Asthma...... what can the GP do?

[insan1tyscartching]

Adult son has asthma, it came on suddenly this time last year at the time he was admitted to hospital with a severe asthma attack. It has been a year of ups and downs, he's had repeated chest infections and changes of inhalers to keep on top of the symptoms.
For the last month or so the asthma is getting progressively worse. He's had a course of antibiotics for a chest infection and an xray that we are waiting for the results of. It's a fortnight now that he hasn't been able to leave the house unless going by car door to door. Any exertion leaves him struggling to breathe and we are talking about a strong and physically fit young man usually. At the weekend he couldn't hammer in a tac without needing his inhaler repeatedly.
He went back to the GP yesterday who ordered blood tests and she prescribed antihistamines even though they have never made any difference when prescribed them previously and the one taken yesterday made no difference as usual.
He has lung function tests ordered and they will take place next month.
Surely something has to be done? He hasn't been able to work or socialise now for a fortnight, he can't sleep at night because he can't catch his breath laid down.
Understandably he's fed up and I'm anxious because I fear he's heading for a massive asthmas attack again. He was only blowing 80 on admission last year and had sats of 80% so it was serious.
The GP advised him to keep using the inhalers (symbicort and ventolin) which he is many times every day and night but they are barely keeping it stable much less treating it.
Any advice please?

[lljkk]

Most asthmatics have individual triggers. Cats, pets, dust, certain chemicals, etc. are common ones but not the full list at all.
Have you tried removing certain things to see what he's most sensitive to in his environment.

Are you sure he's not got another infection brewing right now?

[insan1tyscartching]

He could have I suppose as it's two days since he finished the antibiotics and what generally happens is that it takes two, three and sometimes four courses before it clears. He has anti allergy bedding, I make sure he keeps things well vaccumed and damp dusts daily. He knows whiskey will aggravate his chest but hasn't drunk any alcohol in ages (probably last New Year). We have a hypoallergenic dog because dd has a severe allergy to animals and he doesn't trigger her so don't think it can be the dog and the dog pre dates the asthma. No cats and nothing really makes him noticeably worse he just seems to slowly decline either leading up to a chest infection or taking a long time to get over one.
I think the weather is a possible trigger he was much better in the summer and cold, damp and fog all make him worse but it's not as if we can do anything about the weather.

[Hydradela]

I have adult onset asthma and it took years to get the medication right. I am now on symbicort and take montelukast tablets at night.

I am not medically qualified but I would be unhappy with the lukewarm response by the GP. Asthma can be extremely serious and he sounds very ill with it. Can he get a second opinion?

[EmmaGellerGreen]

Has he had prednisone steroids? They have worked for me in the past. I would firmly request an urgent referral to a specialist. Said as someone who came pretty close to dying of asthma.

[TheGreenNinja]

My fil has adult-onset asthma and his regular treatment is steroids, antibiotics, nebuliser (at home), montelukast and ventolin. Reliever inhalers should only really be needed as a last resort. If he needs it regularly to get through the day, I'd be going to a&we if your GP doesn't take it seriously.
Oh also a handy thing to have sometimes is a pulse oximeter to measure blood oxygen at home.

[insan1tyscartching]

He had had a course of steroids when he came out of hospital but none since. I was furious yesterday because the GP seems to be dismissing how bad it is just now. He told her that he can't do anything, he's using the inhalers numerous times a day far more than the recommended dose. The antihistamines don't do anything not least because I'm not certain it's down to allergy.
He is a strong muscular young man and usually incredibly fit. When he was admitted to hospital they thought the machines were wrong because in spite of low sats and low resps he was still able to walk into hospital yet now he can't walk from home to the GP's which is five minutes away. I think because he looks reasonably fit and well she's underestimating how ill he is.
She's wrote on the blood test slip he has a chesty cough but he's not coughing at all to be honest it's more his chest is so tight he can't breathe. I've told him I will go with him on Wednesday and I'll ask for him to be referred. It's bizarre really as usually she is very quick to send to hospital tbh.

[giraffesCantDoThat]

Gp sounds crap.

Maybe needs new inhaler. There are loads to try flixotide seretide or spiriva

Monteloukast or pred

[TheGreenNinja]

If he can't walk five minutes to your Gps and the inhalers are not working well enough, I'd go to a&e today. Don't underestimate asthma. My DD has been hospitalised several times with asthma attacks and the first time we had no idea she was bad enough to be in hospital. she was happy and chatting. But her blood oxygen was very low and the GP called an ambulance as soon as we saw him.

[insan1tyscartching]

I'll encourage him (drive him there) to go to A&E today. I'm feeling anxious when I haven't heard from him for a few hours now that's how bad it is.

[insan1tyscartching]

Well he's been admitted, had nebulisers, going to get steroids, possibly more antibiotics after another xray and to see the respiratory people tomorrow. A&E doctor quite shocked that GP hadn't sent him to hospital yesterday as he said the inhalers aren't going to sort it now and it was only a matter of time before he ended up in a full blown asthma attack.
Feel relieved now and will sleep better knowing he's getting treated.

[TheGreenNinja]

I'm so relieved to read your update, glad you got him to go. Astonished the gp didn't send him sooner. We've been told the same thing about the inhalers, if they don't provide proper relief for at least an hour or two, they aren't going to, and you need more intervention.

[Hydradela]

Also glad to see your update and glad he is getting the treatment he needs

[hellhasnofurylikeahungrywoman]

Symbicort and Ventolin are not enough to keep asthma like his at bay. Is there an asthma nurse at the GP surgery he can see?

[giraffesCantDoThat]

Asthma uk are always great for advice too.