Was the consultant right?

Hi all

I have just managed to escape after another admission, but whilst I was in a consultant said something that made me rather worried...

""You have a home neb so I don't know why you are here...""

Is it just me that thinks that is out of order? I have recently been diagnosed as brittle asthmatic, and then someone who should know best turns around and says this to me? Next time I have an attack I'll just sit at home and neb away shall I?

Comment?

Emz x

p.s. sorry for rant, it really upset and worried me

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Hi

That sounds not a very nice thing to say...As recently being diagnosed as a brittle asthmatic myself and too on home nebs I was told by the docs on my last hosp admission some weeks ago that if the neb didn't work and my peak flow was at a certain reading I was to go into hospital, I was told that with home nebs you had to be careful because people will stay at home and ' neb away ' when really they should be in hosp because the asthma could potentially get worse ( I hope this makes sense???!!!)

Why don't you make an appt with your asthma nurse and ask them when you should go into hospital to clarify things etc on this...

It would upset and worry me too..

Anyway take care

SAm x

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I have had the same experience so after the cons said that the next big attack i had i stayed at home much longer and lo and behold when i did go in i ended up in ITU on a vent as was asked why did i wait so long!!!

I now have set guidelines too in what i can do based on amounts of nebs, ability to speak and level of general activity and this seems to have helped.

I suggest you speak to your resp nurse-(they seem more sensible sometimes than the cons) or the cons if no choice and get a suitable set of guidelines in place as soon as possible. Good luck and feel free to pm me anytime. Hope u a re feeling better now.

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Thanks for your messages of reassurance, my last consultant told me that if 1 neb didn't work then to go in as I can go downhill rapidly, and usually I will leave it longer than this. To be fair, whilst I was in, apart from the initial IV hydrocortisone and ipratropium nebs, after that I was purely on salbutamol nebs, although very regularly, and I could have done this at home, even though a neb would bring my peak flow up to around 350 (usual 420) then half hour later I'd be back down to 220, and this happened time and again. I was discharged with a PF of 350.

I've been out just over 24 hours now and am starting to neb again, I can barely walk anywhere without getting short of breath and wheezy, and I'm still waiting on my consultant referral here in London...I think this could take more time than I'd hoped for.

One an amusing point, the respiratory nurse based in the hospital I was in came round to see me, and asked what my triggers where, and why this attack came on, and when I said ""I don't know, sometimes it's nothing"" she didn't believe me. I then told her that on any one day my PF can vary between 420 and 60 and her expression totally changed, looked at the nurse next to her, and said ""ok, not everyone is like this. We better refer her..."" I don't think she looked at my notes to see my current meds or anything. Oh well. I live in hope!

Sorry for the essay

Emz x

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I've been told it's always better to go in early and the problem with home nebs is that people leave it too late to go to hospital, so no, I don't think the consultant was right.

Was this a respiratory consultant or a general A&E consultant? - I had a terrible experience with an A&E consultant last week who clearly hadn't a clue about asthma and I was sent home with some really nasty comments about how I shouldn't have come in, GP was wrong, silly paramedics etc etc only to get really bad later. Turns out the consultant was wrong and hadn't followed guidelines at all.

I don't know what you do in this situation though - we're the ones who know our asthma best and when it's going wrong and we need help - if they won't listen to us - and they seem to have the final say at the time - I don't know how we can be listened to?

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Hi Ratty

It was a general consultant on the Clinical Decision Unit, i.e. one stop in from A&E. The respiratory nurse that came round to see me specially said I was in the right place, and next time to get an ambulance rather than a cab...mind you, the consultant did say other things such as maybe I should go home back to Devon where I could have my support structure, i.e. my family (I then tried to explain that I wanted to come to London no matter what, and that I was happier here), and she also said that I would find it very difficult to make friends in Uni if my asthma was so uncontrolled!!!!!

I think my next step is to go and see my new asthma nurse and clear up once and for all when I should go in to hospital, or whether I needn't bother.

It's just very upsetting, I'm finding it very hard to deal with my asthma at the moment as it is getting worse quite quickly, and the last thing I need is those ""who know best"" telling me what I am doing is wrong.

Rant over.