Brittle asthma

I have just been and seen a nurse at my new doctors and she has just said it sounds like i have brittle asthma. Could someone please explain this simply. I am guessing it will turn out to be how my asthma is, good one week and completely terrible the next for simply no reaon?

thank you

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Hi there

I have just been diagnosed with brittle asthma, although please don't take what I say as gospel, only a consultant or doctor can tell you that.

Brittle asthma falls in to 2 catagories: Type 1, and Type 2. Broadly speaking, type 1 refers to an asthmatic whose asthma is very severe all the time, that responds poorly to both maintainence and emergency treatment. This can severely limit the patients mobility amongst other things. Type 2 refers to the type of brittle asthma that can seem quite well controlled between episodes, but attacks come on very quickly and can get life-threatening, and these attacks also respond poorly to emergency reliever medication (not just a ventolin inhaler, I'm talking hefty amounts of nebulisers, IV treatments, etc).

Brittle asthma diagnoses usually come after a lot of hospital admissions, various medication trials, and after a referral to a consultant, who will conduct breathing tests, monitor peak flows etc. I am therefore rather concerned that it was a nurse who suggested this to you - nothing against nurses, I am a student nurse myself, but there are specialists higher up the medical hierarchy that are qualified to diagnose this, as it is a huge step for an asthmatic to take, and requires careful monitoring, care plans, and other things.

Also, brittle asthmatics are generally on a lot of medication - you do not say what medication you are on.

I hope this helps a little, and hopefully someone with a little more knowledge will be able to advise you better. if you are in doubt, please ask your GP to consider referring you to a specialist (if you don't already see one). If your GP/specialist does not mention it or see cause for concern, then please do not assume that the worst has happened!

Take care, feel free to PM me if you want

Emz

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Hiya

I have brittle asthma too, there are two different types, Im a type 1 brittle asthmatic...

Type 1 refers to those whose peak flow varies quite dramatically and has more than 25% variability diurnally, this often leads to you feeling fine in the afternoon but by late evening really struggling with very severe and often life threatening symptoms, these asthmatics can respond poorly to oral steroids and often need lots of treatment in order to stabilise their condition. etc etc...

Type 2 refers to asthmatics who on the whole are fairly well controlled but then out of the blue get very severe rapidly worsening and life threatening symptoms...

Both forms of brittle asthma are at the more severe end of the asthma spectrum unfortunatly, which does mean that attacks can and often are severe enough to mean you need first of all hospital treatment and secondly often may need HDU or ICU treatment, this is by no means saying that moderate or mild asthmatics cant sometimes find themselves in these situations too, the major difference between the different types is the lack of response to most treatment procedures and oral steroids, often needing IV aminophylinne, IV salbutamol and mangnesium on top of steroid injections and nebulisers...

Hope this helps plumie and I hope this hasnt freaked you out, when I was first diagnosed it did freak me out and i was always a little scared when i went into hospital, thankfully the drs at the A+E departmant near me know me very well now and automatically treat my asthma quite aggressively to get it stabilized and i know have a home neb which often prevents me needing to get admitted... If you do have concerns speak to your consultant as they're good at answering your questions generally and can quite often put your mind at rest if you are worried..

Hope your well, take care... Xxx

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Just to say that I have found a lot of doctors and nurses at the moment, and in my case consultants as well, seem to be very quick to label asthma that is more difficult to manage as brittle. I had the *privilege* of having a rifle through my notes while I was in hospital a few weeks ago and discovered that several GPs and 3 different respiratory consultants whom I have seen in the past year or so have classed me as brittle. And this label was being used when I wasnt on significant amounts of medication and many classes of drugs hadnt been tried.

Having just come under a new consultant it has been decided that instead of having true brittle asthma, I just have asthma that is 'dificult' and with the right medication regime. And that there are possibly other factors contributing to my asthma as well- at the moment for example we are looking at whether it is possible my asthma is homone sensitive.

So the gist of the message is that many people are describing asthma as brittle, when it doesnt meet the criteria, simply because it is more difficult than normal.

I hope that you have luck finding some answers. And as the others said if you're having trouble getting your asthma under control it is worth asking for a referral to a consultant- preferably one who specialises in asthma as they have access to more tests and more experience to draw upon when dealing with difficult asthma

Em

xxxxx

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Brittle Asthma what is?

I think this rather depends on what doctor/consultant you see! I am currently Difficult, severe and brittle depending on who I see at the time!

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I was labelled type 2 brittle for years until went to RBH now have been relabelled as allergic asthma, meaning I only have severe life threatening adrenaline requiring attacks when in contact with something I am allergic to and that means i'm not a type 2 brittle!

I don't think the label really matters its just a name. After all so called mild asthmatics can have really bad attacks requiring an A+E attendance.Its more important to know how to cope with your day to day symptoms have a good management plan and know when and where to go for help.

I hope that your new doctors and asthma nurse are looking at your treatment so that you can be more stable without bad weeks!