Severe allergic asthma

[okkjh]

Hi guys I just did my a levels and in September I went on a trip to Switzerland and when I came back I had this terrible cough. I was prescribed antibiotics and pred. Later that day I had an asthma attack and was admitted to a and e. I spent 24 hrs in resus as I was extremely short of breath and was kept in hospital for 5 days. After 2 weeks of rest I returned to skl and by the end of the day my cough was back. I went to the gp the next day who took 1 listen to my Chest and immediately gave me a nebuliser at the gp then sent me to a and e. After another 4 day stay in hospital I had another asthma attack in November but was fine after 1 nebuliser and sent home. In December I went to my gp again with the cough and chest tightness and yet again he sent me to a and e and I was kept under observation for 48 hours. Since September I have attended a and e 10 times with asthma attacks treated with prednisolne and salbutamol and ibuprofen nebulisers. I have been switched form clenil 100 to fostair, but that caused tachycardia and tremors. Then to flutiform 125. Then to flutiform 250 which caused muscle cramps, headaches and tremors. To relvar elipta and now onto trimbow. I tried montelukast which caused severe insomnia. And spiriva gave me blood in my mucus and jitteriness. I have had nearly 15 courses of pred since September and am just fed up. This cough is still ongoing and I hv a flare up just about every 2 weeks. My gp just gives me pred now as he says I don't know what to do as I am running out of options. My peak flows are at best 450 and are usually around 380 or 360 on the daily. My spirometry is normal. I have high igg Aspergillus but my consultant says I don't meet the criteria for ABPA. I also hv high ige of over 1200. I get chest tightness at times even as I'm writing this now but it's not excessive. I always feel I am breathing really fast and am genuinely exhausted. This has causes me to miss 3 of my a level exams as well as I had an asthma attack just b4 I entered the exam hall and had to get wheelchaired out the scho and straight to A and E yet again. Even the consultant has said he's run out of options of what to do and has referred me to guys for consideration of biological agents for my severe asthma. I still have difficulty sleeping as the cough is always disrupting my sleep. I have many allergies especially grade 3 to grass and a grade 6 allergy to house dust mite. I also have chronic headaches but I am allergic to all the medication and nsaids such as ibuprofen so he says there is nothing he can do. Thank you for making it to the end ans plz share any experience or advice I would be eternally grateful as I hv no options now..

[Jamesd1234]

I’m really sorry to hear you have had such a stressful time. I can relate with severe allergic asthma , but not quite as bad as yours. It sounds like you are doing all the right things but keep pushing for biologic treatments, which seems to have been a game changer for people on here who have very bad asthma. There are some that target the allergic kind.

in the meantime , it might be good to try and find out what your triggers are. Get yourself a steroid nasal spray prescription , lots of antihistamines, an air purifier and maybe change of bedding to target dust mites. For me personally I’ve found that layering on stress makes my asthma even worse, so trying to remain calm (which is hard when you’re sleep deprived).

I also take 500mg quercetin / turmeric Curcumin extract with extra vitamin d3/ omega 3 supplements alongside asthma medication, and drink 2 litres of water a day to help with mucus removal. A PPI medication is also beneficial if you are known to have acid reflux that can also affect asthma and post nasal drip. I would try to discuss all of this with your gp if you haven’t already.

It sounds like you meet all the criteria for biologics , so definitely try to push for that. Remember your health is priority. Try not to worry too much about exams and career stuff which you have plenty of time in the future to re-take and focus on when you’re feeling better. Speaking with your school about that might help ease some of those worries.

I hope you make some progress soon

[Jamesd1234 in reply to Jamesd1234]

P.s , I would also reccomend joining the asthma community forum too which seems a lot more active and has plenty of asthma experts on there too

[okkjh in reply to Jamesd1234]

Thanks for the reply. I've heard alot about biological agents and they can be a real game changer. I hv so many triggers hay-fever, perfumes, fumes, smoke, cold weather pretty much any asthma trigger I have it. I hv been given a steroids nasal spray that I used for 5 months. I didn't have any nasal symptoms so the Dr said to only use it when I do. To be honest I didn't see any improvement when using it. I take fexofenadine twice a day due to my many allergies and severe hay fever. I'm still waiting on an appointment letter for the severe asthma clinic at guys and St Thomas even after being referred nearly 3 weeks ago.

[Jamesd1234 in reply to okkjh]

Sorry to hear that . I know these things can take time. You could always try phoning the hospital to ask what the waiting time is and be asked to be put on a last min cancellation list and also see if your gp can write to them to help speed up the process. Good luck

[okkjh]

I have finally received my referral letter and my appointment which is supposed to be urgent is at the end of September. I Don't know how I'm going to cope the next few months

[strongmouse]

Hi, you've had a really tough time of it.

Definitely get a hepa air filter for indoors. I have multiple allergies and chemical sensitivities and asthma, but they developed over time, not in as short a time span as you've had. The hepa air filter takes out pollens and moulds from the air and helps to reduce your 'load'. You can buy them relatively cheaply online. You can also get air filters which remove chemicals. There is information about this on Healthy House explaining the different types - healthy-house.co.uk/air-pur.... I don't usually buy from them though as there are cheaper alternatives elsewhere on-line. Or you can take a look at the information on the MCS website - mcs-aware.org/wp-content/up...

Depending on what you can afford I'd get one for your bedroom, preferably one with a sleep mode that is quiet at night - make sure to put it on at least an hour or two before you go to bed, and one for during the day in the main room you use.

Many doctors don't understand chemical sensitivities and have little experience of it. It is improving. I found it useful to do a 'clean up of my house' that is check the chemicals being used and ensure none have perfumes or any of the other chemicals I react to. The same for everyday toiletries. It is amazing how many products contain perfume. I avoid any items with VOCs - volatile organic chemicals. Many new items take time to 'off-gas'. You won't be able to make the changes all at once rather over time. As well as information about allergies you might want to take a look at Multiple Chemical Sensitivities (MCS) or TILT (toxicant-induced loss of tolerance).

I found it useful to use a nasal wash such as Neilmed, at least twice a day - morning and evening, as it washes out any residual pollen, dust etc. from your nasal passages. It is possible to bring down the levels of your exposure to allergens and other things you react to, and give your body space to improve. Two years ago I went to a private clinic to start low dose immunotherapy for moulds and pollens and this year I've reacted far less than normal. It isn't a quick fix and I wouldn't suggest starting while your asthma is still bad. You are not alone in reacting to environmental triggers.

Wishing you well, and do let us know how you are doing.

[okkjh in reply to strongmouse]

Hi I have humidifiers and lots of mini air filters around my house. I'm glad the immunotherapy worked for you. I got my appointment letter which was supposed to be urgent but it's in September. Even this morning my chest suddenly started feeling tight so I had to take 4 puffs of the blue. And then the leg and hand tremors started as well as my heart rate increasing but I was fine the rest of the day. Its been a while since I've had to go to a and e touch wood. I think my cough is starting to come back now a bit. Also the warm weather and pollen gives me chest tightness and an itchy nose. I'm going on holiday for a few days as I'm turning 18 in a few days so I hope all goes well. I wish could afford to receive treatment privately cos the strain on my body is too much. Even the last week I keep getting this sudden chest pain for like 30 seconds. Hope all is well.

[strongmouse]

Hi okkjh, first I hope that you have a good birthday.

It is important that the air filters are HEPA ones in order to remove pollens and moulds. Maybe the air filters are helping if you've avoided a visit to A and E. Asthma can occur without having an allergy, but minimising any possible allergy triggers will help.

The preventer inhaler can have side effects such as you've described. I've heard that some people find different types of salbutamol are better for them than others, but I've no experience of it. Maybe speak to your GP?

It is so hard having to wait for an urgent referral for so long, but good that you will be seeing a specialist. As James1234 said it may be worth joining the Asthma forum here on Health Unlocked, I found it really helpful when I first developed asthma. It is difficult learning to live with any new health issue and I'm glad it is a little better. Unfortunately the pollen levels are higher on warm sunny days, like today.

I would definitely phone the hospital to see if they could offer you a cancellation appointment if one comes up, as long as you have the means to get there at short notice.

All the best.

[strongmouse]

Forgot to say that there is a National Centre for Aspergillosis which has information about the range of aspergillosis related asthma, which you might found helpful in discussion with consultant, if you're not already aware of it - mft.nhs.uk/wythenshawe/serv...