Not confident with management of asthma

[hb1977]

Hi Everyone

I was diagnosed in 1997 and was managed by an absolutely brilliant asthma nurse! She gave me a fab self management plan which used peak flows and symptom scores and helpfully had stikers on my peak flow meter to help.

Fast forward a few years and things are totally different.....I'm not massively compliant which doesn't help!

I had an exacerbation in February and went to my new GP (I've moved) I was told to double up on the Seretide and given Pred 30mg for 5 days. I know I can't double up on Seretide and raised this at the time and did kind of expect a bigge dose of pred!

Took ages to recover; went to see the astham nurse after 2 weeks! She told me I can't double up on the Seretide and talked to me about the SMART regime; but said I couldn't swap as I wasn't well controlled!

I asked for a self management plan as I often find it difficult to know when I need to see a doctor etc; asthma nurse refused!

I know have another exacerbation and will probably have to see emergency GP tomorrow (Peak flow is about the same as when I finished last course of steroids but I am tight, short of breath and using ventolin four hourly!)

I accept I may need another course of pred to regain control but would like to not keep finding myself in this position.

I'm considering changing practice (I can't even request repeat inhalers over the phone where I am now!)

Any ideas, suggestions welcome!

[Hidden]

hi,hb1977

Sorry to here you arnt getting the support you need.

My asthma nurse is brill and see her every 2 weeks more if need her.

Keep pushing your doc and asthma nurse until you feel you can cope better and

getting the meds you need.

An action plan is good as gives you a little control of what and when you need more help.

good luck ,love Glynis xxx

[Hidden]

hmm its rubbish isn't it, we shouldn't have to fight for information/help/meds should we? I've had to change GP's in the past coz they were rubbish, I just thought even if they sort this problem out, what abaout next time and the time after. I think you need to have a good rapport with the asthma nurse too which by the sounds of it you aren't gonna get. Maybe ask friends & relatives if they can suggest a good doctors surgery near you? You shouldn't have to move though!

[Hidden]

I can't request repeat prescriptions by phone from my GP, but I find a brilliant service is Lloyds online, you phone them two weeks before you need a refill, I do a month in advance, they then get the repeat script and post your meds to you, free phonecall and they don't charge for the service. 0800 707 6160 to enquire and reorder.

Regarding doubling seretide, well technically the answer is still no, but the license for Salmeterol changed and can now be used at 4 puffs twice a day in severe cases, so although seretide hasn't been changed you can double up for short periods of time. Personally I find the addition of extra flixotide more effective and preferable, you could suggest having that as a means of increasing the inhaled steroid when you need.

[Hidden]

hi,

I to like woody -som us loyds to collect my scripts and hubys and sons scripts and I

usualy collect them from the chemist as they deliver when im at work and carnt leave them

anywhere.

My docs you can ring up for scripts but ask us to avoid busy times like monday morning.

love Glynis xxx

[hb1977]

Hi Everyone - thought I'd update you!

Have been to the walk in clinic near me as chest was so tight and I was very short of breath! Have been given another course of steroids (my second course in 6 months) although my peak flow is reasonable the doctor said he felt the most important aspect was the symptoms being experienced rather than the numbers on the peak flow meter!

Thanks for the information about the Lloyds service; I will definately look into that and I'll make enquiries locally into which surgeries offer a good asthma service and hopefully avoid further courses of pred!

Thanks again!

[Hidden]

Wow, looks like you got a good doc at the walk in clinic, why can't they all be like that?!

Good luck with it xxx

[Hidden]

hb1977,

glad you got help,

we have a walk in centre in the next town a bus ride away ,8-8 everyday of the year.

its helped me out alot when couldnt get to see a doc that day ,

get well soon,love Glynis xxx

[Hidden]

im in the same situation as you...move fast - dont wait and wreck your control further like i did

im debating to switch gp's too. the difference in my case is that the practice i go to has always missed the diagnoisis of my asthma as severe, A gp has asked me to top my seretide 500 with flixotide 250 and make it six puffs a day (they are basically asking me to overdose!)

I had an A&E themed weekend when everyone said 'six puffs and the seretide too!' I have been given spiriva by the gp at the emergency clinic and told to go back to see my asthma nurse and discuss the use of adding in theophylline. He was shocked at what i was given and how much to use and his behaviour and manner in speaking to me (and understanding) was so much better than my lot!

Im going back tomorrow to see the asthma nurse and will probably need to come to a decision about the move before the end of the month - as i no longer trust my practice. where was all the new meds this emergency clinic is giving me i wonder !?!?

I think all everyone should be careful about their doctors and the level of care they get. My asthma has deteriorated to this chronic stage as its taken me so long to get them to not treat it as just another allergy!

[Hidden]

Hi hb77,

if you are using your inhaler 4 hourly and your having symptoms like that you need to go back to your gp and ask to be referred to an asthma nurse. Also speak to the asthma helpline they can help you with your meds.If you change dr's check they have a qualified asthma nurse as part of the practice.

You could also speak to your pharmacy as they may be able to give you advice as well.

Hope you get some relieve soon, take care. Let us know how you get on.

sj x

[hb1977]

update

Well,

The steroids finished on tuesday (just a 3 day course) and tuesday evening I had a very brief exposure to cigarette smoke (one of my triggers) by Wed am things were worse and today my PF is worse than when I was prescribed the first lot of Prednisolone!!!

Saw GP today, have another 5 days of Prednisolone. Will have to return in a few weeks to ensure treatment is optimal and consider chagning if not!

I have to admit that I'm not terribly compliant with treatment so this really is my own fault. The denial is rapidly fading.

[Hidden]

Hi hb1977,

sorry to hear the probs your having, but you will find it takes a while to get the hang of the meds/ p/flows etc. Which i'm sure we can all relate to, but its not always your fault sometimes its the meds need changing but you do need to take the meds your given regularly. Don't beat yourself up, try and improve your compliance. You will get back on track, and you'll be steroid free again lol.

Best of luck, take care

sj

[Hidden]

hi

it took me a very long time to get used to self managing my asthma. i found i went through a stage of asking if i could see my gp every other day so we could keep it under control. then i gained a respiratory nurse after a very nasty excerbation. now i am allowed to ring her whenever i have a question or concern but i do finally seem to have the art of self managing now.

feel free to pm me with questions.

plumie