Any experience of this? : I am male, 3... - Asthma Community ...

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Any experience of this?

I am male, 34 yrs old with no history of asthma or allergies.

I have been ill since Sept 21 having mix of cold/sinus symptoms and both dry and wet cough mainly during the evenings and night since coming back from the Middle East (military). I had my COVID booster jab 22 Dec 21 then that week my symptoms got worse I was wheezing and coughing badly at night. I brought a peak flow meter from amazon and checked my peak flow when congested which measured 450 (my predicted 640).

I informed my GP who had me complete 2 weeks of worth peak flows and using Fostair 100/6 2 puffs twice daily which my peak flow improved to within 5% of my personal best/predicted (treatment by trial). My best score is 660 which I achieved once, most readings are 630-650. Fostair inhaler seemed to make my breathing tight on the inhale but I had high peak flows....

Two nights ago, I woke up with shortness of breath 1am. I checked my peak flow which was high near best score and I was advised by 111 to go to A&E. I got checked over at A&E and discharged with no abnormality found. My bloods, ecg and chest x-ray was normal. I have been waking up with increased acid reflux due to haitus hernia (i take 20mg omperazole daily). It seemed my asthma medication was causing increased acid reflux.

When I was discharged, my GP told me to stop taking Fostair 100/6 two puffs twice daily and double my omperazole to 40mg daily and continue with my peak flow readings (change of medication trial).

It has been 2 days since stopping my Fostair and my peak flows have been within 5% of my best score/predicted and my throat tightness on the inhale seem to be better.

Does the above sound similar to any of your experiences?

I am been medically investigated for cough and shortness of breath 4 months, foreign travel to Middle East.

14 Replies

Tricky to assess you say they did bloods were the eosinophils high or or your white blood cells these are inflammatory markers and your platelets were they all really normal no elevations? The acid reflux is definitely an issue acid reflux can make asthma worse and asthma can make acid reflux worse they go hand in hand. The acid can cause throat irritation, postnasal drip and hoarseness, as well as recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis/ pneumonia. A chest xray won't show up asthma. I would push ahead to get the acid reflux sorted asap as this is only going to exasperate your breathlessness more.

in reply to PeakyBlinder50

thank you for your post. Ive been taking 20mg omperazole for the last 13 years and unsure if my acid reflux (hernia got bigger?) has got worse.

I have just checked my A&E discharge papers and my blood tests were full blood count, liver function test and plasma c reactive protein - all within the correct parameters. ECG and chest x-ray - no abnormality detected.

In Oct/Nov, I was prescribed steroid nasal spray for suspected viral sinus infection, Nov/Dec, I was prescribed antibiotics for suspected bacterial sinus infection and Dec/Jan I was prescribed combination inhaler, steriod nasal spray and peak flow meter.

Mid Jan, I was prescribed Nystan oral suspension because the GP saw a small white patch right on the back of my throat (same side where my left nostril has been partially blocked). The GP was not sure if it was oral thrush, post-nasal drip.

I am been suffering from mainly a blocked nose (sometimes runny) since Sept.

I have been running high intensity outside in the cold high with a blocked nose and noticed my peak flow has dropped by 20% 10 mins after stopping exercise then increasing up. I am not sure if me feeling ill, blocked nose, high intensity and cold air in mouth has dropped my peak flow.

Today, my symptoms are partial congested nose with a peak flow of 650 having as directed been off my fostair. My predicted is 640 and best score is 660.

PeakyBlinder50 profile image
PeakyBlinder50 in reply to

Post nasal drip I also have and I find it harder to manage than my asthma. I only was diagnosed with late onset eosinophilic asthma in 2017 just came out of the blue no reason I'm also fit, slim, middle age no indication why it turned up. I am also battling a sinus problem which I think is linked to the post nasal drip I try to manage on my second sinus infection now. Running outside could be irritating your airways I don't know where you live in terms of irritants, particulates but I wouldn't run outside where I live. Smoke and dust outside if you are running and breathing in large quantities of air will irritate your airways. I can't breathe properly with my nose congested. You should see someone if your sinus issues continue it's much harder to breathe with a blocked nose so this could be an issue you need to resolve. Sinus rinses and I use Nasonex for my Post Nasal Drip are good.

I am based in Portsmouth. I dont understand why I have had these symptoms so long since Sept. In the middle east the temp is 50 odd degrees outside and inside with AC 18-25 degrees. I am not sure if the change in temperature has messed up my sinuses.

For my nose, I have been using saline spray 3 times a day and mometasone furoate steroid spray two puffs each nostril once a day.

I have just measured my peak flow 48 hours since being off the combination inhaler and its 650 but I feel head congested again......

It has been frustrating for me because Ive had these mixed cold/sinus symptoms for 4 months now and I am desperate to know whats wrong.

Poobah profile image
Poobah in reply to

I'm sure you're using your nasal sprays properly, but just in case, this short film by an ENT specialist is very useful, especially when it's not helpful swallowing the spray as this can cause other problems.

Are you able to tolerate aspirin? A long shot I know, but it's not as uncommon as people think, developing an intolerance to aspirin in adulthood and the symptoms include sinus problems.

I know how miserable it can be having long term blocked sinuses, but I persevered with the nasal sprays and avoided things that aggravated it. I'm now clear and only use a nasal spray if I catch a cold. The important thing is to avoid over the counter decongestants as these cause untold problems if used for more than a few days.

in reply to Poobah

Thanks for your post. I cant remember the last time I took aspirin, normally its paracetamol. Its a nightmare because most of my GP appointments are by telephone not face to face.

My next telephone appointment is next week and I can provide 7 days of peak flows since being directed to stop asthma medication (Fostair). Since stopping two days ago, my peak flows have been within 5% of my personal best of 660.

In total, 18 days of Fostair with peak flows within 5% of personal best 660. So far 2 days since stopping Fostair, peak flows are still within 5%.

Poobah profile image
Poobah in reply to

If the blood tests didn't pick up raised eosinophils or IgE (inflammatory markers) and your peak flow is staying up near your personal best, the GP may conclude that the acid reflux combined with the nasal drip could be the source of the irritation that is affecting your breathing rather than asthma.

Anything that affects your quality of life is a miserable thing and trying to resolve it can be frustrating when there's no definitive cause and satisfactory treatment.

If your hiatus hernia has resulted in your stomach pushing up into the chest cavity then that alone will create breathing problems, despite good peak flow results. Surgery will be considered if other treatments fail to resolve the issue.

When you do talk to your doctor next week, definitely say what your expectations are and if you're unable to accept being left to put up with residual symptoms and ask where do we go from here? Puts the ball firmly in their court. Good luck.

in reply to Poobah

My apologies, quick question would taking Fostair affect my blood tests in regards to raised eosinophils or IgE (inflammatory markers)? Or doeosinophils or IgE (inflammatory markers) always stay high?

I am still waking up with acid reflux having been increased to 40mg of omperazole daily. I will have to take gavison before bed.

I have received good info on this post, ready for next weeks appointment.

Poobah profile image
Poobah in reply to

If you were only on Fostair for a short time I don't think it would affect blood counts much, whereas steroid tablets would, as they are systemic. Having said that, I have non-eosinophilic asthma, so my counts are low. My IgE though are raised regardless of my steroid inhaler.

There are lung function tests and a specialist would look at all the results in the round, together with your symptoms, in order to reach a conclusion.

Asthma has more than one phenotype but treatment is pretty much standard, the combination inhaler, such as Fostair, is the main plank of treatment, with additional meds for severe and/or difficult to control asthma.

Asthmatics can have high peak flow results yet still experience breathlessness. So ideally other tests are needed rather than relying on peak flow alone.

Reflux is definitely a trigger for breathing symptoms so apart from prescription meds, trying to sleep with your bed or pillows raised can help lessen the reflux. Diet also plays a part so keeping a diary of symptoms and food can help pinpoint foods that make things worse. It's a vicious circle as the medication reduces the acid needed for digestion so it takes longer. It has been suggested that smaller meals taken more often can help. Smoking and being overweight are also contributing factors, making reflux worse.

in reply to Poobah

I have been researching Laryngopharyngeal reflux (LPR) which is a combination of sinus, gerd and asthma symptoms. Acid reflux from the stomach reaches the sinuses, and gets into the lungs.

My peak flow is 660 this morning having been combination inhaler for 3 days. I have been taking omperazole 40mg as directed by GP but also gavison after meals and before bed but gavison only lasts 3-4 hrs at a time....

The other night at 1am, I might of been having a choking fit due to LPR hence my visist to A&E. The doctors looked at me like was mad when my stats were normal.

Poobah profile image
Poobah in reply to

You won't be the first patient with good peak flow results in A&E, this forum is full of evidence of folk who are discharged as AOK as they have no wheeze etc. Unfortunately, if you don't present with classic symptoms then the breathlessness &/or choking is in your mind - and it will depend on who you get to see in A&E.If you haven't spoken with an Asthma UK nurse yet, then I recommend you do so. They're very helpful and for someone newly experiencing a range of symptoms it can be beneficial to discuss things with them, especially after your A&E experience. 0300 222 5800, Monday-Friday, 9am-5pm.

Hello. Hope things are improving for you.

I have silent reflux leading to a choking cough, sometimes bad in the middle of the night. Can go to wheeze. Also sinus problems, post nasal drip, phlegm, blocked nose and persistent cough. On occasion congestion showing on chest X-ray.

I was given Fostair (currently 100/6) four years ago and this helped relieve my cough and choking fits in the night. Also Avamys nose spray.

I have been trying to tackle the reflux problem. Recently, since avoiding butter, cheese, fatty spreads and oils (daytime as well as near bedtime) I have noticed an improvement. I guess this may not work for everyone but some foods may contribute to the reflux leading to these problems.

update - I had a telephone appointment with my GP who told me to continue with peak flow diary without taking combo inhaler. I have been referred for another camera down my throat 10 years after my last one.

My peak flows have been within 5% of my best/predicted for the past 10 days. But I have noticed that when blowing into my meter, my first blow is always lower and the next two blows are higher. I am guessing the first blow is clearing the airways?

Quick update - My peak flows have been within 8% of my personal best of 660 (predicted 640) for 3 weeks without asthma medication.

My peak flow dropped once post exercise to 500 which is 27% drop. The exercise was one hour of 5 a side football in a freezing sports hall. Two days before I did my bleep fitness test indoors and achieved a high score with no drop in peak flow.

Last Thursday, I noticed my peak flow had reduces to 570 which is a 15% drop and I had cold symptoms. By Monday, I tested positve for COVID.

I was advised by my GP to recontinue with Fostair to recover from COVID then start again on my peak flows without asthma medication.

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