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Newbie - Not sure if GP is doing the right thing

10 Replies

Hi there. Recently developed asthma (or so my GP says). Came as a bit of a bolt out of the blue. One day I'm fine, next I couldn't get up stairs without going dizzy and breathless. I have had an annoying night cough for ages before that which I always put down to being post viral. When I first saw my GP my PEFR was 250. I've been put on inhalers, had a CXR, ECG and blood tests which were all normal.

Last week I saw my GP and managed a 440 PEFR. He said, ""well it's probably asthma, the asthma nurse will see you in about 6 months"". It felt as if once I reached my predicted PEFR his attitude was 'job done'. I still get symptoms most days and at night - is that normal? I'm trying to build up my activity levels again as before all this I was a very fit hiker and out in the hills most weekends.

Should I just wait to see the nurse or should I be changing my GP?

Thanks in advance for any replies

Sonja

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10 Replies

I'm new to all of this too so can't really offer much advice.

Are the inhalers helping when you get dizzy/out of breath? I guess as he's checked for any other causes through the ECG etc, and you PEFR has improved with inhalers, then asthma is a likely cause. There is no one test to confirm it and I think its more a case of discounting any other diagnosis.

However, you seem to have just been dumped with the information. I'd get an appointment with the asthma nurse sooner rather than later to get more understanding whats happenning to you.

And remember you hve every right to a second opionion, so if there's another GP at your practise, get an appointment with them too and explain your worries. I've had to get second opinions before, most GPs are quite happy, after all only you know how you're feeling.

Good luck with it, pm me if you wanna chat to another newbie!!

Hi

I have had asthma for 4 years and mine came on very suddenly too. But your GP sounds like he/she can't be bothered. Get an appointment with the asthma nurse ASAP and discuss you concerns with him/her just to make sure it is asthma. Also maybe try and get a chest x-ray, that may be able to tell you if you have got an infection.

Good luck xxx

It sounds like asthma... but then I am no Doctor.

With asthma, as we state on here so often, you have to become master of your own destiny and take control of your own illness.

There are some brilliant GPs who know about asthma and, frankly, there are others who range from ill-informed and don't care to possibly dangerous IMPO.

I think it is important for you to find a good GP who is up to date on this stuff.

Like many you will often find that asthma nurses are more clued up than many of the GPs as it is their speciality.

The NHS in Wales, not sure about England, gives GPs a big cheque per asthmatic who sees an asthma nurse yearly so, each year, you get invited in to have a talk with the asthma nurse and I wonder if this is what your GP is talking about.

What you really need, if you cannot find a good GP, is to go and see your asthma nurse ASAP and talk through issues.

You need to learn up about the medications and learn the difference between the steroid preventers, the emergency relievers and the long-acting broncodilators. Hopefully, the steoird preventers will be enough and kick in within 6 to 8 weeks but perhaps longer dependent upon how long you have gone undiagnosed.

Make sure you carry your emergency reliever - blue - with you at all times and IMPO it is best to have a few of these - one on you always, one in the house, one in the car.

Well said bob. i had to switch about gp's at the start however don't stick to one if in doubt i'm forever questioning the choices my doctor makes even though i know she is good for difficult asthma. i had a previous doctor who insisted stay on stage three treatment when clearly i was at an extreme stage. when i switched the doctor i now see literally said what is waiting for? i had to have a mass of meds because that one doctor was too laid back. go back and keep going until your satisfied with the doctor and or medication.

Hi all, thanks for your replies. Having been reading on this site, I see I should have an asthma plan - so I will make an appointment to see the nurse and find out what she thinks. This hot weather is making things hard work - hope you all breath easy.

Sonja

While waiting for your asthma nurse appointment it might help to talk to one of the nurses on Asthma UK's adviceline - number at top right corner of page. They can advise about concerns and help you prepare for your next asthma appointment.

You need a cunning plan in my personal view Sonja ;-)

Treat this holistically - the medications are vital and it is important that you get the ones that work for you.

You might find that some medications do not work with you but others do so do not be afraid of going back again and again to your Doc... hence why we are all saying it is important to find a good GP.

But you also need to consider other factors - smoking, stress, allergies such as pollen, cigarette smoke, wheat/gluten, dairy. All or some, or none, could be asthma triggers for you. Read about supplementation with Vitamin D3, Omega fish oils and/or magnesium helps some people with asthma.

From what you write it sounds as if you have been asthmatic for some years - most of us are before we are diagnosed - so think back and see if you can work out when this actually started and if anything 'big' happened around that time emotionally, physically, mentally, diet-wise? A change of job maybe, break-up of a relationship, loss of a loved one, change in diet. Is that long commute to and from work stressing you out, burning up all your cortisol and over-loading your adrenals into shutting down.

Don't forget, it can take a couple of months for the steroids to kick in so take the steroids religiously and always have your emergency blue reliever on hand for when needed. You will get better.

Yes, symptoms are often worse at night for some people.

One final piece of advice, if I were you I would give up on the hiking for a couple of months until I was confident that the steroids had got the inflammation under control.

HI Bob, thanks for your message. I liked your list of potential life events that could have been at the beginning of this - I ticked just about every one! Life is never dull! Initial steroids did ease things, was then put on the purple inhaler which was great, symptoms virtually went as did my voice. So I'm on green and brown now, voice back, but symptoms back a bit as well. Guess it will be trial and error for a while. I've seen your posts about supplementation and have been reading up on the D3 issue. Being very fair skinned I am always covered in factor 40+ so may need a bit more Vit D. As to staying off the hills, not sure I can - I see them from my window and its hard to resist the lure of my boots. :)

im always amazed how it seems gps hand out inhalers very fast without loads of tests first but i suppose they must have felt you needed it. i had loads of medical tests (oh god one being a horrible flamin booth that sucked the air out of my lungs...yak yak yak)but they werent completely sure what was wrong...but it sounds like your gp is sure...you could always ask to see the gp asthma nurse sooner rather than later or ask to be sent to see an asthma consultant

Sonja,

Your GP did all the tests I would expect and I had the same tests done two years ago before being diagnosed with asthma. As others have said book that appointment with the asthma nurse, they are a gold mine and if they have the equipment can give you a confirmation of the diagnosis for asthma. What you need is a spirometry test, they are without doubt the definitive test.

Yes it's true it takes a while for the steroids to fully works and looking back at my peakflow charts, the first 6 months were the trial and error stage and the improvements. Don't give up on the hill walking, exercise like walking is very very good just make sure you take your reliever inhaler with you, read this tinyurl.com/35ufbz2

My own GP was originally like yours, once you get to the predicted range they say OK and to be honest they are probably right, but I've since gone on to better that prediction by some way and have peak flow charts to back that up, so we now have a mutual understanding and what you need to do is try and build that sort of two way relationship with your GP. Show them that you can manage and understand your asthma, after all you live with it 24/7 while they only see your for 10mins at a time. The early months are a steep learning curve, but Bob has said it, you need to learn all you can, my own asthma nurse has said it to me that I know as much as she does, but that doesn't mean I don't value her input because I do and would never question her judgement, but I say what I want medicine wise and she's happy to go along with it.

Sunlight and Vitamin D like Bob has said is the key, I'm convinced of that. I'm fair skinned and spend all day out in it, but sun cream isn't something I bother with, If you spend a lot of time out doors all year then you should be building up a natural protective tan to prevent the burning, I know I do for the most part, just when it gets really hot and I work without a shirt the first day I get sunburnt. We in this country have low levels of vitamin D in our bodies, and yet we have one of the highest rates of asthma, coincidence or connection?

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