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[KittyB52]

Hi all. I was told I had asthma when I was 11 and have had inhalers on and off over the years. It's only been in the last couple of years that I've had more tests for my asthma and allergies (I nearly always have a runny nose).

Anyway, whilst at my health review appointment on Monday, the nurse mentioned that I was on both the asthma register and COPD register - news to me! I currently have a chest infection, so am taking antibiotics and now have Fostair with a spacer thing. I am not coughing as much, but I feel drained and tire easily. I have had a few days off work, but feel guilty now that I am not wheezing as much. I tire walking upstairs at the moment, so something isn't right. Does this sound normal for a chest infection?

Also, should I be seeing a specialist of some sort if I have bith asthma and COPD? The nurse mentioned rehabilitation through exercise - until the chest infection, I was doing strength training at the gym 3 times a week! I'm not sure whether I need some sort of 'official' diagnosis (asthma/copd/both)?

Phew, sorry for the essay.

[Hidden]

The last time I had a chest infection I certainly felt drained and I tired very easily. I also made the mistake of ignoring my GP when he said that I should take a week off work with immediate effect. But as I was due to go on leave a few days later and still had one or two things to sort out for the temp. who was due to take my place, I went back in for half a day. I managed to sort everything out, and managed to get myself home, but the knock on effect was that it took me much longer to recover. Three weeks later, although the cough had gone and the antibiotic course had been over for two weeks, I still felt exhausted much of the time. It took a further week (so a month in total) before I felt really recovered. If you go back to work too soon, you'll probably end up taking more time off.

[Minushabens]

I don't think the boundaries between asthma & COPD are always very clear cut. Even when you check online there's no real consensus.

I was diagnosed with COPD a year or so back, but I think essentially that was because my asthma had deteriorated & the nurse didn't know why! So she called it COPD & referred me to a respiratory consultant, who has never once mentioned COPD.

Probably the most important thing to bear in mind about it is that it isn't an illness in itself, but describes a range of illnesses (with I think some debate about what is in or out), so think of COPD as a description as much as a diagnosis.

I wonder if she was also thinking about pulmonary rehab. Although one of the younger hospital doctors told me that otherwise fairly fit people didn't really need it but you can look up some exercises online.

I think fatigue after an infection is quite normal even in non-asthmatics. My wife just had a really bad virus & was shattered for about a week or so, so unless you have other alarm bells ringing maybe just see if it passes? Obviously if it doesn't, or you remain weak or your breathing deteriorates then get back to the doc.

[KittyB52]

Thank you both for your replies. I haven't been signed off, as I haven't seen a GP, which is why I was concerned about taking a few days off work. I feel as though I am 'cheating' by not having a note, even though I am actually ill. Which is silly, I know.

[Hidden]

Can I suggest that you do see your GP, if only to ensure that the antibiotics are doing their job. He/she may then also advise that you do take the extra time off, give you a note and you will then have no need to feel guilty. Worrying about it won't help your recovery.

[KittyB52 in reply to Hidden]

Hi, I managed to get an appointment with 'a' GP this morning (we don't seem to have a regular GP at the local practice) but it was nigh on useless. She explained to me what asthma was and told me she didn't know if I was on the COPD register as she couldn't see my notes. She told me to self certificate and come back if my cough got worse. She did say I should have a spirometry test done every year so I have to make an appointment for that in the new year.

At least I have been back to the GP and she didn't seem to think that a week off with a chest infection was unusual.

[jabber]

Hi Kitty, I would organise the spirometry test as soon as you can. It will give you more answers about your lung function. A COPD diagnosis is usually only made after a CT scan and spirometry tests. But you need to get rid of this chest infection before any tests start or you won't get a true result.

Stay off work and don't feel guilty, your tiredness is a symptom of the infection and you need to rest. You can build up your fitness levels again once you're feeling better. If the infection doesn't go, it maybe that you need different antibiotics - you'd need to give a sputum sample which would tell the experts which abs would be best to fight it.

For great expert advice phone the BLF helpline (03000 030 555) during office hours. They know all the answers - and can also suggest questions to put to your doctor.

Best wishes, Jan

[jabber in reply to jabber]

I think perhaps I should have given you the Asthma Uk phone number (0300 222 5800) rather than BLF as we're on the Asthma Uk forum - oops - though BLF says they cover all lung problems so I'm sure they would be helpful.

[KittyB52]

So I am back with an 'update'. The chest infection cleared OK, and I made an appointment for a spirometry test, which I had a couple of weeks ago.

I mentioned to the nurse about the asthma/COPD confusion and she said she wouldn’t be able to read the results, but she did say that it ‘appeared’ to show that I had a mild obstruction. She said I’d have to see the doctor for the full results, which was fair enough. Test done, appointment made.

I saw a GP (same very patronising GP I saw previously) on Friday who seemed surprised to see me (always fun!). She said the test I’d had done wouldn’t show whether I had asthma or COPD or not (so not sure why they told me I needed it), and that I’d need another test (reversal something or other – I think it’s the test where you do lung function test before and after Ventolin) which the nurses at the surgery ‘were not trained to do’. I half expected her to tell me I needed an appointment at a local clinic or hospital to have this test but no, that was that.

She moved on to suggest I started taking antihistamines and a nasal spray to help with my ‘asthma’, which I said I wasn’t keen on taking as I don’t get hayfever. She continued to explain how important it was to start taking meds before hayfever season kicked in. *sigh* She asked me to go back in a couple of weeks to see if the antihistamines and nose spray had worked – what she’s expecting to happen when we don’t know what I actually have, I don’t know.

I haven’t been to get the prescription as I don’t want to take additional meds until we actually know what is wrong with me. I use an allergy reliever unit from Lloyds if I ever get a bit sniffly (I have a very mild dust allergy) - no side effects and it works a treat.

Is there any way I can get the ‘reversal’ test done myself – I am assuming I won’t be able to self refer, but is it worth going private to get it done? I am not going to get anywhere with the GP, she just talks over you, changes the subject (she started talking about HRT and antidepressants at one point!) and just doesn’t seem inclined to help.

I would like to call the Asthma UK helpline – would they be able to advise on this?