Asthmatic and chest infection

[EllaF1410]

Hi NMs,

Just wanting some advice. Diagnosed Asthmatic of 10 years, but it's always been well
Managed, to the point I'v never really had to take my inhalers.

Had my DD in Sept 2019 and ended up with a really bad case of Pneumonia, that they wanted to admit me for but as a busy mum of two I managed to persuade them to leave me at home under the condition that I went back if I got worse. This took 3 courses of Abs to clear.

Last year I had it again and asthma nurse said that I needed a review and putting a
Asthma plan in place... but this never happened due to Covid.

January, I had a flare up which I believe I caught early and steroids sorted out within 5 days.

Fast forward to Monday and it started again, nighttime cough, wheezy out of breath. Dr prescribed antibiotics and steroids. Spent all last night struggling to breath, wheezing coughing up green mucus, and generally feeling crap!

Dr today said all bloods, ECG and chest X-ray clear and to just keep going with what GP prescribed Wednesday and my inhalers and come back if I got worse. As they thought probably had a mild asthma attack.

Problem is, I'v never had my asthma be this bad before, I don't have a action plan, and I don't know when I need to be making the call to go back?

I'm taking my salbutamol every hour and I'm not wheezing as bad but really coughing.

And I feel absolutely HORRIFIC and my MIL kindly told me I look like death!

I didn't feel this bad when I had pneumonia bad the first time.

Negative Covid test too - any ideas :( don't want to waste their time :(

[AnnaMagnani]

Call back now! Asthma can kill you - taking your salbutamol every hour is not a good sign.

You have very poorly controlled asthma, no management plan and are a high risk patient.

It would be fine to dial 999.

[Floralnomad]

What other inhalers are you now taking on a regular basis aside from the salbutamol

[doctorhamster]

Are you still coughing up green mucous despite the antibiotics?

[Bubnomore]

Would call back ASAP. The guidance we have been given is to go to a&e if using salbutamol every 4 hours or less. With breathing, if ever unsure, best to go and get checked out.

[HarveySchlumpfenburger]

If you are taking your inhaler every hour you need to be seen NOW.

And if you aren't taking a preventer you need to push for them to step you up and give you one. Covid or no Covid.

[EllaF1410]

Good Morning,

Thank you for your replies, I must have fallen into a deep sleep last night catching up from Friday so I'm sorry I didn't reply sooner.

Your right, my asthma is not controlled at all, and I with not having a plan in place I didn't know when I should be making the call.

I realise now I probably should have gone back at tea time last night 🙃

I'v taken my preventive inhaler this morning, and am going to take my steroids and antibiotics shortly. While it's not as bed, yes I am still coughing up green mucus!

I feel a little better now that I'm not wheezing much as I was really scared by that yesterday!

I felt like I was wasting their time if I went back if they said that ECG, Chest X-ray, Bloods and O2 (93%) we're all normal or within a range of being ok. So wasn't sure what more they could do.

I realise I probably sound really uneducated but I'v never really suffered like this before.

Thank you. :)

[AnnaMagnani]

They can do loads more!

If your breathing is worse you should always go back - and sats of 93% isn't normal and I'm surprised you weren't admitted to hospital, or at least given nebulizers.

You can also speak to Asthma UK who are really helpful. Your whole asthma regime sounds wrong if you are having serious problems this often.

Please get checked out today, even if you do feel a bit better given you are still coughing up green mucus and are clearly not right.

[Bubnomore]

Agree, we’ve been told anything below 95% requires a visit to A&E. also, might be worth getting an oximeter to keep at home they are fairly cheap and find that it can be helpful to guide using the 95% threshold. Likewise if your rescue inhaler is really working you’ll see it in the numbers, and it will start to fall again as and whenyou need it again. Anything less than 4 hours and 95% in this time, is our usual indicator to get checked out before it becomes worse and requires more to be done when you get to A&E to stabilise breathing. The only positive thing tends to be when arriving with anything breathing related make it known and you should been seen and triaged pretty quickly.

[GoneCrazy]

I’d say your asthma hasn’t been well controlled it’s more like you’ve had no flare ups.

You need to go back to hospital now I would say for this flare up. But long term you need to be taking your preventer and definitely need an asthma plan.

Don’t leave it please

[ohidoliketobe]

I have nothing to add here except to second that's already been said

• reliever once and hour is not normal, please get yourself seen to if you're ever in thst state again

Without a doubt get this recent instance flagged with your GP and push for a session with the asthma nurse ASAP to get a management plan sorted. Which preventor are you on and do you take it 2 x 2 a day?

• 93% ox is not a good level
• get yourself an at home oximeter - they're less than £20.

[ohidoliketobe]

Opps my bullet points migrated to the end of the post there...!

I have nothing to add here except to second what's already been said

• reliever once and hour is not normal, please get yourself seen to if you're ever in that state again
• 93% ox is not a good level
• get yourself an at home oximeter - they're less than £20

Without a doubt get this recent instance flagged with your GP and push for a session with the asthma nurse ASAP to get a management plan sorted. Which preventor are you on and do you take it 2 x 2 a day?

[Bagelsandbrie]

Are you taking your preventative inhaler everyday, as often as you should? Even when you feel well? Not doing this is one of the main reasons people end up in hospital with asthma.

My asthma was awful from 5-8 and then I stopped taking my inhalers and didn’t need anything else again asthma wise until I was 30! Now it’s back with a vengeance and I’m on Seretide 250 and steroids regularly. Asthma can kill you, suddenly. You have to take it really seriously and get help and take your inhalers.

[EllaF1410]

Thank you for all your messages of advice it's greatly appreciated.

It's only this last 18months Iv suffered so it's all fairly knew to me, and looking over your comments it doesn't look like my GPS have been that great and providing me with all the info I need for a situation like this.

I feel a lot better to what I have done now, and I'v only taken my salbutamol twice today once at 8.30am and again at 1.

I take my preventer every day and have done since my first episode 18months ago but before that I didn't I must admit.

If I'm feeling better and stay like this for the afternoon I might just go to my GP tomorrow but any exasperation and I will be sure to go straight to A&E xx

[AnnaMagnani]

I'm so glad you are feeling better today - I would book an appointment with your surgery's asthma nurse ASAP.

You need a written asthma plan and you may also need a stronger preventer than you are on at the moment as you are getting such frequent flare ups.

I've found advice from my GP Asthma nurse has been really good but usually I have to go looking for it.