Advice: Would I be wasting the Doc's time?

Hi all

No doubt you'll have seen similar posts hundreds of times, so sorry for being a bore, and for writing a bit of an essay!

I'm in my early 30s, and when I was a teenager I apparently had asthma when I got bronchitis a couple of times. Or so I thought....

Since my early 20s, at the change of seasons, I without fail, get a nasty cold that ends in a cough, and real breathing difficulty, that lasts for weeks and weeks into months - around March and November time. Over the years various doctors pile on the antibiotics and it tends to clear around 2 weeks after. I'm quite used to this pattern now. One thing to note is that the cough goes if I go somewhere hot and sunny, and returns when I'm back in the UK.

I moved recently and went to a new surgery who thankfully looked at my history when I went in for the next batch of antibiotics. They booked me an appointment with the asthma nurse, so we've been trying a different approach this time round.

Well, the cold has arrived, and the cough started, so as instructed, I've started on the preventer, which has been doing the trick - until I forgot to take it for a day. I'm now coughing all over the shop, full of a really disgusting mucus and feeling like my breathing is heavy - unless I really concentrate, I feel like I'm not getting any real oxygen in. [I'm not sure if the 1 missed dose of preventer has that much impact or I would have ended up coughing anyway]. I've been measuring my peak flow and it's usually around 500, but it hasn't dropped significantly - to around 450. I have an appointment with the nurse next week, but my question is....

Considering, I'm still at work, and can walk to the station in the morning despite feeling like this, am I wasting a doctor's time / being a hypochondriac if I ask for an 'emergency' appointment? I simply have nothing to benchmark against, so not quite sure what to do!

Any advice gratefully received.

Thanks all

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Hi and welcome! Don't worry, you're not a bore, we always welcome new faces and all usually start with the same 'I hope I'm not asking this question again', so fire away""!

Unfortunately I know all too well, the cold = chest infection = antibiotics, it drives you mad doesn't it?!! I'm glad the new gp seems to be more proactive, and that you are in touch with the asthma nurse, hopefully this should minimise disruption in the future.

In answer to your question, I would think it unlikely that one missed dose would affect you that much, although obviously you want to try not to miss any (should listen to my own advice here lol). What preventer are you on? Unfortunately, a lot of us find its trial and error to find a preventer and dose combination that work well for us, so it may be that this preventer might not be right for you.

How long have you been monitoring peak flow for? Many of us find that peak flow bears no resemblance to how we are feeling, it can be a useful tool, but listen to your symptoms too. Quite often I will feel terrible, be really struggling to breathe, yet my peak flow is higher than when I felt fine! So if you are in any doubt, get yourself that appointment, any issues with asthma are worthy of an emergency appointment (again follow your own advice butterfly!)

Good luck xxx

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Hello!

Thanks for your reply, butterfly. Although it's not much fun being like this, it's quite nice to realise that I'm not alone.

I have been put on Qvar beclomethasone - 100 micrograms, 2 in the morning, 2 at night! The peak flow comment you made is ringing true. I've been monitoring it since end Jan, and when I'm feeling breathless, I'm often surprised with the 'high' result.

I'm feeling better this afternoon, which is good!

Thanks again!

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HI JoHen and welcome from me too!

Basically agree with everything Butterfly said - and I am another whose PF makes very little sense a lot of the time. Sometimes it's higher than it 'should' be with symptoms, but a few weeks ago I posted because it was mysteriously low despite me feeling ok!

I know what you mean about being glad you're not alone - I've found this forum really helpful from that POV as well as learning about asthma. Also found the adviceline v helpful on many occasions for asthma and asthma-related practical advice (eg how to approach a dr and explain what you need).

Re the appt - glad to hear you're feeling better! It's good that you're seeing the nurse next week, but re the doctor: if you're wondering whether to make an 'emergency' appt (which I don't like doing either), remember these things:

1) How long would it be if you requested a non-urgent appt? It's not much use if you have breathing difficulties now and the first appt is in 2 weeks.

2) I'm willing to bet that they have people who ask for these appts for much less - breathing difficulties SHOULD be taken seriously.

3) Whatever they call them, it's not really an 'emergency' but is relative - for a real emergency you'd need to be in A&E, so asking for an urgent appt when you can still walk/work doesn't mean you're demanding immediate, urgent treatment you don't need, just that your problem can't wait days/weeks. You would, for instance, not want to wait long to be given a short course of oral steroids if needed, but you could be at the point of needing steroids asap but not yet needing A&E (and giving one promptly is generally done with the aim of avoiding the other!)

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Very good way of putting it Philomela re: emergency/urgent appointments!

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Hi JoHen,

I too am on Qvar 100 2 actuations twice a day. I started on this in January and it took quite a time to work. Just this last week though I have started coughing again and I notice lots of people on the forum are complaining about their asthma and pollen. I've never had hay fever - to my knowledge - but with this cough returning now and my nose is actually running, running clear without congestion, no sneezing either, most strange.

I've been diagnosed with ""small airways disease"" ""a type of asthma"" - it showed up on chest x-ray and CT scan.

I'm sure you can get a non-ugent appointment with a GP but if you've got an appointment with the asthma nurse that might be better anyway.

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I've been diagnosed with ""small airways disease"" ""a type of asthma"" - it showed up on chest x-ray and CT scan.

Anne, I also have small airways disease, but I havent heard this diagnosis being given to anyone else - my small airways flow has gone from 22% of predicted a couple of years ago, to 11% of predicted now. Who knows why. I was changed onto fostair by Papworth as this has very small particle size, apparently a lot of the inhaled steroids have particle sizes which are too big to reach the small airways - I didnt know that until they discussed it with me.

Did you order the biogel? I meant to say to you, dont use as much as they say, or you will be desperately looking for somewhere to spit it out! I use about 1/2 cm at a time or it feels disgusting...

Lynda

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I've been diagnosed with ""small airways disease"" ""a type of asthma"" - it showed up on chest x-ray and CT scan.

Anne, I also have small airways disease, but I havent heard this diagnosis being given to anyone else - my small airways flow has gone from 22% of predicted a couple of years ago, to 11% of predicted now. Who knows why. I was changed onto fostair by Papworth as this has very small particle size, apparently a lot of the inhaled steroids have particle sizes which are too big to reach the small airways - I didnt know that until they discussed it with me.

Did you order the biogel? I meant to say to you, dont use as much as they say, or you will be desperately looking for somewhere to spit it out! I use about 1/2 cm at a time or it feels disgusting...

Lynda

Hi Lynda,

I'm really glad to hear of someone else who has this ""small airways disease"" diagnosis becasue when I phoned the asthma helpline for advice they couldn't help me. Nor could a lung disease support organisation. I was beginning to think the respiratory consultant wasn't quite sure what was wrong with me and gave what seemed to be a vague diagnosis. I'm not quite sure of the 'damage' to my small airways but air trapping shows on both CT and x-ray with hyperinflated lung fields. The Qvar I'm prescribed is supposed to be very small particale size. The doc thinks the small airways disease is caused by ""pollution"" as I've never been in contact with chemicals.

I did get the Biotène gel thanks ! It's pretty effective and tastes nice too

I read you have many other health problems. I do too but they're not realted to the small airways disease. I have a bicuspid aortic valve and will need that replaced in a few years time - one reason to get my lungs in shape before open heart surgery. I also have atypical diabetes and osteoporosis.

Anne

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Hi JoHen,

I agree with the others. The way I see it, if it is enough of an issue to worry you, then chances are the doctor will be more than happy to check things over. Even if the end result is just a little reassurance. Asthma is one of those conditions which in my experience you can never quite predict it.

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thank you everyone. Really nice of you all to reply. Makes me feel much better and that I'm not alone or imagining half of this stuff!

Have a lovely weekend all!