For background info, I'm 44 and have had asthma since a toddler, which improved as a young adult and then worsened again as I got older. I'm on Flutiform (250, two puffs twice daily), montelukast, salbutamol, cetirizine and recently carbocisteine (for persistent productive cough). Apart from the persistent productive cough I'm generally pretty good with minimal asthma symptoms, although any sort of virus/infection can cause worsening of symptoms.
Anyway I had a cold/cough/viral illness last week which caused a worsening of my symptoms (breathlessness, cough, night coughing and reduced peak flow). I decided to go to the G.P. today because this had been going on for a few days and even with taking the salbutamol inhaler several times a day, I was still having problems and thought I might need a short course of steroid tablets to get me back to normal. I expected the GP to listen to my chest and find no infection (as I wasn't feeling ill as such any more) and maybe do a peak flow reading, and then give me the steroid tablets. But it didn't quite go like that. Now I live in a small Scottish island and our GP surgery relies on a lot of locum doctors. We do have a regular GP but he is only here for a few weeks at a time (he doesn't live here) and the rest of the time it's locums. The doctor I saw today was one I have never seen before.
He did hear me cough, but he didn't listen to my chest at all and prescribed me antibiotics (500mg of clarithromycin twice daily for a week) "to get rid of any residual infection". He looked at all my medication and asked if I had been checked for COPD. I said I had had some spirometry a couple of years ago, which came back better than normal, and that this had been done because my mother has COPD from having asthma since childhood and because of my productive cough. He said that once I am better from this flare up I should either have some more lung function testing or I could try a third type of inhaler (he didn't say what is was called) which if it got rid of my productive cough would prove I had COPD. He thought the inhaler option would be better as he said in the early stages of COPD lung functions tests can come back as normal and he seemed to think that I did have COPD. At this point although I was a bit confused as to how readily he gave me antibiotics (it must be at least 10 years since I had any) I was listening attentively, because frankly I'd try most things to get rid of my annoying cough. But then it got a bit weird. He wanted to tell me how to take my inhalers properly as he said a lot of people don't know. He told me that when I had a flare up like now I should be taking my preventer inhaler and also the rescue inhaler maybe 6 times a day (OK so far as this is what I do until symptoms have gone) and then I should continue taking the preventer only for a few more weeks and then I should stop it (now this is when I thought WTF). He went on to say that I may feel a bit breathless in the morning at first but I will get used to it, and when I get another flare-up I should start the regime again as before. He said that if I do this I will gradually have longer and longer inhaler free periods which is good because long term use of inhaled steroids means the steroids get into your system. Now I have never heard anyone suggest this before. The GP who put me on flutiform after several virus induced flare ups decided not to even try bringing the dose down because if accidentally miss a dose I generally start to feel uncomfortable a few hours later. Now after his guidance on inhaler use I don't know what to make of the first part of the appointment. I've started taking the antibiotics anyway and will keep an eye on my peak flow and symptoms (I'm not in the danger zone). I need to find out when this GP goes (hopefully he wont be back again lol).