Asthma Assessment

Does anybody else here get a bit fed up with the assessments at the G.P's?

I know that they have to be done, but they always make me feel like a am a naughty girl, for using my inhaler 'too much'

I am 45, and have had asthma since childhood, and like many people, used different medications over the years. I did not have inhalers as a child, only pills, and they did not work instantly - so I remember sitting with my parents - waiting for the 'attack' to pass. It was not a good time for my parents or me. I know I am not alone in this.

Anyway. I have had a few major attacks - and been to hospital, but on the whole, I have tried to keep my asthma under control, and keep away from things that trigger an attack, or things that I am allergic to.

When I have these assessments - the nurse always questions and tells me how many times I should use my Ventolin. This is all well and good - but there is no straight-foward answer for me.

Some days I use it more than others. Some days I hardly use it at all.

On my last assessment - I told the nurse that I used my Ventolin 3 times a day - she was mortified - and said it was far too much! Unless they are asthma sufferers themselves - they have no idea what it is like to be short of breath. I tend to use my inhaler, as and when I need it - not at certain points through the day.

I have never seen the point in using the Ventolin when I do not need it.

Yes - I have tried preventers - but personally I could not get on with them

Also, I used to get 2 Ventolin inhalers on one prescription. It is more cost effective - and I like to have a spare (I expect many of you panic, when you do not have one to hand).

Anyway - any thoughts would be most welcome

16 Replies

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  • Hello Bliss,

    The assessments are there to help, though it can depend on who does them and their attitude.

    The main aim of assessments and asthma nurses etc is to get control of your asthma promarily using preventers to stop you having attacks and having to use your reliever inhaler (Ventolin)

    Yes, use of relievers can be variable and they should understand this. eg. some days you may be exposed to triggers, other days you are fine.

    They will always question how much ventolin / reliever you use to gauge how well controled your asthma is.

    You state that you don't get on with preventers?

    Is this because:

    a - they didn't work

    b- too much hassle to take each day

    c - another reason?

    There are quite a few types of preventer around that you can try - different drugs and different inhaler types. Were you ever offered different types?

    Compliance is one of the big issues with preventers as you have to take it each day, but a couple of puffs morning and night is often much better than using the reliever when you do get symptoms which could disrupt your day for a few minutes or an hour etc.

    By just using the reliever only you are not dampening down the inflamation. The reliever only opens the airways. A preventer will with regular use will dampen down the inflamation that causes the asthma and will reduce the number of times you will have to use your reliever.

    Ventolin is not meant for regular use in most cases, though some of us here, a minority with severe asthma do have to use it daily but it is not good - there are side effects.

    Please ask about a preventer.

    Hope this helps and doesn't sound too harsh!

    Kate

  • I totally agree

    The nurse and the Dr make you feel as if you have lost it when you say you use your inhaler all the time. The preventors just make you lose all sense of taste, they have given me a painful tongue and each time they test the way you are using your inhaler they tell you your wrong. Then all they suggest is tablets which is a bit stupid after they have told you to lose weight, the tablets and the preventors are steriods just look up the side effects of steriods and be very afraid. I am fed up of being treated like a child after all I haven't done this to myself it is an illness that I have to live with. Example getting a train a month ago had attack was sitting on toilet in train could not breathe lips turning blue inhaler no good thought oh dear I am going to die like Elvis on toilet luckly the ventolin kicked in after about 15 inhalations. Use your inhaler sparingly!

  • Thank you both for your posts

    Andllan - I feel for you, when you had attack on train. It is such an awful feeling when you cannot breathe.

    Kate - thank you for your info. I do understand what you are saying, but at 45, I am in control of my asthma - and I feel I know my body quite well.

    I am all for help and assitance from the nurses and doctors - but telling me that 3 puffs a day is too much - I think is a little extreme

  • Can I ask in what way you don't get on with your preventers? Have you explained this to your asthma nurse? It sounds like your asthma isn't under control at the moment which can obviously be exhausting for you.

    I'm sure with a little support you will find a preventer that you can get on with as you are probably aware of the dangers of asthma. I find the condition a terrifying and temperamental one in which can turn at the drop of a hat into a very dangerous situation. I would hate to think of anyone putting themselves into such a situation willingly. Hopefully if the asthma was controlled you wouldn't have to use your ventolin at all so wouldn't have that awful feeling of not getting your breath.

    I so hope your symptoms improve and you can find meds that suit you.

    Love Emily x

  • Hello Emily

    Thank you for writing

    I must point out - I am a mild asthmatic, compared to others.

    I just really wanted to know if using Ventolin about three times a day is too much?

    I know of people who use theirs constantly

  • I think that good control of asthma can be defined as only needing to use your ventolin a few times a week. This is why your nurse says you are using too much, and presumably wants you to try preventers. In fairness to your nurse she HAS to tell you are using too much, if she wrote in your notes that she approved of what you are doing, she could get into trouble!

    Have you tried lots of different inhalers (different types of steroids and different mechanisms)? There are loads of different types available and some people seem to find one particular type suits them a lot better than others. If you try lots of inhalers and don't get on with them then you could ask about (non-steroid) tablets like montelukast.

    If you find a preventer that works for you, you might have barely any symptoms at all!

    Bryony

  • Hi

    I use my ventolin 2puffs 4 times a day all the time as advised by the hospital doctor. I use as needed as well so could use it every hour some days

  • Judith, my daughter also takes her ventolin every 4 hrs each day but we see it as a controlled dose if that makes sense. By using her preventative meds too we aim for 'control' as much as we can.However she does need ventolin more than this also, due to her difficult asthma.

    I just feel that by using preventers etc we are doing all we can for her to live as normal life as possible.

    I just don't understand the refusal of medication. This condition has it's own agenda which can escalate without warning.

    Hope all is well x

  • Hi Emily and Judith

    Thank you for your posts.

    I do feel that I am interrogated about my meds.

    This is all well and good, and I completely understand that they have a job to do, and patient care - but, as many of you know, as soon as your chest becomes tight - you may (like me), use the Ventolin to stop a full blown attack coming on.

    This has worked for me for years - and I try to only use it when I really need to.

    At the end of the day - when somebody is an asthmatic, they will use Ventolin whatever to ease the horrible feeling when trying to gasp for breath. This does not mean that I think people should use it willy nilly, I am just saying that I use mine as and when I use it

  • I've had the same experience, almost. I've used a preventer since I was a kid but, while my asthma was moderate, used the ventolin 3 times a day on average. This worked for me and people assumed it wasn't the right way to do things.

    That said, as others have mentioned, using a preventer might make things easier for you?

    Why don't you give the nurses here a call. There are a lot of different types of preventers and ways of getting around the problems they can cause (sore throats etc). The nurses are really nice and very helpful, they may be able to reassure you about the steroid side effects etc. I'm on the maximum steroid inhaler dose at present and the only effect that bothers me is a sore mouth but I get around that by lots on rinsing after I use the inhaler. Of course, we're all different so its best to speak with an expert.

    I hope this helps a bit

  • Hello TS

    My nurse is helpful. And I have tried her suggestions - but she is not listening to me.

    It is hard to explain on here, as it comes across that I am just being awkward - but I am not

  • Bliss you really must get to grip with using preventative medication, there are plenty of options to explore. I am not surprised that your Asthma Nurses are rather concerned. Please explore other options there is something out there that will suit you. Good Luck

  • Hi Emily

    Hope your daughter is ok. As well as using the ventolin I have seretide twice a day Atrovent twice a day

    permament steroids and singulair tablet at night. At tha moment the hospital doctor is sending me for a ct scan of my lungs and a specialist test to see if I do have asthma as he is now undecided. Was diagnosed with asthma 13 years ago at the age of 39. The last 2 years I have really struggled and the hospital say there is nothing more they can do. Its quite good that you can read about other people on here as it makes you feel you are not on your own . Thanks for making a comment earlier

    Judith

  • Judith, I've pm-ed you. X

  • I actually agree with Andllan - every time I got for a review, my inhaler technique is always WRONG. My mum is a nurse and she would know if I was taking it wrong! I always feel as if Im in trouble with my asthma nurse. My GP on the other hand, I feel really comfortable with and will be totally upfront if something isnt right. I had side effects with one preventer and went and asked him to change it - he did after asking some questions but he didnt make me feel like I was a child. Im totally truthful with him but always with-hold info from my asthma nurse.

    Anyways, have you tried every preventer going? Everyone is different and we dont always get along with things but there should be something out there that will work for you. It will make you feel a bit better. As for your use of ventolin, Im needing my ventolin every 2 hours at the moment - I start getting wheezy around that time. I have a lot of stress right now due to a family bereavement. Its normal for me when Im having a rough time and once things in life get better, my asthma gets better. I know when to get help but Im doing okay controlling things and havent had an attack. You know what is right for you. Hope you feel better soon xxx

  • Thank you all for your posts

    I do not have a problem with my G.P or the nurse, I just think that they could treat me in a different way. I am an individual - and should be treated as such.

    I know my body quite well, and have 'dealt' with my asthma all my life. In fact, some of hte nurses I have seen over the years - have got themselves in a tizzy with their lack of information.

    Also, on a different level, I do not have much faith in the health system at times, as over the past few years - I have been mis-diagnosed many times, had surgery many times and even told once that I had a tumour - when I did not!

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