To go to A&E about hayfever problems

[peachesandpears3]

Please don’t judge me for this!

I’ve had horrendous hayfever over the last few days. I can tolerate the eye watering and itching but what is really making me struggle is the symptoms in my chest. Hayfever usually makes me a bit chesty but this feels more severe this year.

it’s like a tight feeling and it sounds husky/whispery when I breath. But I CAN still breath, it just feels challenging and I have to open my mouth really wide and use my shoulders to get as deep a breath as possible.

I have asthma but was only diagnosed with it a few years ago so it’s still all relatively new to me. But this is how my attacks and flare ups usually feel. Im on 4 puffs of luforbec everyday which usually keeps it bay. I also a use a spacer for it. I have my blue inhaler but until recently I rarely used it because the luforbec was controlling it. But I’ve had to use my blue inhaler so much over the last few days especially tonight. It seems to help slightly but then the symptoms start again.

but I don’t know what to do- this is still all new to me and I’ve never had a ‘flare up’ like this. When do you go and get help for it? Or do I just keep taking my blue inhaler intermittently to keep the symptoms at bay and go to the GP tomorrow. If my blue inhaler wasn’t helping I would obviously go to a&e but it is helping which makes me think a&e isnt appropriate, I’m just unsure as I’m having to take it a lot for it to work and then it wears off and I have to use it again. But it’s the hayfever causing this so would it be unreasonable to go to a&e for this? I don’t want to be a timewaster and if I was having an attack and my inhaler wasn’t working I would know to go to a&e but because it’s hayfever causing it I’m really unsure!

I’ve been on fexofenadine for the last 2 weeks too which has been the most effective AH I’ve found so far

any advice would be gratefully received 👍🏻

Shit- I didn’t realise it was possible to overuse an inhaler! This is all still relatively new to me and I’m finding my feet but I hadn’t actually realised that.

I had an asthma appointment with the nurse around 6 months ago but I dont remember being told anything about using it too much or what would be too much for me, she just said if it isn’t working then to go to a&e but because it was working last night that’s where the doubts about what to do crept in. She also said if I ever have a cold that goes on for longer than normal or affects my breathing to call them as I might need antibiotics and chest infections can be worse for asthmatics. This definitely isn’t a cold or chest infection but that’s the only advice I was told about getting in contact etc x

You wouldn’t be going for hayfever, you’d be going for asthma, what’s aggravating your asthma is largely irrelevant in deciding whether to go or not.

What does it say in your asthma plan @ApplesInTheSunshine ?

As a minimum you need to see your asthma nurse / GP as your asthma clearly isn't being well managed at present. If it gets worse, go to A&E though. That's what your asthma plan will tell you to do in these circumstances.

Sorry this is daft but where would I see my asthma plan? I was only given my inhalers and told how often to take it and told to use my spacer but I wasn’t given anything to take away with me (apart from the prescription) x

Have you spoken to your gp, op?

Get an asthma review with your practise nurse, and ask about guidelines for when to seek help.

My asthma is well managed. My plan says 2 puffs blue inhaler 10 mins apart > if no improvement A&E or ambulance if deteriorating. Your earlier description sounds like you would have hit my limit?

As a rule of thumb, if asthma is waking you at night it is not controlled and you need a GP or asthma nurse appointment.

People die from asthma.

They should have given you your asthma plan, ask your gp for it.

Im usually seen by the clinical pharmacist for my asthmA but don’t know how other surgeries work.

Asthma review with GP practise nurse will develop a plan for you.

They should give you a hard copy of your asthma plan and have gone through it with you. Recommend you make an appt to see your asthma nurse asap and say your asthma isn't being managed and it's urgent you see her for a review. And in the meantime go to A&E if you have breathing difficulties that aren't easily resolved by your blue inhaler.

You need to look at your specific instructions on managing youth asthma.

This poster hits the nail on the head:

That will depend on the individual care plan she has. Ds can have up to 10 puffs every 4 hours before we need to consider getting medical attention. Every asthmatic should have a personal care plan in place.

What matters is whether the OP is effectively using her care plan to relieve symptoms, whether she's following it and it isn't working, or whether she doesn't have one for some reason.

also if you feel your blue inhaler isn’t working, take 10 puffs in a row, with a minute between them, and go to a&e/call 999, whichever will get you seen soonest

Right thanks everyone, definitely need to get a plan. I had a review 6 months ago where we went over how often I’m using it and did I feel it was helping, how often was I using my blue inhaler, was I waking during the night etc. I’ve heard of peak flows but we’ve never done that etc because they said I didn’t need to- I was diagnosed by being wheezy and struggling to breath and the doctor listened to my chest and said it was asthma. So they said no need for peak flows etc. But at the review we didn’t really go over things like when to go to a&e other than if the blue inhaler isn’t working. I definitely didn’t get a hard copy of anything either

Salbutamol is pretty safe, actually

hmm.

was it an asthma nurse or the gp who saw you?

@peachesandpears3 are you able to call your GP surgery, explain it is urgent as asthma related? They might be able to squeeze you.

When my DS was diagnosed (after years of, it's probably a chest infection) we felt just as you do- a little bit lost and no one really had a chance to explain things in detail. I would try and book an appointment for asthma review too (once you've been seen for current issue).

As previous poster mentioned, you can take 10 puffs, but if you're at that stage you should also call nhs/999.
We had this twice, called nhs direct and they always sent an ambulance as they started breathing difficulty is an emergency.

Hope you feel better soon.

@ApplesInTheSunshine That isn't true. When my daughter's asthma is bad the consultant has approved up to six puffs as long as it lasts four hours before seeking a&e (but we always see GP next day if it gets to this, as sometimes she needs oral steroids)

OP you should still try to see your GP even if you're feeling better

Your allergies are exacerbating your asthma, of course you need attention. My son ended up in respiratory distress due to bad hayfever/virus combo.

Sorry, should say squeeze you in- not squeeze you 🫤

Gosh this worries me a bit, I have quite bad asthma that's worse with hay fever. I don't think it sounds like you have a proper care plan? You should know how many puffs you can have etc so I really think you should ring the GP straight away and tell the receptionist what happened and that you're going to need an appointment at least by tomorrow. Its quite scary when you're struggling to breathe and new to it so I hope you're feeling ok now.

I was about halfway through reading the thread when I was thinking, you need an asthma plan; that would have meant you'd have known that you should go to A&E rather than wondering if it was wrong to do so. I hope you can get a review very soon and get a proper plan in place. It may well be that you will need more treatment through your hayfever season that could step down later - but then have a plan for when to start it again next year before it gets bad.

I think a lot of people are having a tough time with asthma at the moment, who are usually fine. To anyone else reading this thread - if you need your blue inhaler acutely, use it. But if you need a lot and then more quite soon, arrange to get to A&E (or maybe urgent care) as soon as possible.

If you’re struggling to breathe, then yes. At this hospital, we’ve been told A&E numbers / admissions are right up at the moment in both children and adults due to hay fever/asthma. Must be particularly bad at the moment.

It was my GP who originally saw me and diagnosed me and then I had my first asthma review when the nurse at the same GP practice and I was told we will have these appointments every year

thanks all for the advice - going to phone the GP surgery right now to ask if there any specific details on my file about how often I can safely use the blue inhaler and what the plan details are!

Also it may be worth giving asthma UK helpline a call as they can give you advice

@ApplesInTheSunshine that is incorrect and very dangerous advice.
Salbutamol..the drug in the blue inhaler can be and should be used to relieve symptoms. A rescue dose is 10 puffs via a spacer..this is now recommended over nebulizers.
Most asthma plans suggest 4-6 puffs four hurly for acute situations but obviously not long term.

OP...are you maximizing your hayfever treatment?
Firstly anti histamines every day, max doses. Did you know it's now ok to take more than once a Day?
Eye drops containing antihistamine..
Nasal spray

Wash face and hands after being outside,wear sunglasses outside,keep curtains closed all day, especially in bedrooms.

And ring gp surgery and ask to speak to the asthma nurse...you might need an combined inhaler for the hayfever season

Just as a FYI - my colleagues in A & E reported that 80 % of the patients they have seen in the past week have been severe hayfever with/out exacerbation of asthma.