Steroids for asthma/ long covid

[BG2015]

I'm asthmatic, usually well controlled. Had covid in March and have struggled with breathlessness ever since. I've had 2 courses of prednisolone since March which have given me a bit of normality for about 4-5 weeks then I'm back to square one and struggle to go up the stairs without gasping afterwards.

I'm due to see the asthma nurse tomorrow and want to ask for steroids again but I only had my last course in September.

How often can you have them?

Have you had your inhaled dose increased?

Yes I was told if my peak flow began to drop (which is has from 420 to 190) to increase my Fostair and have a puff at 12pm & 4pm as well as the 2 usual puffs morning and night. I've actually been doing 2 puffs at 12 & 4 and it makes absolutely no difference.
.

I've been doing the extra puffs religiously for a week now.

I had steroids prescribed again. Within 24 hours I could breathe and my peak flow has gone from 190 on Wednesday afternoon, to 310 tonight (Friday).

190 is very low. I've never gone that low. 310 is as low as I've got with a bad cold. My friend took up tennis her 350 increased to 500. Swimming is very good for expanding your lungs as well.

Have you checked your oxygen levels after going up stairs?

One way to check what happens to your oxygen levels on exertion is to do a sit to stand test where you sit on a chair without any armrests, put your hands on your hips and then stand up and sit down again as many times in 1 minute as you can and record that number. Write down your oxygen saturation sitting down before you start (this should be 94 or above before you try this) and then afterwards. If your oxygen levels drop by 3% or more then you should be referred to hospital for further assessment.

Have they considered doing a referral to the Long Covid Service to access the respiratory services under their umbrella? They should also do a chest x-ray as part of this referral.

My DH had a pulmonary embolism after Covid pneumonia which caused breathlessness and this is not uncommon after even a 'mild' Covid infection, so make sure they refer you if you are struggling.

My peak flow was the same around 6 months after Covid (190 before starting inhalers) and I did desaturate on exertion. I also struggled going up and down stairs. Nearly 2 years on I am so much better, but my chest is still weaker and I still need an inhalers (did not have asthma or inhalers pre Covid). There are a lot of respiratory viruses around at the moment and I am finding I am having to use my inhaler more too anytime I catch anything.

What also helped me over time was doing breathing exercises for breathing pattern disorder and a lung exerciser with 3 balls (incentive spirometer).

www.physiotherapyforbpd.org.uk/

<a class="break-all" href="https://www.google.com/url?sa=t&source=web&rct=j&url=covidgpportal.hiowccgpartnership.nhs.uk/index.php%3Foption%3Dcom_docman%26view%3Ddownload%26alias%3D1624-sit-to-stand-test%26category_slug%3Dcovid-resources%26Itemid%3D369&ved=2ahUKEwiehJLXzJX7AhXSQkEAHV54DW4QFnoECAoQAQ&usg=AOvVaw0c912YEUBcVzSCmH0CRSN3" rel="nofollow" target="_blank">Sit to stand test instructions

Sit to stand test link (not sure why it did that 😵‍💫)

<a class="break-all" href="https://www.google.com/url?sa=t&source=web&rct=j&url=covidgpportal.hiowccgpartnership.nhs.uk/index.php%3Foption%3Dcom_docman%26view%3Ddownload%26alias%3D1624-sit-to-stand-test%26category_slug%3Dcovid-resources%26Itemid%3D369&ved=2ahUKEwjZrdDg0JX7AhUXRsAKHbSwAuEQFnoECAoQAQ&usg=AOvVaw0c912YEUBcVzSCmH0CRSN3" rel="nofollow" target="_blank">www.google.com/url?sa=t&source=web&rct=j&url=covidgpportal.hiowccgpartnership.nhs.uk/index.php%3Foption%3Dcom_docman%26view%3Ddownload%26alias%3D1624-sit-to-stand-test%26category_slug%3Dcovid-resources%26Itemid%3D369&ved=2ahUKEwjZrdDg0JX7AhUXRsAKHbSwAuEQFnoECAoQAQ&usg=AOvVaw0c912YEUBcVzSCmH0CRSN3

Still not working - put this in Google and it links to a pdf file that gives the instructions

Sit to Stand Test (STST) to detect desaturation - HIOW GP portal

Yes I've been referred to the long covid clinic. Had a chest x ray and camera down my nose and throat - all fine.

I've also just recovered from cancer and had my last chemo in February which can also cause breathlessness.

I'm an avid walker and go to the gym regularly but haven't been able to do much cardio at all which is very frustrating.

I think it's just time and waiting for my lungs to recover before I'll notice any improvement.

Do check your oxygen levels on exertion to make sure, my husband's blood clots did not show on the chest x-ray only CT because they were small clots all over both lungs. They really need to refer to the hospital respiratory team for further tests if you are still struggling like this. The wait for the Long Covid clinics can be quite long in some areas so the GP could do this independent of that referral in the meantime. Other people have only show issues with their lungs on VQ scan, MRI or Xenon MRI. I would avoid cardio until you have been fully investigated. Both me and my husband found walking fine on the flat (once his blood thinner treatment had started to work), but build up slowly like 5 mins up and down the road, then round the block etc. It does take time, but with your history they do need to take this seriously and investigate thoroughly rather than just presume it is asthma related.

mylongcoviddiaries.medium.com/i-finally-have-a-diagnosis-for-long-covid-and-its-shocking-82ddcb214656

ncimi.co.uk/latest/xenon-gas-and-mri-scans-show-hidden-lung-damage-in-long-covid-patients/

www.pslhub.org/learn/coronavirus-covid19/273_blogs/understanding-covid-19-as-a-vascular-disease-and-its-implications-for-exercise-r8029/

Yes I do agree. I don't want to keep having steroids.