First appointment with the consultant -Sorry for double post

EDIT: Sorry for double post, I don't know what happened!

I know this subject probably comes up fairly regularly, but I couldn't find answers to my specific questions, so sorry if this is a repeat of another post.

I have my first appointment at the chest clinic next week and have some questions on what to expect. I understand that procedures will probably vary between hospitals, but it'd be nice to have a vague idea about what will happen. How long will the appointment last? I expect they will want to do spirometry testing, what other tests are they likely to do and when will I get the results? Are they likely to adjust my treatment on the first visit? My whole life at the moment seems to be revolving around this appointment, I know they won't have an magic wand, but anything that can improve things for me at the moment would be a god-send.

22 Replies

  • Hi there, glad your appt is nearly here for you. I was really worried & exited about my first one but it went well. I didn't have any tests done at the appt with the specialist, he got me an appt for them at a different hosp a couple of weeks after I saw him. The appt didn't take long, about fifteen mins. I'd been in hosp not long before so he already had my CT scan & x-rays infront of him. He did, however, change my inhaler there & then. I hope you get some answers & please let us know how you get on.



  • Hi,

    When I had my first appointment with my consultant it lasted 45 minutes the medications that I take was discussed in great detail. There was no tests done on me on this visit they weighed me and did my peakflow and listened to my chest, my consultant did change some of my inhalers.

    Good luck with your consultant appointment

  • Hi,

    Don't know how much I can help! You said in your other post it was general chest clinic, not asthma clinic, but sounds like they know what you have already and this is to try and get some more solutions? The first time I went it was mysterious SOB with not much else so they threw everything at me trying to work out what it was. I think the actual consultation was maybe 45 mins to an hour but I had a consultation with a student first. Didn't give me any meds because they hadn't a clue what it was, but history/examination then got sent for (another) chest X-ray, ECG (they were going for a heart angle for a bit, later had a 24-ECG and echocardiogram), blood tests and appt for lung function - they may not do that the same day, depending on the hospital, you might have to make an appt. I think you mentioned allergies somewhere, so maybe they would want to do tests on that? Mine were all the standard 'ruling out' ones, yours may well be more tailored.

    I had results back on the next appt, which they scheduled for a month later - though every time I had tests, I think they said they'd be in touch if they needed to sooner, they usually wait until the next appt if it's normal.

    Don't know if any of that helps, it does seem to vary and may be more about reviewing meds and less of a fishing expedition if you're on them already and have an actual diagnosis.

    Good luck, let us know how it goes!


  • First time I went I had a lung function test and then saw my consultant and he went over

    meds i was on and stopped my steroid tablets and sent me for heart tests also.

    I asked for a allergy test but wouldnt do one as on steroids.

    Second time had lung functions again and results of heart tests and

    he changed my inhalers and then discharged me in the care of my asthma nurse and said

    will tell her send me back to him if she had and probs with my asthma she could not sort out.

    I was on 2 inhalers then and 2 lots of tabs.

    The asthma nurse had to send me back 2 years later as she and the doctor needed me go back as on lots of add on meds and back on daily steroids so its going to be interesting whats going happen Thursday.

    Going back to the part about allergy tests,con wouldnt do them as on steroids and the second time i saw his understudy and I asked for allergy tests and he wouldnt do them as the consultant had not put

    on my notes for me to have them so he wouldnt send me for them.

    I told my doctor they wouldnt do them when on steroids witch i understood but the next time still

    wouldnt do them as was understudy.

    so my doctor wasnt happy at all as that would be something needed for asthma and my doc sent me to get them done with a full blood test and rast test for pet allergy and all came back ok,

    DIdnt have skin prick tests just bloods.

    Hope you go on ok just let you know how i went on .

    love Glynis xxx

    edit-since then ive been to have more heart tests done ultra sound and ecg etc It was picked up at AnE and was under cardiology for a bit and found a heart problem but its just boarder line and decided didnt need treatment for it and was not the course of my breathing problem and that was this year so he wont need send me for any when go Thursday I hope xxx

  • Thanks everyone!

    Thanks for your replies, reading about how other people got on at their first appointment makes the whole thing seem a bit less daunting. I'm a bit nervous about the appointment, so it's good to have an idea about what might happen. More than anything I'm trying not to get too excited after so long of going back and forth to my GP and having them keep saying ""best leave it to the consultant"".

  • Consultant appointment tomorrow! Feeling kind of excited and nervous, really hope they can help.

    I'm currently trying to write a list of all the stuff I want to talk about, I'm so worried I'm gonna forget something!

  • Good luck!

    Hope you get some answers - let us know how it goes! I know that feeling of really wanting it to solve everything, will be like this next month when mine finally comes.


  • Hope all goes well with your appointment

  • Thinking of you. Let us know how you get on please.

    Love S.Mama


  • D-Day!

    Thanks for all your comments, in the end it went very well. Before I went in to see the consultant I had weight, BP, Pulse Ox and spirometry tests. Saw the consultant and he examined me looked at the results from the tests I'd just had, and my peak flow diary (which he was very impressed with, probably because I'm a bit overly obsessive about including *everything* in it, lol). We chatted at length about symptoms and patterns and answered all my list of questions and generally reassured me. From my peak flow diary he said that I'm very steroid responsive and is going to top up my seretide with flixotide. He's also going to look at changing my Flixonase to Avamys (thanks Angievere if you're reading), he's also getting me to see the asthma nurse about my problems with my accuhaler in a bad attack and mentioned sending me to see an immunologist as well. I was really worried that he'd want to do a methacholine or mannitol challenge, as when I'm not symptomatic my lung function is very good (apparently better than many athletes and more than 150% of my predicted today, that wasn't even my best), but I worrying unnecessarily as he said he wouldn't gain anything useful from it anyway. He also said it's not that unusual for people with lung function as good as mine to be able to maintain peak flows better than most asthmatics so was unsurprised that my peak flow doesn't always drop when I'm symptomatic. I also had some blood tests done too before I left the hospital and I'm going back at the end of April.

    All in all pretty successful, I feel like I'm actually moving forwards now! =D

  • Hi Nimueh,

    Glad it went well, sounds like a very productive appt and glad you got some answers, especially since you've been waiting so long! Wish I were going to see that consultant, he sounds good.

    Was interested to hear about your good PF and lung function results as I have exactly the same issue which tends to result in them saying I can't have asthma because they're just too good - my PF best is 660 which is predicted for a man over 6 foot, though right now I' m usually around 540 which is still better than predicted! In my case my GP thinks being tallish, 5'8"", and having sung since I was 6 and played oboe since I was 8 is probably why. Being a bit nosy I noticed you play the clarinet and flute and was wondering if they or you thought that was why you have such good function and PF? (also being nosy, I notice you're a fellow House and Bones fan though that is not remotely relevant ;))

    Hope things keep ok with you and the new meds work well!


  • Hi Philomela,

    Healthcare professionals are always surprised by my peak flow and yesterday was no exception my best is 760L/min and since theophylline rarely drops below 700 when I'm not symptomatic. I was told that they would have expected my lung function results to belong to an athlete, which as an overweight couch potato I find highly amusing.

    Everytime I mention playing clarinet and flute there's always a massive ""Aaaaha!"" moment as they are all fairly certain that's the reason. I'm 5'8"" too so my height probably does help and I also used to swim several times a week and snorkel from time to time but they always say it's the clarinet and flute that have probably done it. When I was first diagnosed my GP was convinced that playing woodwind is probably the reason I hadn't run into significant problems before, as with hindsight I've probably had a very mild case of asthma for a long time.

  • Hi Nimueh,

    Wow!! OK, you have officially beaten me - my 660 just seems puny now! And there I was thinking I was all that ;)

    I agree, you have to love the fact that playing wind instruments can give you the lung function of an athlete, speaking as someone who's massively lazy and hated all sports except swimming (I did quite a bit when a lot younger but haven't for a while). And IMO so much more fun than going running! I only wish I'd known this when I used to argue with my PE teacher who was one of those 'sport is the only thing that's good for your body and your team spirit' types and was all for exercise curing my mild, umm, exercise-induced asthma (went away, or so i thought, and now seems to have come back with extra bite). Looks like the oboe and choir might have been more use after all though - and at least you don't have to do those outside!

    Hope your 'athlete' numbers carry on keeping the asthma more or less at bay and the meds keep working.

    Philomela xx

  • WOW!! i'm impressed! peakflow of 760! thats amazing lol!!!

    (mine is 150 when welll...) LOL puts me to shame!

  • my best is 550, which like many of us is above my average (435) and i often get people say, oh well you're supposed to have brittle asthma yet your PF is better than mine!!

    yes i have brittle asthma, but i get GOOD and BAD days and okay days too!! some days PF 550, other days cant manage do PF (not very often fortunately) but most of time i can manage PF 350-450

    x x

  • My worst in recent times was at the surgery about a year ago - 340, which for me is LOW, only about 50% - but I wasn't even that breathless and was feeling ok! I've felt much worse and done 550 or even higher.

    I did get slightly confused the other day though by my GP saying 'at 550 'you ought to have enough lung function not to be breathless'. She does get that that's not my best and that it's relative but wondering if she was getting confused as since we've been saying lots of people even just on here can be breathless and even in the middle of an attack with 'enough PF not to be breathless'. It's just the max speed you can blow out at though, isn't it - doesn't necessarily give the full picture of what's going on.

    EDIT: Sorry Nimueh, sort of hijacked this post when I started asking about the PF and now it's a bit diverted.

  • Some people i know have lung function of over 100% and reall high peak flows and they still get breathless and low SATs when unwell. It all confuses me a little LOL - not that its hard to confuse me! :/ My lung function is 25% and my best peak flow 150 but im on oxygen 24/7. I know it may sound stupid but what does lung function and peak flow actually mean?!!?!?

    Yes we have gone very off topic!! :S lol

  • Bumped up for Gloves - though it wanders off course a little and I was somewhat responsible, sorry!

    If you search for 'consultant appointment' you should find lots of relevant stuff but remember some detailed replies on this one.

  • Bumped up again for Caroline - though again apologies for rambling and taking the thread off course! The useful stuff is at the bottom...

  • And bump again, for Angelica!

    No-one's going to drive over the speed limit on this post lol.

  • Thanks again! :-)

  • Another bump, for Elsa's mum. There is some useful stuff at the start of the thread!

    Think there's another one on this topic too if it doesn't answer everything.

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