My serum bicarbonate level is low. Is it due to respiratory alkalosis?

Hello doctor,

I have been really sick from last two weeks. Two weeks ago, I had flu symptoms, like headaches, body aches, low fever, chest tightness, and shortness of breath. The chest symptoms were there straight away, and my asthma medicines (Symbicort and Ventolin) were not working from the start. I was taking 200 mg Symbicort twice daily, and Ventolin every three hours or so. After a weekend of being short of breath and tight-chested, I was on my way to my general practitioner (GP) just to run my symptoms by him to see if I needed a GP or emergency room physician (ER). He told me to take 12 puffs of Ventolin and go straight to the ER. The ER did electrocardiogram (ECG), chest x-ray, and blood tests. They gave me a nebulizer and Prednisone 50 mg and sent me on my way. I was stillshort of breath. My chest x-ray was clear, and my blood showed no infection. I did not have any improvement for the week, and I was taking Prednisone, Symbicort, and Ventolin every 2 to 3 hours. I was short of breath all week. I went to another GP, who sent me straight to the ER again. An intern took my history, after three hours of waiting with chest tightness, shortness of breath, mild intermittent sharp chest pain, and lifelong asthma, etc. I also explained that I am a non-wheezing asthmatic, and when I feel at my worst nothing can ever be heard on my chest. Interestingly, he only noted intermittent sharp chest pain not worse on deep inspiration. He did not note chest tightness when breathing. I also told them that for the 10 days, I had coughed more at night but the shortness of breath decreased overnight every night and was gone in the morning and then just gradually increased over the day until it was sober. Then the registrar came and told me that I was to be sent home, as I was taking too much medication and that was causing my heart to race, and that is why I had shortness of breath. I explained that I had shortness of breath before taking lots of medicinesand that was why my physician sent me to the hospital the previous day. I did not even know that I could take it more than my usual two puffs every four hours. I was taking medicines as per my brand new asthma plan, which was given to me by my GP. I asked him "was my heart rate high when the intern tested me?" To this, he answered, "I do not know, and I have not looked." Then he took my pulse for about three seconds with no watch and said it was 100 per minutes, but my heart rate has been tested over and over all week and was normal every time, that is why I challenged him. He then said that he would keep me in overnight for observations and to await a blood test for a blood clot. The intern had told me they would be doing an ECG and lung function tests. They put me in a room with about eight recliner chairs and no blanket. The nurse attended to everyone else in that room all night and did not even look at me once. She just ignored me. She did not even come close to me. I was awake most of the night. I could hear everything she did with the other patients. My breathing settled a little, but it was still labored all night, and I was coughing all night. They would not let me have my asthma medication. I felt hot and then cold, and I had a migraine. I felt so unwell that I could not get up to reach the button and was just waiting for her to come and help me so that I could tell her. At handover in the morning, she told the next nurse all my information loudly until she came to the bit where she whispered to him that I had been fine all night. I could not believe it. I managed to get some Panadol out of the new nurse, as he did my observation at 7 AM. Then the morning doctor, a young boy, told me he was sending me home, as I was better. I said that my shortness of breath was slowly returning with movement, as I told the doctors at night would happen. He said with asthma; I would be better off being at home as if I caught one of the nasty bugs in there things would get way worse. He said "you do not look like you are dying, and that is my job to see if you look like you are dying. And if you do not, then you are sent home". They never gave me an ECG, and they never gave me lung function tests. My discharge report simply stated that I should go home and take my Ventolin if severely short of breath with wheezing. They made up their minds that I was just taking too many medicines or that I had a 10-day long panic attack. My GP asked me if I had been put on any antibiotics, and I told her how the ER said I had no infection. The GP said, but how did they know if they only took blood? She told me that the hospital tests would not show up a chest infection. So she put me onfive days of Augmentin, and the headache is gone now and asthma slightly better, but I still feel tightness and short of breath. I have been sitting for an hour and a half and am breathing like I have been on a long walk. This has really scared me. The only message I got from the ER says that do not go there even if you have serious symptoms. I have been sent there by doctors. I have not been believed about my asthma all my life, as I never have a wheeze and since menopause, my asthma has gone from mild to sometimes really bad. Home GP was worried about respiratory alkalosis, as I had been hyperventilating for 10 days. I told the intern and registrar what the GP was concerned about, and they just shrugged like it was unimportant. When I read my discharge summary, I saw my bicarbonate level is low, which indicates thepossibility of respiratory alkalosis, does not it? And my estimated glomerular filtration rate (eGFR) level was low also, which indicates the possibility of a problem with my kidneys. The doctors told me none of this. I am being treated for low vitamin B12 and tested for anemia at the moment by my GP. I would like a second opinion as none of this is making any sense to me, and I am still pretty much just as breathless and just as tight chested when I breath. Between ER doctors and GPs, I have nowhere else to turn. I am now taking Symbicort and Ventolin.