watervole | Entries tagged with asthma

A problem that plagues asthma sufferers (including myself) is how you know if your inhaler still has medication in it. There's no indicator; the medication is almost tasteless and has no colour. They continue 'working' when all the medication is gone (or at a level that is too low to be effective)

I've seen suggestions that they are out of medication when the cannister floats, but apparently that's not accurate.

I've decided to tackle this by weight.

A full Salmerterol inhaler (cylinder only) weights 21 grams on my kitchen scales. 1 dose = 25micrograms medication + 125 milligrams propellant.

Each inhaler has 120 actuations. This gives a weight loss of 15 grams before the cannister is effectively empty.

So, when my inhaler weights 6g, then I will know it is empty.

I found a handy medical site that already had the figures for Ventolin.

A Ventolin (Salbutamol) inhaler weighs 37g when full and 25g when empty

Salamol - my new reliever in 2023) weights 16gm (cannister only) when full. A full Salamol® inhaler (inc all bits including cap) weighs 26g, and an empty one weighs 17g. (cannister only will weight 7g when empty)

Hopefully, I'm not the only person who will find this useful.

I'm actually gaining on all the health problems now. And I promised I'd tell you all what I found helpful.

Realising that the far worse than normal asthma of the last few months was probably due to stress was the key in this case.

Over the course of a couple of weeks, I focused on tai chi, meditation, gentle walks, etc. (and also just telling myself that I was caught in a vicious circle where being unable to breathe was triggering panic attacks which were making the asthma worse, etc.)

The asthma is now back to its normal level for this time of year.

I've still got some remaining stomach pain, but it's not nearly as bad as it was, and googling suggested that IBS was a strong possibility. I've had irritable bowel syndrome before. It's essentially caused by stress - so no surprise that it's responding to the same treatment I've been giving the asthma. It always vanishes when I'm dancing... (ie. when I'm happy and distracted)

Things that helped:

1. Tai Chi, Leia Cohen in particular.

She has several 5 minute tai chi videos on YouTube - this first one is now upto 13 million views...

Watch on YouTube

I subscribed to her app a year or two ago, and have found many useful videos there. I use one most days. There are some that are especially helpful with hip problems, great for people who spend too much time sitting down. (helpful for piriformis syndrome too)

2. Meditation

I use Insight Timer - This site is free and has thousands of guided meditations on many subjects and also relaxation music. I have the paid version purely becuase it was so massively helpful when I had depression five or six years ago that I would gladly have paid them far more than the annual fee in gratitude. (You get some handy bonuses with the paid version, but the free version is still fantastic)

3. Dealing with pain

When my sciatica was really bad, I got some help from Curable (I had the operation on my spine not long after, so didn't get to test it on to the full, but I did find it helpful enough that I've kept the app, though I may drop it soon as I've memorised the best bits)

It's essentially a brain-training technique. I read about the technique in New Scientist and went searching for a site that used the technique. In very simple terms, the brain can become conditioned to respond to pain in certain ways. This means that it sometimes continues to send strong pain signals in situations where they are not helpful. (phantom limb syndrome is probably the one most people will recognise.)

But the brain can also turn off/reduce pain signals in some situations. If you're running from a tiger, the pain in your hip is unlikely to stop you...

What the app does is to help you tell the brain which pain signals are too strong. eg. Sciatica...

I find the 'helpful assistant' on the Curable app to be incredibly annoying, but there are some very good exercises in there and I found them helpful.

This is mainly for my own reference. I'm having my first major asthma attack in over a year. I'd got used to living without asthma - I was really enjoying it...

Things that have probably helped reduce the asthma risk - no carpets. When we installed the heat pump, we opted for an underfloor heating system with LVT tiling. That cut down dust exposure quite a lot (and I know dust/dust mites is one of my triggers)

Most likely cause of current attack - a search through old DW entries finds one where I'd mentioned the risk from fungal spores. This may be spot on - penicillin and aspergillum spores peak in September/October and mould is my other key trigger. Things like wet paths made from woodchip can make me wheezy.

There's not a lot I can do, apart from avoiding mould as much as possible. I've just completed my first course of steroids in a long time - and I'm still wheezing.

Making sure we empty the food waste bin regularly, possibly cutting down on the number of house plants, and drying laundry outside as much as possible are all we can really do to reduce the risk from mould - apart from choosing carefully where we go for walks.

Frustratingly, most pollen count web sites ignore fungal spores, but this one from the University of Worcester has some limited data - https://www.worcester.ac.uk/about/academic-schools/school-of-science-and-the-environment/science-and-the-environment-research/national-pollen-and-aerobiology-research-unit/pollen-forecast.aspx

Their site says:

Aspergillus and Penicillium types

The year starts with a high risk for these types with a total monthly average of 1,333 spores in January and 1,215 in February. Spores continue to be airborne during Spring and early Summer but possibly below the levels needed to trigger symptoms, although studies show that A. fumigatus can be high in March and August, as well as the Autumn. From mid-August the risk starts to rise again and people often report symptoms during warm, humid conditions in late August, September and October, with the peak reaching an average of 1,950 spores in October. Although the spore levels continue to be high during November and December, few people report symptoms, so it is likely that the types occurring during these months are less allergenic.

I'm having my first bad asthma attack for over six months.

I've been increasing my exercise and that's been helping, but the fog for the last few days has been really bad.

The fog traps all the air pollution and I'm very wheezy.

I've had to take a course of steroids and that means in turn that I can't sleep (awake at 3am last night trying to decipher knitting patterns)

My daughter's affected too. Her asthma isn't too bad, but the trapped air pollution has triggered hers as well.

I'm just glad I don't live in London - According to City Hall, almost 10,000 Londoners die every year because of polluted air and the capital does not meet the legal requirements for pollutants such as nitrogen dioxide.

Crossposts: http://watervole.livejournal.com/625337.html

Mainly for my reference - as this isn't a problem that will affect all users of the drug - never use Tiotropine - http://en.wikipedia.org/wiki/Tiotropium_bromide

It's not a medication that will help my asthma as it causes exactly the same throat problems as inhaled steroids. It's about a month since I took two doses of tiotropine and my voice is still very poor (almost non-existent today) and my throat is inflamed (though to be fair that might be an infection as I have been ill recently)

Crossposts: http://watervole.livejournal.com/542028.html

This has been a bad winter for asthma - I've had to take four short courses of steroids so far (which is far worse than my average one course per winter). Sometimes I can identify the trigger (eg. flu), sometimes, I can't. I had a bad attack on Boxing Day bank holiday which remains of unknown cause (I think the bath bombs I bought Entorien were part of it, but not the whole story as she was very sensible and restored them to their double layer of plastic bags as soon as she realised what I'd given her).

Today, I think I've had a narrow escape. As soon as I came downstairs I started wheezing. (I'd escaped the New Year fireworks by making sure all the windows were closed overnight). The flowers from Barclays were in the kitchen and were starting to open out.

My next door neighbour has just been presented with a large bunch of lilies and dahlias and is very happy with them!

Crossposts: http://watervole.livejournal.com/477671.html

I phone the Asthma UK telephone helpline. The nurse couldn't work out what might have triggered the attack (though she had a very sensible checklist of common triggers), but she did have some useful advice for future attacks.

The recommended amount of ventolin that can be used in case of a bad attack is much higher than it used to be. The recommendation is now to take two puffs at two minute intervals for a maximum of ten puffs in total. That's a lot higher than I was taking last night.

Also, steroid tablets should always be taken in the morning (which I already know from experience tends to help the steroid-induced insomnia), but it's okay to do this even if you started the course the night before. I was concerned about taking two doses that close together, but she said it was okay, which is definitely a good thing.

I've just made them a donation via my Charities Aid account - and passed on some money to Marine Conservation, the Bumblebee Trust and a couple of others while I was at it. I believe it's doubly important to support charities when the economy is in trouble.

Crossposts: http://watervole.livejournal.com/473127.html

I had an asthma attack last night, (started about 8pm and hit serious by 10pm), totally out of the blue. I'm not suffering from any illness. I hadn't been exposed to any known allergens (dust, fungal spores, perfume, fireworks). It was so bad that I didn't go to bed until 3am. At the lowest point this morning, my peak flow was down from 500 to 350 - effectively losing nearly a third of my lung capacity. (I think that's actually worse than when I had the flu) Taking ventolin wa making no difference at all.

Got a doctor's appointment this morning and decided to start well in advance and walk as much of the way as possible. (but made sure I had the number of a local taxi firm on my mobile before I set out, in case of emergencies). With the aid of two walking poles, I acutally made it all the way - as long as I walk steadily, it doesn't make the asthma any worse and walking tends to help some of the side effects that are inevitable with the amount of salmeterol and salbutamol I've taken in the last 14 hours. (It helps reduce the shakes)

Walked back as well. I decided to take the bus if it caught up with me, but it was running late and only met me when I reached the stop I'd have got off at!

Peak flow is now up to 460, but I feel totally wiped from lack of sleep and my lungs feel tired after struggling to breathe for so long.

The scary thing is that having no idea what triggered the attack, I don't know how long it will last. It makes it very difficult to plan my medication. Do I carry on with the steroid course I started last night (and accept the insomnia, inability to wear contact lenses, etc) that come with it? Or do I hope that the attack will vanish as suddenly as it came? The trouble is that I don't think I can afford not to take the steroids.

Crossposts: http://watervole.livejournal.com/473051.html

I feel even more out of breath than I did an hour ago, but my peak flow is actually higher, only ten points off my maximum (ie. well nigh perfect).

Just goes to show how totally unfit one can get with just one week flat on your back.

I ought to be doing useful things on the computer this afternoon, but I may collapse and sew some Dorset buttons instead...

Crossposts: http://watervole.livejournal.com/469919.html

One of the hardest things I find about taking a steroid course for asthma is coming off them afterwards.

The side effect I generally notice is muscle weakness (though this may also be due to the fact that I've been ill).

The catch is, that it's hard to tell shortness of breath caused from asthma apart from shortness of breath caused by the lungs being weak after illness and steroids. Thus, this tends to be a time when I'm never far from my peak flow meter.

I went swimming this morning (imperative after being ill as I need to build up the lungs again asap). I'm now pretty breathless, but my peak flow meter tells me that my lung function is actually only 30 points below max (ie. Well within what I'd expect on a normal healthy day). The feeling of being out of breath is actually a result of my body not having had a decent work out in over a week. The lungs are tired after exercise, rather than actually asthmatic.

Without the peak flow meter, I would have assumed it was asthma and taken more medication. (yesterday, the same sensation WAS asthma and I did use the inhalers).

I'm planning on cutting the steroids by 10mg a day (took it down by that much this morning), seeing how much salmeterol I need to maintain lung function, and using that as a guide to see if I can keep stepping the steroids down.

And I'll need to get some form of active exercise every day for at least the next week.

Crossposts: http://watervole.livejournal.com/469622.html

I can hear the fireworks starting and I'm a little bit nervous.

I'm indoors, which will help, but I'm already on pretty much the max medication I can take, because of the flu.

The two worst asthma attacks I can remember were both on New Year's Eve and triggered by firework displays.

Fingers crossed. We don't usually get many fireworks in the village.

It's quite possible that the steroids I'm already on will prevent any problem. Here's hoping. (and it'll be useful data for the future if they do)

My mind's mostly with Anonymous Morris. They've danced out a few times before, but this was our first really big event. I'm so hoping it all goes well. (But I would in no way be helping them if I was there and collapsing on the spot - which I would be. One has to be realistic. I'd be a distraction, not an asset right now)

They're all good people. They'll do fine without me. (Though I do hope the band are okay. Our new band members have only been with us for two weeks and that's not long to get confident with all the tunes.)

Crossposts: http://watervole.livejournal.com/469236.html

I'm definitely past the worst. My body temperature is stabilising now. No hot or cold sweats today. Still very tired, but more able to move about the house.

The asthma is holding steady (but only because I'm taking max salmeterol and the steroid tablets). I'm not needing to top up with ventolin today, which is good. I took so much yesterday that I was getting tremors from it. I'm almost shaking from the salmeterol alone, but not quite.

I'll keep taking the steroids until I the asthma is stable on half the salmeterol dose I'm taking at present. (Or the tablets run out. I've only enough for a four day course, but that should be enough)

Modern medicine may have some problems with side effects, but by Golly, that's massively better than being collapsed on the floor unable to breathe.

Crossposts: http://watervole.livejournal.com/468779.html

There are times when you have a bad cold and you think you have flu.

Then there are the times when you actually have flu, and you remember what the difference is.

This is one of the latter occasions.

I started shivering Tuesday evening (even when wrapped up in a cloak and a blanket on top of three layers of clothing). Since then, I've been through the hot spells, the cold spells and, increasingly, the wheezy spells.

This is why I got a prescription for steroid tablets from the doctor a month ago. I didn't need them then, but I knew that if I did this winter, I would be feeling far too crap to go to the doctor.

I can't use inhaled steroids - which are the standard preventative treatment for asthma. This means that when an infection goes to my lungs, I'm in real trouble. The only recourse I have is massive doses of bronchiodilators (I'm at max now) and short courses of steroid tables. I don't like the tablets, the side effects include really nasty insomnia, but I don't have much choice. My peak flow is way down and the slightest amount of effort leaves me coughing and wheezing. So, I'm now on the tablets. (It's only about one year in four that I get an attack this bad)

Annoyingly, this means I'll have to miss morris practice tonight. I hope the new musicians can manage without me... I'll probably have to miss the dance-out tomorrow which is a real bind. I'd been looking forward to this one. It's the big firework night on Poole Quay and Poole Tourism asked us to dance for it.

I was already planning on taking extra asthma medication to cover myself against the fireworks (I've had some very bad reactions in the past). But if I'm on maximum dose now because of what the flu has done to my lungs, then I've no higher dose that I can go to.

I want to be there very badly, but I also don't want to end up in hospital. (Been there, done that)

Crossposts: http://watervole.livejournal.com/468588.html

Another couple of days with a high fungal spore count. This is really starting to get to me. My chest feels tight a lot of the time. I've tripled my normal dose of asthma medication and the side-effects are starting to kick in now. I'm finding it harder to sleep. It's a choice of feeling tired from the asthma, or tired from the insomnia caused by the salmeterol. And as the tiredness kicks in, it gets harder to exercise, which increases the chance of setting up a vicious circle in which the asthma gets worse overall.

I hope to goodness it eases up soon. Apparantly this has been a really good Autumn for fungi.

Crossposts: http://watervole.livejournal.com/461608.html

My eyes are itching horribly today. I managed to accidentally rub out one of my contact lenses.

It's the fungal spores again.

Runny nose, itchy eyes, asthma.... Bleargh.

Thank heaven for anti-histamines. I've taken one and hopefully the effects will kick in soon.

Crossposts: http://watervole.livejournal.com/460563.html

Something has been badly triggering my asthma this last week or so. Particularly in the last couple of days. I'm taking way more medication than usual and still feeling wheezy.

I suspect the cause is fungal spores of some kind. Grass pollen and weed pollen don't give me much of a problem, but I notice that one of the sites (Zirtek) that lists fungal spores is giving a high count across most of the country at present.

My asthma is always worse in winter. I need to start going to the gym more often. My maximum peak flow isn't bad at all, around 490 today after ventolin, but that will fall over the winter if I don't keep up the exercise.

Over the years, I've found the best thing for my asthma is to maximise my lung capacity so that I can better cope with losing some of it to the asthma.

It's probably time for another dust blitz as well. Dust and dust mites are a known allergen for me, and they're always worse in winter as well. A really good house cleaning can make a surprising difference.

I've now been along to three meetings wearing my new hat as a unit helper for the local guides.

I've enjoyed it. They're a nice bunch of girls and I like the guiders. In addition, they really need my help. One of the guiders is at retirement age and really wants a break. I'm bringing in new ideas and new energy.

The only draw-back is turning out to be a big one. The hut smells very musty. I've had to use my inhaler every time I've been there, but last night I woke at 5am with a really severe asthma attack, my worst since the last time I was exposed to fireworks. I had to go downstairs and take far more medication than is really a good idea and read a book until I was finally able to go back to bed half an hour later. The asthma is finally starting to stabilise again, but it's been dodgy all day.

If this happens again (I may be able to prevent it by taking a double dose of salmeterol on Thursdays) then I'll have to give up helping with Guides.

This was a good new year for me. The credit crunch has had one positive side effect if you're an asthmatic. Less fireworks.

I didn't have my traditional midnight asthma attack, in fact I wasn't even woken by loud bangs.

I feel positive about 2009 already!

I had a very bad asthma attack a few weeks ago, and in the light of that, we decided to get a full set of dust-mite proof bed covers. We'd had a mattress and pillow cover in the past, but this time we went the whole hog and bought mattress cover (the kind that you zip around the mattress as a giant bag, not the sort that just tuck over like a fitted sheet), pillow cover and duvet cover.

The results have been impressive. Firstly, my peak flow is now an average of 40 points higher every morning. Secondly, I've been able (well, for five days on the trot now), to halve my dosage of salmeterol. This is doubly good as some of the side-effects of salmeterol include insomnia and increasing the sensitivity of your asthma.

It's also a source of great relief. Salmeterol is the only asthma medication I can take that stops me waking in the night with asthma attacks, but I've been having to slowly increase the dosage over the last few years. Being able to reduce the dosage makes me feel that I have a bigger safety margin in hand.

Meanwhile, we're doing serious dust reduction on the rest of the house, which is also helping. Richard's cleared masses of old paperwork from the office and it's noticeably easier for me in there.

I'm taking more ventolin than I was before, but that's largely due to a chance in perception. When my morning peak flow was 450, I regarded that as normal. Now my morning peak flow is closer to 500 and I'm taking a couple of puffs of ventolin a day to keep it at 500, rather than 450! (I don't think two puffs a day and one before exercise is a dose to worry about).

I'm hoping that the work we're doing around the house to reduce the dust levels even further will get things to where I can have the high peak flow without even needing the ventolin, but at the moment the dust gets into the air when the radiators come on in the mornings. We're cleaning behind the radiators and between the panels, but it's hard to get everthing there.

This is bad winter for asthma so far. I'm trying to tackle this on two fronts, more exercise (I was badly behind owing to an elbow injury that prevented me working out properly for almost a month), and reducing the dust levels.

Richard's cleaning the lounge carpet. This will help on the dust front. Of course, the downside is that the damp levels go up for a couple of days. Thus, I'm wheezing madly right now and on the verge of getting the shakes from too much ventolin. As soon as he's finished the other end of the lounge, we're planning to go and dig up some more brambles and weeds and chunks of concrete. This should be good both as exercise and getting fresh air.

Meanwhile, I'm off to spend the last of my birthday money on an allergen proof mattress cover as the old one wore out.

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Judith Proctor

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Judith Proctor's Journal

Ramblings on morris dancing, 17th century re-enactment, and gardening

Entries tagged with asthma

How to tell if your asthma inhaler is empty

Health - and apps that may help with stress/pain

Asthma

Asthma

Tiotropine

Flowers from Barclays - the sequel

Useful advice for an asthma attack

Asthma with no trigger...

Still not asthma...

Coming off steroids

I can hear the fireworks...

Flu Receding

The Joys of Flu

More fungal spores

Pollen Count and Contact Lenses

Fungal Spores?

Guides and asthma

Fireworks

Improving asthma

Wheezing

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