So, I managed to get myself a GP appointment for 10 past 10, with the GP at our practice who's supposed to be the asthma expert.
Firstly, I was unimpressed because he was running 45 minutes late. I know these things happen at the doctors and are sometimes unavoidable, but an apology is always nice and there was none of that. In fact he was so grumpy it was almost as though I'd kept him waiting! He asked me what the problem was,so I explained about the nighttime coughing and wheezing, having to prop myself up on pillows and often getting breathless when I talk. He listened to my chest, didn't bother doing my peak flow (I could have told him it was 290 at 4.30am and 340 at 8am, but he wasn't interested in that), and then told me that the nighttime pattern I was describing fit asthma (no shit sherlock...), but as my oxygen levels were ""acceptable"" and my chest sounded clear, he didn't believe that the breathlessness when talking was due to asthma. I asked him in that case what he thought it could be. He waffled around the point for a few minutes before finally saying he didn't really want to overprescribe steroids due to their potential side effects and I had had a course just before Christmas. So I pointed out that I've had steroids several times now, I know what they are and what they can do, and did he have any other ideas on how to solve my nighttime problems.
SO he said no, he thought a reducing course of pred would be the best way to go and he did me a prescription. Then he repeated that as my oxygen levels and my pulse were ""satisfactory"", he didn't think the breathlessness when talking could be put down to asthma. Then he sat and looked at me, as though he was waiting for me to say something. So I said well, apart from when I had pneumonia it only ever happens to me when I'm struggling with my asthma. And as I'm not currently breathless then surely it makes sense that my pulse and oxygen levels are ""satisfactory"", but that doesn't mean they were last night at 10pm when I couldn't talk for longer than 2 minutes without needing my inhaler does it. At which he just shrugged and said well, your chest is clear so you don't have pneumonia (I didn't actually think I did?!), if the steroids stop that too then we'll know it was down to asthma after all. It was very subtly implied that the breathlessness was down to stress, which really irritated me. With my history, every GP at that practice should be well aware I'm not suffering from any stress based disorder. Additionally, I was warned after the pneumonia cleared up that there would be scarring on my lungs that may improve over time but could potentially mask, wholly or partially, any sounds on my chest. That should also be in my medical records which, I assume, he didn't bother to check properly because he was running late. Then again, it could be that my chest was clear as I certainly didn't feel as bad at 11am as I had done at 6am. As an asthma ""expert"", surely he should know that?!
On one hand, he prescribed me pred., which I assume he wouldn't hand out if he didn't feel it was needed due to the potential health risks, especially when I had a course just over a week ago. So the appointment was a success and he clearly didn't just dismiss me. But on the other, he was grumpy, patronising and most definitely trying to imply that I was either exaggerating the breathless-when-talking thing, or else that it was just me being stressed out and trying to attribute it to my asthma rather than admit it (it's hard to describe how he managed to convey this to me, it was done more by expression and tone of voice than anything else).
So presumably the steroids will work but still, I left feeling very cross and thoroughly exasperated. In my opinion, not really good enough, especially considering the amount GPs get paid. I can't believe he didn't even do my pf?!
(I feel I should add here that the GP I saw today is the same GP who spent 18 months telling my friend she was having panic attacks because she said she kept feeling as though she was suffocating and couldn't get air into her lungs. Even after paramedics had been out to ger house and had her on a nebuliser twice he still insisted it was panic attac ks. It took her2 years to get an asthma diagnosis and even then it was done very grudgingly!)
ggrr! I know exactly what you mean, I've had appts like that where ok, I did get some result but I've also been made to feel like I was wasting their time. Maybe I was, but I don't think so and it's v frustrating when they make you feel like that or are just unpleasant; there is really no need and even if they aren't having a great day it's not very professional of them to take it out on patients.
If I were you I'd ditch him and see another GP at the practice - have you seen all of them at some point? Were any better than others? I learned with GPs it's better to forget whether they claim an interest in asthma and go for a good communicator/listener; you'll get much further and feel better. Mine doesn't always agree with the specialists (which has actually been a good thing for me (mostly) as it meant he didn't kowtow to them when they were saying it was all anxiety and stress)but I do feel like he's listening and trying to come up with a solution, often a slightly unconventional but nonetheless effective one.
At least you got the pred though; I do hope it helps but if it doesn't then definitely try another GP and not that one.
Sorry you had a rubbish appointment, I hope the pred helps, but it doesn't help how he made you feel. I do hate it when it happens and its unacceptable, we're there because we believe there is a problem, even if it turns out there isn't anything wrong, its wrong to us and we were concerned enough to see the gp so they should respect that. Ny daughter banged her head once and was lethargic and feeling sick so took her to the gp, she made ne feel as though o was overreacting and said she was fine, ok maybe she was but I'm not an expert and she had signs of a head injury! I'm sure any mother would have done the same.
I suppose I shouldn't complain too much, I got steroids which is hopefully what I need to resolve the problem. In that respect I guess he listened. But I definitely feel that I suffered because he was running late and grumpy, which I don't feel is on. And I don't see that there's any justification for talking to me as though I was some kind of hysteric. He isn't the GP I see regularly as it happens - he doesn't work there on a Wednesday so I had to see someone else. And I don't think I'll be seeing him again!
I thought the 'oh young women are hysterical and their illnesses are probably psychogenic' attitude went out in the 1930s (when the prevailing view was that all asthma was psychogenic). Sadly some doctors (and by no means all, there are some very good ones out there but the other type do exist) still seem to assume that anything that can be psychosomatic is. And I'd be willing to bet a man of the same age wouldn't meet with this assumption nearly so much.
Oops sorry for the rant. But I've had the same; once not related to asthma, with an OOH dr who blatantly wasn't listening to a word I said and hadn't bothered to read my notes. I spent 5 mins in there (on a Sat night, clearly I was just there for fun) to be told I was dizzy because of anxiety and 'absolutely fine', even though I said about 6 times I hadn't been anxious when it kicked off and wasn't at that moment either.
Discovered after seeing my own GP the following week that having had a pretty low BP measured at OOH might have had rather more to do with why I felt dizzy.
Anyway, I really will stop ranting; I have v good drs now who take the trouble to say they DON'T at all think it's all in my head or related to anxiety!
I'm not sure if he maybe thought wow, she comes to the doctors a lot, she must be a raging hypochondriac - because since I started with ME I seem to have almost lived there - but then again, had he read my notes properly he would have noticed that there has been an awful lot of trial and error with my medication and we've had to try lots of different things - not to mention my pneumonia, chest scan, heart murmur and all the many other things I've had wrong with me over the last 2 years. At the end of the day I think I suffered because he was running late and was in a bad mood. But it's still irritating, especially when what he was telling me just isn't true. It's a shame because we're supposed to be able to rely on doctors to help us when we're ill and all too often we're left to diagnose ourselves and push for what we need!
I'm glad you got the pred that you need. I hope you can have a review shortly and maybe a referal to sort out the right meds for your asthma. X
I've had a couple of experiences like that - where I felt like the doctor was dismissive and not listening to me, and yet - when push came to shove did in fact do the right thing.
Just as an alternate take: is it possible that this is part of this doctor's 'getting to know you' dance? Doctor's like their numbers. Even though they know they should listen to the patient, it is a little scary for some because people are harder to read than test results. In my experience, sometimes doctors throw out the ""in your head"" card simply to see how committed you really are to your reported symptoms and not really to question your sanity. Is it possible that you got what you needed because you passed that particular test and helped him feel he could trust you?
I am working with two doctors on this current long running exacerbation: my long time regular doctor and a colleague of his (doctor #2) who sees me when my doctor is not available.
My first meeting with doctor #2 did not go very well. I had just gone to emergency the day before with an asthma attack triggered by simply singing (and that after ventolin less than an hour before) and was seeing him for follow up.
He also hadn't read the file first.
At first he fixated on the wrong things. He thought I wanted something for the mild cough he could hear when I talked rather than a medication adjustment. I told him point blank I don't go to doctors nor emergency for mild coughs. I had far more pressing concerns like not having ridiculous things turn into asthma triggers.
He did the ""what's the problem, you aren't wheezing"" thing even after I warned him that he was unlikely to hear a wheeze. He only backed off when I threw down a file on the table with spirometry results that show moderately severe asthma and pointed out that the doctor who did that test couldn't hear a wheeze either.
YET
a) he wrote a referral to the pulmonologist (the doctors at emergency wanted me to see one - this was my second visit to them in less than two weeks).
b) At the time I didn't have a nebulizer and the doctors at emergency had said I should have one at home. He not only agreed with them, but suggested that I buy one rather than borrow one from Yad Sarah - a local organization that lends out medical equipment. Emotionally, *I* wasn't ready to buy one so I did end up borrowing. In the final analysis, he actually took my asthma more seriously than I was ready to do.
c) Most importantly. It was his suggestion that we try a combination of nebulize steroids and ventolin that was the first real turning point in the exacerbation. Two rounds of oral steroids hadn't made much of a difference and my regular doctor was reluctant to add more. My regular doctor used this to make yet further changes which also helped - he switched me from symbicort to seretide and we added a nebulizer pretreatment to help improve the amount of seretide that actually gets where my lungs need it to go.
Meetings since then have gone well. Now that he knows me better, he trusts my symptom reports. Our last meeting, before he even used his stethoscope, he said ""well, we likely won't hear anything, so we we'll probably just have to go by your symptoms, but lets try anyway"".
If you think he did the right thing in the end and isn't a total ass, I'd consider giving him a second chance to see if his manner improves now that he knows you a bit.
Beth - he does know me, this is part of the reason I was so annoyed. I've been seeing him on a regular basis since September 2009, either for myself or one of my children - mainly for my children to be fair, but I have seen him for myself on occasion. He knows that I'm not fussy, neurotic or overprotective about my children's health, and to be fair he is always brilliant when I take the children down there - he listens to me, takes me seriously and has more than once prescribed based solely on my description of their symptoms without so much as a half-raised eyebrow. He was also the one to give me the results of my chest scan in April that revealed I have a small pocket of fluid still in one lung that is likely to remain there indefinitely, so it's not as if he's never seen any palpable symptoms in me.
I think that is the source of my annoyance more than anything else - if he was a doctor I hadn't met before I would be irritated but more able to shrug it off. But the fact that this is one of the family GPs - he is actually my named GP!- who has had enough dealings with me to have got a fairly sound handle on my attitude just makes it plain insulting. He gave me the prescription in the end, so he clearly believed I need it - I don't see why he had to be so rude. Besides, I'd expect even a doctor I'd never met before to apologise for keeping me waiting almost an hour, surely?! They normally do. And surely it's basic protocol to measure an asthma patient's PF when they're complaining of a wheeze and cough, and to take someone's temperature who had an infection the week before and only came off antibiotics a few days earlier and is still displaying the signs of an infection?
Sorry - rant over - suffice to say it'll be a long time before I see him again. I should really have known better after what he did to my friend!!
Geez. Not much more to say than that. Rant definitely understood.
Still...sorry for the rant *blush* Just so mad.
I am debating loosening the screws on his chair as revenge!!!
Hi Beth!
Firstly let me say rant totally.justified! I had a respiratory cons who was the same! Grrrrrr
Secondly, I can't tell you jow much the sats fixation annoys me!!!!!! I have brittle asthma, end up in resus (and had my 1st ICU & ventilation in October) fairly regularly (they recognize me when I arrive!!) and my sats rarely.drop.
It is usually only after.several hours that my sats drop but.... And an oxygen sats can't tell you this, I am a CO2 retainer.
I wish medical peeps wouldn't think that oxulygen sats tell the whole story.
Hope the pred helps and if jot, go back and ask for a referral!!
I think most of us have had that 'it's a panic attack/anxiety' statement from a GP who's spent the last 10 minutes ignoring our description of our symptoms and it is so infuriating - you kind of feel that you're condemned to be patronised for ever. Even worse, some time ago I was on a combination of Flixotide and Ventolin that really did give me panic attacks and when I told the GP about it he didn't believe me! The irony of sitting in the surgery saying 'no, no, it's a panic attack, please change my meds' instead of 'no, no, it ISN'T a panic attack please give me more meds' wasn't lost on me even then. That was when I realised that I was never going to win and the only thing to do is try and retain a sense of humour and let fly with a damn good rant every now and then. However, I do now keep a peak flow diary on my phone and having the evidence of gradually declining PF seems to be more convincing than all the coughing, gasping and wheezing could ever be!
Nil illegitimi Carborundum!
MilliMoo - really and truly your so-called rant seems perfectly reasonable and justified to me. His reactions strike me as based in stereotypes (dare I say stereotypes about busy moms and women?) rather than psychology. The fact you can and did rant simply shows you have sense. Plus if you want to get all psychological about it, it also demonstrates a healthy amount of self-esteem.
Personally, what peeves me about ""blame the stress/depression/anxiety"" game is that it is also bad psychology. These issues aren't just catch-alls for any old problem a doctor can't explain. They are diagnosis in and of themselves and deserve the respect and consideration of alternatives (i.e. differential diagnosis) any other diagnosis should have.
Annista, your example of doctors refusing to acknowledge an actual panic attack whilst at the same time blaming non-panic attack issues on panic attacks perfectly illustrates that there's no real diagnostic going on when certain doctors throw around the anxiety label.
MillieMoo - I am completely with Beth on this one! I've seen your post about the asthma nurse, and I think however bad a day a GP may be having, they should be professional enough to keep it to themselves and not take it out on patients; if it's bad enough to be affecting their work then maybe they shouldn't be at work. Everyone has bad days but it's an essential part of the job (in fact many jobs) to keep that out of your work particularly if you are dealing with ill people; if he can't do that he should transfer to pathology!
Also, Beth, you have perfectly put into words what I've been thinking for ages ie stress/anxiety/depression shouldn't be used as alternatives for 'I think you're a hypochondriac and there's nothing wrong with you', as it's a) inaccurate, and b) insulting to those who genuinely do suffer from these disorders which can be very debilitating in themselves (I've had friends with all of them - they really weren't 'fine' at all and if a doctor actually thinks someone is suffering from one of these conditions and it's really producing these symptoms, they should be doing something about it, not use it to mean they don't need any help and should go away.)
OK, MY rant over now (can you tell I had to deal with this?) But everyone needs to rant now and again, and I think this one about the GP was totally justified.
Thank you all for your replies to this one...I really do feel so much better after seeing what you all had to say.Beth and Philomela - I COMPLETELY agree with you about the stress/depression/anxiety label, it is far too often used as a black hole into which all people with symptoms that don't fit into a neat, pigeon-holed diagnosis are hurled. For the first six months of my ME my GP (a different GP to the one yesterday's rant concerned) tried to harass me into admitting I was depressed. If I had been a more timid, easily upset person I think I would have given in and let him put me on anti-depressants, which of course I didn't need and wouldn't have done me any good. As it was it took my husband going down to see him one day and being pretty blunt with him (after I had collapsed and couldn't eat or drink anything, but point-blank refused to make another appointment because I couldn't bear the constant harassment!) to make him take a second look, and by that point I weighed 7 stone 4 (down from 9 stone 4 a month earlier) and was barely functioning. This is apart from the doctor who told me in 2009 that my newborn, premature son's ear infection (so bad he had a column of pus measuring about 4cm sticking out of his ear) was earwax, and I had to insist he looked in his ear because he was going to dismiss me as a neurotic mother and send us away without antibiotics. Apart from the doctor who told me my collapsed lung was a pulled muscle and I should stop coughing so much. Apart from the doctor who tried to prescribe me Movicol for my son's constipation and, when I told him he wouldn't take it and just spat it out again, told me I clearly hadn't tried hard enough and I should stop being lazy!!! And apart from (my personal favourite) the A&E doctor who told me when I went to A&E at 10 weeks pregnant with my daughter and bleeding quite heavily ""I don't really know why you're here, there's nothing we can do. If your baby's dead it's dead, you'll just bleed it out over the weekend."" No wonder I have something approaching a phobia about doctors!!!
as with everyone else i agree ghat the anxiefy/depression label is grossly misused especially for asthmaticz. i had to deal aith fhis a lot over the years about asfhma and other health conditio.s. in my case i think it was even more painful in that i do suffer from depression and borderline kpersonnality disorder. and yes it is insulting because in the end they make you feel like you invented both sets of symtoms up...grrr
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