adult onset asthma

[Clarella]

Can this start / be triggered by a virus/ bacterial infection?

I've had abs and steroids now but there's still an odd wheeze. Not sure how long to let it rattle on. Became ill 2 months ago and GP said "small patch of pneumonia". A colleague was quite concerned as her asthma was adult onset and symptoms seemed similar.

[LaContessaDiPlump]

I write research articles on this topic (asthma) for a living! Go and see the GP, explain your symptoms and specifically ask them if your practice has an asthma nurse. The asthma nurse will be much more clued up than your GP on this topic and will be able to advise you more fully.

FWIW I think that yes, it does sound like adult onset asthma. There are lots of studies coming out now supporting the benefits of early-stage asthma treatment - treating early really improves patient outcomes in the long run, even if you don't feel like it's affecting you much. I'd get checked soon as possible if I were you.

[Clarella]

Fuck.

Thank you.

I must say I'm prone to the most appalling coughs. But never had this kind of wheezing and fluid production. before.

It IS better after 3 days of steroids and I feel good. But I can just get this little wheeze.

I guess it could still be settling down? It was definitely a bacterial thing followed by viral as my ears were sore too.

I'm guessing it's a long process to diagnose though as I'm getting completely clear days? Ie I make a dr app and nothing's there to hear?

[Clarella]

I suppose my question is really though can this sort of asthmatic reaction be temporary rather than a permanent change? GP said some viruses can cause an asthmatic response but not that I have asthma.

Every doc I've seen has asked in I have asthma but assumed just stock question. A chest X-ray was clear though things got worse after that.

[Clarella]

Sorry another question.

I'm really noticing (and did all over Xmas) that I feel drowsy. Then start coughing. Then wheezy . Then seem to clear the fluid.

Defiantly had the drowsy thing this morning before wheeze. All gone now and I feel fine again.

I don't want to be ott but this has gone on for 5 weeks.

[LaContessaDiPlump]

Hmmm... it could be temporary, but maybe not. The inflammation process is a major trigger for asthma, so I wouldn't be surprised if it ends up being permanent (sorry). However, as I said, if you start treatment early then it really helps.

Given the list of symptoms you've provided and their duration, I definitely think you need to see a GP. The nature of asthma is that there are often symptom-free days, so you're not being precious! The danger is that people ignore their symptoms for far too long because of that, and then end up being a lot harder to treat. Don't be a statistic

[Clarella]

Thanks lacontessa, basically not unreasonable to check it out.

Arse!

[LaContessaDiPlump]

Yeah, sorry - it's a pain, I know!

Good luck

[Clarella]

I had asked for a blue inhaler on advice from a nurse friend and did noticed over Xmas that if I used it at first tickle cough it did really help.

[Clarella]

(Worst drip feed ever sorry)

[LaContessaDiPlump]

Don't worry.... I think the blue inhalers are reliever medication. They only treat the symptoms of bronchoconstriction and don't have any impact on the root cause. You may need to progress to the next treatment stage, which is inhaled corticosteroids with/without a long-acting bronchodilator. That will help to treat the actual condition rather than just dealing with the symptoms.

[Clarella]

Argh all wheezing and fluid is back.

Not quite as painful but very noisy.

I guess I need to check with GP again.

[LaContessaDiPlump]

Yes, I think you definitely need to go! I know it's easy to put these things off but seriously, people do die of poorly-controlled asthma (over 1200 of them in 2014). PLEASE go visit your GP as soon as you can.

[Clarella]

Yes I am tomorrow. Thank you for your advice.

Because sometimes I'm fine I'm finding it difficult to judge - how much this is affecting me.

I've been using the blue inhaler more frequently and noticed a difference. If anything the drowsiness is less if I use it when I start to feel like that or chest tightens.

I guess it's either a) stupidly horrid stubborn virus which needs more time to go. b) start of an asthmatic pattern. Either way I'll need a sick note for next week and further advice / medication.

The problem is; I've been thinking about the coughs I've had over the last 3 years since ds was born. Very brutal and tough to shift, and I'm physically noticeably weaker for some time afterwards. I just assumed bad viruses / two infections now plus I've had some thyroid medication issues. I didn't know about the impact of asthmatic symptoms on muscles and general fatigue. I got to CFS levels after a combo of illness, thyroid medication messing and trying to do too much/ be brave and carry on. I'm just starting to wonder if this has been an additional issue at times.

[LaContessaDiPlump]

That's the trouble with asthma - sometimes you're ok, sometimes not. I've read a lot of studies showing that people with asthma consistently underestimate their symptoms and their level of disease control, so you're not alone.

It does sound like you could have had mild asthma for quite a while, really. Here's a link to the GINA website and some info for patients: www.ginasthma.org/Patients

It is a bit simplistic in places but you might find it interesting. If you've got any sort of medical background then you may prefer the physicians' guide here.

If you have experienced defined asthma symptoms then make sure you tell the GP - and don't minimise it as 'I may just be worrying needlessly' either. You may benefit from charting symptoms as you notice them before you go to the GP actually - you could be surprised at their frequency.

[Clarella]

Lacontessa - spot on! Wheezing at 3am woke me up, inhaler helped a bit but not great.

This morning I had some coughing and wheezing but feel fine - and already minimising/ feeling guilty about GP appt!

I had decided to quickly write it down before appt in 20 mins.

[Clarella]

GP measured peak flow, the best I could get was 350 which he said on age and height should be 480.

There was a tiny wheeze; I've been set off badly coughing by having to light the fire today due to dead boiler. (Error!) but even trying to do the flow thing set me off.

He's given me a 5 day course of steroids and I'm to get peak flow checked afterwards so I have an appt next Monday. But at the moment still working on the premise it's a very bad virus. My chest was so clear on the steroids he's ruled out any other infection at the mo. He did say the swine flu thing caused lots of similar reactions a few years ago.

Thanks for your advice lacountessa

[LaContessaDiPlump]

I'm glad you got checked good luck with the steroid course and feel free to PM me if you want about how it works out! I'd like to know :)

[maggiso]

Glad you have seen your GP and are being monitored. I thought I would tell you that my DH developed asthma symptoms as an adult after getting a particularly nasty chest infection/pneumonia, but after a year of using puffers, his airways calmed down and eventually he came off treatment - at least for now. He is still monitored but no longer on preventative therapy - so you never know!

[Clarella]

Thanks maggiso, very helpful and reassuring!

I've since looked at the peak flow thing again and my number should have really been 440 (he might have said that) but really closer to 430 from chart. It says in top corner -85 is within normal limits for women which means 350 is only 5 off really? I did think I was fit cardiovascular wise as don't get too out of puff if I jog or skip or swim (I don't think any way). I
Used to though.

[Clarella]

Thanks la contessa - I was very nervous last week about taking them. Not so much now, esp as i know I will get relief!

Will do.

Regarding the peak flow I asked a potentially silly question but it made logical sense at the time - I have a very narrow frame; my chest and waist are just narrow. A friend is same height but her back and rib width are just much wider in comparison.

I proposed (maybe stupidly) that I
Just have a lower lung capacity therefore less puff? Therefore 350 could be my normal? Quickly retracted when GP looked puzzled!

[LaContessaDiPlump]

I think you made a reasonable statement. We're not all the same shape/size, so a smaller peak reading may be normal for you. The trouble is that we never do these measurements when we're healthy so have no frame of reference!

Peak flow measurement just defines how quickly you breath out and how constricted your airways seem (see [[https://www.asthma.org.uk/advice/diagnosis/tests/ here]).v I don't think it's impacted by cardiovascular fitness.

I'd just take the drugs and see if your peak flow has improved when you go back. If it has improved then that may be a sign you need regular medication to maintain that level of airway opening; if it hasn't improved but you feel better then that may just be your 'normal' value.

[Sidge]

Peak flow is a rough reckoner, and one or two readings don't really tell you much - it's better to see a pattern of peak flow readings over time and at different times of the day. Ideally you should have spirometry with reversibility to diagnose asthma, however you'll need to wait 6-8 weeks after a course of steroids to do that as the steroids will mask the true picture.

A bit about spirometry here

Sometimes people do get persistent wheeze following a significant chest infection, it doesn't necessarily mean you have asthma but repeated chest infections and other symptoms such as cough, wheeze, chest tightness and shortness of breath on exertion even when you are well are all signs that asthma is a possibility.

Try and make an appointment with your surgery's asthma nurse (if there is one) or see a GP with a special interest in asthma.

[Natsku]

I got adult onset asthma after having the flu a few years ago, noticed that after every cold after that I would have a bad cough for months, was diagnosed as asthma after two weeks peak flow monitoring (before and after steroid inhaler morning and evening)

Another possibility is illness related asthma which my OH has. So whenever he has a repository infection he gets asthma symptoms and needs to take the steroid and reliever inhalers for a few weeks and then is back to normal until the next illness.

[Clarella]

Ok, thank you all for your experiences.

I'm just feeling a bit cheeky asking to see the asthma nurse? Ie self diagnosing? Obv after next week. It's a different GP I've booked to see so we will see what she says. I'll make sure I ask her I'd like to check there is nothing going on. I did say to GP today's symptoms feel very familiar when I have a lingering cough.

I'm thinking from gps comments he was suggesting I might have a bit of illness related asthma natsku, hence to keep a blue inhaler in the house for when I have a bad cough.

[Clarella]

I seem to have come down with another cold which might be why chest flared. Steroids clearly helping but not completely now. I'm going to see GP tomorrow as the same patch of chest has been cracking for 4 weeks now. I just want to be bloody well and be able to sleep flat!