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What to look for from asthma nurse

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I have my first meeting with the asthma nurse tomorrow. I'm not optimistic, because I don't feel anything I've tried so far is really controlling my asthma at all. Luckily it's not severe, and the symptoms are a nuisance but no worse, because if the symptoms were bad, I have no confidence that I have any way to control them. Hormonal variations are the biggest factor I can identify.

Over the last five months since my first doctor's visit I've tried salbutamol, then steroid plus salbutamol, then seretide plus salbutamol, and now I'm on symbicort. They make the symptoms less, but I haven't yet had a symptom-free day.

Does anyone have any suggestions to get the best from the visit?

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14 Replies

Asthma nurses are often extremely knowledgable do not assume that because it is a nurse nothing useful will come out of it.

Bex

It's not because it's a nurse that I'm pessimistic, it's because nothing I've tried so far has made more than a slight change.

Felix there are many many combinations it is just a case of finding the right one for you, and that may take some time and some tinkering you will get there I am sure.

Bex

Thank you for the encouragement. After five months of trying, I'd have thought we should have a bit more progress than this. It feels as if it could take years! I suppose I posted here because I don't want to go into the meeting feeling it's hopeless - I'd like to approach it with a more positive attitude.

At my last doctor's appointment, the doctor mentioned that she's still considering it might not be asthma, so there's always a slight possibility I might have to start all over again with some other kinds of drugs.

Hi Felix

Asthma diagnosis confirmed by asthma nurse - Feb 09.

Still looking for a suitable combination of inhaler etc. Each trial I'm given by the asthma nurse, I see as another step forward on the route to finding the one that's 'just right' as baby bear said of his porridge.

Best wishes and keep smiling. The answer, like space, is out there.

GM xx

Thanks, GrannyMo. Let's hope we both find something that works soon :).

Asthma Diagnosed formally in december 2008 but been suffering attack like symptoms (thought is was allergic reactions) since june 2008. Still havent ot a mediction that is effective... Despite loads of hospital admissions. But due to the complexity of my history they generally wont add more than a short course of steriods without me seeing my consultant!

Postive thinking... everything is a step in the right direction although it might not seem it

One thing I'd like to get is more flexibility to adjust my medication. The major variations seem to be hormonal, and I'd like to maybe drop the LABA for a while during the better times, and add it back in as necessary. And maybe have something else available as a top up option for the worst times.

I don't yet have an ""action plan,"" so maybe that's something she'll want to work on, but I haven't been seeing a lot of variation in peak flow, just in coughing, mucus and that sort of thing, which is harder to rank so objectively.

Felix - I have coughing and sputum all the time even when my asthma is well controlled and my peak flow is stable. I would go by your peak flow, if that is at or near your best then i would say your asthma is well controlled. I was told i will always have the coughing and sputum now i have never really understood it but you may be like me and always have it. Try to concentrate on how your peak flow is and how you feel in yourself, ie if peak flow stable and you feel well your asthma is controlled, but if your peak flow is bouncy and you feel ill your asthma is off.

I also get hormonal variations and add in an inhaler to combat it at the correct timing. It works some months but not others. Asthma is really trial and error to find out what sorts it out. It is also very different between person to person.

Plumie

Plumie, I think you might be right that the symptoms are just something I have to put up with.

On my first doctor's visit, when I'd been having symptoms for about six months, and had not had any treatment, my PF was 500. With practice and drugs, it's now around 550. It doesn't vary much, and the tightness & mucus don't really go away.

The nurse brought in a doctor to listen to my lungs. He couldn't hear anything untoward, and neither has anyone else on previous occasions. They are still not sure it's asthma, but it's hard to tell with the drugs masking any PF variations, so they want me to stop using the inhalers and go back to be looked at untreated.

I'm not looking forward to the next six weeks.

The doctor wasn't one I've seen before. He seemed to think that deciding it wasn't asthma would solve the problem. I don't care what they call it, but I'd like to be able to breathe properly.

Just remember if things get any worst to go straight and see the doctor, and if they say no appointments explain they are trying to work out if you have asthma.

Plumie

If I do see a doctor, it won't be the one who came in today - he made me feel as if I was wasting their time. The fact that until May I hadn't seen anyone in the ten years since I registered with the surgery should be an indication that I don't go if there's nothing wrong. I was starting to feel that if they're not going to bother to treat my symptoms I might as well save myself the trouble of dealing with their wretched bureaucracy and not go any more. Luckily the nurse was much better than that.

hormones and asthma

hi Felix,

my hormones used to play a big part in my asthma, i now take the progesterone only pill all the time, no periods, and no monthly dips,

it might be worth discussing with nurse, i have just noticed your age, are you becomming menopausal? maybe HRT is a consideration,

good luck,

george xx

Sorry Felix, totally unhelpful response here but I have been bottling this up for days now. My answer to what to look for from an asthma nurse would ""one who does run when they see you* coming"" :)

Bec

*is a generic ""you"" not you personally

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