When to take emergency pack?

[Misscrisps]

Started with a very sore throat, bad head 12 days ago. Soon turned into a streaming cold. Negative Covid test. For the past 5 days my breathing has been poor, chesty cough, wheezing etc. I've been taking extra blue inhaler and upped my steroid inhaler. Feel awful, lightheaded and breathless. Last night I coughed so much I retched. Question is, I have an unused 5 day course of prednisolone given me 'just in case' when I had covid. Shall I take them?

[Misscrisps]

Decided to start them.

[Troilus in reply to Misscrisps]

You might need some antibiotics as well.

[Poobah]

Morning Misscrisps. It sounds like you don't have an asthma plan, which would help you decide what action to take when you have an asthma flare or attack. I note you've started your steroids, so give your GP a call on Monday so that they know you're taking a course of steroids. They may ask to see you, just to assess the need for antibiotics or other treatmen. But I would ask for an asthma plan so that you're not left wondering what to do in future. Hope you start to feel better soon.

[Misscrisps in reply to Poobah]

Thanks. I will try but they don't take phone calls only eConsult. And when I tried to get an appointment with the asthma nurse a couple of months ago, to discuss a plan, they were only doing phone appointments 😕

[Poobah in reply to Misscrisps]

Wow, that's terrible service and care. My surgery is almost back to normal and I saw a GP last December, over the Christmas period too (same day appointment). Plus this week I had my annual health MOT.

I guess you'll have to use the e-consult to advise you've had to take your emergency steroids but need an asthma plan pronto and maybe a face to face assessment in case antibiotics are required. Stress that you can't risk getting any worse. NB - use a headline in upper case, "UNCONTROLED ASTHMA FLARE" , just to grab attention. And take a screenshot of the e-consult before you send it, just as proof of what information you provided.

But if you do feel worse, take advantage of the 111 Service and they will be able to steer you to emergency out of hours treatment and/or recommend seeing your GP. In my experience, once they recommend a GP appointment, it's guaranteed - I believe they put the recommendation on your digital records.

All the best.

[Misscrisps in reply to Poobah]

Thank you for the advice. Yes I'll try 111 if necessary but I'll certainly do the recommended headline! Hopefully I can grab someone's attention.

[Misscrisps in reply to Poobah]

GP appointment later this morning.

[Poobah in reply to Misscrisps]

Excellent! Good luck. Hope you get over this infection quickly.

[Nerja2012]

Same here misscrips. Breathing problems due to a virus over Bank Holiday so started taking emergency meds Bank Holiday Monday. Saw Doc Tuesday agreed with what I did and on 7 day 40mg course steroids. Coughing for England but no infection. Exasperation of Asthma. You can't afford to hang about. Doc gave me another script to keep for next time. I average twice a year, otherwise Asthma not a problem, pollen a Biggy for me though.

[Misscrisps in reply to Nerja2012]

Thanks for that, I think I've done the right thing. I just hope I can get to see the doc on Monday. Feel better soon.

[Nerja2012 in reply to Misscrisps]

Misscrips . Takes a while for the steroids to kick in, I'm on day 5 and just starting to feel them working but they do, you must have an emergency plan in place with your GP. Weekends away, Bank Holidays etc , it's your safety net until you can can checked over to make sure there's no infection. Take care .

[CasperWalker]

Do you have a peak flow meter at home? That might help you to decide when it is time to “break the emergency glass”.

[Poshcards in reply to CasperWalker]

so what would your peak flow meter have to be for an emergency please? x

[Misscrisps in reply to Poshcards]

See Africanleopards post below. Less than 60% of your best

[Poshcards in reply to Misscrisps]

Thank you, I am fairly new to asthma xx

[Misscrisps in reply to CasperWalker]

Yes, it was down to 250 on Saturday but I'm only usually around 350 so not under 60%. Yesterday I had a high temperature of 38.5 and uncontrolled shivering, followed by vomiting (which unfortunately will have got rid of yesterday's steroids as it was only about an hour after taking them). I must have a chest infection. Done an eConsult this morning.

[hilary39]

I’m with you in coughing so much I retched and having to break into the prednisone. I’ve been in a bad flare for a week and am traveling so that’s prolonging it. Just letting you know you’ve got someone in the same boat reading this message! Take good care and keep us posted.

[Misscrisps in reply to hilary39]

Thank you for the support, I do hope you're somewhat improved now. After an horrendous day Sunday with a high temperature, vomiting and unable to stay awake, I did get an emergency appointment with GP yesterday. Chest infection, so now on antibiotics as well as steroids. Hoping to improve by tomorrow.

[Africanleopard Verified User]

Hi Misscrisps

Sorry to see that you’re having trouble. How soon you need to be seen depends on how bad this attack is. Good that you started your steroid tablets. They should start to work about 6 hours after you started them. If not, you need to be seen urgently to make sure that your asthma is causing your symptoms or if there is something else that needs treatment eg an infection needing an antibiotic.

I’m really worried that you may not be able to contact your surgery by phone - your E-consult note may not be seen and acted on quickly and in my view and experience as a doctor, you should get yourself seen ( A&E if you can’t get to speak to your doctor or an asthma trained nurse if there is one in your practice) urgently if there are any signs of a bad or deteriorating attack.

Clues that you may need urgent care are:

I) not sleeping or waking because of asthma symptoms ( cough, wheeze, breathing trouble)

II) needing your blue inhaler more than every 4 hours - ie if its effect doesn’t last for at least 4 hours

Iii) has the lightheadedness improved? If not get to A&E urgently

Iv) if you have a peak flow meter - are your readings less than 60% of your best ( to calculate 60% of your best - multiply your best reading by 0.6

V) if you are having trouble breathing or if you have chest tightness

Hi) if you have ever had a severe asthma attack

if any of these things are present, either call 999 or get to the nearest A&E and make sure you tell the ambulance call taker or A&E exactly what’s been happening, tell them how much & for how many days you have been taking extra blue inhaler; if you are having breathing trouble or difficulty breathing tell them that as well.

If you are not having any of these problems and you are improving, make sure you see your doctor urgently, and I would suggest ring one of the expert asthma nurses at the Asthma Helpline at Lung&Asthma U.K. while waiting for your appointment.

If you do go to A&E - make sure you get an urgent appointment with your doctor afterwards for a post attack check up to see why you had this attack & if your controller medication needs to be changed. Also as Poobah suggested it’s important to agree a self management plan with your doctor.

Hope this is helpful.

[Misscrisps in reply to Africanleopard]

Thank you for your detailed reply, that was really helpful. Peak flow 250 but only usually 350 ish so not under 60 %. Spent yesterday asleep, literally couldn't wake up, and 38.5 temp and vomiting so probably didn't get benefit of steroids yesterday. Got a GP appointment later this morning.

[Misscrisps in reply to Misscrisps]

I got an emergency GP appointment yesterday. Diagnosis of Chest infection so antibiotics and more steroids. She said I was borderline on sending me to hospital as my pulse rate was 115 and oxometer level fluctuating between 93/92. BP 150 over something (can't remember!). Anyway she took my oxometer reading again later in the consultation and it was steady at 94 so no hospital, thank goodness. Gave me the oxometer and I have to keep an eye on both readings and if pulse goes up or oxygen goes down I've got to head to A&E. So far pretty stable so fingers crossed. Thanks again for your detailed reply which I've screenshotted for future reference.