Referral to respiratory consultant

[Choristermum]

I have been struggling with a recurring chest infection and asthma symptoms over the past few months, have had several courses of antibiotics and steroids and am taking the maximum dose of inhalers as well as Montelucast. My GP has just referred me to a respiratory consultant saying that they would carry out more specific tests and be able to adjust my medication accordingly. What can I expect these tests to be?

[risabel59]

Hi there, There are quite a lot of tests that can be done! It will depend a bit on where you have been referred. And your personal history. I can guarantee that they will do extensive spirometry, which even is your GP has a machine will be more detailed.

My main advice if you have not seen a consultant before is to be well prepared. Make sure you have a peak flow Diary, and a note of when you had chest infections, when you stepped up, used antibiotics etc, how much ventolin you are using and when etc. It will also be really useful if you take the time to write out a history of allergy and asthma symptoms that you have had over the years, and when you get worse etc. It is worth doing some research on the consultant that you are referred to. Not all respiratory consultants are the same. Some are much better with Asthma and Allergies than others. So try and get referred to someone who is an asthma specialist.

[Choristermum in reply to risabel59]

Thank you - that is helpful advice.

[Minushabens in reply to risabel59]

As well as risabel's superb advice, I'd expect that they will send you for blood tests & probably a CT scan. I would imagine at this stage they may suspect something like bronchiectasis (which is typified by recurrent, difficult to treat infections), or other related problems, or possibly other severe allergy problems.

The consultant I saw (I'm in W. Yorkshire) when I presented with very similar issues to those you describe pretty much did that. It took 3 or more months before she had a full set of results and, in my case, precribed ABPA/SAFS. So, be patient (if you'll excuse the pun), be prepared as risabel advised you and hopefully they will get to the bottom of your issues.

[Choristermum in reply to Minushabens]

Thanks for your reply - another useful insight.

[Matti21]

It would be a spirometry test where you blow into a machine very hard and it gives off your lung function. It can be hard to breathe out for the time they ask and they keep saying 'keep going' throughout this test. You may have blood tests, be asked to walk a certain distance and blow into a machine that in appearance was like a telephone box but it wasn't uncomfortable at all. That was incidentally at a private consultation.

None are uncomfortable apart from the spirometry which the nurse does and it gives me a feeling of lightheadedness and headache but to get an accurate reading you have to do it.

One of the blood tests they did on me was for Aspergillus and was positive however after some treatment it seems to be gone, it was a sensitivity to the mould which lives in the woodland and rotting leaves and its within the atmosphere. They may send you for chest x ray. I've just had CT scan first time in 54 years and an asthmatic and to be honest it was by my GP. My respiratory consultant isn't great and that's why I sought a seconds opinion. They might all you if you have had allergy skin testing. I think that about covers it. Nothing is painful, spirometry uncomfortable, blood tests I don't mind at all.

Good luck hope the chest infections improve.

[Matti21]

Just seen risabel reply, excellent advice. I think as you do it as a matter of course you don't think. Write down all allergies you can think, when it started, what helps, exacerbates it. Full history as she said, sats levels of you have pulse oximeter, peak flows.

Everything risabel said is the most useful, I'm not sure if they'll do CT scan yet but the previous lady refers to ABPA, SAFS which is related to allergy or sensitivity to Aspergillus fungus which I had also.

Like was said some aren't great, mine wasn't but the matron specialist respiratory nurse is great. Fingers crossed you get a decent consultant.

Great advice given previously.

[Choristermum in reply to Matti21]

Many thanks for sharing your experience with me. I at least know what to expect and how I can best prepare for it now.

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My first referral I just had spirometry with an Asthma Nurse at the Charingcross Hospital in London in 2011 where they basically check your breathing when you blow into a tube. There I learned that my lower lung was affected and they sent a letter to my GP to put me on another course of antibiotics and to give me rescue meds at home. However the nurse was not satisfied and referred me to the consultant. And then on started a waltz of inhalers, tablets and denial... it took a trip to France 5 years later when I called the emergency service to have a CT scan and discover I had a cystic lung disease!

So yes as our Asthma friends said ask the right questions and I would add make sure you get the right answers for you.

Take care xx