To ask if/when an adult should seek medical treatment?

[y0rkier0se]

I’d really appreciate any medical professional’s views. I have chronic asthma which has been under control (I.e no hospital admissions) for around 4 Years. I sometimes have to have courses of prednisolone or antibiotics as I get a lot of chest infections. I have prednisolone at home to self treat (prescribed by consultant). Last night, I had a sore throat and was coughing up gunk and was tight chested, so I took six prednisolone. I had an awful night - all the side effects of Pred (head ache, mood swings, ringing in ears, waking up sweating then freezing). Today I haven’t taken any more pred due to the side effects but have used sore throat spray, inhalers and paracetamol to manage symptoms. Tonight I feel even worse, freezing and shivering despite having heating on top whack, heater on, fluffy pjs and two quilts. My AIBU is should I wait this out and hope it improves? I don’t want to go to the doctors if it’s just a cold - I have had the flu jab and have been able to walk around today so I don’t think it’s flu. (It’s probably relevant that two years ago, I had a bout of sepsis in my throat that really knocked me off my feet - doctors treated with antibiotics but I was very poorly).

Given your history a call to 111 wouldn't be unwarranted

Do you have an out of hours doctor service you could call for some advice given your history, particularly with sepsis? Or NHS direct as an alternative maybe? Does sound quite flu like but knowing how horrible chest infections/flu can be for an asthmatic it's probably worth getting an opinion from a medically qualified person. Hope you feel better soon x

Ring 111, chronic asthmatics shouldn’t take any risks! Hope you feel better soon

Thanks for your advice, in my experience of 111 as soon as you mention respiratory problems with a history of asthma they want to send an ambulance and I could really do without spending 4+ hours in A&E on a Saturday night . We do have an out of hours doctors service but I’ve never used them - my chest has eased a lot so i’m not having breathing problems any more it’s more the shivering but being very warm I’m concerned about? x

What's your peak flow like? What does your asthma treatment plan say you should be taking and doing right now?

Shivering but being hot is typical of a virus. What's your temperature?

Check your peak flow is the best way to know what is happening with your asthma.

Sounds like a temperature. Take your temperature and then if it's up get it down with paracetamol.

And yes check your peak flow.

Peak flow is 370 which is slightly dipped, I normally average about 400. Temp is 38.8 x

That sort of dip on my peak flow means I need to start using my brown inhaler, how about you?
Agree that paracetamol to bring down your temperature sounds like a plan.
In your situation i probably wouldn't be seeking medical attention unless my breathing deteriorated in which case I'd call 999 and get the paramedics to come out and nebulise me.

My brown inhaler is used twice daily anyway and I can up to 4 times daily if needed, and take up to ten puffs of salbutamol every hour. Thanks for the advice Barbarian - I’ve never been one to seek medically attention really but the sepsis shook me and this is the first time I’ve felt properly ill (not just chesty) since then x

Sepsis must have been terrifying. Are you clear on the symptoms to look out for? Certainly if you start experiencing anything like those you should seek urgent medical attention.

10 puffs of salbutamol every hour? I was told if I needed 10 puffs it's the equivalent of being on a nebuliser but I should really go to A&E if that bad. I'm an allergic asthmatic so only need salbutamol after a reaction, but I did feel very tight chested after a recent bout of flu and was coughing up (or trying to) gunk. I had a very rattly chest and ended up at the gp after 9 days as it wasn't getting better. Was prescribed antibiotics for potential chest infection but I was much better the next day so didn't use them. If I were you I would absolutely get checked out.

Keep checking your peak flow if it dips to 350 you need medical attention according to my asthma plan. My last thorough check at clinic last month was 410.

If you can’t get your temperature down with paracetamol to below 38 I would seek medical advice. Likewise if it spikes over 39 get immediate medical attention as that is when organs etc... become affected.
It sounds like a nasty cold/flu virus but with your history of chronic asthma I would get advice from the out of hours GP. If you ring 111 you can request a GP calls you back rather than just speaking to someone who goes through a check list. Feel better soon

There have been some horrid bugs going round this winter so please do take care of yourself, I know a few people hospitalised with the flu and chest infections. I agree with keeping an eye on your temperature after some paracetamol, but if you continue needing increased asthma medication I would get checked out to be on the safe side. Walk in centres normally have nebulisers and can send you to a+e if necessary

You need medical advice - you are asthmatic, under consultant care, regularly need pred, peak flow dropped, pyrexial and feel crap.

All red flags that this can't wait. And having had the flu jab doesn't guarantee this isn't the flu.

Please ring 111 now, you need to see a doctor. You may need antibiotics or Tamiflu + to have the whole course of your steroids.

You are high risk for flu and to be most effective Tamiflu should be started as soon as possible.

Out of hours is my suggestion. Hope you feel better soon.

Febuable, my DS’s asthma plan is that he is to take 10 puffs of salbutamol per hour if he has a cold. OP’s might be the same?
It sounds like you have a nasty cold OP. If you become short of breath, absolutely seek medical attention ASAP. You would be triaged as a high priority as we assess by A: Airway, B: Breathing, C: Circulation and so on so you trigger high.
High temperature and shivering (rigors) are indicators of sepsis. Please have a look at the sepsis 6.
Hope you feel better soon.

Hi, sorry I fell asleep, temp is now 103.8 so partner is currently phoning 111. Thanks for all your help x

For reference another time, I would have thought the purpose of "rescue medication" at home was to enable you to start treatment right away, but not to "avoid" seeing a doctor. So, if you need to start your emergency pred / antibiotic supply, do so, but get an urgent GP appointment the very next day. Unless worse in which case A&E.

Hope you can get yourself seen soon, and get well soon. Good luck with sorting out a clearer plan of all the steps to take in future when necessary.

Hope you're ok yorkie, I'm glad you're getting medical help as I would have said definitely go and see someone. You can't mess about with asthma

Hope you are felling better soon.

I don't think Shivering = rigors... I've had rigors & I've had shivering. They aren't the same.

That's a high fever for an adult, OP. Hope you are feeling much better, now.

Hope you're OK OP.

It is true that 111 offer you an ambulance because this always happens to DH. He just says 'it isn't that bad please can I be seen in out of hours' and they have never insisted.