Telephone consultation with Consultant?

[Woofly]

I received a call from the hospital to say I will have a tel. consultation next week. I have been waiting for over a year! my query is what on earth can I tell him!¬ yes, very breathless can scarcely do anything now. What on earth do I ask him? (I am on oxygen ) how the h***l can he diagnose anything via telephone!! I am feeling VERY angry! What do you good people advise?

[Hidden]

I had one of those today. Bit pointless as you say, the consultant can’t listen to chest or do spirometry etc so there’s a lot of questions & guesswork. She suggested some drug changes & if no improvement will arrange treatment via the Home IV service, so I felt was doing her best in the circs.

[Oshgosh]

I’ve got a diagnosis of lung disease and 2 auto immune diseases.

The pandemic hasn’t been good for me.my shortness of breath has got much worse,

I’ve had a few phone consultations with GP.Its not ideal,but I’d rather keep away from any potential source of infection.

I’ve had Dmards bloods done at GPS surgery,felt safe ,everything cleaned,not allowed to touch anything.

Started going worse with increasing shortness of breath about the end of March,rung the helpline. Emergencies only,so left it,much to my husband’s disgust.ive been through A N E 3 times this year,sent twice by 111 and once by GP 2 day admission last time.

At the end of May,still getting worse,rang helpline and left a message,I as surprised to ring a phone call from a dr.

We discussed my symptoms.she made me a phone appointment with the rheumatologist 2 days later.

She was also concerned, upped steroids and made an appointment ( phone) for 3 weeks.

Still detioriation,theLung Consultant and rheumatologist said reluctantly I would need f2f appointment.its this Friday.im quite worried about going,but needs must.im worried that they feel the need to see me.

They wanted me to send a sputum sample.

This has come back with yeast plus plus plus,so now on tablets for yeast.

Perhaps you could write down some questions,tell him how you have detioriated and your concerns.

Do you have access to an oxygen nurse? Perhaps she could answer some of your questions and concerns.

This pandemic has been hard on us lung patients.

I honestly thought that I would catch Covid and die.

When you have your appointment tomorrow,ask if there is a helpline you could ring if you have concerns.this has been really helpful to me,you have to leave a message,but they always get back.

I apologise for the length of this post,but wanted to respond to you before I went to bed.

Try taking pen and paper to bed and write your concerns down.hopefully you’ll manage some sleep.let us know how you get on.take care

[Caspiana]

Hi Woofly , 😁👋

A year?!? Wow. That's too long to wait for an appointment. And it's over the phone? I don't know what your diagnosis is or what meds you are on so that makes it a bit tricky for me, but I will try.

Well for starters, you'd need to make a concise list. Just off the top of my head.

* What are your oxygen levels at rest as opposed to when you are ambulatory? If it dips below 88 (if I remember correctly) despite having your O2 on you may need an oxygen review. Any changes you've noticed, increased wheezing, increased coughing, breathless?

* How you feel generally , are you eating well? Weight loss, weight gain? Appetite?

*Your medication. For example if you are on inhalers do you get relief? Do you need a medicine review?

*If your symptoms are worsening, what might be causing the decline and what to do about it.

*When can you next be tested for changes, CT scan, spirometry test? When was your last scan/ tests?

* How much activity/ exercise is advisable and what kind of activity? Any restrictions?

*What can I do to improve my wellbeing?

*Concerns about going out during this time/ travel ?

Sorry, that's all I can think of for now. I hope it goes well.

Cas xx 😊👋👍

[Woofly in reply to Caspiana]

Goodness, what a wealth of information you have provided! you are a real star! I will follow all your suggestions, and let you know what transpires. Thank you again xxx

[skischool]

Excellent list from Cas,we have spent too much time clapping.justifiably i might add for front line Nhs staff,now we need the rest of them to up the anti and start providing the medical service they shut down many months ago,too many people with long term serious medical conditions have been abandoned and forgoten and this needs to be rectified sooner than later.

[Yasyass]

Well can advise you on anything much except write everything down wh u want to ask I too have asked the same question how can a good diagnosis be made by ph because some symptons can be similar to other illnesses but all reply is COVID-19 so I just calm myself down thinking there r thousands like me waiting I’m not alone

[MoyB]

I think the medics are doing the best they can in a difficult situation. I suspect that if, during your phone consultation, your consultant thinks they need to see you face to face, this will be offered to you. It's not an ideal world at the moment and we have to make the best of it, I'm afraid. Getting angry or upset doesn't help, although getting it off your chest on here can be very therapeutic in my experience.

I had a phone consultation a while back. Like you, I wondered how useful it would be. I got my list of questions ready and my consultant had his list too. True, we couldn't do lung function tests and he couldn't listen to my chest, but he DID listen to ME and that was really important. We were on the phone for an hour. I had him on speaker phone so my husband could hear as well and he joined in where appropriate.

At the end of the call, the consultant said that he would order a CT scan for me which he hoped would happen in September (backlog willing) and he would arrange to see me face to face to discuss the results. I agreed to these arrangements being made, fully aware that it will all depend on how things go with COVID-19 as no one can accurately predict how things will be by then.

I know it's really hard when you're struggling and feel you're at the back of the queue for treatment, but please don't let your anger and frustration get in the way of having a productive telephone meeting. Arm yourself with your list of questions and don't be afraid to tell the consultant how much you are affected on a day to day basis. Ask what they can offer that might help you. If, by the end of the call, you haven't been offered a face to face meeting, ask if you can have one.

I really hope you get somewhere with this. Good luck! xx Moy

[Seapop-in20]

Hi do you take your oxygen and pulse details this is useful for the dr ... how are you coping exercising and moving? How is your weight and how is your wellbeing? These will help.

[R1100S1]

As others said make a list of questions beforehand and take notes

I have over the phone consultation with my chest docs and my oncologist

Whilst not what I really want it better than catching or passing on the virus

[katieoxo60]

Hello Woofly, I totally agree with you on telephone consultations. I have been doing it this way for a long time with my Gp. It does not work I ended up at the wrong clinic twice , in hospital due to change of inhaler without GP consultation. Diagnosed as depressed when I need an orthopeadic surgeon ect ect . Now the coronavirus as left me with no care whats so ever, because the doctors cannot cope with the demand which is understandable. Right now my surgery is only doing emergency services as the computer is being updated, not even sure we will get repeat prescription. Unfortunately this has been in the pipeline for future care long before coronavirus emerged. Gps were averse to the idea as were lots of patients but appears our voices were not heard and coronavirus as been used as a scapegoat for it to commence. Many like yourself and myself are really angry at the outcome, but sadly anger wont solve it. When calmed down it still looks like those in most need have been consigned to a list which allows for us to be treated as none emergency and able to remain at home if unwell.

[Patsy164]

Great information, I too have a telephone appointment Monday with the respiratory doctor. I will now be prepared. Xx

[Woofly]

I cannot thank all of you so much for taking the time to help and advise me, I truly appreciate it. I have started to make my "list", and hopefully will have all the information needed when they phone.

[Smoggy1990Boggy]

I think this is the way a lot of the NHS will go. Matt Hancock thinks an app will solve most things and likes technology to be used as much as possible. Primary Care receives a tiny proportion of the budget but does most of the work. Things are going to be hard for a long time. The NHS needs more investment urgently.

[Kristicats]

I think most consultants are doing telephone consultations at the moment unless patient is in hospital. Obviously as a safeguard for the vulnerable patient ( and themselves) they are more likely to have telephone appointments with newly referred patients to see if they need to be added to their clinic list. Hope you have written down everything that is happening with you, the changes in your health, how your mobility/ activity has declined and over what period. Physical factors such as chest pain, tightness, rapid breathing ,frequency of SOB,sputum( excess, thickness , colour etc) How oxygen helps/ hinders , not enough what concerns re your oxygen sats are they up and down , too low at certain times during and after activity?

List what you want to happen:- Ie tests because you are worried (to see what’s changed/ what’s caused such a decline .

Tell him if you think you need a Regular appointment and monitoring with chest doctor/ clinic to feel more assured Re lung condition and have current facts of the condition of your lungs ie levels ( proper spirometry)and meds reviewed.

Sometimes it’s easier to concentrate on your list of questions if not face to face especially as often one sees the other is clock watching etc. It’s not ideal as you will not get an examination or spirometry etc. But hopefully the consultant will have enough cause to put you on his regular appointment/ clinic list when things get running again.

Obviously many of these things may not apply to you but just giving some ideas.

Good luck Cx

[Davyroy]

I had a telephone consultation a few weeks ago with a doctor I have never met or heard of. When I received the hard copy of the conversation it was full of lies that will make it difficult for me to get the operation done at all. I will demand that any future telephone calls must be recorded so that they have to tell the truth.

[Davyroy]

After your telephone consultation you will receive a hard copy of it. I suggest that you try and record the phone call. My hard copy bore no resemblents to the phone call. No one will admit any mistake made ever.

[Woofly]

Davyroy, Thank you for that advice, my goodness you have to try and think of everything! Fortunately the 'phone call WAS recorded, but I will make sure all conversations are recorded.