Hi all,
First of all apologies for this really long winded post... I'm just at the end of my tether and fed up of being made worse because doctors and nurses don't listen to me and/or don't read my medical history.
I had pretty chronic asthma issues in my teens, but have been extremely fortunate for the best part of 15+ years in getting hardly any symptoms aside from a bit of a cough most winters, and the odd bad chest infection which caused me problems - but luckily no actual attacks since my teens.
That said, when I've had a chest infection, doctors have found that I generally need a decent course of Prednisolone and anti-biotics. Unfortunately, due to moving several times and then different practices having different doctors and nurses, sometimes they seem reluctant to do this initially and/or read my medical notes/history. This means I can end up really ill before they prescribe this course of treatment (by which time I need higher doses for longer), and it's a recurring situation that has put me out of action for a fortnight or longer at a time before.
I've been registered with my current GP practice for a couple of years, and upon moving down here I had a winter of bad chest infections and we went through the above mess a few times. Eventually they understood the cycle (at my expense) and the fact that I really don't like taking Prednisolone unless I really, really have to - but there comes a point where it's a necessary evil.
They operate a nurse triage system - they like you to speak to a nurse on the phone first, then see a nurse - and if they decide it's necessary then see a doctor, so as to ease the load on doctors. Quite often the nurse prescribes treatment that's needed in anycase, and all apart from the last time in November it's always worked. It's something that I think is a good idea and I can see how it helps both medical staff and patients.
I had a good winter last year, and so didn't need to see anyone at the surgery. In November I had a cold and was also waking up wheezy, tight-chested and coughing up rubbish from my chest in the night, and after a few weeks I could feel the cold move into my chest and it got to the point where I booked in to the surgery and saw a nurse. She listened to my chest and did my peak flow (which was around 500) and despite me hacking up in front of her decided that nothing else was necessary, just go home drink fluids and take paracetamol. As my inhalers were due in less than a week, and I was there (and she was in my records anyway), I asked her if she was able to provide me with my repeat - and she said ""that's not our policy, you'll have to request at the front desk and come back in 48 hours"".
This is a bit of another battle I have with most GPs and nurses. My normal peak flow is 800+, and so 500 is pretty bad for me. I was born premature and the Birmingham Chest Clinic found when I was a teenager that I have larger lungs for my frame, which my consultant there said would explain my seemingly high peak flow when my symptoms were bad and why sometimes it was harder to hear what was on my chest (it's why I ended up being sent for many, many x-rays). Unfortunately again GPs and nurses seem to ignore me saying about my normal peak flow rate (despite me having bought my own meter and keeping my own chart), really believing that they know best and not listen to me nor read my medical history (which will have all of this in there). They instead choose to go on what they ""think is right"" by some ""average"" which just isn't right in my case.
It took me until the middle of December to get over it myself. My cough remained, and I've had on and off wheezing and being woken up in the night since - but I thought ""what's the point of going back to the surgery, they'll just send me away again"". By the first week of January I started to get ill again, but nothing more than anyone else and just carried on doing all the normal things that you do with a cold.
By about 3 weeks ago I was really started to feel ill and my chest was very tight - I was using my reliever a lot for shortness of breath, and it wasn't really helping overnight. I booked in to the surgery and insisted on seeing a GP instead of a nurse. When challenged and I explained why, I was told that I probably got a nurse that couldn't prescribe. This would make sense (and it would have been helpful if she explained this herself at the time, if only to explain the inhaler repeat situation!) - however I was a little perplexed as to why an asthmatic going down with chest problems had been sent to see a nurse that couldn't prescribe - when I asked about this I was told ""well it is always your right to insist to see a doctor"". This is something I didn't want to do - after all, they have put in place a system to try and ease the load and work better for staff and patients alike, but surely it has to be able to be appropriate on a patient-by-patient level? At least now I know that I need to insist on seeing a doctor at least when it comes to my chest.
Anyway, they did get me in to see a doctor the following day - and by this point I was pretty bad. The doctor was really good, and despite not reading my notes he picked up by listening to my chest that I had larger lungs - he said that it didn't sound too bad, but then said ""wait - have you got slightly larger lungs by any chance"" and when I said I had, he said ""ah, it's probably worse than it sounds then"". He prescribed me a week course of antibiotics and a three day course of Prednisolone (which seemed way too short, but I think I was just grateful to have not been ignored!). After a few days, I was feeling a lot better, and by the time the antibiotics finished I was feeling back to normal.
So two days after the antibiotics had finished, I was a lot worse than I'd been when I saw the doctor. I booked back in, insisted on seeing a doctor again (albeit it was a different doctor), I struggled to get to the surgery with the coughing and the hacking off my chest, and although I'd been wheezing overnight I wasn't at this point. When the doctor saw me, he told me that my chest didn't sound too bad but he could see that I was really not in a good way. He prescribed me another 7 days antibiotics and 5 days 30mg Prednisolone. I struggled to get home - and despite ""my chest not sounding too bad"" according to the doctor, I hacked up a lot of crap from it - and I could feel it from my chest - in the streets on the way home from the doctors. It really wasn't my finest hour.
That was on Friday - and I'm a lot better than I was then, but I've still been having really bad nights, waking up wheezing and hacking up crap off my chest. I've also found on this website (link here: asthma.org.uk/knowledge-ban... that under-treating can cause symptoms to return. This is what looks like has happened with me the first time round this time, but now it looks like they've also given me a lower dosage than the minimum recommended the second time round. I only have today and tomorrow left of the course of Prednisolone, and knowing how I am now I know that it's not going to be enough - which means I'm going to need another course (if the doctors will give them to me) - and that's something that could have been prevented had I just been given the correct dosage/course length in the first place.
So I suppose what I'm saying is that I feel like I'm not getting the level of support I need from my local surgery (and they're no different to any surgery I have had to go to since moving away from my family surgery in my mid 20s). I'm always polite, friendly and try to work with the doctors and nurses that I see. I feel it falls on deaf ears, and sometimes I feel like I'm being ignored (or maybe that they don't believe what I'm saying, despite everything I'm saying being verifiable in my notes).
The thing is, when they don't listen to me, I'm the one who pays the price with my health. I don't know what else I can do differently to try and get the so called ""partnership"" in my health that I'm promised, to not feel ignored, and to ensure that when I do get a chest infection or I'm waking up of a night wheezy that but my peak flow seems okay to them that something is done before I'm knocked out of action for a fortnight.
It's starting to really get me down now too.... Any advice on how I can handle the situation would be gratefully received...
MrB
peak flow best of 3 today ws 400
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