Flare up again

[Dl98]

Just feeling breathless again and coughing. Peak flow between 400-500 my normal is 570

[twinkly29]

That's on the edge of it being in your ok/green zone but you need to do what your plan says, or what you normally do when it does this.

This post explains what you should do and when:

healthunlocked.com/asthmauk...

[Claire_ALUK Partner ALUK Asthma Nurse]

Hi Dl98, it sounds like a flare up, I would contact your GP today 👍. Lots of people are finding the pollen is causing their asthma to flare at the moment so I'll pop over our hay fever page which you may find useful. Please don't hesitate to give us a ring for advice 0300 222 5800 option 3 for nurses, M-F 915-445asthma.org.uk/advice/trigge...

asthma.org.uk/advice/manage...

[Dl98 in reply to Claire_ALUK]

Thank you Claire. I will try but always get fobbed off coz they can’t hear a wheeze

[Claire_ALUK Partner ALUK Asthma Nurse]

🤦‍♀️ oh no, perhaps point them to this post about asthma symptoms: asthma.org.uk/advice/unders...

[Dl98 in reply to Claire_ALUK]

I do. I even showed them I fit the criteria for the shielding list at the time but still no. Was a priority for jab so don’t quite get that

[Dl98 in reply to Dl98]

They said I have moderate asthma

[LRLR]

Hi Just noticed your post, sorry to see you’re having trouble.

My normal peak flow is the same as yours-570 end the last few weeks I’ve gone down like yours too- between 400-500 and have no idea why. I thought it might be helpful to you to share what my gp said:

I phoned my Gp who spoke over the phone so I didn’t have the ‘no wheeze issue’ (I never wheeze) she has put me up from 100 fostair to 200 fostair.

She said to phone back in 10 days if symptoms aren’t better- she said the higher fostair will have some effect straight away.

Not sure what medication you’re on or anything but I feel that is the sort of response you should be having from your GP??

I am newly diagnosed so not experienced.

Hope you managed to get something sorted xx

[Dl98 in reply to LRLR]

I’m on fostair 200 as well. Been on increased dose of fostair and that seems to be helping. It’s really annoying with GP. Like I’m sorry but it’s my body don’t sit there and tell me there nothing wrong. Why would I be here otherwise

[Dl98 in reply to Dl98]

And montelukast

[LRLR]

Yes that is really annoying and ridiculous. Why else would you actually phone and make an appointment? You have a right to be believed and your explanation of your symptoms should be listened to and accepted.

Glad the increase in fostair is helping. I am on day 7 of increased fostair and this is the first day I have not used blue inhaler so it seems really good and worked quicker than I thought.

I asked for the montelucast tablet but she said increasing fostair would work better.

[Dl98 in reply to LRLR]

I’d say that’s wrong. Montelukast is meant to be used when your asthma is mild to stop it getting worse. Luckily in the end I might add. I found a GP that listens to me but they’re always booked up. Wonder why 😂😂. Everything I’ve thought was wrong with me I was right about. So tbh she trusts my word for things and just verifys it pretty much. I suggested fostair and was put on it without hesitation.

[Dl98 in reply to LRLR]

Does the blue even help you or does it have to be the fostair you use? Blue does nothing for me really compared to fostair

[LRLR]

Haha! It’s the same at our doctors the good ones who listen are always booked up!!

That’s brilliant you found a good doctor anyway and you’re sorted.

I did think the montelikast would be a good option but when she said no and offered higher fostair, was just grateful for anything! Lol

[Dl98 in reply to LRLR]

Honestly just bug them. I did

[twinkly29 in reply to LRLR]

Montelukast is just another add-on, not necessarily just for mild asthma. It used to be the next step after a combi inhaler but now different doctors do things in different ways - in theory this is a good thing as it could mean treatments more suited to the patient. For example, a friend struggled with a LABA so she's on high dose Clenil and montelukast (rather than the more traditional Clenil to combi to add-on montelukast route).

So I can understand the GP wanting to tweak the Fostair first. But at least montelukast is there as an option if you need something else in the future .

[LRLR in reply to twinkly29]

Thank you for this advice, that’s really helpful to know!

[LRLR]

I find my symptoms are really stubborn and I have to take loads of blue like 4-8 puffs throughout morning and similar at night. I am fine in afternoon. I feel like 2 puffs of blue is nothing at all lol!

[Dl98 in reply to LRLR]

It’s worse when my nose is blocked with hay fever. Like I didn’t have air to begin with 😂

[LRLR in reply to Dl98]

Yeh I can imagine! I feel like I’m suffocating when my nose is blocked which happens suddenly but then quickly goes again which is weird.I’m on nasal spray dymasita and antihistamine daily I don’t know which of them is helping or if all of them are but I just take everything I am given and hope for the best! Lol

[Dl98 in reply to LRLR]

I’m on avamys and fexofendine I think it’s called. Once I take them one of the knocks it out

[LRLR]

I am on 4 puffs a day of fostair so they said I can’t use it as a reliever

[Dl98 in reply to LRLR]

I’ve been told I can use 4 extra puffs per day. On 2 twice daily

[LRLR in reply to Dl98]

Have you really!?? Wow that’s loads. I was told no more than what I’m on.Are you diagnosed as severe if you don’t mind me asking?

Just wondering how it works and why you have different to me?

[Dl98 in reply to LRLR]

They say moderate but I’m not so sure. refuse to give me steroid tablets

[twinkly29 in reply to LRLR]

It will probably be nothing to do with the level of asthma as such but the strength of the Fostair. Fostair 100/6 can be used traditionally as a preventer or as MART where extra doses are used as relief. Fostair 200/6 shouldn't be used as MART.

[LRLR]

Have you got medication for your hay fever? Nasal spray etc

[LRLR]

Yeh it doesn’t sound moderate more severe but I’m just thinking about what I read in the step management- I think our medication is step 3/4 maybe?

I have fexofenadine (can’t spell!) too I’m lucky I tolerate it quite well I have it every morning.

I swapped from avaymys to dymista because it has an antihistamine in as well as steroid so thought this would be good.

Do you often have these flare ups? I was managed for 5 weeks then this happened.

[Dl98 in reply to LRLR]

Really just depends. Sometimes I’m fine for ages then boom. Always had it though since birth. Was always getting chest infections as a child.

This is what it says for my plan thing

Use 6 puffs of Fostair via spacer. If no improvement or if peak flow below 220 phone 999

Green 570

Amber 450

Red340

Don’t quite understand why it says 220

[LRLR in reply to Dl98]

I was just thinking that about 220 that is soooo low!’

your peak flows are exactly like mine. I’ve had a bad asthma attack where couldn’t talk or walk and my peak flow was 420.

Don’t know about you but I think I’d be dead if mine was 220! Could it be an error??

[Dl98 in reply to LRLR]

Perhaps I remember running up the road and I was pure laying against wall coughing like hell. Didn’t have my inhaler with me at time. Ended up phoning 111 that night. Same problem. Wanted me to drive down to Dundee. Oh yeah with what? I’m still on a provisional and my car just sits outside grr lol. What severity of asthma do you have?

[LRLR in reply to Dl98]

That sounds terrible you must be brave!

[Dl98 in reply to LRLR]

I’m just used to it. The way I look at life is I’m all good as long as I recover. Got acid reflux issues so that also doesn’t help

[twinkly29 in reply to LRLR]

Asthma UK's advice is never to go solely on peak flow so although people should have plans linked to their own peak flows (so someone else's "low" might not be that low for others) and symptoms and treatments, symptoms should be the main focus for seeking treatment. So if you can't walk or talk you seek urgent help regardless of your peak flow!

[twinkly29 in reply to Dl98]

Because 220 is where, for you, it becomes a medical emergency. The other zones are the "get this help at this stage" bits (hopefully your plan does say what to do at each stage?)

healthunlocked.com/asthmauk...

[Dl98]

Had to use wasp killer today probably didn’t help

[LRLR]

No sprays can be terrible can’t they.

I have no idea what my asthma is. I was fine all my life never had anything then last November aged 39 I became more and more breathless and went to the doctor. They did peak flows, I was really unwel had course of steroids, put on clenil which wasn’t enough they upped it to 8 puffs a day still not enough. Then went onto all medications I’m on now. Took ages to settle the. I did for 5 weeks, but now been bad again for 4 weeks.

Doctor thinks it’long-Covid induced asthma which was left and got worse over a year. I’m seeing respiratory clinic in June.

[Dl98 in reply to LRLR]

I swear I had COVID in December 2019 but feel crazy saying it. I was on clenil as a kid. That was crap 😂😂

[LRLR in reply to Dl98]

There’s a very good chance you had it December 19. We had it in our work place February 16th 2020. My friend has it in her work place in December /January 2020.

[Dl98 in reply to LRLR]

I just remember having to constantly cough up crap just to breath a bit

[LRLR in reply to Dl98]

I was just thinking how well you did to fight that off given your asthma! Have you found you’re breathlessness has been worse since? My friend had life long asthma at the time of getting Covid and she has to have montelicast tablet as was coughing in the night for months after

[Dl98 in reply to LRLR]

Tbh before that I can’t remember having a problem. It really is a great tablet. I was on Kelhale when I had that attack. I was on the priority list for jab but not the shielding list. 💁 I cannot carry heavy bags to save my life though. What caused you to actually seek help?

[Dl98 in reply to Dl98]

Looks like I won’t get the AstraZeneca one for second dose so no idea what’s happening with that

[LRLR]

I realised I’d had a daily cough for over a year, and breathlessness bad when going up the stairs which was unusual. I had my first ever asthma attack triggered by dust- coughing and breathless and had to use my sons inhaler - used it by instinct and it helped! I thought this was very strange so went to the doctor, within two weeks of them monitoring my peak flow I was having asthma attacks every day. That’s when they gave me predinosone. Felt so much better on this then came off and went back to daily attacks. I don’t know about the vaccines either I have had two Pfizer’s (through work) and my family have had Oxford.

[Dl98]

Finally on top of it. Been going gym. Think montelukast is finally working