So, I'll keep this brief. I had a chat with the nurse, talked about chest being tightest in the morning, had a spirometry.
The good news is, I'm up to 89% of predicted (as opposed to 81% of predicted in October) which is good considering I've been in hospital once, had a really bad chest infection, and had that issue with the guy who thought smoking an E-Cig RIGHT NEXT TO ME was acceptable (grrr…) although it isn't amazing, seeing as I'm a highly-trained singer so I should be between 100% and 125% of predicted, at least. But it's a start and it's progression in the right direction.
I showed Asthma Nurse my peak flow chart and she grimaced a little at the large zigzags on every page (see below) which should be, I discovered, more like little serrations or 'hops' rather than 'jumps'. What is basically happening is my peak flow (the biggest amount of air I can blow out really quickly) is okay in the evenings when I've had all my medication for the day, but when I'm waking up in the morning my airways are narrowed so my peak flow is low. This meant my chest felt really tight and breathless in the mornings so I resorted to using my reliever every morning, which is not right.
So, the verdict: steroid therapy has worked well to get down inflammation in my lungs, increasing my lung volume and peak flow and improving my symptoms, but I need a bit more help to keep my airways open so I've been given Seretide (Advair in the US), which contains a different steroid (dose-matched to the one I was on) but also a Long-Acting Reliever, which keeps my airways open for 12 hours instead of 4. Seretide is purple, so that makes a nice change, and it also has a counter on the back which makes me happy, because I am really bad at remembering when I've used an inhaler and in the past resorted to using a Sharpie to mark each dose on the canister which is not only a drag but also looks kind of untidy. The counter is really neat and it automatically counts each dose so..I'm happy :P It also seems to be working so far to stabilise my peak flow and keep me from getting tight in the mornings so I'm hopeful.
There's also this chart which illustrates that Seretide is a combination of two different medications to help me in different ways:
I've also gone back to Salbutamol for my reliever, because I was really struggling to use the Turbohaler as I couldn't pull the medicine into my lungs (it has a really high resistance) and it was mainly getting stuck to my throat, which is no use to anyone and just meant I had to keep clearing my throat all the time.
I got a spare spacer so I can keep one with my ice hockey kit. I also got a refill on my reliever inhaler, but I requested the smaller, gentler IVAX Salamol inhaler instead of the standard bigger GSK Ventolin inhaler, which has a harsher puff. It's mainly just due to the fact that the smaller IVAX one fits in my pocket better and is more discreet at college. I haven't finished my Ventolin yet so that's staying in my medicine pack as a spare. On the left is my Ventolin, on the right is my new IVAX inhaler:
Yeah okay so that wasn't really short, but that's where I'm at. Check-up in about 3 weeks will ascertain whether I stay on Seretide or change or whatever but for now..it's looking alright :D
Happy Holidays!
~Liz
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