which should I consider is the worst

which is worse, Richard getting an infection, or his breathing getting worse with no visible signs of infection. When I ask him he says he feels "rough and exhausted" but his sputem is not too dark and he doesn't have a temperature. Considering it's a bank holiday the usual venues are out, ie calling dr, respiratory nurse etc. Shoul I make him take the anti biotics we always have in 'stock', or will that be worse. Can anyone help? thanks in anticipaton.

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  • Could be the start of infection though, I would take mine, rather be safe than sorry and let it get a hold. Val

  • hello amagran :)

    Sorry to hear your hubby is feeling this way. His breathing difficulties may not be due to infection so I wouldn't suggest starting the antibiotics just yet, especially if there's no raised temperature and the sputum isn't changing colour significantly.

    I used to feel the way he's feeling now and my health professionals finally, after several months of taking stabs in the dark, diagnosed that I was a CO2 retainer. I felt exactly the way that he's feeling now. Is he sleeping a lot ? Do you have difficulty waking him ? and when he does wake does he seem confused ?

    After my diagnosis I was given a BiPAP machine to wear at night and am amazed at the difference it makes to my breathing and general well being. Unfortunately the best way of diagnosing this is an arterial blood sample, so no use to you over the Bank Holiday I'm afraid :(

    I do hope he's feeling better soon :)

  • he sleeps most of the day and night, and yes deeply, I went out to the shop other day and came in he didn't even flinch, banged about in the kitchen and he still didnt wake. When he did and saw me there it worried him that he'd slept so deep.

  • Has Richard always slept as deeply as this or is it since his breathing problems began ? Have you discussed this with your gp or the respiratory specialist, and has he ever had an arterial blood gas sample taken ?

    If the answer's no, then I would suggest you arrange to see your gp and discuss your concerns, sooner rather than later. :)

  • Hi amagran

    Sorry to hear Richard is feeling poorly. I hesitate to give advice because I only have straight forward copd, so have no experience of the fibrosis side of things or what regimen he may / may not be on . I only know that an 'exacerbation' for copd does not necessarily have to include infection. If we have no sign of infection but have increased breathing difficulty we are told to first up our 'rescue inhaler' usage, and then if that fails to help, start the Prednisone (steroids). If things then continue to worsen its time to call the doc. We only take the anti bio's if we suspect infection (eg sputum colour change).

    I think you are doing the right thing monitoring his temperature and any sputum, and of course you now have the added advantage of the pulse ox to monitor his sats. Obviously if there is a serious drop in his resting 02 levels, or rise in pulse rate, temperature etc you would know to do something more. I hope it will turn out to be just one of those rough days, but feel sure that knowing him as you do, you are the one best placed to judge the situation. I guess all any of us can do is to be sensible but vigilant and if in doubt always err on the side of caution. Sorry I can't offer anything more definite, Best wishes to you both, Parvati. x

  • Hi amagran

    It could be unrelated to emphy / copd, there is a virus going around. Sometimes people automatically think is lung related but its not always.

    There is always NHS Direct to get some answers:

    nhsdirect.nhs.uk/

    Have to say I felt rough when I got up this morning and my breathing is more difficult than usual and I am feeling tired but I don't feel I have an infection, today I just think I am having one of those off days, also the weather affects me and the low air pressure has been awful for me today with headache an all.

    If symptoms are really bad ie very difficult breathing, coughing more an increase in production of mucus or mucus has change colour, walking more difficult, slower than usual, etc etc I would likely take the anti-bios, but I wouldn't with just one or two of those symptoms alone unless they were extremes on the norm.

    Maybe a paracetamol and a lie down may be a good starter. If things do deteriorate further then do reconsider.

  • PS just read the sleeping part, Richard sleeping day and night, as elian says those symptoms are worth checking with the doctor, it may be a number of things, blood oxygen, diabetes or something else entirely, but that amount of sleeping does need to be looked into.

  • thanks all

  • No wonder you call him rip van winkle luv, all the above comments sound good and will give you food for thought. See, ur only aloud to be ill Monday to Friday, 9 til 5.30pm!! My dad rang up to request oxygen yesterday to be told it was full and he would have to wait til Wednesday! As if innit. After a lengthy phone call they sent a delivery this morning but he will probably run out by then so he will have to ring the emergency number. If they answer!

    See how hubby goes before giving him the antibiotics...........but you know him and you know if summits not rite so don't hesitate to ring NHS Direct for advice or go to Out of Hours.

    Thinking of you both xx

  • I hate days when my breathing gets bad and I struggle, with no obvious reason for that to happen. Only last week I struggled for two days as I was far worse than usual. My first thought was I had an infection coming on so was tempted to reach for my stock of prednisolone and antibiotics. But I hate taking these at a whim so as in the past, held off. I did not have a temperature, my pulse was not racing, I had no temperature. All would give me an indication of an infection setting in. I held off on the second bad breathing day but promised if I was still the same on day three I would take the meds. I woke up on day three to one of those breathing days that can ony be described as remarkable. I was not only much better, but better than usual. And that lasted two days. No reason. I did not do anything, just one of those unexplained things that happen with copd. If hubbies temperature rises, sputum changes, pulse starts racing then start the meds. If hubbies breathing gets very bad, visit to doctor or if a weekend or bank holiday, visit to hospital. But, and this is personal with me, try not to take the meds at the first sign of worse than usual breathing. What might help and I find mine a great help is a nebuliser. Worth buying one and getting the capsules from the doctor. You then have everything you need for home treatement. I only use mine when my breathing is worse than usual or when having an exacerbation. But for me, mine is priceless.

  • thankyou stitch, after reading this article I have decided that unless he improves a lot overnight I am taking him to a and e tomorrow to be checked out. He is very down about it and I think he realises he's not right, but as usual he always says he's ok, which I have stopped listening to. In he table 8 list of criteria he meets quite a few of them, enough to warrant a visit to a and e, again, thanks.

  • With all due respect to the OP,if you are worried by any symptoms why not just call the Ambulance.

    They don't always want to whisk people off to hospital,and can very often do some checks in the home and give advice as to the seriousness of the patient.

    At least then you will have peace of mind,as you say,bank holiday weekends are notorious for things happening,so don't think you are on your own,if you call NHS Direct they would probably tell you the same.

    Alan

  • Hello Val,

    I don't get how you are allowed to have antibiotics in stock.

    I may be knowledgeable on that position but, it i a fact that many people ue antibiotics incorrectly, namely they do not take the full course, which is not just a danger to the individual but lad to antibiotics becoming useless in the long-run s the bacterias they are supposed to combat gradually become resistant.

    This is why antibiotic should never be over-prescribed, they should not because they are supposed to be for cases of emergency, and people grow resistant to them too if they use them often: they stop working on them.

    I thought that antibiotics were prescribed, for a course and then after that one would need a new prescription for them.

    I suppose I must be all wrong about this, as you say you keep them in stock.

    The way you say you keep them in stock makes me think you might use them a few days when you think they are necessary but you do not (I mean your husband) follow the full course.

    a) Does your husband follow a full course of antibiotics

    or

    b) does he just have a few here and there according to no particular scheme?

    If the answer is b), I think that is a very bad practice and it will not help him.

    So many people have been using antibiotics incorrectly, like not taking them as prescribed up until the last does that these antibiotics have become useless.

  • Hi John

    In UK many patients with COPD especially those that are subject to repetitive lung infection are prescribed both antibiotics and steroids for emergency situations to keep in the home. Usually the doctor does issue a patient advice leaflet on when (at what point to take the medicine) and how (ie dose etc)

    I always have a reserve in during the Christmas period myself but whenever I can I always try and get checked first before embarking on the course of medication/s.

    Some people are prescribed a maintenance dose (lower dose) to be taken daily and in addition when they get an exacerbation or lung infection the are prescribed a course to be taken until finished, this is usually a much stronger dose than their maintenance dose.

    Just the way things are done in UK. Of course I am not entirely sure if amagran is in UK.

  • Hello Tjohn, I have antibiotics and steroids at home all the time 2 lots I take are for maintenance as 1) I have no spleen - very little resistance to infection! 2) I have reoccurring infections all the time that knock me off my feet as they are so bad! These have been prescribed by my consultants I am not irresponsible - not taking correctly simple fact is if I have an infection I can barely walk around the house. I was talking about myself not my husband!

    So if I get an infection the antibiotics can be started straight away not hours down the line or the next day - waiting for an appointment.

    I have worked in care and nursing for 30 years I do know what I am doing Val

  • both my GP and my Consultant constantly remind me to have my emergency Anti biotics and steroids at home for use when required. This is the norm for COPD patients.

    Its sods law that if an infection is going to start it will be over the weekend or bank holidays and when i go on holiday i always make sure i have both with me just in case, fortunately on the last 3 holidays,

    Tjohn your remarks are irresponsible and can cause confusion for already concerned and confused patients and family,

    QUOTE

    I thought that antibiotics were prescribed, for a course and then after that one would need a new prescription for them.

    I suppose I must be all wrong about this, as you say you keep them in stock.

    The way you say you keep them in stock makes me think you might use them a few days when you think they are necessary but you do not (I mean your husband) follow the full course.

    a) Does your husband follow a full course of antibiotics

    or

    b) does he just have a few here and there according to no particular scheme?

    If the answer is b), I think that is a very bad practice and it will not help him.

    So many people have been using antibiotics incorrectly, like not taking them as prescribed up until the last does that these antibiotics have become useless.

    a) COPD is painful, distressing and depressing so a sufferer will do anything to clear up the current exasparation - as adults i believe we have realised that when it states to "take the full course" we do so, we are not stupid

    b) are you aware of the medical history of any of the patients on here? our GPs and consultants who prescribe the antibiotics do so to enable us to live our lives as comfortably as possible and i think it is very irresponsible to insinuate that to prescribe medication for emergency use is " bad practice and it will not help him. "

    You have stated you are on only 1 medication for your COPD, whereas most of us will be on several inhalers and tablets indicating we suffer incredibly.

    Can i suggest before making comments such as the above you do not assume that because your doctor does not do it for you that every one elses doctor are using "bad practice" which will cause fear amongst those in genuine pain and suffering.

  • Nothing of the ort like that ctually, that is in your mind, my concern was that perhaps people were taking things without being on a course of it, it i not or was not an accusation, that's your interpretation, I said I don't know, so I guess I'm wondering what your problem is, perhaps that you yourself do not understand things

  • Hello Val,

    I'm sorry I'm only writing now, after a few days, I can't always locate where certain blogs are.

    I mean that I am unknowledgeable on these things, so, as is clear now, I didn't know about how that is, for some people, such as yourself. Excuse me for muddling you up with your husband, I thought it was about him.

    I get it now a little.

    What I was concerned about though, is a real thing, I mean correct concern, obviously not in your case or any like it, but the misuse of antibiotics with other illnesses is leading greatly to the diminished effect of those medicines, they are becoming resistant, sometimes fully, and different bacterias are better t mutating, so i was wondering what was going on when I heard the word in stock.

    Glad you understood what I was talking about, and, as you was in medicine yourself for o long then at least we do not need to worry about you having any bad effect on the situation. Many people take a few doses then do not run through the entire course giving the bacterias the chance to become resistant.

    Just read about situation in places such as Russia and Asia where, like in Russia then apparently lots of homes do stock antibiotic and dish them out for things themselves where those receiving have no doctor's orders at all.

    I was actually relieved to hear what was what with your situation as I am pretty ignorant on what people receive with COPD and extremes of lung diseases, etc.

    I hope you are feeling better.

    John

  • Thank you John I do feel a little better Val

  • no, he always takes the full course of doxycycline, the consultant said he was happy for him to take them when needed but to see the gp asap and get another prescription.

  • I see, thanks for the info Stitch and Zoee,

    I guess you both comprehended what I meant and the fact that I was in no way intending to be accusative; if concerned, ask questions, which I did.

    Surely one can ask how things are and then get answers which I have received, and then find out how it is, instead of have someone such as Krazylady trying to turn a thing into something that it is not and then in that way using it as a way to get on my case.

    Anyway, to further my enquiries, Val, Stitch & Zoee, is it then the case that if an exacerbation starts and the medication, antibiotics, are already in the house, that one then takes these for a set time?

    like no less than one week?

    I know nothing of all of this, so I don't find it pleasant getting my head bitten of by certain people when trying to learn.

    As I said, the misuse of antibiotics is leading to resistance, as bacteria mutates,

    So that misuse by some, not here then in Val's case but by people in the world, means that everyone ends up with no medicine when needed, as it stops working, this is now the case with venereal disease, the bacteria is very good at latching onto bits of DNA..

    A point I'd like to make is that it is all well and good people copying and pasting bits from other people's texts that are right there (here in this case) for the reading in full and in the original form anyhow, without any need for reproduction, additionally, it isn't always as clever to copy and paste as some people seem tothink it is as the context is lost and then what is left over may appear to be entirely different to the meaning of the original, perhaps that simply is the intention with some individuals when copying and pasting, to misconstrue, I cannot say but I suspect that sometimes it is.

    Looking again at what you wrote Krazylady I don't think you understood a lot of my post, I asked a) and b) but do not need a sanctimonious lecture from you, thank you very much indeed.

    I also did not ask you.

  • Hi amagran - how is Richard doing today? Hope is feeling a little better and not a little worse.

  • gonna take a trip to a nd e unless he improves overnight, play safe methinks.

  • Amagram

    Sounds a good idea and one I have followed over te last few years. Luckily I was kept in once overnight and one occasion went home after I had been stabilised. On both occasions I was not showing symptoms of infection, just unable to breath much and sats plummeted, given prednisalone and nebulised and felt tons better afterwards.

    Good luck with A&E, will put both your minds at rest

    Mulie

  • Well thanks all for the advice, he says he feels a lot better this morning so won't go to a and e, do I believe him? well I have to he's a grown man and I can't physically drag him there, our son came and talked to him and he thinks he is ok for now and to leave it for today. The trouble is if I made him go and they said it was nothing, it would be even harder to get him to go next time, so I don't want to force that scenario. So again, thanks.

  • Welcome to the roller coaster, ups and downs, nothing to be flapping over ?

    hope so

  • Amagran,

    I know exactly how he feels, i am feeling exactly the same for the past week, tomorrow is the last day of my antis and i got 4 days of steroids left, although i am not so sleepy all the time i am still snoring well during the day. fortunately my doctors are really good so i will give them a ring weds morning and get them to squeeze me in.

    i hope he feels better soon, nothing worse when the weather is so nice and you just want to sleep xxxxx

    K

  • Hi - I know exactly how you feel! I would love to give you a definitive answer but have just learned overtime sometimes my husbands breathing is worse for no apparent reason. Over the bank holiday he has been really very short of breath and sitting watching TV most of the day (so not like him) and he is coughing more. So I sit and watch and watch and worry - the next couple of days will tell which way it will go. Sometimes he just returns to normal with no apparent cause - though the weather has changed so much recently that this colder snap could be the cause. I find it really stressful to be honest and it has taken me a couple of years to try to accept that sometimes he will be worse. I am not sure he realises the other symptoms - suddenly the pillows become very uncomfortable, he snores more, has more headaches and becomes a little irritable. Good luck TAD xx

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