spirometry results

Hi Vee2 can you tell me how many times a year you are checked for c.o.p.d, as i have had it for 5 years and only been checked once, thanks

hi vee 2 thank you for your advice i have asked for steroids the last twice he just doesnt give me an answer and im afraid im a bit on the quiet side so just basically leave with just the antibiotics im not coughing up any blood anymore the last time was last week so theres hope . im here in uk and there has been a nasty chest virus doing its  round so not sure if thats why im still coughing, i cannot get chest x ray never mind a sputum sample done  i think only once i have had a sputum sample taken many years ago i am thinking of paying private for a lung ct so i can see why im so out of puff daily doing minimal tasks yet my spirometry shows good results but not sure if your gp has to refer you even when you go private i have never had a clip put on my nose when having spirometry .

Hi Susan....WOW, I am amazed that you have only been checked once in 5 years!  I have had COPD for about 5 years and after my FIRST appointment with a Pulmonary Specialist, I was told to come back in 6 months.  After THAT appointment, I was told to come back in a year UNLESS something changed or happened (exacerbation).  I think you need to either change doctors or see a Specialist.  As long as my stats are staying the same, I only visit my Specialist once a year.  My blessings to you!

For stable COPD annual checks (once a year GP respiratory clinic)

Unstable COPD 3-6 monthly checks usually under consultant until become stable then referred back to GP.

If unresponsive to treatment for ongoing chest infections referred to respiratory consultant and visits may be more frequent.  

When you have a chest infection and cough up mucus that is when you supply the sputum sample for testing. 

If you've had one of the winter bugs chances are this is where your cough is coming from.  Unless you had it before you became ill.

Its only if you have repeated chest infections and you do not respond to treatment over several weeks/months and your symptoms are getting worse or no better that a GP will refer the patient back to the consultant.

If you have some improvement you are not likely to be referred to a consultant.;

As I said before you may want to consider seeing another doctor in your GP surgery or changing your surgery.

I had bad exposure to bugs this year, it took 5 lots of different anti biotics and 2 courses of steroids to clear the chest infection.  I was very ill and would have asked for IV ABs if the 5th AB didn't work as it happens it did work.  But for IV ABs it means a hospital stay.

i have seen another gp at my practice he is bad as the first one ,there is  only three drs in this practice so its difficult, i need to change drs but worried what is on my notes because i honestly believe my dr thinks its all in the head he sees me for 5 min if im lucky he doesnt see me at home doing normal minimal tasks .

Billy doctors don't prescribe oral steroids for flare ups, you only get prescribed oral steroids for lung infections.

If you just have the flu for instance without a chest infections you may just get prescribed anti biotics.

It all depends on your symptoms.  

Ask your new GP for a referral to a pulmonary rehabilitation course / education programme.  This way you will learn how best to manage your symptoms, recognise the difference between a narrowing of airways and full blown chest infection.  What to do to help yourself etc.

 

Hi Vee I have to disagree with you there.  If I have an exacerbation without infection I am prescribed just predisilone to clear it.  That is very common I have found amongst lung sufferers,  x

hi Vee2 thank you for your advice .

exacerbation of symptoms do not necessarily mean a chest infection.

exacerbation of symptoms just means a worsening of symptoms

a flare up can be an exacerbation of symptoms by airways narrowing as in asthma or allergic reaction to air borne pollutants.

Some doctors may prescribe the oral steroids if inflammation of airways and or lung is the problem. 

oral steroids control better inflammatory illness including that which can be experienced by COPD.

For many COPD patients inhaled steroids are used daily as a preventative measure in avoiding inflammation of the airways, when steroid inhaler is prescribed but proving to be insufficient in certain circumstances, oral steroids may be prescribed or indeed another steriud inhaler tried, it really depends on the patients symptoms presenting at the time they communicate with their doctor.

This is especially the case if a patient is unfamiliar with recognising a lung infection for instance, someone who is not prescribed an emergency pack for this reason (because they are not yet able to recognise the difference).  But generally people should see their GP where there is concern about their deterioration on symptoms, asap to determine what may be the cause of exacerbation of symptons or flare up, or other.

Standard narrowing of airways due to weather conditions for instance / pollen / smoke / pollution will not necessarily require oral steroids.  That is why its always good to check in with own doctor.

 

Standard narrowing of airways due to weather conditions for instance / pollen / smoke / pollution will not necessarily require oral steroids.  Standard narrowing of the airways could be misunderstood by some to means an exacerbation of symptoms.  Its why its always good to check in with own doctor rather than rely on what is communicated in forums, confirmation and clarification for the individual patient concerned.

In addition symptoms exacerbated by allergic reaction to pollen, dust etc could be treated with anti histamines under the guidance of ones own doctor of course.

Smoke inhalation can exacerbate symptom and cause excessive coughing and narrowing of the airways, naturally to alleviate these symptoms one needs to remove themselves from the cause and drink plenty of water and see their GP if symptoms persist.

Oral steroids are not prescribed for any exacerbation in symptoms regardless, it would be detrimental to patients health if they were.

But for sure in some case oral steroid will be prescribed for an exacerbation in symptoms where a doctor's patient sees fit. 

 

last sentence should read:  where a patient's doctor sees fit.

Hi Vee2 i always thought an exacerbation was a chest infection you learn something new everyday so thank you for sharing that with us i did know about the irritants of copd mine being animal fur and plug in air freshners and many more, and of course smoking which thankfully i gave up 13 years ago but im sure  i have a lot more to learn, i am so glad i found this website ,thanks again.

Yes that's what I said Vee!   If I have a chest infection then I start my  ab's (for the infection) and steroids as well.  If I have a worsening of my symptoms without an infection I use just oral steroids which clear it..  I have a rescue pack of both and know how to use them.  I very rarely see a doctor and can self medicate with confidence. 

This is what I have been told to do by my nurse and doctor. 

Both are called exacerbations only one has an infection with it and the other is caused by one of my triggers ie dust mites,  pollution etc.   I usually only get chest infections though.  x

yes that is so wrong i do get my emergency steriods to keep for each time i have a flare up and could not manage without them i also get predisilone to clear it

In my own experience billy, you can have an exacerbation (a worsening of symptoms) without developing a chest infection and won't necessarily need to have oral steroids.   

Any smoke can irritate the lungs of course, someone burning rubbish in the garden, I always close my windows if I am aware of this so that the smoke doesn't enter the home.  

Best wishes in finding your next doctor more patient friendly with awareness of COPD and lung related issues.

V

 

Do ask for a referral to pulmonary rehabilitation if you can access one through your GP or respiratory nurse.

 

Agree HyperCard I have rescue pack on repeat prescription. Antibiotics and steroids for chest infection (coloured sputum) and steroids only for wheezing and out of puff. Having had copd for many years I get to know when to take them and find I manage things fine

Thank you James  for your support.  I was beginning to think I was deluded! x

 

thank you for your sound advice V.

You are welcome Billy

Yes, Hypercat, you are sane & not alone ,,, or we're all deluded together! In my part of the States they've been giving steroids to those who can tolerate them to stop horrific coughing jags with & without infections, and they've been doing it for chronic bronchitics for at least 20 years. Part of the rationale, I think, is how hard all the coughing is on the entire body. So when Rx inhalers & codeine syrup & OTC cough syrups aren't working ,,, ta da. Once a doc is familiar with the severity of the chronic bronchitis, they'll not make you go through all the syrups. Still won't give us emergency packs for home :-(

Thanks altarg.  I am in the UK and steroids are given for exacerbations.  I rarely need them but am not afraid to use them if necessary.  Usually any exacerbation (apart from chest infections) clears itself in a short time. x