Todays appointment

Well, I saw my consultant again today (sort of my consultant, he deals with inpatients and this was my 2nd outpatient with him, but going back to my usual one next week). Overall the appointment was pretty good. I was worried that he would either a) readmit me as Im not wonderful thanks to the pollen and heat, or b) want to reduce the pred again - he seems determined to do it far faster than I am happy with. In the end neither happened and I didn't even have to argue with him!!

The next steps at the moment seem to be a metal wire up my nose and into the top of my stomach to test for silent reflux, sputum induction and possibly a bronchoscopy which I am not over keen on - especially after he told me its dangerous to do it to asthmatics! He said again that my asthma behaves in a way that is far more common in young children, that its reactive and spasmodic leading to the sudden severe attacks I am having whenever I come into contact with a trigger - hot drinks, cold drinks, pollen, perfume, you name it. He says there is almost certainly the more common inflammation side too, but the steroids are hiding that and I am not stable enough to be off them for them to test for the inflammation etc etc. For the same reason, blood tests for allergies are coming back negative even though I KNOW I am reacting! I am too unstable to come off the antihistamines for skin tests at present too so they are on hold.

My blood sugar tests from last week were okay - both the one for that moment and the longer term one - so I just need to be careful with what I eat, its definitely prediabetes not, as he feared, that I am already diabetic.

I then told him that I had been highly offended and very cross with his comment last week that suicide isn't illegal. I told him I thought it highly inappropriate that he should say that to any patient, and that had I been emotionally unstable, or even just totally overwhelmed with my asthma and having a wobbly moment, it could have had very serious consequences. He apologised, and said that he considered me to be extremely strong and had no concerns about my mental state, and if he had been worried he would not have said what he said, and in the past he has actually had a patient sectioned as he feared they were at risk of harming themselves. I am not 100% happy with his explanation but do feel better about the situation than I did before. Next week I go back to my usual outpatient consultant (Im on weekly appointments for the moment until I am more stable) but would be willing to see him again in an emergency - and would have to if I was readmitted.

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Glad to hear it went reasonably well, if not perfectly. Good for you for raising your concerns about the suicide comment.

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Just to reassure you, it's not a metal wire they shove up your nose - it's a flexible small bore tube (like the size of a tiny nasogastric feeding tube) which has a probe in. The end of the probe sits in your oesophagus, above the stomach's sphincter so that it picks up any changes in PH caused by stuff coming up the oesophagus. It's not entirely comfortable but it's bearable for the 24hrs. Are they doing oesophageal manometry too?

Glad you feel a bit better after challenging him on his comment, good on you

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He only mentioned the tube up the nose so not sure?

Had a wierd one today - me being wierd! I was out and feeling tight but thought oh I'll take my puffer when I get to the tube. Then, oh I'll do it on the train, and so on. Eventually got home having not taken it and in some trouble. Thankfully okay again after salbutamol and atrovent nebs, but know I need to stop doing this. Its silly, Im a generally sensible amd responsible 33yr old woman, yet I put off something as simple& important as taking my inhaler

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Sparkley, I don't hink you are alone in doing that. Were you putting it off? Or just distracted by needing to move from place to place?

I do the ""put it off"" thing sometimes too. My reasons aer varied: getting distracted, hoping things will improve, not wanting to use the inhaler yet again within 3-4 hours, and telling myself it isn't bad enough because its just a cough and i've been coughing a lot recently. (which is why people are stopping me on the street and asking if I need help - yeah right).

Given your recent history though, it does seem wise to move sooner rather than later with the reliever - catching things early will help you avoid another trip to the hospital.

I struggle with the ""use reliever at first symptoms"" thing, but when I can get myself to do it, it really does help.

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Just home from seeing usual, lovely cons. Reasonably stable at the moment, tho stable at 60% PEF so far from ideal. She wants me to reduce pred to 25 as Im fairly stable, but wants to see me again next week as Im too unstable to go longer, grr, would rather stay on 30 red and have a couple of weeks rest between appointments! Ive had enough of this rollercoaster, every time Im a bit better they reduce meds and I get worse again, just want to be 'normal'! Anyone else get like that?

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Also, does anyone else get tearful when using lots of salbutamol? I cant seem to stop bursting into tears over nothing, lack of sleep from the heat doesnt help either - this is my first real London summer and Im not coping too well! Also been told I cant have an action plan at the moment, only 'plan' is if I need a 3rd neb b2b or more than 6 in 24hrs, or PEF below 50% then I'll be readmitted, and thats the last thing I want!

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Also, does anyone else get tearful when using lots of salbutamol? I cant seem to stop bursting into tears over nothing...

Low potassium does that to me - and salbutamol lowers your potassium, hence the muscle spasms and shakes and all that jazz.

I've switched to using lo-salt as the cheapest, easiest way to top up my potassium - but you can get supplements as well.

I turn in to a gibbering wreck. A potassium drip had me returned to my normal sane-ish self rather pronto!

YAMV, but that's what it made me think of...

Cx

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Currents drugs: Seretide 250/25 8 puffs a day; Ciclesonide 160 4 puffs/day; atrovent nebs 4xday, flixonase 4 puffs/day; Montelukast 10mg; pred 25mg; bambuterol 20mg; roflumilast 500mcg; lansoprazole 15mg; chlorphenamine as req; phenergan 10mg 3xday,adcal d3; alendronic acid; quinine 300mg (for cramps); salbutamol nebs and puffer as req. Paracetamol to stop my head spinning working out the above, lol!!! Anything stand out as missing at all? I sometimes feel I need to keep one step ahead of the doctors!