Tag Archives: ventolin

Asthma action plans and vaccinations

First of all, I apologise for not finishing RABlog week… My life is super hectic right now with the uni work mounting up and living with a chronic illness so sometimes it’s hard to keep up with the blog too.

Today I had an appointment with my new asthma nurse to see about getting an asthma action plan. I have found that recently my asthma has been a lot more controlled than it has over the past year and I am having virtually no symptoms unless I am sick… which I was the other week when I made this appointment. Stupidly I hadn’t thought about getting an asthma action plan earlier so I pretty much just survived on Ventolin because I wasn’t ill enough to see the GP or asthma nurse.

This new asthma nurse is amazing. She checked my inhaler technique without my asking [it’s always better to know that you are doing something like this correctly, even if you have been doing it numerous times a day for years] and she didn’t put a huge emphasis on peak flow numbers. My new asthma action plan doesn’t even contain any peak flow readings to work off because my nurse would prefer me to treat based on symptoms and not to get too caught up with readings. She did ask me to check my peak flow a couple of times a week though because this can provide an early warning for whether my asthma is getting worse or not. We also discussed my treatment options. She asked me whether I would want to try the lower dose of Seretide even though when I was on the equivalent dose of Flutiform my chest got bad again… I agreed to give it a go because I really don’t like taking inhalers/medication at all, and if there is a chance that my asthma could be controlled with a lower dose then that would be awesome. I have been given a prescription for 3 months of Seretide 50/25 to take, and I still have 3 months worth of Seretide 125/25 so I have been told to switch up and down in accordance to my new plan. And if I find that my asthma does become worse again on the lower dose then my asthma nurse is happy to switch me back up to the higher dose. She explained that some people need the higher dose to stay stable, and it is better to have he best control possible over asthma than to get caught up trying to reduce the dose when you can’t.

I also got given the flu jab and the pneumonia vaccination… one shot in each arm. Surprisingly the flu jab hurt a lot more even though the pneumonia vaccination needle was larger. I can’t remember if I wrote about my experience with the flu jab last year but I ended up with an incredibly itchy and hot red circle around the injection site last year, which popped up a couple of days after the jab. I have the same red circle at both injection sites this year but the rash came up within an hour of getting the jab. Thankfully it isn’t too itchy right now but I am keeping a close eye on them. I presume it is just going to stay as a local site reaction because I haven’t got any other symptoms apart from being slightly achy which is awesome!

Asthma and exercise: My current experience

I haven’t really blogged that much about my asthma for a while, mainly because I have been focusing on my joint health a lot. My asthma has been pretty well controlled these past few months, and I have only really experienced symptoms if I am exposed to a trigger. My Ventolin usage has been right down which is excellent, my peak flow has been okay for the most part, and I haven’t really needed to increase the dosage of my Flutiform that much either.

My main issue has been when I exercise. My friend and I have just finished our second week of running using the “Couch to 5K” app which gradually increases the distance, and length of time that you run for over a period of 9 weeks until you can run for 30 minutes [and hopefully run a distance of about 5k] at the end of it. I have never been a fan of running, although a lot of the sports I used to do involved running [football, cricket, netball, ultimate frisbee, rounders, etc]… I just hate how running makes me feel while I am actually doing it, I hate how tight my chest gets, and I hate how it makes me cough, I hate the excessive mucus production I get after every run [that may be a bit TMI]… But having said that, I really like how running makes me feel after I have finished a session [apart from the chest issues part]. The release of endorphins is fab. My main concern is now that the app is slowly increasing the length of time I have to run for… Running intervals of 90 seconds makes me feel like my chest is going to kill me, so how is running intervals of 2 minutes and 3 minutes going to make me feel next week, or running for 5 minutes the week after.

I admit that I am not that fit right now, but being unfit does not make you wheeze, it does not make you cough till your head hurts, it does not make you feel like you have an elephant sitting on your chest. Being unfit makes you more out of breath, more hot, more sweaty… that is the difference between being unfit and having asthma that is triggered by exercise. I explained all this to my asthma nurse on Monday and she decided that we could try Singulair to see if it helps. I have just done my 2nd run since starting it and so far no difference, although I haven’t been taking for Singulair long enough to make a difference so hopefully I will see a difference over the coming weeks. I have also increased my Flutiform to 3 puffs twice a day on days I am exercising and I have also started pre-medicating with 400mcg [4 puffs] of Ventolin before I exercise… Both of these are helping somewhat but I am still really struggling… I have also started taking my peak flow before and after exercise, and even with the added Ventolin and Flutiform my peak flow still decreases by up to 100 points [in my case this is equivalent to 25-26%, although this drop can range from 13% all the way up to 26%, most likely depending on how I was feeling that day, as well as environmental factors]. If the singular doesn’t decrease this drop, or if I am still feeling pretty rubbish during exercise my asthma nurse and me are going to have to put our heads together to work out what is best in terms of treatment.

However, despite my asthma I do feel as if I am getting stronger, I have lost 5kg [11lb] since January, and I have only been exercising properly for the last 2 weeks… Right now I try to swim twice a week, and I run 3 times a week too although because of my asthma, I can’t work out as hard as I would want to, but with the right treatment I’m sure that will change. It is just very frustrating because my joints are at a place where I can exercise and build back the muscle I have lost and I am really motivated to get fit but my lungs are putting the breaks on it a bit… I am so incredibly lucky to have an asthma nurse who understands what it is like to have asthma, and have it preventing you from exercising to your best ability [she has asthma herself, and likes to cycle], and she isn’t one to tell me to stop exercising like my last asthma nurse asked me to do… Actually my last asthma nurse asked me to quit my job [as a swimming teacher and coach] and to stop swimming, but this asthma nurse is happy for me to continue exercising as long as I know when my lungs have had enough, and she is fully on board with trying new treatments so that I can work out as much as I can, within reason of course.

Medication 101: Ventolin

It’s be a while since I have done a Medication 101 so I am going to try and pop a few out now.

I’ve been taking Ventolin for nearly 3 years now, since June 2012. I’ve taken Ventolin through 2 different devices, the Ventolin Evohaler which is the typical aerosol inhaler that most people are familiar with, and then I also used the Ventolin Accuhaler for a short period from January 2013 to October 2013.

Ventolin is a brand name for Salbutamol [AKA Albuterol in the US] which is a Short Acting Beta 2 antagonist (SABA) or in layman terms a fast acting reliever inhaler. It is used to to relieve spasms in the smooth muscle around the airways which produces asthma symptoms/bronchospasm [cough, wheeze, tight chest, shortness of breath]. Most people with asthma are treated with a reliever inhaler and a preventer inhaler, and it is very important to be aware of which inhaler is your reliever. The reliever inhaler is the inhaler that is going to help you out when you are experiencing symptoms or having an attack. [Note; some people use a SMART or MART regimes, please always use your inhalers as directed by your doctor. This is simply to provide general information about Ventolin].

Doses:

The dose of Ventolin is variable. The Ventolin Evohaler contains 100mcg of Salbutamol per accusation and the Ventolin Accuhaler contains 200mcg of Salbutamol per accusation. Most people take 100-200mcg of Ventolin to relieve symptoms but may take up to 1000mcg when needed. Please phone an ambulance ASAP if your symptoms are not easing even after taking your inhaler, or if you don’t have your inhaler with you. Asthma can be very serious, don’t mess around with it.

Precautions:

Consult your doctor before you take Ventolin if you are hypersensitive to Salbutamol Sulphate or HFA 134a which is the aerosol in the Ventolin Evohaler.

Special care is also advised to be taken when taking the Ventolin Evohaler if you have high blood pressure, have an overactive thyroid or have a history of heart problem including angina or an irregular heart rhythm. Please consult a doctor or pharmacist if you call under any of those categories.

Side effects:

I have starred [*] all the side effects I have experienced when taking Ventolin.

  • Allergic reactions [affecting less than 1 in 10,000 people] – Please seek medical attention ASAP if you experience swelling of the face, lips tongue or throat, if you have difficulty with breathing, if you have difficulty swallowing, if you develop an itchy rash, if you feel faint, feel light headed or collapse.
  • Common side effects [affecting less than 1 in 10 people] – Headache*, feeling shaky*, heart palpitations* [please consult doctor about this].
  • Uncommon side effects [affecting less than 1 in 100 people] – mouth and throat irritation, muscle cramps*
  • Rare side effects [affecting less than 1 in 1,000 people] – low blood potassium levels, peripheral dilation [increased blood flow to extremities]
  • Very rare side effects [affecting less than 1 in 10,000 people] – changes in sleep patterns, changes in behaviour [e.g. restlessness, excitability

I have found that Ventolin/Salbutamol has got me out of some sticky situations but if you find that you aren’t responding to your reliever inhaler any more or you are still having issues with your asthma after taking you inhaler, go to the hospital. Don’t hang around because you aren’t sure if your symptoms are bad enough to seek medical advice. Asthma can be life threatening so be pro-active!

Source:
Patient information leaflet.

A busy few weeks

My life has been pretty hectic recently. I found out I was going to go to university about a week ago (on the 14th) which I really wasn’t expecting based on how I thought my exams had gone, so I hadn’t bought anything that I needed. For any of you who have moved away to go to Uni, you’ll have some idea of what it is like to find out that you have to get 6 freaking pages of stuff [i.e student essentials] in 4 weeks… and for those of you who don’t it’s super stressful, exciting, nerve-wracking and really expensive! This week I have had to pay out over £500 for necessary things including the deposit on my accommodation, the gym, Uni essentials including pots and pans, bedding, towels and bathroom stuff, and my Gym membership. It’s been crazy expensive week, but thankfully I think I have got almost everything I need to move out, so the next few weeks shouldn’t be that expensive. I have a new found respect for anyone who has ever had to move out and get new stuff because it is far more difficult than I expected!

I am also happy to report that I am back on track with my asthma meds… I took an impromptu break from Flutiform and relied solely on Ventolin for a few weeks which was a stupid thing to do and was a result of the massive amounts of stress I was under from certain events going on in my personal life… I have now either resolved or come to terms with these issues and I am feeling a lot happier. However, my lungs are still hating on me for leaving them without a controller med for a while and so I have had to up my dose of Flutiform back to the 125/5 inhaler but I shouldn’t complain because it was my fault. I am hoping that in a few weeks everything will settle back down to normal, but if not I shall just phone my nurse and ask her to change my repeat prescription back to the 125/5. And that has also reminded me that I need to book in for my flu jab! GET YOUR FLU JAB GUYS! There is no point getting ill if there were steps that you could have taken to reduce the risk.

Now onto the hip… I think I mentioned that my bursitis has come back in my hip, or maybe I didn’t. I am incredibly tired right now because I haven’t slept well in about 2 weeks because of my bursitis and it is affecting my memory so I can’t actually remember if I have told you about my hip. So in short, my bursitis came back about 2 weeks ago after no problems since the end of June when I had a burst of pred. There was a few low points last week where I was feeling really sick because of the pain but thankfully I wasn’t actually sick. I am now considering my options for treating the bursitis again and as far as I can tell I have 5 options:

  1. Continue treating with 1000mg of Naproxen a day, and 1000mg of Paracetamol PRN/every 4 hours, and Ice
  2. See my GP and ask about a burst of pred or a cortisone injection
  3. See a private physiotherapist
  4. Phone my Rheumy
  5. Do a combination

So Option 1 is what I have been doing for the last 2 weeks and although it’s preferable to doing nothing, I am still having a lot of pain and my hip is still warm to touch (except from right after I have iced). As for Option 2, I am feeling particularly self conscious about the way I look right now so pred is definitely out of the question but I might be up for a cortisone injection into the bursa if the GP can guarantee that it will at least help a bit. Option 3 is out of the question, but it was something that my Mum brought up in the middle of the night when I was still wide awake and intercepted her on the landing when she was going to get a drink of water… I have looked at the prices of the private physiotherapists around here and they are all far too expensive, and there is no guarantee that it will help. You may be wondering why I didn’t think about NHS physios, and whilst every physio I have had has been awesome, the waiting time is really long and I just don’t have the time, or the patience, to wait. Option 4 was another idea that my Mum had, again in the middle of the night, but since I have an appointment on the 17th of November [the appointment letter came this week, along with a letter saying that I DO NOT HAVE LUPUS] I might just try and wait it out. The Rheumy also said to phone her if I was flaring but this technically isn’t a flare… or at least, I don’t class it as a flare. Option 5 seems like the best option, there is no way I am going to let my GP take me off Naproxen since it’s the first time in years that my joints have felt relatively good, with the exception of my hip, but I don’t feel like I can carry on with just Naproxen and Paracetamol, as much as I hate to admit it, so I guess I might see about the cortisone injection… Especially because I have read that a cortisone injection could “permanently resolve” the bursitis, which after 2 years would be excellent!

I have been planning/thinking about some more posts that I could do and I may have also found another person to write us a guest post, which I am very excited about… and I also need to ask Justin of Haika Clothing to do another interview with me to tell us about the progress he has made [I am currently saving up to buy some more of his awesome shirts, and $5 of every purchase goes to an asthma charity!]. For more frequent updates check out my Facebook page.

World Asthma Day 2014 Q&A

Today is World Asthma day and in an attempt to raise some awareness about what it is like to live with asthma (from my perspective) I’m going to be answering some questions that my followers have e-mailed me. [Sorry for the late reply for those of you who have asked me questions!!!]

[Note: I have paraphrased some questions]

How were you diagnosed with asthma?

I was having issues with symptoms when I was exercising and people in my Cricket club were starting to make comments when we were playing matches about how loud my wheezing was, or they would ask me if I was having an asthma attack etc. So I headed off to the GP who sent me to the asthma nurse for a Spirometry. Basically, at that point, my Spiro was normal (because I wasn’t having symptoms) so my nurse and I decided to try a peak flow for a few weeks. Based on the massive variance in my peak flow, coupled with symptoms, I was diagnosed with asthma.

Do you see a consultant for your asthma?

Nope, I’m under the care of an Asthma Nurse (who is actually a Diabetes Nurse) and my GP. I don’t have severe asthma so I don’t need to see a consultant.

Why did you start this blog?

Basically, I started this blog to try and raise awareness about asthma and other chronic illnesses, and also to share my experiences with asthma (and bad joints) with other people. I found it extremely helpful to read blogs after I was diagnosed, so you never know… someone might find this blog helpful.

Are you worried about going to University?

Erm… I’m going to presume you mean, am I worried about my asthma. Well that would be a yes and a no. I’ve never had severe asthma, or had attacks that have landed me in hospital and I feel quite safe in the knowledge that I can manage my asthma, and attacks, fairly well by myself. And, of course I know when I need to see my GP. But then I am slightly concerned about being able to afford my medication, thankfully there are pre-payment schemes that are cheaper in the long run but there is always that worry in the back of your head. I’m very fortunate to live in a country with a National Health Service that subsidises the cost of medications, otherwise I would be forking out a fair bit of money.

Does asthma affect your life much?

Well, asthma is always in my thought processes when I go out… Money, check. Bag, check. Inhaler, check. But overall asthma doesn’t play a massive role in my life, I don’t have severe attacks, and I am pretty well managed. But of course, those nights when your asthma isn’t behaving it’s self as well as it should are rough, or if you are having a bad day, that’s hard. You can’t completely separate your life from asthma because you are living with it, but I am lucky enough that I don’t have to think about carrying around a portable neb or bringing umpteen different inhalers with me.

How do you go about getting an asthma plan?

I asked for one… When I was getting put on my first combination inhaler (Seretide, AKA Advair) I figured it was time to have a better understanding of my asthma and what I should do when.

If I were you, I would either ask your GP/asthma nurse or your consultant, if you see one.

How did you find out your triggers?

The hard way… i.e. by being triggered. I don’t have allergic asthma so allergy testing would be pretty useless for me, so I just made a note of when I h attacks/exacerbations and what caused them. Of course it isn’t always that easy, and sometimes multiple factors play a role e.g. having a cold and meeting another trigger, or having a cold and meeting something that doesn’t normally trigger you, which causes an attack/symptoms (or at least, it does for me).

 

So that was my Q&A for asthma, I have another one to raise awareness about Arthritis/bad joints that I will post in the next few weeks.

If and if you have any questions feel free to comment below or visit my “Contact me” page.

Another UTI?!

[Warning! This post is TMI]

Do you remember about 6 months ago when I had a UTI? No? Well have a look here. Well yesterday I got diagnosed with my second UTI in 6 months.

However this UTI is quite different to my last UTI, in that I really don’t have that much pain. My main symptoms is really frequent urination (sorry that’s quite TMI). Yesterday night I had to get up 3 times to go to the toilet and I ended up going to the toilet 18 times during the day… And I’m not exaggerating that, I actually did go 18 times. And 8 of those times were before 10AM. I texted Mum after my 8th time because I knew something wasn’t right but I was hoping it would just pass. Mum said that it was probably best to phone the doctors and get checked out because it sounds like a UTI but then again, I didn’t have much pain so maybe it was nothing, but I was definitely not going to risk anything when I only have one kidney so I rang the doctors.

I was told that a nurse practitioner would phone me back within an hour to discuss my symptoms and maybe talk about treatment. The only problem was that I had a lesson and the classroom that my lesson was in has no signal AT ALL! So I ended up having to go and speak to my teacher about doing the work elsewhere in college where there is signal, and my teacher was totally cool with the whole situation and let me go.

The nurse practitioner phoned me after about 40 minutes and said that she thought I did have some type of UTI and that she would prescribe a 3 day course of antibiotics, at which point I told her that there was absolutely no way that I was going to take Trimethoprim without anti-nausea medications because last time, I was almost sick on somebody because of the nausea that they caused, but the nurse wasn’t cool with prescribing some anti-nausea meds so I have ended up on a totally different antibiotic that I need to take 4 times a day. The nurse practitioner also wanted me to drop off a urine sample so they could see what kind of bacteria was causing my symptoms. So I ended up going down to the doctors office after college to get my prescription and to give a urine sample.

However, as usual, everything was quite chaotic at the surgery. I had to stand in a queue to get the sample pot, then stand in the queue to hand it back in again. Then I had to wait while the receptionist looked for my prescription and told me that it must have already gone over the pharmacy and to check there. So I headed over to the pharmacy to stand in the queue and get my prescription, except I was only given Flutiform (which I was due to collect anyway) and the pharmacy hadn’t heard anything about any antibiotics. So I had to headed back over to the doctors, to stand in the queue and I had to ask them to look for my prescription again, and it turned up in a box of prescriptions that are never collected. So back to the pharmacy I went, prescription in hand this time, and tried to get my prescription filled. However, it turned out that the Nitrofurantonin box had gone walkabout so I had every pharmacist (literally all of them) looking for this box which turned out to be waiting to be used to fill another prescription. But on the plus side I did, eventually, get the Nitrofurantonin! What a fuss for 12 little tablets!

Unfortunately I wasn’t given any patient leaflet about the Nitrofurantonin so I ended up looking online for the patient leaflet to see the side effects (all of which are scary) and any contraindications, since I always double check the pharmacist’s and nurse’s/doctor’s actions. And I found that Nitrofurantonin is usually prescribed for longer than I have gotten it…

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Of course, you can’t trust everything you find on the Internet, but this advice was similar in a few sources that I found… But I guess if it doesn’t go then I can have more?

The only thing that the pharmacist told me was that this antibiotic can discolour your urine, whatever that was supposed to mean… (TMI here but it turns out that Nitrofurantonin can give you neon yellow urine, which is slightly shocking).

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I didn’t have a small panic after I had taken my first dose because I started wheezing like crazy. However my neighbours had decided to burn a tree and the smoke was everywhere, including in my house, so after I had taken ventolin and managed to get my thoughts together I realised that I probably wasn’t reacting to the antibiotics because wheezing, coughing, tight chest etc were the only symptoms I was having, and if I was reacting surely I would be itchy, swelling etc. As it turned out, my asthma was freaking out because of the smoke and I didn’t really have any symptoms after taking the other doses, so it was my asthma and it wasn’t the antibiotic.

I’ve taken 3 doses now and I’m feeling significantly better already. I only needed to get up once in the night to go to the loo and I only went 3 times before 10am unlike yesterday’s 8 times. The only thing that hasn’t changed is how tired I am, but I don’t really have time to stay of college to recover so I am having to plod on, and take things as easy as possible.

One of my main concerns is that my appendix is sore again, which is what happened with my last UTI. So I am going to keep an eye on that and I’m also going to try and find out if I will get the results of the urine analysis over the phone or whether I have to go and find out what they showed…

Stubborn lungs

I feel that I haven’t really talked about my asthma for quite a while, probably because I have been having quite a hard time with my joints lately.

In all honesty my lungs haven’t been great either. Since Bonfire Night (October 5th) my peak flow has been up and down, my lungs absolutely hate mornings and my ventolin usage is quite high again. I haven’t increased my Symbicort to 4 inhalations twice a day although that would probably be the sensible option purely because I want to decrease my Symbicort but that isn’t an option right now.

My lungs are being stubborn and I am being stubborn too, which isn’t a good combination. I just really want my lungs to calm down again, even if that means that I have to stay on the dose I am now. The thing is, I’m not quite sure if I can reduce my dose until the spring now because it seems like the cold is effecting my lungs more than it did last year. And that, in itself, is worrying because I am supposed to go skiing in February and if my lungs can’t cope with 10 degrees Celsius, how are they going to cope with -10 degrees Celsius?

Last year, I was in a similar situation and I got by at skiing with increasing my Symbicort to 3 then 4 inhalations and a couple of hours of skiing a day as opposed to the 7-8 hours I used to be able to ski. But I got by without any pred. And now I can’t even get down to 2 inhalations and I am just managing with 3, I’m not entirely sure that 4 inhalations will actually be able to cover me, which could potentially mean pred, if I can’t get things under control by then. Although I think having a rescue course of pred as a just in case when I go skiing is quite a good idea anyway, I just don’t want to have to need it!