Hello everyone, I'm just doing a bit of research to find out if NHS services are starting to do Spirometry tests again.
I had a fairly mild case of Covid in April 2020 which has since left me with fatigue and breathlessness. I finally got a lung x-ray after switching GP surgeries back in June 2021 where I was told my lungs were hyperinflated and that I had COPD as a result of Covid, but they weren't doing spirometry tests due to Covid. I have had a couple of check ins with a respiratory nurse at the practice and again they say they're not doing them and they have a number of new patients waiting.
I feel I'm one of the lucky ones in that my symptoms are currently not severe but I would like to know where I am on the scale and have noticed some posts here saying people have been for spirometry, so I just wondered if they are being reintroduced.
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bowiefangirl
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With the caveat that I’m not medically qualified. Spirometry in hospital-led care has been back in normal use for a considerable period of time. When it comes to GP based spirometry, my understanding is the picture is much more mixed. Some surgeries are offering it again, others feel the risk to services is still too high. From family experiences, and years of being a member here, though, I personally believe that many GP surgeries aren’t appropriately trained or qualified to provide spirometry. It’s actually a highly skilled test, with significant experience and understanding required to interpret the results correctly, and most performing GPs and nurses get just a couple of hours of training before being let loose. Having spent a lot of time talking to respiratory physiologists over the years, who are essentially the spirometry experts, I’d argue you need two hours of training just to properly cover correct technique, never mind interpreting the results. On several occasions we’ve had new members here post GP performed results and had to explain to them that the analysis the GP had given them was wrong, in some cases really worryingly so, and they needed to ask to be referred to a respiratory team.
Obviously, the above doesn’t help you, but I have to say I would also be extremely wary of accepting a covid-caused COPD diagnosis on the basis of symptoms and an x-ray. In all honesty, I’d be wary of accepting a COPD diagnosis on that basis even without covid in the picture. But in your case in particular, in practice, GPs have fairly limited understanding of most lung conditions, and my own understanding is that the lasting lung damage from covid is not typically COPD like in nature. It’s more fibrotic, meaning the formation of scar tissue, and therefore I’d be pushing the GP for a referral to a respiratory team for confirmation: a Ct scan is the gold standard for diagnosing any lung condition, but if nothing else, you do need spirometry, and your surgery are freely telling you they can’t provide that.
Thank you for such a detailed reply Charlie...it did strike a chord as I do have scarring on my lungs that was found about 20 years ago, which I am told is a result of getting chicken pox when I was 21. Perhaps I misunderstood the covid involvement here and the issue is actually the problems caused by that scarring and that covid just aggravated things, as I had not really had any respiratory issues beforehand. If that is the case then a referral to a respiratory team is my next course of action. I will be attending a long covid pulmonary rehab course in the new year and have an assessment for that in a couple of weeks with what I am assuming is a respiratory physio - perhaps I may get more joy there. Many thanks again Charlie for flagging this up.
A bit of the point, but I was very interested in the comment you made regarding scarring and chicken pox. I didn't get chicken pox until I was 22 and caught it of my husband, who had a nasty case of shingles. I was really ill with it, but did not know it could affect the lungs. Who told you?
Hi Ann, A hospital consultant at the time, initially they thought it might be TB but soon came to the conclusion it was chicken pox - apparently the chicken pox rash can spread to your lungs and when I had it I was pretty ill with a bad cough.
I agree with Hidden on this. I had spirometry earlier this year, but the NHS isn't a truly national service and there will be local variations in availability. I was also surprised to see a COPD and hyperinflation diagnosis as a result of COVID. I had bronchitis as a child and that seems to have damaged my lungs and caused my COPD, but hyperinflation is the body's natural reaction to loss of internal lung area caused by the damage - I wouldn't have thought it would arise as result of COVID, at least not that rapidly. My diagnosis keeps changing, so I think you'd be right to take advantage of spirometry when it becomes available in your area.
Thanks Superzob, yes I'm beginning to realise that Covid probably just aggravated an issue with existing chicken pox scarring so I will keep raising the issue of testing as it would be nice to get a diagnosis.
hi - I ve had a test in 2020 and 2021 die another one in December at my hospital in London though have had a bad touch of covid recently and heart/lung issues so not much puff in me lol .
Thanks TheBoys - It certainly sounds as though the hospitals are more on top of this than the GP surgeries! I'm sorry to hear about your heart and lung issues...that must have been scary with covid too! I hope you're making a good recovery.
no probs! The hospitals seem to be trying. I know there is frustration from some front line at the lack of proactivity from some GPs which leads to people like me ending up at Emergency Dept .
I can't understand why you haven't had the tests as I have mine every 3 months, right through COVID. Once again I think it's the postcode lottery again, it all depends where you live.
Where I live in the UK the last time I had a spirometry test was over 3 years ago I've tried getting once since but was told they won't be doing them anymore which is wrong as I'm sure there are many of us would like to know what level we are at im in lancaster so it comes under The Morecambe Bay area the only thing they have done with me is sent me texts with questions and this time they gave my results as better than last year which I know myself isn't true because I can't do much this time compared to last year I know my lungs have got a lot worse yet answering questions they say its better than before just wish they still done spirometry I know my lungs better than the medical practice
I'm sorry to hear you're feeling worse Danielmystar...I agree that having a test will at least set many peoples minds at ease as to how their lungs are doing.
I'm the same. I was told that they were being stopped as they only upset the patients. All my reviews have been over the phone and the only time my breathing was ever monitored was when I was in hospital.
After a six month wait, I have a spirometry test booked for the 27th of this month. A slot was found for me after I had a COPD review with a nurse, and I told her that I had no formal diagnosis of COPD. The test will be at the GP surgery.
For what it is worth, I had X-ray and CT scan 18 months ago, as I was increasingly breathless and was diagnosed with COPD off the back of those tests. Asked what type, emphysema for example, and was told that I had hyperinflation. No Spirometry was available. I have moved area now and am changing GP Practice, so will try again, as hyperinflation alone seems like an incomplete diagnosis?
Absolutely Autumnman...I was told that hyperinflation could be present in a range of lung conditions but that's not very helpful when they won't do the tests available to them to tell you what the condition is!
Have you asked for sight of the CT report? CT is the gold standard for diagnosing most lung conditions, and with the exception of early stage chronic bronchitis which I’m given to understand doesn’t always show up, it’s definitive for identifying what form of COPD you have. The report might not make diagnostic conclusions like patient has x, but should at least list any pathological changes seen.
I had a spirometry test a few weeks ago at hospital that was requested by the respiratory consultant I saw , last week I also had to have a mannitol challenge uk test and another different breathing test .
Yes,same for ct scan 10yrs.this is a specialist chest unit! I had to spell out how their neglect has caused my conditions to very seriously deteriorate before they acted.not gd.stand firm x
Reading everyone's stories here I think it's the only way forward - it's hard to find a balance where you can be firm and still keep the nhs staff onside...sometimes I think it's a case of "he who shouts loudest".
I had a test in August after waiting 18 months to resume them. I was sent an appointment in July 2022 at my local hospital for June 2023 but went online with my previous e-referral details ( having had 2 earlier appointments cancelled as they wanted spirometry results before seeing me) and found an appointment at a hospital 20 miles away for an appointment for August. The nurse who did the test said they had a very big backlog and was surprised how I managed to get an appointment so quick. Despite being diagnosed, I wasn’t referred to respiratory nurse, given any change of meds and told I would be seen again in 3 months. Not impressed.
That's great that you got an appointment Cruise1 and finally a diagnosis, although the follow up doesn't sound the best...it strikes me that the system is a bit broken right now.
Hello bowiefangirl, my surgery have never reintroduced spirometry tests . I agree with others this should be undertaken by a specialist team generally found at the hospital. My local hospital does not routinely do these tests , they now refer to clinics to help you manage your breathing difficulties due to your lung diagnosis. Times are changing but most people do have spirometry tests to establish diagnosis before treatment proceeds.
It's a real lottery on tests right now Katieoxo60 - my local hospital doesn't either and goes down the management of symptoms route instead, which I do understand to a degree, but to manage anything you need to know exactly what it is you're managing. I was hoping there would be positive news on testing by the end of 2022 but I won't hold my breath (pun intended) as with the talk of strikes etc there will be a bigger backlog no doubt. 🙂
You are right bowiefangirl, its a lottery BP is the big test area now it seems. As there is no cure for chronic illness it does work on the basis of symptom relief . But I think most people including myself still feel as you do that you need to know what you are managing i.e you need correct diagnosis, to access tried and tested treatments to relief your symptoms and rule out other causes that might have a treatment for cure. I agree with you the strikes will cause added delays no doubt and expand the queues on the waiting lists. Another thing you have to watch out for is a new illness being blamed on existing illness i.e cancer when you already have a lung disease . Or deterrioration that needs increased treatment. Do make sure you still get an annual reveiw of your condition. Enjoy your weekend and wrap up warm.
My GP surgery is doing spirometry although my partners surgery is still very much on high covid alert... my daughter had a cough and they *insisted* we did a lateral flow before she be given an appointment... we had already done one and it was negative (it was a chest infection in the end, she is also asthmatic)
However my gp surgery wanted to see me when I told the I was covid positive they said no problem we have a room we use (they actually ended up calling me and just prescribing over the phone)
It does seem to be very much a postcode lottery and sometimes it's not even that much of a change (our gp practices are a few miles apart)
It is very frustrating, especially when the hospital said to me during covid how have you found it? ... when I said terrible because everyone tells me my cough is covid..... the doctor said yeah I wouldn't want to tell anyone I had a cough right now
And we are supposed to be " living with covid" and on the letters I've been getting from the hospital it says DO NOT ATTEND YOUR APPOINTMENT if you have symptoms of covid (bit daft really as it's a respiratory unit)
And on a few of the letters it said to order and do lateral flow tests before attending the appointment
I have to admit I don't mind doing a test to confirm I'm negative before any appointments but then test results can be wrong and if you have a lung condition causing a cough how can you really know.🙄
Oh yeah I don't mind doing the covid test but the any symptoms of covid when 100% of people are there with respiratory conditions and 99% at least of them will have a cough or breathlessness.... the unit would be empty if the people on the ground weren't using a degree of common sense
Thats what I meant by it being daft having that in the letter... for a few of the breathing tests I had it said please do covid test the day before (which I think makes sense to protect the staff in the hospital and other people in the unit)
That's great Homely2 that you've got that full care at the hospital - it sounds very thorough. It seems to be across the board that GPs are doing most appointments by phone - I suppose they can get through more patients that way but mistakes can be made.
I've had a few lung function tests recently, the hateful one in the glass box with the nurse/technician apologising the whole way through! Most recently at Harefield tx clinic and my local hospital only last week.
That's great you've had some tests Karenanne61 although it sounds like one is not very nice. It seems like surgeries are in the minority now for doing them.
I don't remember ever having spirometry at gps. But my memory is rubbish now. That's what type 2 respiratory failure and subsequent coma and drugs does!
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