Should I wait for GP call back? What else can I do? Oxygen sats 93

[Evenstar]

I have had a terrible cough since having a virus in November, I am asthmatic and last night the coughing was uncontrollable. I tried to get through to the surgery, but all the appointments had gone. They have said a doctor will call me some time today.

I am feeling very unwell, my peak flow is low and my oxygen saturation is varying between 92 and 93. Would you wait for a call back or do I need more urgent care?

If the doctor does call you back,do they have any resources to treat you at the surgery, or are they just going to send you to A and E? I think you should absolutely go to A and E, but might hang on for the doctors IF they can treat you and it would save you the wait in A and E. Either way, you need seeing and assessing in person in the next couple of hours

This is NHS E advice for Covid: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/02/pulse-oximeter-easy-read-2022-digital.pdf (I realise it isn't Covid or you would have said). It says if your sats are 93% you should call 111.

I would agree with @SeaToSki though is the GP going to do more than signpost you to A&E? In which case I would definitely call 111 and try to get that signposting sooner.

I would imagine that the GO will send you to an urgent care or urgent treatment centre. You sound like you need a nebuliser and perhaps some follow up steroids.

I would head there now, waiting times are awful so the sooner you there the better. Take a blanket, book and water and snacks.

I was hoping they might be able to help me at the surgery, I have only been at this surgery for nine months as we moved last year so I am unsure of the arrangements. I am very reluctant to go to A & E as with the doctors strike I know I could be there for many hours.

Last time I attended A & E with low sats I was there for hours and sat on a hard upright chair which made me feel even worse, they gave me steroid tablets which I was hoping the GP would do. I am also concerned I might pick up another infection.

Thanks all I think I will probably call 111

What is your normal peak flow and what has it dropped to? Your oxygen sats are slightly low and long term will need investigation but not urgent. Have you been using salbutamol and if so how are you responding?

If you have asthma your GP should give you a "rescue" pack of steroids to keep at home for emergencies like this. I found seeing the asthma nurse/ nurse practitioner very helpful; she was really thorough and went through everything with me; inhaler technique, peak flow, etc. Are you able to get a telephone appointment/asthma check with yours? You should be getting regular asthma reviews and advice for times like this. Definitely ask if you can have the rescue pack of steroids to keep at home; it's definitely put my mind at rest, and is probably what you need. Hope you get the help you need.

@Bracksonsboss my best this morning was 230, I think it is usually about 320-30, but I don’t take it that often as normally I am well, the asthma nurse was happy with that figure in October when I told her it verbally at my check up. They are still not measuring peak flows since COVID apparently, it was my first face to face check up for several years

Call 111. You might have pneumonia which requires antibiotics but you might need an xray to confirm.

Good luck, and hope you start to feel better soon.

That’s a low peak flow and with the slightly low sats, I’d be wanting further investigation. I’d await your GP call back but if that doesn’t materialise, a trip to A&E is unfortunately your next option. It is most likely post viral exacerbation of your asthma and that would respond quickly to steroid treatment but a quick physical examination will rule out anything else.

Definitely ring 111 I've just had a week of the same symptoms and could hardly breath. Not asthmatic. Negative for covid. There is a flu going round with all these symptoms Nd mine developed into pneumonia. Once I was started on doxycycline I have turned a corner at last. My zgP surgery gas been inundated with cases.

@Bracksonsboss hope you don’t mind me asking an inhaler question? I use them infrequently and am never sure what to do…

How long to keep using the salbutamol and spacer? Is it just for the severe period or will it speed up recovery? I’m using it for the first time in some years. Thought I’d finally grown out of needing it!

I’d use it every day while you are struggling. You can take up to 4 puffs a day regularly. I’d take one puff 4 times a day. If you find you are having an asthma attack, you can take up to 10 puffs with. 30 second intervals. After medical review, they may well prescribe a combined bronchodilator and steroid inhaler for a while which should settle things relatively quickly.

Thank you. I need to be more systematic, clearly!

Don't be worried by the PP's saying you may have pneumonia. You probably have a 'normal ' chest infection as that is more common (still treated with antibiotics but not as dangerous) but with asthma it hits you a bit harder. Your O2 sats are not massively low- did someone tell you to monitor them at home? They're always slightly lower than normal in someone with asthma. Go somewhere if you feel it's the right thing to do.

@pickledandpuzzled Take it as your doctor recommended. Stop when they tell you it's OK to stop.

Thanks everyone, I have taken some more of my reliever inhaler and the peak flow and sats have improved. I will hang on and hope that the surgery get back to me soon.

I was never told specifically to use the oximeter, but even before COVID the surgery I was with at our old house was overwhelmed and it was difficult to get care and I found it reassuring if I felt very unwell to check. I have given readings over the phone and they were noted and nobody ever said I shouldn’t use one.

It’s been years since I saw a doctor for it, Bae. I haven’t needed the inhaler at all for maybe five years.
At one time I use a steroid one daily, then gradually came off that. At that time I was using it all according to instructions. But when you only need the ventolin every five years or so, you forget the system. Hopefully this isn’t the start of a return to regular use like I’ve had in the past.

@Evenstar I found my Fitbit’s recognition that I was ill strangely validating 😂 ‘Three of your matrics are outside your usual range’

Rescue packs of steroids aren't provided for asthma.

As an asthmatic I found this really annoying but it's because you need an assessment every time.

People have died from thinking 'well they will just give me steroids and I've already got those '

@pickledandpuzzled you could just have a phone appointment to ask about it, or they might want you to go in for a quick check before giving you new advice. I would never play about with when I took my steroid inhaler, but then I've been on those preventatively since I was a young child. If I miss a few days because I ran out or something,then I feel like my lungs are slightly worse. Because I take them, I've been able to run a half marathon, teach aerobics, whatever I like. My Salbutamol is just for when required for me, but I take it quite a bit out of habit.

I think taking something I was prescribed in the way it was prescribed is a good thing:) I don't have any desire to come off/cut down on the steroid inhaler as it doesn't have any negative side effects and means I can do as much fitness stuff (if not more) than the next person.

Salbutamol is not preventative, just easing of current symptoms. You want something else to prevent, usually taken morning and night. In the past this was the brown inhaler, but my son had orange and now has a red one called Symbicort which is magical!

Just had a call from the GP, they have sent a prescription for steroids to the pharmacy and feel that based on my symptoms it is the after effects of the virus on my asthma. They said it was very helpful to have the Sat readings and to continue to monitor those and peak flow and ring again or access out of hours if they deteriorate or my cough becomes more productive.

Thanks all for the advice.

Don't be worried by the PP's saying you may have pneumonia.

Sorry OP if I did cause concern. I only mentioned it because my DD ended up in A&E last month with it and she's normally a very fit and healthy young adult, and took us both by surprise. It's been mentioned there is more cases about this year so wanted to reassure you that it was a reasonable thing to think, rather than dismiss it as a possibility. PP is very probably correct though

EDIT - cross posted. Glad you've had a result with your GP.