It's a long one, but could use your opinions please!

Hi all, I'm a new member but have been reading the boards for a while. I've had asthma for about 5 years, and mostly it's been well controlled till I had a bad exacerbation at the beginning of this year that resulted in an admittance.

Since then my asthma has never got back to being how it was , and I'm really confused about it since I saw a consultant last month and she seemed really disinterested and has left me feeling like I'd be wasting her time and mine if I continue to see her.

My exacerbation came after several months of going back and forth to my asthma nurse because after being a victim of an assault last year I was feeling pretty stressed out. I don't know if that was the eventual trigger for the exacerbation, since none of the doctors actually told me anything, choosing instead to talk to each other over my bed and not to me. I was treated for a chest infection that 3 doctors and a chest x-ray said I didn't have, but they gave me antibiotics 'just in case', and I'd also had 2 colds in the weeks preceding it which also could have caused it, but since no one's told me anything I'm confused and unsure of the real cause, and the notes from the hospital just say 'shortness of breath' as the reason for admittance, which seems pretty general to me.

My asthma nurse had been trying to get me referred to the consultant for a while before I was admitted, because whenever I did have any problems I didn't seem to follow the 'normal rules' for symptoms etc, but my GP always wanted to hold out. Since I was admitted I automatically got an appointment with the consultant, which my asthma nurse was pretty pleased about, and she told me to do peak flows and write down everytime I had symptoms, and what I was doing at the time. She also said they'd be doing a spirometry test and generally getting to the bottom of my triggers etc.

The exacerbation was in January, and the cons appt in June, and since January I was really struggling some mornings with shortness of breath at work, to the point sometimes where I just had to sit down for a breather before carrying on (I'm a care assistant in a nursing home, pretty physical especially in the mornings), and taking the reliever didn't seem to make much difference, probably because I was still working. The s.o.b would only really go once all the running around was done with and I could take things slower. It wasn't every shift where it happened, just a couple of mornings a week, so I kinda figured it wasn't just me being unfit since I'd expect it to be every shift if that was the case.

I saw the consultant last month, and although I know better than to expect some miracle cure, I was at least hoping for a little interest in my symptoms and maybe a change of medication to see if the s.o.b could be eased. She hardly looked at my peak flow charts, when she did she pulled a figure out of thin air for my 'best' (480, which I haven't blown since early last year when I was actually 'well'), and when I asked about the shortness of breath she said there was nothing she could do about that unless I quit my job. No spirometry was done, so I have no idea if the exacerbation has left my lungs worse than they were before, or if the s.o.b is even connected.

I'm supposed to be going back in 6 months to see her again, but I really don't want to. I don't see the point if I'm just gonna be wasting 3 hours on buses and sat in waiting rooms for the sake of a 2 minute one-sided conversation.

I have spoken to my asthma nurse since seeing the cons, and she was pretty annoyed too. She's now put me on singulair, which, although it's only been 2 weeks I think is helping, at least I'm feeling the best I've felt all year, and I'm seeing my GP at the end of this month and she wants me to tell him everything that happened with the cons.

This is where I'm after your opinions; if I tell the GP is it likely to make any difference? I know a lot of you see consultants a lot, I don't really know what to expect from them, so I don't know if I'm just being petty and pathetic in expecting more from them. I'd really appreciate any input here!

Sorry it's such a long one, I kinda figured the whole story kinda connects the dots

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Hi Sandy,

I am sorry to hear of yoru awful experience with that particular consultant. It is incredible that they still turn out people these days who think they are some kind of God. I have met them from time to time in hospitals and I know many GPs and Nurses who know of such people also - they should have been got out of the Medical Profession years ago IMPO.

At the same time there are wonderful Consultants out there - good, warm, generous Human Beings who care about the job they do and about their patients well-being. I don't know how the NHS works in England but here in Wales, I believe, it is the GP's Practice who pays for the care of a patient when sent to see a Consultant so the GPs have a strong say on which Consultants get the work and which ones don't. I was in hospital a few weeks ago and I saw an absolutely wonderful cardiologist and his team were wonderful also.

If I were you I would write down your experiences of talking with that consultant, arrange to go back and see your GP, explain that to him/her what happened and explain how you have told your asthma nurse also about what happened to you. I would be polite but firm and tell your GP that you wish to see a different consultant. I suspect your GP, if any good, will be equally as angry as yourself with this consultant - any good GP will be - as that consultant is not only rude with no communicative skills but also is wasting your time, the time of yoru GP, probably funding from your GP's practice and, worst of all, your health.

One last point though... Please remember that we all have bad days in our lives and that the consultant you were seeing may well have been having a bad day on the day you went for your appointment. I know that does not excuse what happened to you but maybe, just maybe, there were / are things going on in that consultant's life which is causing her to act in such a way. She might be going through a divorce or may have a sick loved one to care for or anything. As I say, it does not excuse the way she treated you.

Please go back to your GP and tell him / her what happened and how you feel about it... and that you wish to see someone else.

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Thanks for your reply jandc, I had no idea what to expect from a consultant, which is why I posted here about it. I didn't want to just go running off 'telling tales' to my GP about something which I was unsure about. I still don't really like the idea of telling him, cos I hate causing problems, but I guess it's probably the only thing I can do!

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Hi sandywen,

Welcome to Asthma UK, I'm sorry to hear that you've been having a rough time. I hope you'll find us a good source of support and information.

First up, something I say to all new members - you've probably seen me say this before, if you've been reading the boards for a while, so please bear with me! These boards inevitably attract a disproportionate number of asthmatics at the severe end of the spectrum, so you may read stories of poor control, multiple medications, frequent hospital admissions and even Intensive Care admissions. Please don't be frightened or put off by these sorts of things - whilst unfortunately common on these boards, such experiences are rare in asthma as a whole. The vast majority of people with asthma - perhaps 95% - can be completely or almost completely controlled, with little or no interference with their day-to-day lives, once the right combination of medication is found. It's highly likely that you will be in this group.

That's very relevant to you, because reading your story, it seems that your consultant is not aiming for this goal of you being able to lead a normal life without interference from your asthma. I am quite disappointed that she should say that she cannot do anything about the breathlessness interfering with your work unless you quit your job. She should be aiming to control your symptoms to the extent that you can still do your job, and in fact anything else that you want to do. Unless you are already on maximal medication and have been fully investigated - and reading your post, it seems that that is very much not the case - I don't think that you should be content with this level of treatment. There are many medications that you could try to get your asthma under control, which might make a great deal of difference to your symptoms on a day-to-day basis.

You have a right to go back to your GP and ask for a second opinion - ask to be referred to another respiratory consultant. When you go, make sure that you write down a list of your concerns and make sure that the consultant addresses them. Taking someone else with you to the appointment can be useful in terms of moral support and helping you to say what you need to say. I would expect a consultant who was assessing you to do spirometry, or even full lung function tests, to get a measure of how severe your asthma is and to exclude any other diagnoses.

Hope this helps, and that you have more luck next time

Take care

Em H

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Hi again Sandy,

You sound a lot like myself - don't want to cause a nuisance or think that you are causing trouble for someone.

I was brought up that way and I know that my parents were brought up like that by their parents and so on and so on. It is a bit of that old British class mentality where you know your place, do not speak out of line and, as I jokingly refer to it now, was brought up to trust 3 professions - Doctors, Teachers and Policemen(Look, I have even capitalised their titles - even now ). There is no doubt that today large numbers of us Brits are suffering all sorts of anxieties and stresses as a result of the old stiff upper lip!

There is a saying that is on the tip of my tongue that I can't quite think of now but... basically it is the notion of he who shouts the loudest gets heard. If you do not speak up for yourself then no one will realise that anything is wrong and, for those of us who were brought up to mind our ps and qs, most of us do not realise that Socety has changed... and we have to shout now to be heard. You know, a bit like that Unison advert they had a few years back where an ant is trying to get a bear to move out of its way but the bear does not hear him... so the ant goes away and comes back with a few thousand ants and they all shout at the same time causing the bear (I think it was a bear) to jump! LOL.

I've had a few years of cognitive behaviour therapy Sandy - which I won't go into here now (phewwwwwwwwwww) - but there is a great deal of evidence around today that points to people like you and I - those who do not wish to create a fuss and who bottle things up - ending up with all sorts of illnesses such as anxiety, panic disorder and, yes, even stress-induced asthma.

So one thing I have learnt from all my CBT training is to become like an army of those ants and, metaphorically, 'shout', not to bottle things in and to tell people exactly how I am feeling and to not keep all the anger and hurt inside. When people take us for granted, especially those to whom we have turned to for help, it causes hurt which usually then becomes anger - some people let it all out and it does not affect them. Others, such as myself and perhaps also you, bottle it up and hence we get upset and even ill. Sensitive, caring people are more likely to suffer from anxiety and stress because they bottle their feelings up whereas, for want of a better term, sods tend not to care less about anything and usually stress, anxiety, panic and so forth often does not hit them till very late in their lives.

Right, I am ranting on now.

I think Emily has posted you some excellent advice and I hope you follow both her and my suggestions. Get back to your GP and get to see a different Consultant. I think the idea of writing things down before you go to a GP to be excellent and it is something that I do myself.

This is your life. You are entitled to live it well!

Best of luck,

Jan.

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Well....

Thanks for your replies. I saw my GP yesterday, and he wasn't actually too understanding about the way I felt. He wants me to keep the appointment and wasn't too concerned about the whole phantom peak flow or ""quit your job"" thing. He said he wants me to go because they can do better lung function tests there than in the surgery, and he wasn't too impressed when I said I didn't see the point in going when they weren't doing any of the tests anyway >.<

I dunno... maybe I am just being petty about it all. At least now I'm back seeing my asthma nurse she's getting my meds sorted and I'm slowly starting to drop my inhalers down so I'm certainly feeling more positive.

Jan- What you said about not wanting to bother people and stress related illnesses rings very true with me. I only ever seem to suffer from colds and exacerbations when I'm stressed out about stuff, and a lot of the time I don't realise I'm stressed out till I look back on it. I'm gonna start looking into ways of managing stress a bit better so hopefully things won't affect me so much.

Thanks again for your posts. Although not much seemed to be achieved, it's the first time I've ever had a proper discussion with my GP instead of just sitting there taking what he said as gospel so I kinda feel I've made a bit of headway in our relationship (for want of a better term!)