Doctors

[Kate99]

Hi,

I am getting ever more frustrated with my doctors. I have to go for an annual asthma clinic with the practice nurse where she weighs me, checks my peak flow and says everything seems fine even when i have said it's not! Then when i have run out of my inhaler and need one asap they can't give me a prescription because my asthma clinic is overdue but my appointment is overdue because they can't fit me in around my work. And the doctor isn't the best person to see me apparently! I saw a locum who said he would put a prescription request through but would have to wait and see if i get it ARGH!

Is it just me or is anyone else frustrated with GPs?

[Kathryn Dewdney]

I am sorry to read that you are having difficulties at you surgery, and concerned that your nurse tells you that everything seems fine when you feel that it is not. I would be interested to know how frequently you are needing to use your reliever medication and whether your peak flow is taken within 4 hours of using it, as this could give a misleading result.
The aim of asthma treatment is to make the patient symptom free; ie no wheeze, no cough, no limit in activities, no waking at night due to asthma and not requiring to use reliever medication. If you are getting any of these symptoms it would indicate that your preventative inhaler needs increasing or changing.
It is important that your asthma is managed correctly, so if you are not happy with the present situation, it may be worth changing to a surgery that has a special interest in asthma who employ an asthma trained nurse and can be more flexible with appointment times.

[Kate99]

Thanks for your reply. I am not sure how much i need my reliever but i will try and monitor it more. My inhaler (i don't have it with me at the mo, i left it in the car so can't remember the name!) is a white one that is a turbohaler(?) type.

I regularly wheeze, cough and am awake with it plus asthma has always limited my activities although this is the best i have had with my asthma.

Every time i get a cold i get a chest infection, is this normal for asthma sufferers?

[Kathryn Dewdney]

If you are using a turbohaler you should have one with a blue bottom and one with either a brown or a red bottom. The blue inhaler is your reliever and should be carried with you at all times, but if your asthma is well controlled you should not need to use it very often (less than 3 times a week). The brown or red inhaler is your preventer inhaler (it helps to stop the narrowing of the airways caused by swelling and mucous production) and should be used twice daily or as directed by your asthma adviser. The red inhaler also contains a long acting bronchodilator and is licensed for use as a reliever as well as a preventer in people over 18 years of age (usually a maximum of 8 puffs in a day). You should have been given a written asthma action plan so that you know which inhalers you should be taking when, and what to do if you are getting symptoms or if your peak flow drops below 80% of what it should be.

Someone with asthma should not be regularly getting symptoms, if your asthma is not controlled on standard medication you should be referred to a respiratory specialist.

People with asthma will get a chest infection when they catch a cold if their asthma is not under control. This is because the mucous, caused by inflammation, already present in the airways is just the right environment for bugs to grow. Sometimes this has to be treated with antibiotics and oral steroids to get the asthma under control again.

I would urge you to make an appointment with your asthma adviser and tell him/her of the problems you are having. It might be an idea to take a record of your peak flow readings taken morning, midday and evening. A single good peak flow taken during the day at an asthma check is not proof that asthma is under control.

[Kate99]

I have the red bottom one but i was told i use this inhaler as preventer and reliever. Sometimes when it has got really bad i use my sister's ventolin which i used to be on but was taken off for this 'all in one inhaler'

I think after everything you have told me i need to go back to my asthma nurse and try and get this sorted out.

Thanks so making me so much more informed than i was before.