Wow, I’m so sorry, you sound alot like myself, I have always had asthma, so I live with it no matter how much it brings me down. I was up all night for 3 nights because of coughfing so much. If you take 4 puffs of you emergency meds, that is a clear sign you need to go to the hospital. For myself my husband doesn’t really feel it is an emergency unlike yours, so it is good you have family who understand how bad it can be and are willing to take action when you are not. For myself, I was so short of breth, when i did pass out for exhaustion, I would wake up gasping for air. That is a very very bad sign, especially because it has gone on for 3 days, that means I should have gone in 3 days ago, and I could have died. I mean if you are waking up gasping for air, you still have fight in you, but what if you don’t wake up. You may never wake up. So I would be calling 911 if I were you. You can explain to them that you peak flow is at 250, normally 500, and you can’t bring it up, that is all they need to know.
As for your fears, you need to talk to your doctor about that. Mine gave me alot of hope and education about my asthma, but yours is different, I’m sure. I do not have COPD yet, I asked my doctor that exact question, what if I get worse... but if I don’t get it undercontrol, and find out why it is out of control. That could happen. And then life will be alot harder, I feel for the people with that. I really don’t want to be in that, so I am always counting my blessing I got such a good doc, who is going to help me get it undercontrol.