This morning I had an appointment with my asthma nurse mainly to get my flu jab but also to discuss a few other issues I have been having.
First of all we talked about my peak flow and although she had a few issues with certain things such as the “pretty significant morning dip” and the two asthma attacks I had a week or so ago and the symptoms I still get fairly often we agreed that I am doing a LOT better than I was last time I saw her. And there is a significant difference in my ventolin usage since we increased my dose of Symbicort to 3 inhalations twice a day…
My home people flow this morning was 340 which was done at 7AM and by 9AM my peak flow was 360 (of course there is a variable in the peak flow device used) but that is the highest peak flow I have seen on a morning in a long while so I was pleased with that! I’m slightly (too) excited to see what this evenings peak flow will be.
She asked me what I think my major triggers are now and although they haven’t really changed I still feel that since increasing my dose of Symbicort has enabled me to work better when I am teaching swimming as I can actually speak in full sentences by the end of the session. But I feel that that I still haven’t grasped how to deal with weather changes and how they affect my asthma, particularly thunder storms. I still struggle during sudden thunder storms to control my asthma in a way that I am comfortable, I mean no asthma symptoms are comfortable but if I can avoid having an attack then I’m happy.
About a month ago, I was having issues with my heart palpitations while I was taking Symbicort, particularly since the palpitations would wake me up at night and I would get them frequently throughout the day, and so I spoke to the nurse about this. She said I was using a lot of ventolin that weekend in addition to Symbicort which didn’t really answer my question since I stopped the Symbicort because of the palpitations and then was struggling with my asthma because of missing the Symbicort and ended up need ventolin. But I guess since I haven’t had palpitations for a good month, it is just something to be aware of in the future.
I didn’t mention the wheezing issues I had last night. For those of you who don’t follow the MyLungsMyLife Facebook page, I posted about how I was just about to get to sleep when my lungs decided that they were going to start wheezing out of no where. So I ended up needing ventolin and staying up till 12 just incase my lungs decided to wheeze again. It is odd that I started wheezing though because it is so uncharacteristic to start wheezing before I cough, but then asthma can be unpredictable so I should be expecting the unexpected. But I mean apart from needing my ventolin a few times a week at most and a couple of attacks a month, I do feel really good. So I told her that I wouldn’t mind trying to lower my dose of Symbicort and she agreed that, that would be fine. She also said that she can see from my peak flow diary that I know what to do, when to increase my dose and when to lower it again even though I don’t have any sort of official plan and so that she is going to give me “free-reign” on dosing my Symbicort myself which I think is pretty cool, although I do that anyway.
I do absolutely love my peak flow diary, and I find it super helpful in tracking how my asthma has been and I write what has triggered each attack/exacerbation and why I have increased my dose etc so because it was so apparent to her that I do like to track my asthma (apparently other patients aren’t as good as keeping it up to date) she gave me another peak flow diary, despite the fact that I still have 8 months left on the one I am using right now. She had ran out of the official Asthma UK diaries so I got a generic NHS one but hey, it’s still good!
I also asked if I could switch back to the normal ventolin MDI for a few reasons really:
1) I can’t take a ventolin accuhaler on pool side in case it gets wet
2) during an attack it is hard to breathe in deeply enough to get all the medication out and it is also hard to hold your breath for long enough, whereas when using and MDI and spacer you can use tidal breathing
3) the accuhaler is REALLY loud, especially to use in a quiet room
4) I am sick and tired of people asking me what on earth I am using… Clearly people haven’t seen many accuhalers around
So the nurse prescribed me a ventolin MDI and put it on my repeat prescription. She said that I didn’t need to get a new spacer as the one I have is only just over a year old and so, in theory, should still work. So it is adios accuhaler and a welcome back to the evohaler!
And then I decorated it with some sheep Sellotape (my apologies for the slightly over exposed picture)
To be honest, I wasn’t totally sure if I would be prescribed ventolin as my prescription says salbutamol which is the medication in ventolin (ventolin is the brand name) but a few people I know who have has salbutamol on their prescription have been given salamol at the pharmacy which is the generic version of ventolin. And I’m an pretty sure that it would have been fine but a) salamol is smaller than ventolin and so is harder to use, especially with stiff, sore and swollen hands and b) I wasn’t sure that the delivery system would be the same but as my friend GG assures me, the delivery system is the same and plus it doesn’t matter if you are going to use a spacer.
But anyway when I was at the pharmacy I asked if Salbutamol meant I was going to get ventolin or salamol, to which the pharmacist replied that ventolin IS salbutamol. But then again salbutamol IS also salamol, and that’s what I said… She looked pretty miffed with me, apparently pharmacists don’t like patients to correct them.
Anyway that was today’s events… I don’t need to be seen by the asthma nurse again until around May unless I am having issues that I can’t fix by upping my Symbicort. I did forget to mention about my hiccups but I haven’t had any since last week, so maybe that was just a phase.