Can we talk about Asthma?

[IHopeYouStepOnALegoPiece]

I am of course aware of Asthma and always thought I knew how serious it was but I don’t think I really got it, or understood how quickly the situation can deteriorate until I watched a little boy go from running round the park to being blue lighted to hospital yesterday.

So educate me about asthma please. The inhalers, signs of an asthma attack and things to do or not to do.

I don’t need eye rolling about my lack of knowledge, just education!

I didn't know, until I was diagnosed, that you can get it as an adult (I was late 50s) - and that the symptoms are not obvious. I had a persistent sort-of-cough that interfered with speaking. Since being diagnosed and taking the preventative inhaler it's gone. I'm much more aware now of how my breathing actually was affected but I'd got used to it. I use the preventative morning and night, have the blue (ventolin) always with me but only have to use it when I'm in a very polluted area or it's very very cold.

I had to use it more when I commuted up to London. I'm very aware of air quality and pollution levels these days.

My, now adult daughter, is a brittle asthmatic, she goes from fine to really not fine in the blink of an eye, last week she was blue lighted in due to some Christmas trees standing outside a shop she walked past. She has been asthmatic since she was tiny and manages it really well but it still gets her with regularity. She is a silent asthmatic, her lungs shut so much there is no room for a wheeze. When she has an attack she needs those round her to remain calm, help her to sit with a straight back but leaning forward with her elbows propped on her knees (laying down makes it all the more difficult to breathe) and help her to use her inhaler, she has a spacer device that goes with her inhaler and she uses 10 puffs of her inhaler via it until help arrives. Despite her asthma she is a high level competitive swimmer and a triathlete.

Symptoms of an acute attack can be variable, wheezing, unable to catch breath, coughing, cold/blue extremities and lips, nausea. If they have a blue inhaler (usually ventolin) that will open up the airways with each puff (shake vigorously before administering) but seek medical help asap. A spacer is a tube which you can puff the inhaler into and patient breathes the dose in more gently from other end, particularly useful for small children. Patient needs to rest in meantime. However I have an all in one inhaler which acts as preventer as well, not all treatments are the same.

Asthma.org.uk is an excellent resource if you want to know more.

Sorry don't know how to add a clicky link.

My son has asthma which can worsen rapidly. Signs that his asthma is heading into a flare up can be a persistent cough, pale and clammy skin, blueish lips and snoring at night, (he doesn't usually snore so I keep an eye on him and up his use of a preventer for a little while until he calms.) One of his triggers is very cold air or damp weather.

Thank you! This is all new and very helpful information

I was diagnosed with it last winter. I'm late 30s.
I had a cold, with a cough that wouldn't leave. I'm not in great shape, but had a 30 min walk from Waterloo to work. I was usually under a time constraint for home journey so would walk briskly. I found that I was still really struggling to breathe half dead even a few weeks after rest of cold symptoms had gone. I was also perpetually wheezy in sleep.

I now use preventor once a day. Supposed to be twice but I do ok. I have the blue one too, but use it pre-emptively when doing exercise (ie: before swimming when DS has his lesson)

An audible wheeze is the symptom most people associate with asthma, but it isn’t the only one and some people don’t wheeze at all. There are 4 main symptoms - tight chest, shortness of breath, coughing, wheezing- but you don’t necessarily get all 4 of them.

There are different types of inhaler. The blue one is a reliever inhaler and is the one you need in the event of an asthma attack. If someone’s symptoms are getting worse you can give 1 puff every 30-60 seconds until the symptoms improve. If you need to give 10 puffs, then you should call 999. You should repeat the 10 puffs after 15 Minutes if the ambulance hasn’t arrived yet.

Ds is a brittle asthmatic. He also doesn’t wheeze. This has caused us issues even with doctors who believe because there is no wheeze he is fine

In his case he will be very pale and breathless. Coughing is also increasingly becoming an issue.

The best way to tell if he is struggling is to look for the “tugging” at the base of his throat and in his ribs

Imagine having your chest squeezed and not being able to take a full satisfying breath - it’s scary
My son gets Wheezing and coughing at night when it’s less controlled

If someone is having an asthma attack or if it just symptoms getting worse you’ll see them panting blue lips pale skin shoulders hunched
My gp said if you struggle to talk eat or drink then you need emergency help
The patient should sit up and slightly forward maybe leant backward on a chair
Give blue inhaler 2 puffs. You can give inhaler again 5 mins later
If not better then call 999

It’ is scary op People just don’t realise until they’ve seen it

The chair backward not the person that is
They should sit up and forward

A colleague passed away due to an asthma attack years ago, he was found apparently reaching for his inhaler.

I've had it since childhood, again rarely wheezy, mainly cough a lot and struggle to get a full breath in or out, chest tightens so it feels paralysed it's very frightening.

I've only been blue lighted twice. Once with my first attack that led to Dx, once as an adult I'd not had an attack in over a year and stupidly didn't have blue inhaler to hand and local farmer i think changed something they were spraying on crops in field near my house (paramedics also mentioned they'd had a few similar calls in the vicinity) triggered an attack.

Twit that I was instead of calling 999 I called nhs direct (as was) and barely got out my info before they said they were sending an ambulance as they didn't like how I sounded at all. Stayed on phone with me till ambulance got there. I got quite a ticking off for not having inhaler handy - lesson learned.

Last attack I had it was someone vaping set it off, I believe, plus something went wrong with inhaler luckily I was near a boots and the pharmacist was switched on that it doesn't always present as wheezing, as I was just coughing really hard and couldn't stop and couldn't catch my breath. Pharmacist didn't hang about and grabbed an inhaler and brought it to me I had grabbed a chair in pharmacy area. He showed me inhaler and I nodded, 4/5 puffs and I started being able to talk. By coincidence a friend had come in to collect a prescription and she kindly gave me a list to a&e, they popped me on a nebuliser for a whole till they were happy I was sorted.

Dd has it but seemingly less severely, she recovers quite quickly from attacks but I've had to drum into her not to be complacent as it IS a serious condition.

Good on you for finding out more. Certainly I think more people should have 1st aid knowledge generally and some understanding of asthma particularly.

I've come across people in real life who think asthmatics are just "a bit chesty" and that those who've gone into "emergency action" mode when dealing with their own or others attacks are "overreacting" and I have put them straight, the example of my poor colleague (an otherwise fit healthy 30 something father of one) usually brings them up short.

Over 1000 people a year die due to asthma.

Allergic asthmatic here.

Imagine panting for breath, as if you've just run a mile.

But there's no respite. No relief.

You keep panting, like there's not enough air in the world.

Even hospitalised and on a nebuliser or CPAP, it takes a long while to return to normal.

I need treatment with antihistamine doses as well as corticosteroids when I have an 'attack'.

For the most part, you'd never know I had asthma.

Until I'm triggered.

Certain perfumes, some dust, smoke and chemicals can trigger me, as can pollution and pollen in summer.

I take an antihistamine all year round, beclomethazone inhaler twice a day, a nasal inhaler twice a day and carry my blue salbutamol inhaler wherever I go.

Thank you all, it sounds incredibly scary.

I’m extremely first aid trained (every 2y for 10y) but asthma never ever comes up which is quite shocking really

That is shocking, given that three people a day die of an asthma attack in the U.K.

Perhaps they just assume that the person having an attack will be able to deal with it.

I was diagnosed at 38ish after struggling for most of my life with coughs that lingered and an intense hatred of smoke and various chemicals. Fine around animals. My hatred of sports was probably the coughing it brought on but I must say I discovered that swimming really helped (pre diagnosis) till I had ds1. Then it all went to pot.

As far as I can work out it's an immune system over response - inflammation. And everyone has different triggers. Not everyone wheezes; dry coughing is my symptom but I'm so used to it I can often not tune into it.

I'm currently having a reet do with my lungs; I think I need to try a different type of inhaler.

I actually came on to see if anyone could answer this query - if you've got a bad viral cough is it normal / ok for your peak flow to be about 50/60 points lower? (About 90-80%) Ventolin isn't doing anything but I'm not uncontrollably coughing as I do when really asthmatic. Or should it be the same as normal? I'm never sure at what point to go to the Gp. I find I either knee jerk too quickly or carry on regardless (which I did for many years following nhs advice that gps can't help with most coughs and was existing in a near cfs type state). I spoke to asthma uk today who told me to go to the Gp and I'm happy with what we've got planned out but I realise I don't understand that bit.

I also now know there's woeful management/ understanding among staff in schools tbh. As a teacher. Again as they think that wheezing is the symptom.

Can I just add that if you don't have your spacer with you then a makeshift one can be made from a paper drinks cup with a cross cut in the base ( the inhaler fits through the cut) this goes over the mouth and nose and acts as a mask and is very effective. you could also roll a piece of paper to form a cone. This too can act as a mask.
The sitting on a back to front chair is very effective as is raising the arms to open up the ribcage.
I have used the above when I worked in a primary school and I know that they can work very well.

That’s a good question neuro, and one I meant to ask my GP last time I saw her. I took my peak flow when I had a cold a few weeks ago and it was 130 points lower than usual. I really wouldn’t have noticed at all if I hadn’t taken it and I usually know if it’s dropped by about 80.

My GP practice works with computers that give prompts to the doctors and nurses every so often.

Check weight, check blood pressure and in my case, check peak flow.

There is a nurse that has one afternoon a month to take peak flow readings and check all is well and if patients or their relatives need help/education/further referrals and I have a yearly review where the computer automatically generates a letter inviting me.

I understand that this isn't the case with many people.

Basic understanding, the reliever inhalers are not to be used routinely.

Any more than once in a blue moon and you have to make an appointment with the GP as your asthma isn't controlled.

Salbutamol shouldn't be used to control asthma, only the preventer inhalers should be used to do that.

The British Lung Foundation is a useful source of information.

They do Singing for Health groups around the UK.

www.blf.org.uk/support-for-you/singing-for-lung-health

My DD spent her 3rd birthday in hospital due to asthma. She didn’t have an ‘attack’ as such, just seemed a bit subdued and slightly breathless - first time it had happened. It was only when my mum came over and said to get her checked that we did. GP told us to take her to hospital. It frightened the life out of me and I felt so guilty that we hadn’t done anything earlier. Thankfully, her episodes are (were) viral-induced so she doesn’t need inhalers all the time. She’s now 10 and hasn’t had to use them for a while now. She does have eczema though and the two do seem to be linked.

Asthma and eczema can sometimes be linked, especially linked to allergies.

I was dx age 31 ish after swine flu. My chest gets bad if I have a cold or during certain pollen times. The rest of the time I am ok.

Mostly it is just annoying. At the moment it is a nightmare as I’m being investigated for other lung conditions which may have been missed because they were all thinking v about asthma.