART, but have never been told (remember the Covid issue!) I am glad, but concerned they have put Fostair as my ‘instant’ reliever as well rather than Ventolin. With symbicort, though good over a day, I did not find it instantly relieved, and so I haven’t turned to Fostair for that. Is it as fast as Ventolin for relief? For me Ventolin kicks in after about 10-15-20 minutes, no faster, but it is certainly faster than Symbicort was! With Symbicort I even found that at first it depressed my peakflow slightly, but after , say, four hours it really made a difference!

My understanding is that I can take up to 8 inhalations of Fostair per day (Fostair 200/6), and I will read up, but is that other people’s experience too?

My next move is to copy my new AAA, and then scribble all over it, as all they have said is what they assume my best PF is, but nothing else filled in.

Oh, well. It will be the task for the day, calculator in hand.

[Celie1]

Hi Wheezycat, 😊

I was put onto Fostair 100/6 too, on a MART. To begin with I had to take 8 puffs a day for 2 weeks and then reduce it down to 2puffs twice a day. Previously I had been on Duoresp Spiromax 320/9 (same as symbicort) but was not on MART with that.

A couple of months later I started getting sob symptoms and had an extra puff of Fostair but found it didn’t really help and resorted to the ventolin.

I didn’t get an action plan from the nurse (phone consultation) so wasn’t sure when to increase the Fostair, by how much and for how long! In the end, after an asthma attack I phoned the nurse and was put straight on to steroids. (I thought the point of Fostair was that you had a way of managing your symptoms and ‘adding on’ extra when needed. So it didn’t work for me this time 🤷🏻‍♀️ Good luck with yours. 😁

[Wheezycat in reply to Celie1]

Thank you. I have a review on Monday, and hopefully that will make it all clearer. I think it is due to the Covid situation, and it hasn’t been properly considered on the AAP. It looks a rushed job. I now know it says clearly on the BNF that for 200/6 you can only take four puffs per 24 hours, but it seems professionals occasionally over ride it. For myself, I manage with salbutamol until I have had a chance to discuss it.

[Tntjsghk]

Hi. I have been told that you can take up to 4 puffs of Fostair 200/6 or up to 8 puffs of Fostair 100/6 a day. I sometimes use fostair as reliever and it does work well for me.

[Wheezycat in reply to Tntjsghk]

Thank you for your response. I have now sorted a review for Monday when I can discuss these things. Before Fostair I was on Symbicort 200/6, on SMART. I didn’t find it worked anything like fast enough if getting breathless on a walk, say, but if I had a bit of a deterioration from a small cold, say, it worked very well! But thus I worry about having Fostair as a quick reliever, as it is the same reliever as Symbicort. It seemed to take a couple of hours to really get it to relieve.