Relievers for reversibility test

Not quite sure what was going on, I posted this and got multiple copies, deleted duplicates and then loads vanished!

Anyway...just wondering if it's possible to request a different inhaler/drug to be used for reversibility testing, and if so how?

Saw on the form today it said salbutamol which seems to be the standard; didn't really have a chance to raise this during appt but I don't seem to respond well to salbutamol and have been wondering if that's why my last reversibility test showed nothing (though oddly my PF does seem to go up a bit with it).

I seem to respond better to Atrovent and best to both salbutamol and ipratropium combined. Is there any way of requesting an alternative to salbutamol? I'd like the reversibility test to be at least vaguely useful which it won't be if it's like last time (though I'm reasonably sure they won't abandon me this time if it does come back normal).

[yaf_user681_2584]

not sure how helpful this is but sometimes when ive seen spirometry done when investigating COPD patients theyve used both salbutamol and atrovent when doing reversbility testing. so maybe an option to ask about?? probably best to phone before though incase they need to ask your cons/change anything.

B x

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Thanks - I think that would be good for me. I need the contrast especially because my results are usually pretty high so if there's no change they don't even think there's anything wrong!

I was definitely thinking I'd need to say before the test, just not sure how I'd go about doing this or who to ask - reception staff aren't going to know about this though guess they could ask the cons.

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Sorry to bump but just wondering if anyone has any ideas how I could do this eg who is the best person to ring?

Or might the AUK nurses know? Was thinking about ringing them but wondered if anyone had requested this before and how successful you were.

[yaf_user681_30355]

Hi Philomela,

At the hospital I go to, all of these tests were done in the Lung Function Unit, and I could always ring them direct. Are you having it at St Mary's? As it might be on their website. I know it is for Southmead.

Jac xx

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Thanks Jac!

It is at St Mary's yes and think the number is on the website. Have you ever contacted yours about anything? I wasn't sure if they'd be able to change it or if they'd need the cons to approve it, though I guess they could ask her if I ring them to start with.

[yaf_user681_30355]

Yes, I have contacted them many times... When the consultant's secretary was so slow with requesting appts for several tests in lung function unit and also the echo & bubble study at a different hospital, the lung function unit were more helpful, efficient and supportive than she was! lol.

They will probably have to check with the consultant first so would be better to ring them soon if you can.

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Definately agree the lung function centre is the place to ring, should be a number if you've had an appt letter/card, if not have a look on their website or go through switchboard.

Have rung a few times and they may will have to go and check with someone

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Aha! Thanks TJ, number is on my appt card and on the piece of paper they gave me with details of the test (which warns you about not exercising vigorously beforehand but says nothing about how knackered you'll feel afterwards!)

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Well, rang lung function who told me to ring cons secretary. Hope I can get hold of the secretary as no number listed.

It was one of those conversations which makes you feel like you're asking a massive favour or something completely unreasonable; think maybe just the way the person talked but she really made me feel like 'why on earth would you request that, we can't do anything about it' when I was just trying to work out if it was possible and had started by asking them!

I'm not going mad here and demanding something which can't be done, am I? Just feel like it's a waste of their time as well as mine not to try it with a reliever or combo which I know works best. Last night, after I'd run out of Atrovent and just had Ventolin, confirms the Atrovent really does make a difference though Ventolin does make PF go up a bit. Evidently not enough though if the last reversibility test is a guide.

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No luck (and rant alert)

Just in case anyone else weird like me wants to try this - no luck. Said 'not protocol for asthma' - fair enough I guess but surely consultants should be able to make a decision to go off protocol when necessary, for specific patients? I'd said it wouldn't do much and said what did help me - just seems a bit of a waste of their time and money to do it like this.

Was given 2 puffs of salbutamol and when I said wasn't really doing much and I'd usually take more and/or Atrovent, LF tech really laid into me about my reliever use and made me feel like I was irresponsible and doing something wrong for needing so much - made me feel like crap. Why does she think I am there seeing an asthma specialist?! She didn't even say 'if you find yourself needing a lot in a short space you should get help' which is how I'd understood the way you use reliever (and dr had said to do it), but said that it was medicine not sugar and there were specific amounts I should limit myself to (I take a fair amount in a day, but what I said was not at the 'over 10 puffs in a short space of time and needing A&E level) - she made it sound like I was just taking it for the hell of it! Trust me, lady, I don't take Atrovent for the taste!

Also said Atrovent was a LABA and couldn't possibly be helping me in the time I said - umm, if it is a LABA and takes hours to work then why is it used in nebs for acute attacks?! Only thought of that afterwards but seriously, there is no need to lay into people like that and especially not when your info isn't even correct. Everyone else in this clinic is lovely but LF seem a bit...hmm.