Frustration over GPs!

I have come onto this forum for the first time today hoping to see I'm not alone!

I had to take my just-6 year old to the doctors today as she had a bad night and I was going to nebulise her but realised the nebules were out of date. I left feeling very upset and frustrated that I was once again told that I wasn't handling her asthma well. The doctor thought it inappropriate that I had been issued a nebuliser and that I wasn't giving her daily becotide.

A little bit of background. She has acute viral-induced asthma. It's very predictable, 3 days into a cold she gets bad and I start her on treatment with her salbutamol inhaler. I assess the situation and start on 4 puffs every 4 hours or so. As and when it gets worse she can end up on 10 puffs every hour for a spell, but I wean her down to reduced amounts and longer periods between. She hasn't been hospitalised for over a year, but from the age of 18 months had 14 stays in hospital.

She was under a consultant but he said I that knew what I was doing, issued a neb for emergency to give me time to get her to A&E as she goes down hill so quickly, and signed her off saying I would do what the hospital would do and knew at what point to take her there. He rightly said that quick intervention at home would control it better. And it works. He also said that daily Becotide was a waste of time and that even on it she would still have these episodes so not to bother.

But I have had so much grief from GPs and have had to explain and justify my actions so often! Am I on my own?

Now I don't need to take her for clarification of what to do when she gets bad. But in the earlier days, they often listened to her chest and detected no wheeze. They then packed me off telling me she'd be fine, even though she was clearly struggling to breathe. On these occasions she has always, as I predicted, gone down hill rapidly after and needed hospital treatment.

Why do they not instead take Oxygen levels at the GPs as an indication of how ill a child is as they do at hospital? And why are they unaware of the course of treatment given during an attack or episode? So many GPs have been so alarmed when they have heard how much salbutamol is given by inhaler or nebuliser in hospital.

It worries me that they are feared of advising to take more than 2 puffs twice daily or when needed-which frankly has no affect when a child is struggling! Is it just me?

My GP says I should give her becotide daily now and to take her back next week. He will then see that she is fine (Which she will be as the cold will have passed and she won't need her inhaler until her next cold!!) and he will conclude that the becotide has fixed the problem!

Would love to hear your thoughts and to hear if you have had similar problems.

Thank you!

[Thomass_mum]

I haven't had similar problems but how long have up had home nebulisers for? I asked about this for my son and they refused saying if he needs nebulisers he needs to be in hospital.

My son takes seretide 125 (2 puffs AM/1 puff PM), Nedocromil, flixonase, montelukast and ventolin yet despite all these his consultant has admitted this wont prevent his hospital admissions but he is hopeful that it will reduce the overall severity of the attack and should mean he won't need the IV salbutamol as nebulisers didn't work. His admissions are usually a result of catching a cold or virus. My son rarely wheezes he quickly passes that stage and on almost every admission has had a silent chest.

The only problem I have with our GP is they refuse to prescribe my sons medications the hospital have out him on so I have to get repeat prescriptions either when we are seen by the consultant or posted to us. I am sure I would have more problems if his asthma was managed by the GP rather than his consultant though.

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Welcome siobhan! This problem with GPs is so familiar on this forum, if you search back in the topics you will find one entitled something like 'Hands up who is fed up with their doctor saying the child's chest is CLEAR???!!!""

Your story sounds similar to ours with our son, Leo. Our GP may be good at many things but it has become clear to us that he really doesn't have much of a clue about asthma and how to diagnose or treat it. He once even told us our son was 'an enigma' because he doesn't generally wheeze when he has an asthma attack! He refused to believe that it could be asthma simply because of this lack of wheeze, until the consultant set him straight, despite seeing him on several occasions clearly struggling to breathe.

The final straw for us was a time when Leo was having a prolonged asthma attack and having up to ten puffs of ventolin every 40 minutes. We took him to the GP who said his chest is clear and just to bring him back the next day! This went on for 3 days until Leo started to recess so badly at the ribs and throat that we took him straight to a&e where they found his sats were 88! He spent 3 days on nebulisers and oxygen and preds.

Luckily we now have open access to the ward so whenever he gets bad if the preds don't seem to be helping we just phone up and they get a bed ready for him, I don't even bother to call the GP as I know it will just prolong the process.

I really think GPs need more training to understand that asthma presents itself in many ways and I agree with you, why don't they check sats at the GP surgery as a matter of course?

Maybe one day things will improve. Until then I'm bypassing our GP altogether to do with anything asthma related!

Best wishes,

Rebecca

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Oh and I forgot to say, our consultant was happy to give us a home nebuliser too once he was happy that we would know when it was too serious to treat at home. Luckily since then we haven't needed it touch wood.