I saw a consultant this week and gathered from her reaction that the asthma care at my GP practice is really poor. From what I read on AUK website it is rather common, unfortunately, but I'm curious as to how others have dealt with this and what their experiences were.
The nurse that was assigned to me initially had been adamant that I was not suffering from asthma, despite my obvious improvement on steroid inhalers. Her words were that I 'don't fit the criteria' (no big variation in peak flow, no night time symptoms, spirometry normal). I then saw a GP who said that if I responded to a trial of treatment then I did have asthma. I showed him some concern at the time about the amount of steroid I was getting from a double dose of clenil (ha!) and asked him if I could have a combi inhaler so I could have a smaller dose of steroid. He put me on Seretide 125 and said that was a tiny dose of steroid. I was told to see a nurse for a review in a month and when I went to see her she said the seretide dose I was on was twice as strong as the clenil dose I was on before (doh!). By then I developed a cold and was told to stay on that dose until things calmed down. So they never did and I was put on a high dose of Symbicort, and a nasal spray (for rhinitis). I won't bore you with all the details, but eventually I was put on a short course of pred by the first nurse that had said I didn't have asthma as she still didn't think I did. I still didn't improve fully and she said it was definitely not asthma, go back to your GP. GP then said he wasn't sure but that he would continue to treat me for asthma. By then I was begging to see a specialist and was still not given a referral. Eventually I had to go in and be quite assertive and say I wanted a private referral as I felt so uneasy at having quite bad sob and being treated for something they were not sure I had.
Consultant's eyes opened wide in surprise as I related these things to her and she's now transferring my care to her team at the hospital. She was very reassuring and we have a definite plan of action in terms of drugs. Am now back on symbicort and was put on bricanyl instead of ventolin. Must carry on with nasal spray but told to stop antihistamines I had been put on as apparently they do nothing for asthma. We'll review again in 3 months and might be put on Montelukast then as I am fairly atopic. She said to not bother with peak flows as they are not a good tool for me (seems like my small airways are more affected than my large ones).
Did any of you have a similar experience? Are you now under the care of a specialist? Why are general nurses called 'asthma nurses' if they evidently don't receive enough training in asthma??? Why are GPs so out of touch with asthma drugs that they think they are prescribing a lower dose of steroid than they actually are? Why is a GP unsure of a diagnosis and still unwilling to refer? I am lucky that my asthma is not that bad (although it was allowed to get far too uncontrolled for my liking!) but I wonder how many severe asthma sufferers are managed similarly and how many severe attacks could have been prevented by better care.