Asthma - Steroids not working?

[GingerleyBred]

Any asthma pros or respiratory bods out there?

I have always had asthma but generally very easily kept under wraps with inhalers and I really only struggle when I get a cold. Usually I have a quick blast of antibiotics and steroids and everything calms back down again.

Since the dc have gone back to school this autumn I have caught everything they’ve had and I am now constantly wheezy. I've finished antibiotics (and GP is happy it is all viral anyway) but peak flow isn't coming back up, so I am carrying on with steroids.

I am really limited as get so short of breath, not sleeping well, feel really fatigued. Inhalers do help briefly but the relief doesnt last.

I'm not ill enough to need to go to a&e as my sats and pulse are fine, I can talk and eat etc but also feel pretty rubbish and like this is my life now (drama).

I will contact the GP in the morning but it will be the 5th time in a month and I am not sure what else can be done or if I am just impatient?

Has anyone has similar? What has helped?

Have you tried an antihistamine to see if it’s allergy? As it’s so damp and warm lots of people still suffering with hay fever like symptoms.

Have you tried a Trimbow inhaler?

What preventer inhaler do you take?

I found last year my Seretide just seemed to stop working after years of being amazing. I was switched on to Relvar Eliptq and I'm back to well controlled asthma where it feels like it's not negatively impacting me day-to-day.

It could be that you just need a change.

What inhaler do you take and how often?

Ask for asthma review with an asthma nurse
You might need a switch up of inhalers
I've recently gone onto a Fostair Nexthaler, I love it as it's the preventer & reliever in one so only one thing to puff and carry around.

Fostair on the MART regime so currently 8 puffs a day, plus salbutanol in-between

I haven't heard of it, will google!

I haven't but will try it!

This has all very definitely been kicked off by colds/viruses but I guess anything could be keep it going now

This is what I have (mdi not nexthaler) and has worked well up until the last month or so.

Now I am having to use salbutamol all the time too

do you cover your nose and mouth when outside?
having plenty of warm drinks?
just while you wait for your appointment.

I use Fostair combined with montelukast (one tab at night). My peak flow doubled within a week as did my energy levels.

That's amazing!

I did take Montelukast a very long time ago but stopped it years back becakse everything was well controlled.

I'm fairly house and sofa bound at the moment as get so short of breath.

I am trying to drink plenty to keep hydrated and stop sore lips. Helps with coughing everything up too!

My adult DS has recently had Covid and his asthma has been really bad since, his inhalers were not helping at all, he has a new dry powder inhaler, which he says is way better than the traditional ones, it’s red and white, thinking it’s like the Trimbow, it’s steroid combined, but he’s still needing it several times a day. He’s been given a 2 month course of steroids, which he is reluctant to take, but he is improving slowly. He has had an X-ray which was fine.

You shouldn’t be needing a blue as well, that’s the point of MART.
Restart Montelukast, if no better after several weeks swap it for a Spiriva Respimat inhaler alongside your Fostsir. In the meantime ask your asthma nurse to check your Feno/eosinophil level and if either are raised you need a respiratory referral.

Just seen, if you’re sofa bound through shortness of breath you need an urgent medical review today.

Go through the 111 online info and check whether you need review today.

If not, montelukast works differently to inhalers so worth a try again. Asthma nurse may actually be better than a GP.

Are you allergic to mould. And have you been in contact with any?
I have found rotting leaves in the woods and gardens around me are affecting my asthma plus local bonfires and chimney smoke. I have stepped up from Relvar to Salamol blue and Clentil Modulite brown. I take also take montelukast
at night which really helps.

I think you should see the asthma nurse at your surgery for a review of medication.

You could try speaking to Asthma and Lung UK nurses. There's a helpline on their website.

I think this is where I am hesitant because if I stay home and resting I am ok, but I can't really do anything else.

When I have sought urgent medical help before it has been much extreme whereas this is more a boiling the frog situation.

In the past taking prednisolone would have sorted this in the first day or so, so I am worried that I am not getting the usual relief.

I don't feel so unwell that I can't sit it out for the GP tomorrow, but I would like to know there's something that might help (like the steroids normally would).

I have noticed I am mucb more aware of any woodsmoke locally and with fireworks and bonfires this week I have definitely felt the difference in the evening air.

I haven't considered leaves and mould but we have huge piles in our garden!

I have never really read around all the different inhalers out there - just take what I am told.

Will go and do some reading, thanks for all the suggestions.

You know Im boiling the frog, the frog dies right?

The whole point of the analogy is that problems that come on more slowly can still be significant.

Go through the 111 online info. It’ll tell you whether to wait for a GP tomorrow, see out of hours GP today or A&E.

It might be that you need a nebuliser session. In which case 08:30 on a Sunday morning actually isn’t a bad time to go to A&E.

There are four deaths every day in this country from asthma. Why are you hanging on for the GP? No wonder general practice is overwhelmed. The care and treatment provided today would be just the same (if not better in A&E).
See my comments below re Feno and eosinophil checks going forward. You are not well controlled and need likely additional meds and possibly a referral. Practice nurse.

I appreciate what you're saying. I am scared that this isn't going well. But I feel like I am coping at home and sats are ok.

Unfortunately my experiences of a&e care with asthma do not make me feel that I would receive any quick or kind help when I can still talk and eat and sats are ok. I have been there in a total state with low sats before and still been left in the waiting for hours.

I've seen the GP 4 times in the last few weeks, twice last week, and they've said to keep on with the prednisolone. I'm just not convinced it is doing what it has in the past. So hanging on for the GP is because they told me to, not because I want to be difficult or use services inappropriately.

I do appreciate your advice.