GP's!!!

Hello I wondered whether anyone has any advice.

I had intended to email the helpline about this but just noticed its closed and I am in Portugal on holiday so phoning would be expensive!

I am on 3 asthma meds (symbicort 400/12, montelukast and ventolin) I had finally got almost symptom free after a rough couple of years and was discharged from asthma clinic 5 months ago. I had a cold a few weeks ago and it left me really wheezy especially at night, and coughing a lot in the day. My partner commented that I'd not coughed like I am doing now, for months (since the cold)

I left it 6 weeks or so but as it hasn't improved I went to my Gp yesterday hoping he'd give me some prednisolone as that has sorted me out in the past. But he refused and said I'd have to 'ride it out'. To be fair my pf isn't too bad and at the time my chest was clear. But last night I was soooo wheezy and awake all night and I am in Portugal now - flew yesterday - and the heat is getting to me.

When I go home in a week, I'll go back to a different GP but I don't know what to do if they just dismiss me. It is like they want it to deteriorate further and I know from past experience when I have a gradual decline like this it takes so long to get back to normal. I can't run at the moment cos I'm wheezing and my chest gets tight so quickly. And that GP didn't fill me with confidence as he started looking on google for a leaflet about Symbicort Smart regime when as far as I know, you can't do that with the 400/12 and I am on 2 puffs twice daily as it is.

Sorry for the long rant. I just feel like he thinks I am over anxious but my bf never notices my breathing unless it is actually bad. And I am a bit uncomfortable being in another country when I only feel it is getting worse.

Thanks

Emma

[Hidden]

Hi Emma,

Sorry to hear your are struggling, especially while being on holiday.

I had a very similar problem at the beginning of May (a few weeks after the cons told me to see GP and get pred as soon as I start to feel symptoms - I also just get progressively worse and if I leave it too long, end up needing a few courses to get it under control). Whenever I went to my GP, I had taken my reliever to get there and then my chest was clear and pf was ok. I went back a few days later to another GP who actually listened to the symptoms and said that while my chest was clear, she understands that this does not mean I am struggling. I think I looked awful as she commented on how tired I looked and that my throat was irritated from inhaler use/coughing. The nurses on the advice line also told me what to say and confirmed that I probably needed pred. A few weeks later, when that course was not enough, another doctor told me I didn't need it (same thing) so I ended up phoning later in the day when I was wheezing and asked to speak to someone while I knew I had symptoms. GP phoned me back and prescribed pred within 10 minutes! I didn't do this in a cross way but simply stated that I was having difficulty getting advice when they I didn't have symtpms, now I've got them is there anything they could do?

What I am trying to say is that while I can understand the reluctance to prescribe pred, it is not as of we actually want to take it. I'm not sure whether it was the change in GP or the fact it was still happening which meant I got it in the end but the advice line were invaluable (even just confirming that I probably would need it). The other thing I did was to record my inhaler use (including the trigger, location, time, pf if possible) and took that along with my pf chart. I think having it there is black and white illustrated what I said well. As I was told, you probably know your symtpms and what is not right more than anyone else so stick with it (I appreciate this is hard and I have posted many rants on being made to feel like a fraud).

With regards to the SMART, I was on 400/12 x2 puffs before changing to Seretide 500. My cons suggested trying SMART again (I got on with it very well before having to increase the dosage) and I had the same concerns as you. However, the theory is you have more ICS when struggling and less when you're not (like I said before this did work very well for several years and I liked the control it gave me when things started to get bad plus the extra ICS was much better than pred). When a tried it a few months ago, it was clear I needed more preventer so she added Pulmicort as extra ICS. Unfortunately, the hayfever seasons meant I lost all control and they wanted me back on something that they know works but it is in the pipeline to try again and I think cons are quite keen on it. Of course, the GP may have been trying to find out whether it is possible on that dose too.

I hope you are feeling a bit better and manage to enjoy your holiday.

Take care

[Hidden]

In Spain you can get pred over the counter at the pharmacy, maybe you can in Portugal too? Sorry to hear you're struggling and not able to run. xx

[Hidden]

Thank you for the advice KaylaCP. I will definitely try recording my inhaler use, triggers etc - that's a fab idea. I don't think u always explain well enough when I go to the GP so maybe that will help them understand. What does ICS mean? I used to be on seretide till cons changed me to Symbicort but I hope I can try SMART when I am eventually able to reduce. I am glad you eventually got what you needed as it is so frustrating to feel dismissed.

Lou - the pharmacy here opens tomorrow - in a little fishing village so its all shut at the weekend - I think I will go and ask just to see what they say. Thank you.

[Hidden]

How are you doing now, hope you're ok