How to approach GP

Hi,

A bit of a random question but I am wondering if anyone can share any experiences/has any advice.

After a meltdown with my asthma nurse today, she asked me what I wanted (except a cure). This took me by surprise so didn't really know what to say however we had a long chat about trying to get a bit more stable so asthma doesn't necessarily interefere with everything/allow me to cut down reliever use and I now have an appointment to see my GP next week.

The problem I have is that everything they give me (high dose ICS, Spiriva etc.) helps but I am still symptomatic. Having had much more severe asthma in the past and then going back to just Symbicort SMART, makes me think that much more can be done but I think this needs more meds. I am don't really like suggesting things as I don't want to look over researched or just asking for meds (it's not like I want them but I really think they could help). Theophylline has been mentioned by a cons and my GP in the past but my last cons was reluctant to prescribe it because of the side effects. Xolair has also been mentioned by I have a very high IgE and anaphylaxis. I was discharged from the cons with a list of things to try (Intal, Atrovent etc) but nothing has really made a huge difference. My GP/asthma nurse admit that they are out of my depth but being referred has only been mentioned/not acted upon which is something else I need to discuss.

Has anyone got any suggestions for how to approach this?

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Hi Kayla,

As you know I can very much relate to this - in a similar position to you with this, as things help but not enough (cons, not my usual one but saw him in clinic last time, said 'well you know it's not going to be miraculous at this level don't you?' - buzzkill!)

However, the difference is I am under a cons with no current plans for discharge and you're not - and I really, really think you should be at this level! Still can't work out why they discharged you! I don't think it's a GP's job to be messing around with things at that level, and most wouldn't be comfortable doing it. So I would definitely ask for a referral - say you really appreciate what they're doing but would like to see if the cons has any more ideas? As you say they admit they are out of their depth so they shouldn't mind you asking: the whole point of specialists is to deal with this kind of stuff, though of course they're not perfect... Would you be seeing the cons you saw before? Would you want to? Think getting in sooner rather than later would be good.

In terms of how to approach it: I know I always say ring the adviceline here but I really would as I have found apart from their medical knowledge which is brilliant, they are very practically minded and being nurses have a good understanding of the realities when it comes to talking to doctors. I've been advised several times on the best tactics for raising things in appts and been told how to 'think like them' for the best results, so I'd definitely say it's worth giving them a call to see if they can help you frame it in a way most likely to get results.

Good luck! Let us know how you get on. If only there were a cure...magic wand time definitely. I don't like this whole 'lifestyle management' thing I've just been bollocked about.

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Hi Philomela,

Just read you post on Costa - hope you are recovering well.

I don't understand the discharge and my GP is quite cross about it too (apparently it is prob something to do with funding). I don't think I would want to go back to the same cons (the registrar however was very good) so if I went through Choose and Book, I would probably go to Leeds who his where I go to the allergy clinic. However, I think there was an understanding that my old cons would see me again if needed and I would sooner see her in a month than wait for three to see another cons (especially if it was to do with funding). She was also very good when I had a difficult period and saw me the next day. When theophylline was discussed, they were reluctant because I have a heart defect but I saw my cardiac cons at Papworth (yet another hospital) last month and he said that there shouldn't be a concern.

It was talking to the adviceline after the shook of being asked for my opinion that I came to this conclusion. Perhaps I will come home early tomorrow to give them a ring for pratical advice.

Thanks for your help.

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I too think if your asthma is still not controlled on a level of drugs your GP is not comfortable with then he should refer you back to a chest cons. I am surprised you were discharged also. It certainly sounds like you need more specialist advice and a step up in drugs that only a chest cons will prescribe even if it is only for a short term until control is gained then you can work together to slowly step down again.

Good luck with whatever you decide x