Confusing bit of advice: I visited my... - Asthma Community ...

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Confusing bit of advice

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I visited my local GP today (despite going walk in to get checked out yesterday following attack) as I already had it scheduled and I told her what has been going on past couple of weeks. Been given pred but told not to take it for at least a week (just completed 5 days) as she thinks I am getting better and also if I start taking it then I'll have to then come off it gradually or I'll get worse from suddenly stopping it. She is also testing bloods just in case for infection as see if salts etc are all normal.

The confusing bit of advice is, I told her about my attack on Monday night. I was able to contol it after pumping a lot of salbutamol in me but I did not feel right after it, however I was fine that night and slowly recovered yesterday. She told me that I should have gone to the hospital and that any acute severe attack can be dangerous and be treated seriously. However, I feel that I would have just been clogging up A&E and using my spacer and salbutamol seemed to eventually control it. Surely in this situation I am fine to stay at home to rest and then seek walk in next day?

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Hiya, you should really follow the AUK guidelines on when to seek help and listen to your gp etc. unless you have a good reason not to!! It might be that you can go, get a neb or two and it resolves, or if it doesn't then you are in the right place to receive further treatment.

What I mean by a ""good reason not to"" is that I have very different to the norm guidelines. I have home nebs etc, so have a plan which says at what point I need to go in. This means that by the time I go to hospital I need IV treatment (at the very least mag and hydro) and am acutely unwell. NOT something I'd recommend you do unigirl!! It ain't something you can mess with!!

Well the GP I saw today seemed to really know her stuff asthma wise. She wasn't saying that I had done anything wrong, but she was saying I should have gone hospital. But I am fine now (apart from tired and the usual). I have told my friends what my GP said (flat mates etc) and told them to make their own judgement even if I don't ask for ambulance or argue etc.

Also, guidelines say to take salb every 2 mins, I sort of take it all while I can without thinking about times, if I am struggling I just need relief and don't want to get into an even worse state. Also it is very hard to think when I'm struggling for air.

Your attacks must be a lot worse than mine, are the home nebs good for you? I don't think my asthma is as bad as to need them which I am glad of.

Ok, hmmmm. It is a tricky one. I personally find that once im better I can safely no longer seek help, however I can be a bit atypical (like Laurs) in how frequently im ill and having very severe attacks. Its not massively fun tio be in all the time! That said – I would suspect that you might be a bit different than that, and actually if you are not having IVs regularily or using an awful lot of salb on a day to day basis then actually an attack that really takes its time to get better might be worth getting checked after! Are you in an area where you can use 111? That might be a happy middle ground? Not going to A&E unless they feel you need to be seen, but also not waiting until the next day to get checked (bearing in mind that nights can be quite bad for asthmatics and I find when im very tired I will sleep till im quite unwell which can be a bit dangerous! So yeah - i guess it might be best to contact someone, if you feel paraniod about it (easily done when OOH only see you once you've recovered) then tell them that you have been given stirct instructions to contact someone after an attack, and that you dont want to go to A&E so you would rather see them. in my experiences, 111 can be a bit over-zealous with ambulances, but other than that its a good way to clarify you are doing the right thing! Hope that makes sense - im tired! lol!

I didn't even think of using 111, I am in 111 area though yes. To be honest, I wasn't really thinking much, was in a daze. it was a night time attack so I guess speaking to someone would have been sensible.

What happens with the OOH? Do you go to them or do they come to you?

I think you go to them apart from exceptional cases (i'd suspect that an awful lot of the time if a young asthmatic was too ill to get to OOH they need to be in hospital anyways) and the way it has worked with me is ive usually found i have to refuse an ambulance (often silly rules about breathing difficulties or salb usage would make them send an ambulance any time i rang) and so they tend to get a doc/high-up nurse practicioner to ring me up fairly promptly, they book me an appt with someone who can give out nebs and then tell me where to go - there are different places depending on the time of day near me! Then i go and it is like a docs appt - they listen to lungs, can prescribe pred and can hand out nebs, and will often try to send me to hosp if things arent perfect again fairly fast! hehehe! thats what our system is like - id assume this is typical - im sure others will correct if they've had different experiences. also - you'll spend an awful lot of time trying to convince 111 that you dont have meningitus and are not having a heart attack! lol!

This 111 business sounds like a lot of hassle... from what I can determine you need to spend a lot of time explaining yourself/ giving in depth details.... not ideal for during attack!! I will give it a go next time if needed. would make me feel better if they listen whilst the bad happenings are going on.

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