Hi, I posted what is below on Asthma uk forum and one reply suggested this would be another good place to get info. I am awaiting re-referral to a consultant, but really wondering if I can get them to give me a ct scan to check for bronchiectasis (which my mum had), as my diagnosis is atypical asthma but my issues with chest infections and odd presentation make it hard for me to get looked after well in primary care.
I have read an article for GPs that mentions that frequent viral infections (which I think mine usually are) can also be a feature. However, I don't generally produce large volumes of sputum (and it's never been discoloured or bloody), although the typical cough I have is wet. Any ideas or info or experiences welcome.
I was on Clenil or Fostair for apparent asthma (neither seemed enough, and even together they weren't enough, though a brief spell on 2000 mcg Clenil was more effective), and with Montelukast added seemed to get through more colds without developing bronchitis. I would still feel a bit rubbish but get a bit of a dryer cough. This seemed to throw unfamiliar GPs off as the crackle and wheeze were missing, even when a problem (aggressive cough) was developing.
Back in November I struggled with bronchitis for about 2 weeks, not quite giving in, using lots of salbutamol, until I cracked and got the rescue pack of Pred (40mg/day x 5). I saw a new GP to check in and he was thrown by the lack of crackle and wheeze, but by then I was waking up during the night and sitting up coughing for an hour at a time and not in any mood to wait longer for Pred.
I finished the pack on Friday and got sicker over the weekend, resting on Saturday and spending Sunday in bed. That evening I realised I was shivering, got back under the covers, took my temperature (39.5) and realised things were worse. I saw an out of hours doctor who put me on a nebuliser and gave me Amoxicillin (7 days) and Pred.
Back at the GP a few days later I tried walking and injured myself so badly from coughing that I am still in pain now and unable to wear a bra. The following week I was still feverish so I had a week on a broad-spectrum antibiotic (Clarithromycin?). Altogether it was 2 weeks in bed before I started gradually going outside again. After 3 weeks or so on 40mg/day of Pred, I am now tapering gradually by 5mg/day every 7 days. I feel 100% better (in fact like a superwoman; I wish I could take Pred all the time even though I know that's really a terrible thing for people that have to).
My mother had bronchiectasis and her symptoms were very similar (other chest issues in the family may have been misdiagnosed). I have been referred back to see a consultant and I am really hoping they will give me a CT scan to rule this out (my x-rays are fine and I have normal spirometry when well, but I believe the same was true of my mum and it is common in bronchiectasis). But I have never needed antibiotics before this bout of pneumonia (I have been given them before but always suspected they were unnecessary and had never previously had a fever related to a chest infection or been ill in that exact way).
Clearly I have some asthma (though I have unusually good peak flow as my baseline and rarely wheeze), given the inflammation that develops from any cold. I have exercise-induced asthma and react to cold air and smoke.
Does anyone know anything about what else is going on (especially why steroids work but not well at low doses)? Particularly, does bronchiectasis sound likely?