Another update - 8 weeks and counting

[Tabitha58]

After obeying the GP who told me the cough was pharygeal and to take a cough suppressant and reduce the QVar (brown) inhaler, and that I did not have asthma, unsurprisingly things became worse.

I then developed an ear infection but no surgery appointments available so saw out of hours GP - who told me that I should increase the QVar and take the salbutamol more often at the moment while the cough was so bad (she also diagnosed the ear infection and prescribed drops for that).

Rang the Asthma UK asthma nurse on Monday as I woke up in a right state: she helped me take my blue inhaler until my breathing was back under control and suggested that the 5 day courses of steroids I had been given were not long enough to reduce the inflammation completely.

Today I had another GP appointment - with the same GP who saw me before and told me I was hyperventilating and 'did I think there might be something a little bit stressy going on here?' LOL The only stress here is the fact that I cannot breathe properly and can't stop coughing and nobody seems to want to take it seriously!

Anyway, he went on to prescribe me a ten day course of steroids and to agree to my request to be referred to the respiratory clinic - but also said there was 'no objective evidence that this was asthma as my chest x-ray was clear, blood tests all fine, and no wheeze'. He emphasised the lack of wheeze three times in his dictated letter to the clinic!

I am still utterly exhausted but feel that I may be able to get some answers from the clinic. Here's hoping!

[Lysistrata Administrator Community Ambassador]

I'm glad you got a referral but aghh to the GP! Can you avoid him in future? I swear someone needs to make some kind of mandatory sign for GPs, A and E s and even resp clinics saying 'ASTHMA DOES NOT NEED A WHEEZE'. I am so over them not knowing that but then the guidelines etc don't help- they bury the no wheeze needed part and still emphasise wheeze as a symptom.

I'm also curious to know what he thinks you'd see on an X ray with asthma. It is possible to spot hyperinflation I believe but that's subtle and not always present, and otherwise chest x ray in asthma is usually normal - what is there to see? I do think a lot of doctors have COPD and other lung diseases which are more 'obvious' in their heads and try to force asthma into this box.

Oh and bloods...again, not necessarily anything there. Eosinophils could be high but it's not a given, especially since pred tends to suppress them.

I hope you get your appt through soon and find it helpful.

[Tabitha58 in reply to Lysistrata]

The blood tests were mainly to look for infection and inflammation markers and for anything underlying that might have been causing my fatigue (as if constantly coughing wasn't enough to do so!) X-ray also to look for signs of infection. So far they have managed to tell me what it is not, rather than what it is

[Lysistrata Administrator Community Ambassador in reply to Tabitha58]

It makes sense to do them and rule other things out as you say - just ridiculous of GP to then use those normal tests to say 'no evidence of asthma'- well no, that wasn't the point of doing them and for the CXR at least it means very little asthmawise!

I don't think many drs appreciate the fatigue that goes with bad breathing. Hope you get someone to listen soon - I've been there and it is so frustrating!

[Hidden]

Silent reflux (which asthmatics are prone to) can cause cough, ear infection and shortness of breath.

[Tabitha58 in reply to Hidden]

I am on proton pump inhibitors for reflux and there has been no change in that so I don't think that is the problem - but thank you for the suggestion

[Hidden in reply to Tabitha58]

PPIs do not have any effect on silent reflux/LPR.

ncbi.nlm.nih.gov/pmc/articl...

The fact you have GERD makes it much more likely it has some bearing on your problems.

You should join this group and ask some of the GERD sufferers questions it might be helpful to rule it out or in.

facebook.com/groups/7568595...

[Tabitha58 in reply to Hidden]

Never too old to learn! I expect the respiritory clinic will investigate this if I ask them to. Thank you for the info and for the link

[Hidden in reply to Hidden]

Interesting, because I was put on a PPI (lanzoprazole) for silent reflux and it did sort the problem out. I was on it for a month (and it took another month to wean myself off them - one reason why I really don’t like taking them), but they certainly worked.

[Hidden in reply to Hidden]

Placebo is a powerful drug

[Hidden in reply to Hidden]

But not in this case, Initially I refused the PPI and requested something else instead, so I was given Gaviscon advance. As I said, I don’t like PPIs and I already had experience of them before this event. They do the job, but I was one of those who had real problems when coming off them. The Gaviscon advance wasn’t enough - I ended up on the PPI. Problem solved.

[Hidden in reply to Hidden]

Makes no difference to the placebo effect, even patients told they are taking a placebo get a benefit from them, we are all capable of experiencing it and if it works then thats fine.

[Hidden in reply to Hidden]

In that case the Gaviscon would have worked:-).

I fully acknowledge that a placebo can work wonders at times and if it does, that’s great. But it doesn’t always and that’s worth remembering too.