I know this is the million dollar question, but here we go.
I'm one of those 'atypical' asthmatics in that I don't wheeze. My main symptoms are breathlessness and cough - and increased heart rate as I deal with the others. Until this flare I was 'managing' on seretide 250/25 x6 puffs (more of this later!) and recently upped to include montelukast, but was still having to take salbutamol at work (I'm a teacher).
Evidently I wasn't as controlled as I'd thought, as I had a bad flare at work, an ambulance was called, and I ended up admitted for 3 days. All the usual - magnesium, 4 hourly nebs, IV something or other, pred... you name it.
Thanks to a full asthma review (possibly the first "proper" one I've ever had) in hospital, I'm now home with symbicort, pred, and then spiriva when pred runs out. The nurse was horrified at the seretide dose, and arranged a full blood sweep for allergens plus spirometry, FeNo etc booked for January once I've got over this flare.
Peak flows are consistently back to green, and whilst I'm still dipping to amber, it's less frequent, for a shorter period, and requiring fewer meds to get back up. Obviously I'm tired.
I know I'm not well enough to return to work yet. There are two weeks of term left - is it likely a GP will agree to sign me off the fortnight, especially given the fact I've now had 2 x pred since march, and am still dipping about 15-20% after showers / eating etc.? I can talk in full sentences most of the time, but not for prolonged periods (which, I guess, is kind of what teachers do!)
We do have quite high covid rates in our area too, which obviously isn't helping anxiety. I also have an occy health referral this week.
I guess I'm just looking for reassurance that a 2 week sicknote isn't unreasonable... how long does recovery normally take? The new meds are obviously suiting me - PE is over 100% more than when I was admitted, but obviously I'm still on pred.
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NorthernKitten
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If you're not feeling 100% don't go back. Speak to your gp, explain theres only 2 weeks left of term anyway. You need to recover and be 100% especially under the current circumstances. Also, (if this helps) imagine how traumatised those kids would be if you keeled over in front of them in class (my mums a teacher and its a nightmare to get her to stay home when she's really not coping! She has arthritis and this is often the only way she listens to me). Think of yourself, even just for a wee while put yourself first. 2 weeks resting could make the world of difference. Hope you feel better soon
I have a similar issue although my flare hasn't been as bad as yours. I'm also a teacher and it's so hard going from home back to full teaching days. I feel ok at home but have the same issue with not being able to sustain talking for long enough. Was told off by my GP when I described being in school desperately clockwatching during the story because I didn't have enough breath to keep reading. If you're still at that stage and considering you've been in hospital, I think having that time off is reasonable. If you're thinking you need it you probably do because mostly we never want time off - I know that if I consider needing more time it's definitely necessary. If I'd taken more time a few weeks ago, I wouldn't be back in the same situation now.
A good GP should be happy to sign you off for 2 weeks. I’ve been signed off for longer than that with asthma and didn’t even have to ask. It sounds like you’ve been very poorly and need to rest and take it easy - do take it seriously and seek the help you need.
Definitely talk to your GP - the 2 lots of pred since March is probably irrelevant but the fact you're not fully recovered from this exacerbation, including exertion affecting you and the prolonged talking (or inability do it), is really important - you don't sound fit for work. As an ex teacher who used to rush back ASAP..... it doesn't work and will make you worse in the long run!
I am in a very similar situation to you at the moment. I had already been off work (teaching) for 2 weeks on prednisolone before being admitted to hospital a few days ago. The consultant told me that I definitely need time to recover - a week minimum. She suggested to the end of term off would be sensible so that's what I'm going to ask my GP for on my sick note (I think, ...definitely).
Don't go back until you are better. I have just had nearly 3 weeks off for the same reason. 5 day hospital admission then got a sick note for a week. I was still struggling so took an extra week off after that. My GP just did the certificates, didn't even query it.
Hi I read on site somewhere a fortnight off work considered appropriate after flare up/attack requiring hospital admission. ( 1 in 6 chance of returning ) I was hospitalised 9 to 16 Nov, signed off for 2 weeks I thought that was probably excessive but I did need the rest, my stress job as Health & Safety manager wasnt exactly enticing me back however breathing seemed fine, peak flows amber. On my birthday 25 Nov the wheezing returned, used reliever inhaler 10 times, peak flows back in red. I submitted reform to GP 26 Nov, no response on 30 Nov was hospitalised again ( the day I agreed I would work from home) was just released yesterday. ( another 6 nights ) more meds, again, this time will have no hesitation in taking the fortnight for full confidence & recovery, hope my story puts into context.
So I had 7 days hospital ( signed off fortnight, amended return to work from home ) 6 further days in hospital , I will be speaking to GP today about sick note, but fortnight I believe required just based on my story here.
Well that got interesting. GP receptionist has just refused to even put paperwork through to GP, saying it was hospital’s job (it WAS supposed to be done in hospital, but it was missed, nurses asked me to ask GP as it should be a formality).
Receptionist also made me feel really rubbish for asking for the follow up app, saying I didn’t need one if hospital discharged me - i must be well enough and should just sort fit note.
Phoned hospital, and they said GP should do fitnote, but they’re looking into it. I haven’t raised the follow up because I was so upset and stressed and trying to sort out work.
I am so cross, and obviously this isn’t helping lungs!!
I completely sympathise. I am now retired but I've been in your situation many many times, ( I used to work as a Care Assistant). I used to end up having up to 2 months off every winter, and have seen my husband drive me to wait outside the GPsurgery for them to open and me begging for an appointment. I have also come out of seeing aGP in tears. I know how awful some Dr's receptionist can be. I don't know why they're employed in such a position when they show no empathy or understanding. I am now on Carbocistiene tabs, montelukast, fostair, tiotropium, fexofenadine, and a winter maintenance dose of Azithromycin. This has sorted me out and made a massive difference to my life. These were prescribed when my consultant sent me to the Severe Asthma Clinic in Nottingham City hospital. That's my story. I would advise to keep pushing for a further appointment and don t accept no for an answer. If you can't talk you should not be at work,and stress makes thi gs so much worse. Good luck. I hope you feel better soon.
Just what?! To the receptionist! Absolutely follow up should happen - that's usually on discharge letters! Asthma UK nurses will agree I'm sure (0300 2225800 M-F 9-5)
Can you contact the practice manager? That receptionist is just wrong.
Just what you don't need at the moment. Is there another way to contact GP, like e-consult or something?!
I’m waiting for hospital to call me back, and then will contact GP again once I know what I need to do re documentation.
As for the follow up, I was so upset and confused that I just let her browbeat me into saying I didn’t need an app - but will rectify that when I phone back. I’ll also ask to speak to the practice manager - when I’m a bit calmer!!
Discharge letter is also a bit meh. Says nothing about follow up, “felt like asthma attack” (!), and nothing about the blood work that concerned them so much at the time. *sigh*
In fairness, I had a great asthma review (actually 3....) whilst an inpatient, so I’m not sure what GP app would do, other than reassure me. I am still dipping (up to 20% variability) and showering / eating causes problems, but nothing anyone can ‘do’ apart from authorise rest I guess?? Pred due to run out tomorrow, so that’ll be the interesting landing...
If nothing else you can tell GP how you're managing (or not!) at the moment and about the reviews in hosp. As you've discovered the discharge stuff is often not very informative!! My GP always likes more info from me.
Thanks all. Hospital have sorted me out a 2 week sicknote (till end of term) with a lovely apology call for the oversight.
I’m now working on my phrasing to call the surgery again, ask to speak to the practice manager, and raise a formal complaint about this morning. I have an asthma review booked with them for next week anyway, and so am not overly worried about seeing GP immediately, but I am just so cross about the receptionist’s flat out insistence that because I was discharged, that was the end of it!! Stupid woman - and they’re normally soooo good.
I am similar to you. I am a lecturer and in my 5th week sick note. Floored by this flare up since October. I have NO voice at all for past week too. I have hospital tests coming up soon.
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