Royal Brompton

[Polzovatel]

Hi, do you know if patients from outside of London can get a referral to Royal Brompton- i have been feeling short of breath for almost 2 years, tried all usual asthma medications and don't seem to get anywhere with my local hospital. Also- who is the best consultant for undiagnosed shortness of breath in Royal Brompton or privately in London? Thanks

[Tracey1972]

Hi yea I'm from Wiltshire I go there every two months for iv treatment and in between for check ups really nice hospital I c professor Durham one of the top ones he's good but the answer to ur question is yes good luck

[Asthma-girl]

I live in Hampshire and I'm under Royal Brompton Hospital. I used to be under respiratory team at my local hospital but it was my consultant who referred me to Royal Brompton Hospital.

I also had the support from my GP who also believed they were the best hospital to go to.

[Katinka46]

This is entirely anecdotal and he may no longer be there, but a consultant at the Hammersmith Hospital said that what Dr Mike Polkey didn't know about unexplained breathlessness wasn't worth knowing. But that was three years ago.

Push for a referral. RB is the hospital mentioned more than any other.

If you have consistently tried asthma mess with no effect it isn't asthma!

Good luck and let us know how you get on.

K x

[Polzovatel in reply to Katinka46]

Thank you very much for your replies

I've been taking seretide - 1000 mg a day, spiriva, numerous courses of prednisone, montelukast for a few years, did not notice much improvement, now the consultant is saying that I should just live with this .Not sure if my GP will agree but I will try anyway.

Has anybody been to unexplained breathlessness service in Royal Brompton?Is it inpatient or outpatient?

[Katinka46 in reply to Polzovatel]

Sounds as though your GP is on you side. Treasure her/him. There are other lung conditions that cause breathlessness. Have you had the Mannitol challenge test? This gives increasing monitored doses of Mannitol, and if your airways react, then it can be concluded that you do have asthma. Then there is reversibility Spirometry, which looks at the difference between your normal Spirometry and what your readings are after a dose of inhaled Ventolin, if those readings show an improvement then again it is an indication of asthma. There is also the Nitric Oxide test, the patient exhales steadily into a device that measures the particles of Nitric Oxide that are exhaled. Nitric oxide increases in the lungs if there is inflammation, and above a certain level then it is likely that there is asthma. All these may well be done by your GP practice nurse.

Good luck

K xx

[Polzovatel in reply to Katinka46]

Hi,

I am under specialist asthma clinic - my GP doesn't do anything, just says, " if they cannot do anything, I cannot either' I didn't have nitric oxide or mannitol but had lots of lung function tests ( which were ok) , methacholine test ( with mild reaction), laryngoscopy, took PPIs( omeprazole)

I've got high eosinophills which go down when I am on course of oral steroids but it doesn't help breathlessness!

[Katinka46]

Hmmmm.... All very complicated. The methacholine test sounds like the mannitol one.

Even if it is asthma, asthma can of course co-exist with other conditions. I am a great believer in people knowing their own bodies. What do you think?

K xx

[johnsmith]

Try an Alexander Teacher with about ten years or more experience. You could have a muscle behaviour problem and also a posture problem. Muscle behaviour and posture is an area that the medical profession know virtually nothing about.

Hope this helps

[Polzovatel in reply to johnsmith]

Thanks , will try. Its quite difficult to find somebody with experience. I tried yoga , also bought a Buteyko DVD, tried PowerBreathe and other breathing trainers - didn't have much improvement. The reason I am not sure if I have asthma that I mainly have problems on inhaling and not exhaling

[johnsmith in reply to Polzovatel]

The weight of the atmosphere should enable you to breathe in. Atmosperic pressure is 14lbs per square inch (1 013.25 millibars). When you breathe out air should come back in. It is possible to have a faulty breathing style where the muscles of breathing are not functioning as they should.

A number of people have breathing difficulties because their collar bones are raised restricting breathing. Another group can have breathing difficulties because they are arching their chests either to the front or to the back. Yet another group can have rib muscles which are too tight and prevent the chest from expanding properly.

You cannot learn breathing from a book or DVD. You will tackle breathing by using what you know and thus repeat the errors you are already making. You need the input of an experienced Alexander Teacher or Yoga teacher who can spot the faults your muscles are making and give you clues to enable you to change to a better muscular behaviour.

Hope this helps