Question regarding asthma

susi_q · Jun 11, 2004

I am new to this whole asthma thing. Two weeks ago my doctor diagnosed me with asthma. He thinks that I am allergic to pet dander and dust, but is getting me a referral to an allergy specialist. He gave me an albuterol inhaler (2 puffs PRN every 4 hrs), an advair diskus thingy (2x a day every day), and allegra (daily). I think I caught a cold, started symptoms yesterday (sneezing, runny nose, cough, headache, no fever) and of course now I am having a hard time breathing.
My question is this: at what point do I need to seek medical help. I took 2 puffs of albuterol 30 minutes ago, used my diskus thingy 15 minutes ago, and took my allegra this morning. My breathing did improve slightly; however, my chest is still tight and I am still wheezing. It is after hours for my doctor. Urgent care is open for another 2 hours, and after that my only option is Emergency room. My heart rate is elevated, but I am pretty sure that is because I am nervous with the difficulty of breathing. I am not in danger of passing out and I don't feel like I am about to suffocate and die. I am just afraid that if I wait too long it may get really bad really quick.
I don't want to go in unless it is necessary, but I am not sure what constitutes necessary. Sorry if this seems like a stupid question, but I am just not sure. Any help would be great. Thanx a mill.

With asthma, the important thing is to know your peak expiratory flow. I'm guessing that since you are "new" to it, you haven't got your own meter yet. When you do, you can know your personal normal. When you are below 80% of that, you are in your yellow zone and need treatment, but your own albuterol is OK. When you are below 60% you are in your red zone (some say 50%). That's when you need more help - NMTs, steroids, etc. So ... if you have a meter and know your normal, check your flow. If you don't, and aren't getting relief from your MDI, you should get in to the readi-care. (might want to call ahead to make sure they can do NMTs. Most can, but some don't) Since it's a breathing problem (remember, airway first) - you'd probably get seen in ER pretty quickly, but the bill will be bigger. If you haven't discussed this episode with you doctor, that might not be a bad idea either ... he or someone will be on call and can direct you to their choice of facility.

Good luck to you. Don't wait too long if you can't get relief ... last I checked breathing was pretty important

gypsyatheart · Jun 12, 2004

I realize this was going on last evening. I hope you're doing OK. Asthma isn't anything to fool around with. You need to get your follow up education and know your "plan" as the previous poster was talking about. In general, your albuterol inhaler is your "rescue" medicine....whenever you start feeling tight, SOB, wheezy. Take 2 puffs, if no relief or minimal relief; it is usually reccomended that you repeat 2 puffs after 20 minutes.(Sometimes protocol states you can repeat a final time 2 puffs, after 20 min.) If still no relief, this is when you need to be getting yourself in to a doc, an urgent care, the ER, wherever. You need a breathing treatment or two. Sometimes, if it has progressed enough, you will be put on steroids. Your heart rate was up due to the albuterol, it also makes you very "shaky"...like you just drank 10 cups of coffee.

If you are having a hard time getting under control, or have a lot of exacerbations they will set you up with a nebulizer for home use.

Anyway, there is a lot more to asthma education, please start learning as much as you can, get a peak flow meter, know your triggers (URI's, dust, pollen, allergies, etc), medications, etc.

Good luck!

Farkinott, RN · Jun 12, 2004

The advice from Moondancer and Suzi Q is great.

The most important thing is to stick to the "plan" you have decided on with your physician. Chucking a few steroids down your throat when you know an asthma attack is coming on, may mean the difference between a day or two in bed at home, or a hospital stay.

To keep yourself well with asthma you need to make sure you are diligent with the use of your "preventer" medications/puffers, these are generally coloured brown/green or yellow. It may be more beneficial to take a couple of puffs of your "reliever" (blue) medication before taking your reliever as the bronchioles will be opened up and better delivery of the (preventer)medication will occurr.

The use of a "spacer" increases the efficacy of the inhaler used. The inhaler medication is ejected at so fast a rate that most of it is plastered to the back of the throat, some is swallowed and a small percentage is inhaled as intended. By using a spacer you get most of the medication, as it is airborn within the spacer, whilst you inhale.

Good luck! just don't forget the preventers!

kids · Jun 12, 2004

Hope you are better.

Sounds like an upper respiratory infection aggrevating the asthma.

The Advair id preventative and will not help during an acute flare. While *we* know it is probably safe to increase the albuterol that is instructions you need to hear from a doctor.

A trip to the doctor (or urgent care) is probably in order if you are not feeling a lot better today.

My daughter gets into trouble sometimes in that she gets so tight she doesn't wheeze, she doesn't realize she's in trouble until it registers that her back aches.

susi_q · Jun 12, 2004

Hey Belle ... how are you? You've been in my thoughts, hope all is well.

Love4Me, RN · Jun 12, 2004

Thank you everyone for your feedback. I am feeling MUCH better today. Last night I suffered for a while, but when I took my 2 puffs around midnight it seemed to help and I fell happily asleep. I am still wheezing today, but I feel fine. I am going to call my doc first thing monday morning and talk with him. I think that the peak flow meter may make me feel more comfortable with knowing where I am since I am still new to this. Thanks again to everyone!