first respiratory appt tips please

[nmcv13]

Hi, I’m 59, asthma since 50, on luforbec 100/6 2 puffs twice a day, montelukast & fexofenadine. I have a first respiratory appt at the hospital and am wondering what to expect?I’ve had 3 exacerbations in the last year, 2 of which needed steroids. Between the 2nd & 3rd (Aug - Nov) I continued to cough and coughed most days until about 4 weeks. I’ve had a normal chest X-ray and spirometry was pretty normal too. Thanks.

[Chip_y2kuk]

Your first appointment they will look at what medication your on, what your symptoms are and then discuss booking tests... some of which you will have before you leave the hospital (bloods and spirometry)

The rest you normally get the appointments through the post

[peege]

After weighing i was sent for allergy tests - mainly because bronchiectasis or aspergillosis was suspected because aspergillus was in all sputum tests. Luckily only a very mild reaction to that thankfully but strong reaction to mould so at least I can avoid it all in soil, leaves etc. Next was full lung function tests both before and after using Ventolin.

Then discussion with consultant. Four further appointments after that one of which included CT scan which diagnosed Small Airways Disease on top of asthma.

Can't think of any tips except take a sensible empathic friend with you for support, witness & to take notes

[peege in reply to peege]

I forgot, take your own inhalers to use when asked by your consultant to show how you use it/them. Mine passed me an inhaler whilst I was sitting at his desk,. I didn't realise the importance so I just did a perfunctory puff, nothing like the way I do them at home. In his initial letter he wrote 'very poor inhaling technique '! At least I also got copies of all letters to gp.

[Tiggertheterrier]

Ask if you can have a copy of all letters from your consultant to your GP. My consultant, although useless for everything else, was very good on copying me in on his correspondence. It came in handy when I had an argument with a locum GP about my inhaler use, he couldn't be bothered to read my notes, so I pulled my copy of the hospital letter from my bag and plonked it on his desk.......he apologised!!!!

[Homely2 Administrator]

It depends where you go.

My hospital operates a nurse led respiratory clinic and a consultant led clinic.

The nurse led clinics I have been to are very practical, I have been to two different ones, they have a lot of equipment in their clinics. They did full medical history, and both did feno test immediately and one did spirometry immediately. One diagnosed asthma there and then, the other within a month,

both recommended a change in medication, and checked my inhaler technique. All in a couple of hours. Any issues I can ring up and they get back in 24 hours, brilliant back up for when I need pred and my GP asthma nurse is unavailable.

The consultant led clinic was much more about getting the correct diagnosis, so discussing and then ordering tests, blood, x ray, ct scan, spirometry, feno etc. The tests then were spread over five months or so, then he ordered more tests. The tests are mainly done by technicians rather than nurses. He did initially alter my medication, but he was much more interested in getting the diagnosis right, rather than going for a quick diagnosis. After a year of all this he diagnosed severe asthma with poor control, but he had also proved that it was not a bunch of other things. He now has me on drugs that are helping.

My consultant led clinic does not accept the test results of my nurse led clinic, or the results from other hospitals, they have their own separate testing facilities.

I hopefully have the best of both worlds, I have a consultant ensuring my diagnosis is complete, but I asked and he agreed that I could also remain a patient of a nurse led clinic, so I have practical support.

[nmcv13 in reply to Homely2]

thank you so much for all your comments.

[Patk1]

If u have any questions or things u want to say, i'd take a list with you as it's easy to forget individual points x