No relief with inhalers for asthma at 27 weeks what's next

[Justasconfusedwithnumber2]

Any others struggle with asthma? I am newly diagnosed, was out of breathe from around 19 weeks and bloods flagged for d dimer. Pulmonary embolism was ruled out so breathlessness was put down to asthma. I have been on inhalers and extra iron for 6 weeks which have done nothing. Flow rate yesterday has not changed. I am breathless talking, walking, lifting, anything. Dr's are baffled why inhalers haven't worked, I had bloods taken again yesterday and am now waiting for doctor to call with next steps.

Did anyone else go through similar? I am concerned she said I may have hosp tests repeated e.g. Xray, VQ scan as these carry risks to the baby. Ive had them once so can't believe they will show anything this time.

Are you using a preventer inhaler too? I've had asthma for 8 years now and still haven't found the right inhaler for me, but I also have a myriad of other health issues which contribute. My sister has had asthma since childhood and has changed inhalers more times than I can count. However she has finally found one which works and her asthma is so well controlled you wouldn't even know she has it. Have they tried you with a combined inhaler? LABA plus steroid? Something like Seretide, flutiform, fostair etc?

Agree with mite. You need a preventer and also to try some different ones if it's not working. Keep on at the GP too. Hope you feel better soon

Have you seen an asthma nurse to check how you're using your inhalers? Do you use a spacer?

I had pregnancy related asthma with my third child and the spacer made all the difference, it felt like I was actually inhaling the dose because you take in in over multiple breaths rather than trying to take it all in in one, when your breaths are so small/ restricted.

I also take hayfever type tablets at this time of year as it's particularly bad for something that agitates.

As a new asthmatic watch out for events around fireworks, particularly if the atmosphere is still. The heavy air thick with smoke and firework smell can be really aggravating.

Best wishes for today. It sounds to me like you've had a "trial of treatment" to see whether your breathlessness is really asthma. Since it isn't helping a lot, your doctor is probably considering a range of other possibilities. I'm glad to hear you'd had the xray and scan at the start; they won't repeat them lightly but the risks to your baby are small compared to the risks if your breathing problems were to get worse.

I wonder whether they may try to get a cardiac echo (ultrasound scan) - that would be helpful in ruling some of the most worrying (but less likely) possibilities out before deciding your next treatment.

I hope you can get some positive progress soon.

Get an appointment with the nurse to review your inhalers. There are lots of different ones. My asthma was much worse during pregnancy and I was put on Fostair which is a steroid preventer inhaler and worked much better.

Thanks all. I am on a preventer, and am also using a spacer. I was told they would take 6 weeks to work but would feel better after 3. After the 3 weeks I went back to doc and flow rate had dropped. I was signed off work for the last 3 weeks to try and rest and let them kick in. Difficult with a 2 year old!

I honestly thought like you all, that I would have been given a different inhaler to try yesterday but she kept saying she was at a loss and was concerned how far I still had to go in this pregnancy. I did have wheezing in my right lung but she said yesterday she could no longer hear it.

Which preventer are you taking OP? Is it a combined one or just steroid?

It's soprabec if that makes a difference

Go back to the Asthma nurse.

I've had Asthma all my life and has been mostly well controlled. However about 2 years ago my breathing got so much worse. I went to my Asthma clinic and my preventer inhalers were completely changed - new things are coming out all the time.

I now have a preventer called Flutiform alongside a Montelukast tablet, as well as the normal Ventolin inhalers of course (although I honestly don't use them often now).

Ask to try something different. It's possible they could supply an oral steroid at first too to ease things.

Hmmm I've had a lot of inhalers but never had that one! I'm assuming it's just beclametasone? I would speak to the GP or asthma nurse and ask about combined inhalers and whether they would be suitable. They have a long acting beta agonist (so basically a version of ventolin that lasts around 12 hours) with a steroid combined. The good thing with these is you feel the effects straight away as the LABA kicks in quickly, although of course you have to continue to use them every day to get the protective effects of the steroid.

I would say if a LABA/Steroid inhaler doesn't work, then there's a chance it's not actually asthma, although I can't offer any wisdom as to what else it could be.

Yes it looks like it is just beclametasone. Sorry, I have no idea what I am talking about this is all new to me!

I haven't seen an asthma nurse, just the GP. I feel like the GPs don't really know what to do with me. I appreciated being signed off work to rest, it's been exhausting, but I feel like they ve called my bluff to see if that was going to 'fix it' iyswim. I just don't know that they've taken the asthma very seriously (obv they took the d dimer thing separately). Sigh.

Ask for an urgent referral to the asthma nurse, they are far more knowledgeable about asthma and the different inhalers available than GPs. That's not an insult to GPs, it's just asthma nurses have had specialist training in these things

In my (vast) experience, the practice asthma nurse is usually more knowledgeable than the actual GP! Worth asking to see her/him. It's all a bit of a learning curve, I didn't really get to grips with it for a long time.

Do you recognise signs of a serious exacerbation? I was always wary of making a fuss, but the most important thing I've ever been told is to take asthma seriously, although it took a week on a respiratory ward after being rushed in by ambulance to actually pay attention.

I don't want to scare you but I delivered at 28 weeks and 27 weeks in my pregnancies due to severe asthma. Ask for an urgent referral to a respiratory consultant, you may need some oral steroids to give you a boost. I had prednisolone in pregnancy and it's considered 'safe', a 5 day course gave me enough breathing space (ha-ha) to manage. You absolutely need to force a referral as if you become hypoxic - you and baby are both at risk.

You need a cardiac ultrasound

Blimey. I have been worried about the potential effects on the baby. And even how labour will go this time. I am still waiting for the doctor to call with the blood results but can't imagine they will show anything. I don't feel ill, have no other symptoms of infection, and am already on a higher dose of iron.
Today I have done very very little but am still sapped of energy. More than anything I feel sorry for my son because when he is home I cannot interact with him anywhere near like I want to. I am really fed up of having to say I can't do this or I can't do that

The doc has called and said the blood results were OK. They're going to discuss it in the morning at a meeting and call me again tomorrow. I literally don't think they know what to do. I'm not even sure they believe me tbh

I’m going to suggest you try to get referred to a chest consultant. When not pregnant I have very mild, easily controlled asthma, then during pregnancy my breathing goes completely haywire. Midwives, asthma nurses etc found me baffling, particularly as inhalers didn’t seem to have much effect on some of my symptoms. Barrages of tests revealed that my body is basically overreacting to progesterone, and that’s making me hyperventilate, which in turn is affecting my asthma. I’m still spending a lot of time feeling breathless (I’m 19 weeks into 5th pregnancy) but my wheeze is now well controlled and have been given ways of coping with the constant gasping for breath and trying to yawn.
I’m not saying yours in necessarily exactly the same but, it wasn’t until
I got to see a chest specialist that I got sorted.

Well you were right @7to25 I have been referred to an obs consultant for a cardiac ultrasound. not quite sure what to expect now

@Justasconfusedwithnumber2 how are you feeling physically?

Do you have a blue inhaler as well (a fast acting reliever)?

If so, try taking two puffs before you go up stairs, walk around or similar and see if it helps. When mine is bad (although a bit of juggling inhalers around has sorted me) sometimes it seems to work better to take it first, rather than try to "rescue" it afterwards.

If the reliever inhaler doesn't work at all though, I'd think it might be something other than asthma.

Hope you get some answers soon, not being able to breathe properly is horrible.

@stylishmummy I am generally just very tired 90% of the time. Up and down the stairs is the worst to knock the wind out of me, although somedays I can literally stand up from kneeling and feel exhausted out of breath and have to sit back down. The worst is at night. I lay in bed for maybe 30-40mins just feeling like I have a gauze over my face/in my wind pipe so I am conscious of every breath. I don't have any pain just like a tightness in the middle of my chest. Like a strained muscle.

I do have a reliever but it makes me feel light headed. If I took it every time I felt out of breath I think it would be attached to my hand

I have put in more weight I think thus pregnancy though as last time I was still on the cross trainer at 38 weeks!

Hi op
Been thinking about you. Did you get seen by Cardiology?