Shortest Admission For Months!
I feel like it says something about my asthma when I'm excited that I only needed an overnight admission for the attack I had yesterday! I was on holiday in Lanzarote last week (very low pollen so absolute heaven for someone with severe allergic asthma!) which was brilliant, but unfortunately it did mean that any tolerance I had been building up to the grass pollen disappeared.
Cue an almost instant deterioration in peak flow and symptoms on return to England. It steadily dropped over a few days from my personal best of 440 down to around 230 at which point I decided to bite the bullet and increase my prednisolone back up to 40mg from 30mg (that reducing regime is going really well...) in the hope of managing to get some sleep. The insomnia from the steroids may be annoying, but at least I could breath a bit better and cough less overnight!
The next day things hadn't really improved so I rang the severe asthma nurses at my local (who now know me quite well) for some advice and was told that I sounded pretty wheezy and short of breath and to go get seen ASAP if I didn't improve or if I deteriorated at all. I hoped that might be it but later in the day went downstairs to get some more drink and getting back to bed finished me off! My peak flow was down to 150 (so 34% of normal), wheezing and not really improving with my salbutamol inhaler.
I managed to settle things a bit and so decided to ring my GP practice and book an emergency appointment for early evening (my surgery tends to be pretty good if you ring up and say its asthma - particularly when they look at all the admissions I've had!). But typically the walk from the taxi into the practice (around 50m at the most) sent me downhill again so I was immediately put on a nebuliser and a 999 ambulance called...oops!
It was a little weird because I'm quite used to severe attacks now, having had 9 admissions to hospital this year (with 8 of them being at least severe exacerbations) and a couple more A&E trips, so I tend to be quite calm and chill during them. In fact, the GPs and the paramedics kept remarking on how calm and "ok" I looked in spite of having quite a severe attack - and yet they spent a couple of years trying to tell me I was just anxious!
Thankfully, having the paramedics turn up meant that having been stabilised a bit they managed to sneak me straight into the clinical decisions unit at the respiratory hospital, so I didn't have to spend a few hours sitting around in resus waiting to be transferred and most of the nursing staff and consultants there now know me (and so take things seriously and manage it well!). This meant that for the first time in ages I managed to escape needing any IV medication, as they kept me on back to back nebulisers until things settled down a bit.
I'm learning that my purely allergy attacks (like yesterday) tend to respond fairly well to nebulisers and IV magnesium (if I haven't responded by the third neb) and its only the ones that are complicated by infection that tend to require more intensive drugs like IV aminophylline. Unfortunately my immune system is a bit broken at the moment so I've kept picking up infections!
Still, at least I only had to be kept in overnight for observation and am now free again! I also have my next appointment at the difficult asthma clinic in just over a week so hopefully we'll make some progress then. Here's to the end of the pollen season and breathing easy again!
Cue an almost instant deterioration in peak flow and symptoms on return to England. It steadily dropped over a few days from my personal best of 440 down to around 230 at which point I decided to bite the bullet and increase my prednisolone back up to 40mg from 30mg (that reducing regime is going really well...) in the hope of managing to get some sleep. The insomnia from the steroids may be annoying, but at least I could breath a bit better and cough less overnight!
The next day things hadn't really improved so I rang the severe asthma nurses at my local (who now know me quite well) for some advice and was told that I sounded pretty wheezy and short of breath and to go get seen ASAP if I didn't improve or if I deteriorated at all. I hoped that might be it but later in the day went downstairs to get some more drink and getting back to bed finished me off! My peak flow was down to 150 (so 34% of normal), wheezing and not really improving with my salbutamol inhaler.
I managed to settle things a bit and so decided to ring my GP practice and book an emergency appointment for early evening (my surgery tends to be pretty good if you ring up and say its asthma - particularly when they look at all the admissions I've had!). But typically the walk from the taxi into the practice (around 50m at the most) sent me downhill again so I was immediately put on a nebuliser and a 999 ambulance called...oops!
It was a little weird because I'm quite used to severe attacks now, having had 9 admissions to hospital this year (with 8 of them being at least severe exacerbations) and a couple more A&E trips, so I tend to be quite calm and chill during them. In fact, the GPs and the paramedics kept remarking on how calm and "ok" I looked in spite of having quite a severe attack - and yet they spent a couple of years trying to tell me I was just anxious!
Thankfully, having the paramedics turn up meant that having been stabilised a bit they managed to sneak me straight into the clinical decisions unit at the respiratory hospital, so I didn't have to spend a few hours sitting around in resus waiting to be transferred and most of the nursing staff and consultants there now know me (and so take things seriously and manage it well!). This meant that for the first time in ages I managed to escape needing any IV medication, as they kept me on back to back nebulisers until things settled down a bit.
I'm learning that my purely allergy attacks (like yesterday) tend to respond fairly well to nebulisers and IV magnesium (if I haven't responded by the third neb) and its only the ones that are complicated by infection that tend to require more intensive drugs like IV aminophylline. Unfortunately my immune system is a bit broken at the moment so I've kept picking up infections!
Still, at least I only had to be kept in overnight for observation and am now free again! I also have my next appointment at the difficult asthma clinic in just over a week so hopefully we'll make some progress then. Here's to the end of the pollen season and breathing easy again!
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