private visit to royal brompton.

Hi after months of bliss of having my asthma calm down its suddenly kicked off. i'm worried as my gp is still not referring me to a consultant and i wondered is there anyway that i can go directly to royal brompton on a private basis.

[KateMoss]

The Royal Brompton (RBH) is a Tertiary hospital and the usual route is via a local consultant.

If you really want to go private, I would go localy first.

RBH assesses and treats difficult / brittle / severe asthma etc that hasb't been assessed or been successfully managed locally.

GPs will try to manage your asthma within the practice and will only refer you if you have reached the maximum doses of what they can prescribe.

Have you had any hospital admissions? Sometimes admissions will trigger a referall (Don't get yourself admitted just to be refered!!!!)

Also do you have an asthma nurse?

Perhaps you could ask them why? Also ask your GP why he isn't refering you - perhaps there is a reason or otherwise.

Kate

[Hidden]

I would go back and pester your gp ,they will refer you but you have to make a nusiance of your self.I don't see why you should pay to get treated properly. Have you tried asking your gp out right to refer you. If you still want to go down the private route, you could ring the hospital (private opd) and enquire that way.

Good luck and take care

sj

[Hidden]

Hi

wolfspirit, Im now strategising! I cannot suffer no more! In my other topic (preds and Amox) i have my outline for my plan.

The docs have given me seretide 500 (1 puff twice a day) flixotide 250 (3 puffs twice a day - topping up seretide) and the ventolin. I didnt get on with singulair so thats out.

But im fed up and its now:

- 5 flare ups in a year

- 7 rounds of antibiotics

- 5 rounds of preds.

- 3 puffs of a flixotide 250 and 1 puff of a seretide inhaler and flixonase Nasuls too (this is everyday!)

and a bundle of A&E trips!

i have to ask for medicines now i think! Im struggling to breathe most times!

[Hidden]

I didnt get on with Singlear but I tired Accolate which is twice a day and although it didnt make any different to me I managed to stomach it! There is also other ad on theapes still left to try Theophylline and a oral beta-2. There are also different inhalers such as Alvesco and Atrovent. With brompton being a specilist center i doubt unless its your nearest hospital would be the first one you get sent to. I am under heartlands and makes life harder when i am ill as my local team dont want to step on consultants toes and my consultant dosnt realy see my unwell!

[Hidden]

confused if you feel you are not being listened to by your current GP, could you ask to see a different GP in your practice or possibly move to a different one?

most people who go to the royal brompton have very difficult to control asthma and are referred there from a local respiratory consultant, as you haven't seen a local respiratory consultant I really feel this is the best thing to do, they will assess you and see if you need your treatment altering/need adding to or discharge you if they are happy with how things are.

[Hidden]

Confused have u spoken to astha nurse at ur practice they

May be able to offer advice on why gp hasn't referred or may speak to gp on ur behalf to get referred. There is also asthma nurse helpline on auk offering advice. Have you tried them

[Hidden]

Hi,

Im due to see the practice asthma nurse on monday - im going ask for both spirivia and theophyllin. It seems like the doctors at a&e, the pharmacists and the doctors at the emergency walk in clinics - and auk are all wondering why im not being reffered. even though my doctor uses the term chronic and difficult asthma with me all the time.

Hopefully this nurse at the practice will have some sense to give a stronger LABA! Or a nebuliser!

gussypoo i did at the flare up number 4 and the nurse was excellent and also wondered why i havent been reffered.

[Hidden]

Hope things get answered for you on Monday. Try and relax if u can. as stress can be a nasty trigger for asthma. I know it's easier said than done. I usually sit wie headfones and listen to music or laptop and ds. Are my de stressing gadgets as can't cope wie house arrest when asthma bad..

[Hidden]

private visit to royal brompton.

hi gussy, i'm actually trying to convince myself that im not that bad and keeping myself active around the house. i'm really infected and with preds it seems to have gotten worse. i'm going in on monday with my whole kit including the mini asthma book i picked up from the chemist with the chart of inhalers. plus print outs of all the meds i think could help - is getting good asthma treatment always this much work. i remember months back woody said he does something similar never thought i'd have to do this too. i think its when i was moaning about keeping a peakflow diary.

i'm just wondering if i've been too calm and polite with my surgery all this time.

by the way i do that with the ds too - so glad i don't have the dsi. i'd be hooked permanently.

[Skee-skee]

Confused- just a thought, have you looked at the British Thoraic Society Guidelines for the management of asthma? This is what they should be following and it also recommends when patients should be referred to a specialist. You could take the relevant bits with you to your appointment.

Could you get a someone else to come along with you to your appointment to keep you calm (works for me!)?

Hope it goes well.

Bryony

[Hidden]

Hi Confused,

I had the same meds as you and it didn't work, so they need to sort you out. I have singulair but i don't know if its working tho', ive also had the pleasure of having 6 lots pred and 7 lots of antibiotics so far this year 000h the joys of asthma. But they do have to fiddle about and try and find the right combination of meds for you, this can be a total pain in the ass. But if your not happy go back and stand your ground and be firm and insistant- but be polite or they'll be stuborn and unhelpful. You could even drop in about the other specialists think you should be on such and such a med.

Go for it, Good luck and take care i hope you get sorted soon.

sj x

[Hidden]

confused it is highly unlikely you'll be given a nebuliser to use at home by your asthma nurse/GP, home nebs are usually initiated by hospital consultants specialising in Asthma for those who either have severe sudden onset attacks allowing them to wait for an ambulance o r those with severe difficult Asthma which for quality of life issues is prescribed as frequent trips to A&E for nebs are more likely to result. I was given a home nebuliser after years of admissions to hospital, HDU and ITU, they don't like giving them as they can cause a false sense of security - it hasn't stopped my attacks and also there is evidence which says 10 puffs in a spacer is as effective as a neb. The Kick Asthma holidays I believe don't use a nebuliser for attacks and a spacer is used instead .

There are several things that can be added to help improve your Asthma control, changing your inhalers around a bit for example the Symbicort SMART programme has worked for some people, adding in theophyllines, allergy testing if appropiate and montelukast/zafirlukast. Please don't give up, most people with Asthma do manage to get control of it eventually. I hope your asthma nurse does add in the LABA for you to try or else ask for a referral even if it just for an assessment.

simi x

[Hidden]

preds and amox together?

Hi

firstly thanks everyone for all your advice, its like i've gone from depression and crying like a fool to full on battle mode. i've now booked in with the asthma nurse and one of the Doctor's straight after im sick and tired of being sick and tired (if that makes sense) i've been printing stuff out from the patient uk website so im not having any 'thats not suitable for you' line.

they just keep making the same mistakes over and over and over again. i'm looking into that link bryony thanks i did'nt even think about that.

i just have a women's intuition kicking that the nurse won't want to go against the doctor's recommended dose.

i just need something to keep me breathing simi i might ask to borrow the practice one? so i have that excuse covered now too.

why is this such a battle? I wish they would stop calling my asthma brittle and then not take me seriously!

[Hidden]

confused if you are needing nebs to breathe you probably should be in hospital. :s

[Hidden]

Hi confused,

as simi suggests if your so breathless dont delay go get your self to a&e, hopefully theyre admit you and sort you out properly. You will get very tired and go into combat mode as its survival. It sounds like if your having a continued asthma attack or on the verge and it needs to be better controlled.

If you are hospitalised they gp will have to acknowledge you are not controlled properly.

look after yourself, let us know how you get on.

sj

[Hidden]

hi wolfspirit and all,

i called an ambulance around last night and they instantly put on a nebuliser and taken in for observation. they let me out pretty quick luckly as the nebs did the trick they also gave me a booked appointment at the nearest walk in clinic for a full medical review and collect a nebuliser to keep over the weekend as an emergency. the doctor was wonderful and yes he gave me spiriva and said to go back on friday to see if spiriva works and will check if i need more preds - i'm hoping im getting there now.

Wolfspirit - said its exactly that, the repeated attacks are leaving me with hardly any breath and hence my pulse rate is high i want to get this flare up over as i want that refferal!

[Hidden]

Yes you can. Please contact Linsee Richards at the Private Patient office and Linsee will be able to deal with your request. Her office number is 0207 351 8475 or email me at [e-mail]

David Shrimpton

[angievere]

Bumped up for Sarah1234. It's a long post but someone from the Royal Brompton has posted (last post) with details of who to contact. Might be worth a try.