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British Lung Foundation
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questions about identifying infection and using rescue pack

Is there any way to know if you have a virus or chest infection?

Im so unsure of when to take ab and pred. I cant get any sputum up so cant tell by that. I started AB yesterday but don't know if I need the steroids too. How can I tell for sure? I really do not want to take them if I don't have to.

Im more SOB on moving around but not severely, Peak flow was 400 the other day , then 370 yesterday and 350 now. Very slight cough and a feeling of thickness in throat so I want to clear with ahems. Also slight temp and a bit of discomfort/tightness in my back. Doing breathing exercises bit don't feel up to physical, as Ive had 12 days of irregular heart, prior to this and don't want to provoke it

Id also like to thank you all for being here and caring. It makes such a difference when you live alone to know others are still there via group. Thanks all.

Carole

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Carole, can you not get a phone appointment from your GP?

Pred is to treat tightness, increase of shortness of breath etc.

Since your peak flow is decreasing and your sputum isn't loose, it seems likely that the pred would be a good idea but we are all different. One possibility would be to wait another 24 hours as ABs usually start working within 48 hours. You could find the mucus is looser and easier to cough up. But for some people that would not be appropriate, and taking it early would be better.

This is a struggle that many of us have lived through, certainly me - Im in exactly that position now and the GP is phoning this afternoon. Your GP knows you best - if you haven't been dealing with this long enough to know your own sickness pattern, then really best to speak to her/him. And you do need a care plan which sets out what works for you. Nothing worse than to deteriorate badly at the weekend or out of hours in evenings when there is only 111 available, as their untrained staff do not know you and will diagnose by kickboxing. (By untrained i mean that they are not medically qualified, though i think this may be changing as so many people have complained.)

Tell your surgery receptionist that you have copd and need advice about an exacerbation.

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Forgot to say Im 14 years into this illness, well at least since dx, so actually longer than that! I mostly know my pattern in relation to when to start rescue meds, but still now and again, like right now, have unclear symptoms which send me into a spin.

The other thing you can do is call the BLF helpline 03000 030 555 - they are always very helpful.

Good luck :)

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Thank you that is so valuable to me ,that's what's been happening .x

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Everything O2trees says is good advice. You need a care plan geared for you. It would probably relate to your peak flow meter, telling you at what stage you should start on steroids, and colour of mucus telling you when to start taking anti-biotics. The care plan would usually be drawn up by a respiratory nurse and gives you good guidance for when you can’t easily get to your GP. These things always seem to start on Friday evening!

I’ve found deciding when to start on the rescue pack has come with experience. I tend to get a feeling that things aren't right and just make a judgement. I thought I had something coming on last week - I wasn't convinced it was an infection because I wasn't coughing, but knew my breathing wasn't right and chest felt very tight, so I started on the prednisolone. Within a day my chest seemed to loosen up and I started coughing up nasty looking mucus, so then I started on the abs. I stopped the steroids after my usual 4 days and I’ve got 2 more days of abs to go. I think this time I judged it the right way round, my chest loosened up with the steroids and the abs seem to have done their stuff with any infection, as I’m not coughing much at all and what I am bringing up is lighter and thinner.

I hope you feel better very soon. Let us know how you get on. All the best, Jan :-)

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It is very hard to tell the difference. Especially when it may begin with a virus and turn into an infection.

Then there are non infection exacerbations needing only the Pred.

You pick it up over time.

Normally I'd go straight to the gp to have a quick stethoscope listen only to be told it was clear. Then within a few days I'd have to go back to find it had become an infection. That happen so many times that this last time in early December I wasn't near my gp, I waited a couple of days and sure enough, the mucus changed colour so it was out with the antiBs (I can't take Pred). I was definitely right but it's taken 5 years to 'get '.

Best do as O2 suggests and check with doc.

Good luck, all the best to you. P x

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Its so complicated P - I've just been to the doc and chest entirely clear. But last night i was thinking i would have to take the pred as i have asthma too and was spasm-coughing like mad, bit scary, like choking.

So I took my regular ppis (for reflux) and while i was waiting an hour for them to work, after which i'd have taken the pred, the coughing spasms turned around completely so no need to take the pred after all. (i know you can't take it)

Ive had all these viral infections this winter, nothing on the chest, but have still needed ABs as sputum test showed there was haemophilis (sp?) infection in my throat .

Im still learning how reflux makes infections much worse for me - it seems the medics know very little about reflux complications, even while they do know that reflux is common for people with copd. We are all so different.

Anyway today is a better day, hoping now this will pass without further problems. Hope so as i'm joining a 100 strong choir in Canterbury and due first time next wednesday. Faure's requiem they're singing at the moment - i have to have something to counter my slavish attachment to Eastenders (see other post) :D

Hope you're good today xxx

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Haha re eastbenders ! I cannot bear it & I'm a Londoner.

I listen to Chris Evans on radio 2 in the mornings so I've heard someone's been done in. What a Hhooha. I've got Greys Anatomy, dubbed in French on whilst waiting for the Archers. Can't think why I like the Archers, not being too fond of the country.

You poor woman. I'm glad yr chest was clear - at least for now.

Good luck for the weekend and staying well for the choir. That sounds great fun. Envious. Perhaps I could get involved with singing at Gloucester Cathederal later on. I find I forget how to talk let alone sing.q

I know what you mean about the coughing/choking. I remember it well, it just drives you to distraction and misery.

Has the infection gone from your throat and is this the sort of infection that can go down the airways into your lungs? I ask because my infections have usually begun with a sore throat.

Have a very good weekend J. xxxxx P

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Hi P, don't think i'll make the choir, this is turning out more complicated than i thought. At least no spasm coughing at present by very very tight. To pred or not to pred?? My GP seems to think i may be getting more infections due to pred having caused a lowered immune system.

I listen to the Archers sometimes - a friend used to take her radio down the allotment every sunday.

Don't like title EastBenders, its what the Sun thought up when gay characters were first introduced into the soap, not nice.

Have to find some good telly for the weekend as my concentrations's a bit shot for reading :(

You enjoy the weekend too P xxx

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Hi I sympathise with you not knowing when you take your rescue meds, I think we all find it hard at first to learn when to do this. Despite having bronchiectasis I tend not to have much mucus even when I have a flare up and my peak flow and sats are usually OK as well. I have learnt to go on how I feel, if I am feeling unwell then I am brewing an infection so change to my rescue antibiotics. I take my pred if I am really struggling with my breathing. If you are at all unsure then try and see your GP so they can help you learn when you need to take your rescue meds. I used to leave it too long and ended up with exacerbations lasting much longer than they do now when I start my rescue antibiotic as soon as I think I might need it. Hope you start to feel better soon, Take care

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Hello,I live alone and it is hard to know if I ave an infection or not even though I can't breathe well, I have got a degree in fine art but not medicine !! I suffer a lot because I get colds ,,rarely chest infection,I feel very unwell don't go out, emphysema /mild asthma.so I think eventually I will know what to do but yes this sight is a life line to me,I couldn't mannage without it, learn from other people.keep well.x

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Hello Carole,I too struggle to determine whether or not I have an infection.I don,t like taking AB,s unnecessary.I always try to see GP to confirm although negates the point of rescue meds but I know I,ve got it wrong so many times.If it,s at the weekend I wait to se if I get dizzy then take AB,s,even that has been wrong so I,m a bit in limbo really.I think we just have to see the GP.Good luck,regards D.

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Hi Farmer D - i dont agree that this negates the point of rescue meds. Not for me anyway. I always discuss if the GP is available whether or not to take them - i get a phone appointment or go in for a "chest listen". Like you say its easy to get it wrong on your own. Where rescue meds are brilliant is when you're desperate at weekends or evening. And when you're desperate, then its likely deteriorated to the point that taking them is the right decision.

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02trees,I want to thank you ,I've started anti bs and steroids today.your msg had a powerful effect on me.thank you I chooose meds.x

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Thankyou all for responding, I did ring Dr and he said start the rescue pack so that's what I did. I think the answers have helped me clarify a bit, and Im glad it helped others too. I think I will ask for a preventer type spray seeif it helps reduce the infections for me. Thanks again all for replying, hope you all have a wonderful weekend and breathe well. x

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