COPD and asthma treated the same!

this is just a rant and a question really!

The respiratory wards at one of the hospitals in my city treats all asthmatics as tho they were copd sufferers whereas the other doesnt!

Recently every admission ive had has been a blue light job so ive ended up at this hospital. It annoys me as i really struggle wit v low sats but copd patients can cope a bit better. The nurses and drs seem to treat us the same i was discharged yday wit sats of 90-and tho i was fine whilst sat in bed i do find doin anythin really puffs me! I know that if i turned up at a and e now they'd not b impressed by the situation but the medics on the ward said that it was normal to hav low sats and a respiratory disease.

Does anyone else hav low sats all the time or is this just an excuse to discharge a patient who has been there practically all yr! I find it v difficult to argue wit the medics theyre supposed to b the experts but asthma and copd are two different conditions and i was under the impression from my gp that sats less than 92 indicates life threatenin asthma am i wrong? Im not doin too bad tday before anyone worries-went to gp this am and sats were 94 stil low but at least better than yday!

I suppose i wanna no if this is the same country wide or whether its just a local thing? And is there anythin i can do nxt time im in to ensure they treat me as an asthmatic and not a copd patient?

Thanx and sorry 4 the rant it just annoyed me! Kitkat Xx

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I don't know about the actual question you're asking (on COPD/Asthma) but I think the way sats are viewed varies not just between hospitals (which I've experienced) but within hospitals.

One time I was sent home from A&E with sats of 90, another time they wouldn't discharge me (from the same hospital) when I was admitted because my sats were 93 - now that doesn't make any sense to me, and they wonder why I get confused!! I've read the 92 level thing somewhere, but I don't know if it's true...

[KateMoss]

COPD and Asthma are two sepparate diseases.

COPD is chronic and mainly not reversible ( though a bit like severe brittle asthma at times) and asthma is a reversible airways disease so I would have thought that you should be treated to achieve your nearest possible normality.

They used to be called COAD and ROAD ......Chronic obstructibe airways disease and REVERSIBLE obstructive airways disease.

The Sats debate I can't really answer but if you are usually OK when not in hospital they should ensure you are back to your normal levels when you go home, though you may run a little lower in day to day life anyway.

The ward seems to be too COPD orientated!

Kate

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thought id clarify a few points...

I know copd and asthma are two totally separate conditions its just my local hospitals respiratory ward doesnt treat them as so.

I personally run wit sats of 96 to 100% wen im very well if im poorly im happy wit anythin ova 94 really.

My main gripe was that i was told that i should get used to rubbish sats as this was normal for someone wit a respiratory condition and that anythin ova 90 was fine.

Ive heard anythin less than 92% in an asthmatic is potentially life threatening.

My local hospital is a copd specialist centre but i often feel they treat me the same as a copd patient.

Question is what can i do about it? As i really struggle wit very low sats if i wanna do anythin its fine if i just sit and dont do anythin AND

Is anyone else fightin a similar battle. Just wondered if it was a local or national thing.

Sorry if the original rant was confusing... Thanx kitkat Xx

[KateMoss]

Hi KitKat,

Sorry, I didn't mean to explain what it was, was trying to give you some amunition to use. I probably didn't come over well either LOL. Had a tiring few days.

We have a resp nurse at our local specifically for COPD which has anoyed my Cons a bit as they should also be available for the difficult asthmatics too! I think there is a big push to keep COPDs at home at treated as much as possible at home hence the emphasis on COPD I think.

You should not have to live with rubbish sats! COPD pats run at lower O2 levels I think because of their CO2 levels which can drop and reduce the drive to breathe or something along those lines.

Sorry, can' be of more help

Kate

x

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Hi

I was rushed in to hosptial two weeks ago with bad asthma and every single person who spoke to me asked if I had COPD and I hadn't even heard of it and quite honestly after a few days I started to get quite annoyed. In the end I sat and gave the consulant a long list of memories of being really ill as a child... now I was on oxygen the whole time as that thing on my finger was only registering at best 94 % with oxygen. It was awful not being able to breathe.. so i really feel for you going home with only 90%.. gosh the memory of waking up in the morning after only about 30 mins sleep and that mask had fallen off my face gives me shivers.

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hiya sorry to hear u hav had a rough time recently. Its gud to know im not the only asthmatic who gets the copd card thrown at them but its frustrating and they should b treated differently as they're two totally different conditions. Ooh it does make me cross!! Id like to clarify somethin jeanette im usually ok with fairly lowish sats but 90%was low even me lol! It was prob the same as the 94 for u!! Its not a nice feelin not bein able to get ur breath and o2 is a wonderful thing wen ur in that situation.

I hope ur feelin much better now and hope u manage too stay well and out of the national hotel nhs! Take care xx

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my daughter just been in hospital with bad asthma attack her sats were 88 at lowest. n.i.c.e states that oxygen should be provided as soon as sats levels drop to 92 and a patient should not be released til they can maintain a much higher level for 24 hours. i know this because my daughters kept yo yo up and down and i was arguing wit doc that nurse was to quick to put oxygen back on but she said thats therule made by nice the governing body for medical profession.

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thanks for ur reply i had heard the 92% limit before and often wondered why 92%!? It was never a prob wit me till this yr as ive spent so long in hospital and on oxygen i think the ward just got frustrated n fed up therefore acceptin lower levels for me plus bein so poorly for so long wit rubbish o2 saturations has left me wit fairly rubbish normal levels though i couldnt tell u if this was 'normal' or not...

Thanks for ur reply tho and it is gud to know that it isnt the same everywhere! Wud b great to know wot to do wen the drs start lowerin ur o2 before ur body is ready as usually feelin bit too rubbish to argue wit the medics .....

Hope all are ok take care n keep warm. Lv kitkat Xxx

[KateMoss]

Regarding O2 levels, there is a new policy out from the British Thoracic Society about how & when to give O2..... hence some diferences in treatment recently.

You can become too dependent on O2 and I think sometimes it is better to try to wean off it if your levels don't drop too much.

Kate

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To confirm your status I would suggest Spirometry. This is a lung function test that specifically measures certain readings that can be read to determine your asthma progression. If you have previously had this done do you know what your FEV/FEV1% was?

Sp02 (sats) levels of 92% are TOO low for discharge and require stabilisation.

Asthma and COPD ARE different and regardless of protocols etc, patients should all be treated differently depending upon their symptoms and status.

Good luck.

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Hi,

Asthma & COPD should not be treated the same, they are entirely different diseases. There is a similarity in that there are both 'obstructive airways diseases' however asthma is reversible (the airways can be opened up with medicine) & COPD tends not to be.

Deciding between a diagnosis of asthma versus COPD tends to be a 'clinical one' i.e based on a doctors instinct. Doctors will take into account factors such as smoking history, eczema/hayfever, symptoms etc. Spirometry would NOT be particulary helpful in distinguishing a diagnosis of asthma from one of COPD. Both diseases may produce a similar picture on spirometry. Many asthmatics may also have entirely normal lung function when they are well, this does not mean they do not have asthma.

I would be careful in categorically saying that sats of 92% are too low for discharge. It may be appropriate to send a patient home if their peak flows are back to normal & the doctors are happy that they are safe for discharge. Low sats are often due to a faulty reading, cold hands or nail varnish. A one off reading should not dictate management. However, consistantly low sats and a patient with symptoms should raise concern.

Hope you're feeling better,

All the best,

STxx

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gavin

In response to ur question my last fev1/fvc was 0.6 -fev1 and 1.4 -fvc. I hav no idea wot this means my normal peak flow is550wen im well n up and about! Anyone no wot this means .at the other hospital this time and actually treated as asthmatic tigs time which is always. Gud! Thanks for all ur replies lv kat Xx