Recovering from an asthma attack is something that I used to be able to do (or least think I could) in a matter of hours or at worst a day or two. As I have got older and my attacks have become more frequent and severe I have discovered that making a full recovery usually takes weeks. Obviously the severity of the attack effects the recovery time as well as the care and treatment received and the actions that I take.
A large percentage of my asthma attacks and hospital admissions happen overnight which usually following the emergency care in A&E / Resus it is quite of well into the evening before I am stable enough to be admitted to a ward, the ward can vary (again depending on the severity of attack and my response to the treatment), Intensive Care, High Dependency or Acute Medical Unit.
Every attack is different and so the treatment given varies but in general my admission and recovery for a typical (if there is such as thing) asthma attack would be something along the lines of below:
Stage 1: The attack begins, I will be taking back to back nebulisers in an attempt to ease things.
Stage 2: The nebulisers aren’t helping and so an ambulance is called. The emergency services are usually excellent and the person on the other end of the phone will stay on the phone with the caller until emergency help arrives.
Stage 3: The ambulance / paramedic arrives, will examine me and get something basic information and check my sats. I am then usually given oxygen and further nebs.
Stage 4: I am then transferred via ambulance to the Hospital A&E / Resus.
Stage 5: I usually continue with back to back nebs and oxygen, my sats monitored, I am examined, usually an x-ray is taken of my chest and blood gases are taken.
Stage 6: After a while I begin to become de-hydrated and so will be given fluids, I may be give IV Magnesium, IV steroids etc depending on my condition.
Stage 7: Once I am stabilised I wait for a bed on the ward, I am then transferred to the relevant ward.
This is when I consider the recovery process begins, usually I am kept on oxygen, given lots of nebulisers and usually given IV Aminophylline. Sleeping in the days immediately after an attack is almost impossible, due to the high dose of prednisolone, the back to back nebs and the general noise there is little chance of getting much rest.
Usually after 2 or 3 days I begin to feel slightly better, however the biggest problem that I have is that I am prone to further attacks following the main attack. Usually these secondary attacks aren’t quite as severe as the original attack although on occasion the secondary attacks have been worse. Either way this usually sets back the recovery be a day or so. For the first few days I am often confined to my bed or if I am lucky just confined to the ward. By the time I am allowed to get up and walk about I have usually started to suffer from cramps and stiffness in my legs. This usually eases after a day or 2.
Once I am free of attacks and my sats begin to improve the aim is to try and get me home as soon as possible. I am lucky in that I have the nebuliser at home and I am self medicating. I also have a very good relationship with my consultant and as long as I don’t need oxygen or anything intravenously the aim is to get me home. This is always in the strict understanding that I don’t over do things and in fact quite often I am expected to remain housebound for at least a week. During this week I usually remain on regular nebs and high doses of steroids, due to this sleeping is still usually an issue. It is also very hard during the day to ensure that I find the correct balancing between trying to do things and not overdoing it. Walking upstairs to the bathroom can take a lot out of you following an attack, especially if you have hardly left your bed in weeks!
When it is time to try and venture outside I wrap up very well, ensuring that my mouth and nose are covered with a scarf or snood, it is a major shock when you haven’t been outside for weeks and then suddenly step outside into the cold and damp English winter. Walking even for just a few minutes can be very exhausting both physically on your body, your legs and arms aren’t used to it at all and then even more importantly it can be real shock to your lungs. It is so important not to do too much but it is only natural to try and do things as normal. Judging when you are fit to return to work is always an issue, I always have battles with my Occupation Health and Human Resources departments regards returning to work. I always want to go back as soon as possible but obviously they have a duty of care to both me and my workmates. They usually insist on a phased return to work which I find frustrating but I also understand the value of it. One of my biggest problems with returning to work following an asthma attack is not usually the asthma but instead my diabetes which is often well out of control following weeks of increased steroids, this result s in me having high blood sugar levels which mean that I have to increase my insulin which can then have the opposite effect and I end up having hypo’s which means that I can’t drive, which therefore means no work (I travel 60 miles to work).
The longest time that I had off work following a bad asthma attack is just over 3 months, this was due to the fact that I kept having bad attacks and actually had 3 separate admissions rather than having 3 months off following 1 attack. My consultant always insists that to make a full recovery from a moderate to serious attack is likely to be within the region of 6 weeks. I always thought that she was been over cautious when stating that but I must admit that I have started to agree with her. Such a long period may seem excessive and if you have only had a minor attack maybe it is, however for a fairly major one it is not. A major attack takes it out of you both mentally and physically, it is important not to rush things or else you are likely to end up back at square one!
Always listen to your GP, consultant and respiratory team. Always keep work informed of your progress and condition!