COPD rescue pack

[Pnut]

Here is a link to what gp’s are reacting too

pcrs-uk.org/sites/default/f...

[hypercat54]

That is very interesting. Thank you so much for posting it.

[knitter]

thanks for the link …..a well balanced article in my opinion

[sassy59]

Very interesting thank you xxxx

[Patk1]

All very valid

[Jaybird19]

note the date of being published was sept 202 0. interesting but who has time now to explain when you needed it .

T his was a time when you could phone the surgery and get to talk to doctor . I cant do that now here. I even had a n appointment some time ago a for doctor to call me as i had resistant UTI and needed a different antibiotic. he didnt call . it was friday i was told he would call me when i phoned and spoke to receptionist after due time for callback--- he still didnt call so next day saturday, I had to contact duty doctor on emergency clinic at local hospital who sent scrip to local duty pharmacy and i got a taxi who to collected it fron there and delivered it to me at home. . Took most of the day but i got it .

This was after a hospital stay and i wasnt very mobile and it was a hospital strain and ,of course, resistant to first line of drugs. Pipmecillinam cured it in 3 days when naladixic acid and nitrofuantoin didnt touch it . Had UTI for 3 weeks of agony.

[Patk1 in reply to Jaybird19]

That's awful.hope yr feeling better xxx

[Pnut in reply to Jaybird19]

it’s very sad the way everything is moving ,

I’m glad that you’re sorted 🤗

it’s frightening on the way people are thinking who have a responsibility to the public health and welfare , they have stopped questioning and challenging the thought processes on who want to make a name so many are suffering🙁 these need an advocate , so sad

[Alberta56 in reply to Jaybird19]

A sick person should not have to go through this to get the medicines they need. I'm glad you got there in the end, but how exhausting. xxx

[Nula2 in reply to Jaybird19]

You dealt with all that whilst being so poorly! 😟It must have been so so exhausting. ❤️xxx

[Alberta56]

Thank you Pnut for posting this. We all need to know this.

[beech]

An interesting article, thanks for posting the link Pnut.

From the article:

“According to Professor Hurst, rescue packs are both over- and under-used. “We certainly see some GPs who feel uncomfortable prescribing them, and that is OK if you can facilitate a patient’s urgent access to the practice when they are developing an exacerbation. Indeed, in some ways that might be a better standard of care than giving them a rescue pack to take at home – but this is very difficult to implement for many practices, and increasingly so with the impact of COVID-19.” “

And sadly, even some time since the end of lockdowns and the ‘worst’ of the pandemic, it is still a difficult process (where I am) to talk to or see a GP in as timely a manner as we had prior to the whole mess. I seem lucky to have had my rescue pack refilled recently, but for how much longer?

It must also be proving a saving to a Practice’s budget not to issue as much medication regularly.

[Biker88]

my consultant and GP won’t prescribe rescue pack antibiotics until I have had a blood or sputum test to confirm if the problem is bacterial, viral or fungal.

[Pushkins in reply to Biker88]

so sorry to hear this. Are you struggling to breathe? If so contact your NH Hospital “Breath Team”…I recived good response and also they telephoned my Drs with suggested medications

[Biker88 in reply to Pushkins]

thanks for the reply, I’m O/K fortunately I rarely get exasperations, if I do they are more likely to be fungal so a rescue pack won’t help very much. It’s interesting how different areas have different ideas as to when to take antibiotics, the recommendations used by my aspergillosis colleagues is to start your rescue pack and get a sputum test asap.

[Davegt in reply to Biker88]

That makes sense because antibiotics have no effect on fungal or viral infections.

[BreatheasyBe]

I see this is dated 2000 and gives a suggested 30mg of steroids, yet prior to covid 19 I was prescribed 40 mg daily of steroid for my rescue pack. I had a recent exasperation and used the 30mg and felt it just wasn’t enough. I ended up seeing the locum gp and in her opinion I should never have been dropped down to 30mg. Unless I was less than 50kg. I did explain it was a change I noticed during the start of the pandemic. I also remember briefly reading something along the lines that only those taking 40mg or more would be classed as immunosuppressed. Which in turn meant those taking 30mg of steriods would not be classed as immunosuppressed therefore not on the first run of the ladder for the vaccine. My Gp has now put my rescue pack back up to 40mg steroids.

[Davegt in reply to BreatheasyBe]

Dated 2020.

[BreatheasyBe in reply to Davegt]

yeah sorry typo date 2020 that’s what I meant to type. That’s when my steroid prescription was dropped from 40-30mg

[Brenda56 in reply to BreatheasyBe]

Thank you for that very interesting x

[Sgt_Pepper]

Very interesting - especially the bits about access to the medical facility. In my case it will normally take about an hour or longer to get through on the phone only to be told (usually)that there are no appointments available! I have figured out a way to get rescue packs without them being on my repeat prescription and ut seems to work for me!

[gardeninglady]

Thank you Pnut for this info. I myself have been quite upset when having GP's telling me that I can't have my rescue pack of ABs on repeat prescription. If I were to have to wait for the sputum test results to come back several days later before having ABs prescribed I would be wasting valuable time with a chest infection when it could have been being treated. I have let them know that I do know what I am doing with regard to my treament and pointed them to the original letter from the Consultant saying I should have a rescue pack at home. I think they have now written that in my notes,

[Tykelady]

I noted the point about not issuing rescue packs -as long as there are facilities for the patient to be seen. At one time our surgery had a rule that COPD patients had to be offered an appointment on the same day but since Covid this has not been applied. The other point which struck me was that different symptoms might not actually be an exacerbation. In my case I can tell, because of the difference, what is a bad day and what is something to worry about. Mine are always accompanied by tremors and a feeling of what i can only describe as 'offness'.

[Karenanne61]

Interesting! My gp has put the rescue pack back on repeat following a strongly worded letter from two consultants. Infection further damages already fragile lungs. Mind you, she admitted, amongst other things, that she rarely reads letters!!!

[Cookiemonsterr]

I have never been given an official rescue pack, but I do have spare prednison tablets in the house and my specialist agrees with this approach. I use them rarely. I cannot self treat a full flare-up, as it typically requires oxygen and steroid injections

[mikecom1]

Today's GP's are pro self help and self diagnosis I find. At best one gets a phone call rarely a surgery appointment. I seem to know when to use my rescue pack due to obvious changes, given the performance it is to see a GP since Covid I couldn't do without the reassurance that I have the pack if needed.

[bazcranleigh in reply to mikecom1]

Agreed totally.

[Yeo58]

this worry’s me. I have a rescue pack because, several years ago I was having an exacerbation, saw locum GP who diagnosed flu, told me off for attending surgery, refused to give me “steroids under ant circumstances” said I didn’t need antiBs and sent me home to take paracetamols and drink plenty! 12 hours later needed ambulance….I’ve never been so ill!

[Karate-Kid1]

I have a rescue pack of prednisone and doxycycline and when I feel a chest infection or exacerbation coming on I phone the Urgent Care team who are available 24/7. They usually get to me in under 4 hours and on examining me and doing all the checks inform whether I should take antibiotics or steroids or both. They also take a sputum sample away with them to check I am on the right antibiotic, The UC team are trained nurses and are available to housebound adults in my area

[Kristicats]

I agree with the thinking that anyone given rescue packs should be advised how and when to take them.

[Musicalways]

Put thank for this information. I have been educated but its nice to be reassured. When I'll you get messed up re thinking. I will keep.

[jacic64]

Very interesting, thank you for sharing. I've had to fight to get steroids when needed for an exacerbation. The paramedic that called me back from the GP surgery insisted that steroids wouldn't help me! Thankfully my consultant contacted the surgery & told them to add steroids & antibiotics to my repeat prescriptions as an emergency pack.The latest exacerbation was a totally different experience. I had an emergency appointment within 20 minutes & the GP prescribed steroids & antibiotics for me. The surgery are trialling a swab test to check whether an infection is viral or bacterial. I had the test & the GP messaged me the same day to say the infection wasn't viral & to start antibiotics straight away. Hopefully moving forward we can all get this level of care!

[Jaybird19 in reply to jacic64]

that is interesting about the swab to detect if bacterial or viral.

[Trevor6]

yes, although I have COPD it was a shock to be told I had Addison’s disease