The last ten days have been very stressful for my husband suffering with a chest infection, seriously heavy headcold and severe copd – and not forgetting me (the carer!!)!! Having come through it I though I would recall some of the details and some information maybe of help to others that are suffering.
He started about two and half weeks ago with what appeared to be a straightforward chest infection – more breathless, coughing green sputum. Started the emergency abs and steroids – all seemed well and four days later he was recovering. Two days later at the end of the course, out of the blue he began sneezing – extreme sneezing which was the beginning. We had about 2 hours sleep Friday night – coughing, sneezing, breathless – out came the neb and we used that every couple of hours. Over the weekend the symptoms became worse – I rang the Doctor got another course of abs and steroids and we started again. This time though the side effects from the steroids were dreadful – he could hardly hold a cup of tea because of the shaking and had become very irritable. Worse than those – were the panic attacks that started as he began to cough. So frightening – for the him, for me and for the children.
Wednesday night was the worst night and I called my sister who is a nurse and asked her to come and have a look at him just to advise whether we should be going to the hospital. She arrived talked meds and sats – and we agreed that he was Ok to stay at home. I also rang the respiratory team for advise about increasing meds and was told that in an acute situation – we could increase the salbutomol in the nebuliser as much as necessary but not continuously! to keep the breathlessness under control (on the premise that if he was taken to hospital they would give salbutomol back to back 4 of 5 times) Actually he was only needing it about once an hour every 2/3 3 hours during the night. He was going to sleep but waking up coughing and coughing.
So I began to monitor his sats, check his recovery time, check that he was not breathless just sat in the chair which gave me the confidence to continue. His sats are usually 93 to 95 and even after the worst panic attack dipped to 91 but then recovered. This was really useful for me – never mind my husband – it gave me a plan!
Having come off the steroids and talking through the panic attacks – they eased. And slowly things have got better. He did find though the saline in the neb was not particularly effective and seemed to make the mucous more sticky and more difficult to cough. He also found that using the spacer with the ventolin inhaler was really effective – sometimes more than the neb.
The most effective thing was the vicks nose “sticker upper” to clear his sinuses. The respiratory team are also writing to the doctor to suggest he is prescribed carbocysteine – last time we were recommended this our doctor refused to prescribe it, they wont this time! Also she suggested that after one course of antibiotics that the doctor change them and after a third course that we should be asking they take sputum samples. Also that the respiratory team can fast track us to a chest consultant if infections didn’t clear up or his breathlessness seemed continuously worse. AND he has been referred again for pulmonary rehab.
ALSO not to increase the Spiriva inhaler ever - it works by attaching itself to receptors and once full they are full. Therefore you will only increase the side effects if you take it more than once a day. AND if you have an asthma element you can increase the symbicort inhaler using the SMART regime.
I am not for one minute suggesting that any of this information is gospel or is the way for you but thought that some of the information may be useful. I found that I was searching this site for useful tips in the middle of the night!
With love TAD xx
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