To not agree with the nurse practiser's view that my DS has asthma and to think a diagnosis should come from a doctor?

[PolkadotCircus]

Soooo my v healthy but skinny boy 9 has had a nasty winter virus that he has had problems shaking off,symptoms involve a cough that won't go away.Loads of other kids and adults have had/got it here.

The same happened last year and our fab doctor gave him temp inhalers to calm his airways down which worked a treat and were never used again.

His grandad is the same(very skinny and some times gets a chest infection in winter it takes a whole to shake off) but still cycling 16 miles a day at 80.

Anyhow dtwin 1 keeping dtwin 2 awake so tried to get an appointment with our fab GP but because he is so fab it is nigh on impossible so was offered an appointment with a nurse which I reluctantly accepted as all I wanted were temp inhalers and ds better ASAP.

Anyhow after a very lengthy appointment when his puff was measured,history looked at,records filled in,weighed etc she finally gave us some inhalers.Puff was poor(errr yes he has a virus and a temp) and we were told to come back for a follow up asthma review.I said but he doesn't have asthma only to be told well this happened last year etc,etc.

So we went to the review puff beyond normal now and very good,virus over so no surprise.Nurse then said as he had asthma she'd like to see him again,keep him in her records,how many inhalers did he have etc,to keep him topped up when tight in the chest etc etc.

I said very firmly he doesn't have asthma and never gets tight in the chest.She then asked if he had eczema or hay fever.He had eczema as a baby and gets a bit sneezy in the summer ahhhh then they are linked so he does have asthma.Me-no he doesn't he just gets a cough he can't shake some winters.
I don't want asthma on his records unnecessarily.We politely agreed to disagree.

So aibu to think a)he doesn't have asthma and b) a diagnosis should come from a doctor.

Some drs are amazing, some nurses are amazing. Some drs are crap, some nurses are crap. Same in any profession. No one is superseding anyone, services are being redesigned so that patients get more specific input of more benefit for thier specific need. Your gp is the gatekeeper to specialist services, he is there to treat minor ailments and funnel you off to the right specialist if you have more complex care needs.
you have said you refused her diagnosis of asthma, so why would she have given you any written info? "I said very firmly he doesn't have asthma", this is not a person likely to read any educational leaflets on a condition they refuse to believe their son has.

DDT the doctor didn't refer us we didn't get to see him,he may well have felt he knew enough to treat the cough himself and that it wasn't asthma having treated all 3 for the same illness -GOT IT NOW?I can be rude and patronising too.

We already knew that op.

(hi-fives idshagphilspencer)

:)

Monty I was very surprised had,had no info in the other meeting re how to treat the illness or low weight or asthma info and my questions weren't answered in the current one which was interrupted by a colleague barging in.Hence my stating he didn't have asthma.If you want to diagnose my kid give me info re the diagnosis,tell me why you have come to that decision and answer my questions.

Drip....drip....drip.....

It is surely general knowledge that you cannot treat a virus with antibiotics? Otherwise, we'd all be getting them for our colds. Surgeries tend to have posters or leaflets up explaining this.

If the doctor prescribes antiobiotics it is because he believes there is a secondary infection that can be treated with ABs; it doesn't mean he thinks the original virus could. A secondary infection of a respiratory virus could e.g. lead to pneumonia which would manifest partly as bad coughing.

In people with the predisposition a virus can also trigger a narrowing of the airways (=asthma) which may take the form of full on breathlessness or wheezing or simply present as an obstinate cause of coughing. This narrowing of the airways can be eased by inhalers. But the inhaler won't treat the original virus; it will just deal with this secondary effect.

So before any responsible doctor prescribed anything at all, he would need to see the patient to investigate what was likely to be causing the cough: it is just the original virus or is it a secondary bacterial infection or is it an asthmatic reaction triggered by the virus.

A GP, who will have had masses of training in general medicine, but may not have any specialist training in asthma, would be likely to pass any such cases on to whichever member of the practice has had such training- and that will often be a practice nurse.

But none of that would actually change the diagnosis. Admittedly it probably isn't brilliant practice but it doesn't make any difference to whether your DS has asthma or not.

Following further posts by the GP: If the GP has seen other family member whose virus infections has led to bacterial infection requiring treatment by antibiotics, that is no safe reason to prescribe antibiotics to further family members with same virus infection- he'd need to know that their virus infection had also led to a secondary bacterial infection. The same illness is not always the same.

"by the OP", I mean; I expect the GP is innocent

PolkaDotCircus - My DS2 has Chronic Asthma and he only has an ANNUAL asthma check. With the Nurse Practicioner. Because she is more knowledgable about Asthma.

Annual checks are normal - they only need to be seen before that if they have an attack.

Why would your DS's asthma be treated any differently to another person's asthma?

It's like you are saying that because he is YOUR DS, he qualifies for extra-special treatment and more frequent asthma checks.

Annual asthma checks are NORMAL. Even in cases where a very young DC has Chronic Asthma.

Yep except Cory he didn't,we were in the middle of the illness but so were half the town.Couldn't see him.

Anyhow best thing will be to see him at a later date.If he refers me to said nurse I shall request all the info I need,how it works,symptoms,what to do and won't be fobbed off.If she doesn't give me the info then back to him I will go.

I have learnt more about asthma in this thread than in either appointment,that wasn't good enough.

YA still BU

The responses are overwhelmingly that YABU. The advice and responses to your questions have been sensible and measured, yet your responses show predjudice towards nurses and receptionists, unwillingness to listen, and inability to take on board anyone else's opinion.

The NP that you saw gave excellent care, which you still dispute. If she had not given you best care your post today would be complaining about that too. Her job is not to argue with you about diagnoses and battle with you when you disagree, it is to care for your child. If you were disputing the diagnosis, her advice, and everything else in the consultation, that probably would not have left much time for her to give you information (which you probably didn't want because you didnt, and still don't, think your child has asthma!).

Please at least try to take on board some of the advice on this thread, and think about how your beliefs and attitudes may affect your child.

To be honest l think YABVVU
Most nurse practitioners are far more qualified in the diagnosis and treatment of long term conditions than many GP's who tend to see more of the acute cases.
Reading what you have written -and unless you have left a lot of information out-then as a fellow nurse practitionerhe DOES have asthma.

But why not go straight back to the asthma nurse. Or ask the receptionist to get her to call you so you can discuss it. Going to the GP first is just unnecessarily wasting a GP's appointment.

No Merry. I know nothing about asthma and have very little inhaler left.

Sorry said appointment was shite.I want more info,more inhalers and info as to when to give them- do you give them for every sniffle,morning and night regardless of any sniffle- I don't know because until I walked in I was oblivious to him having asthma and the info given was shite.

Going by the last appointment sorry I have no choice but to see the gp.

NICE recommendations are for Asthmatics to have an ANNUAL check. Not 3 monthly, not 6 monthly, but annual.

It's NORMAL for the asthma checks to be annual. And with a Nurse Practicioner.

Why the insistence that the GP knows best?

Even with my DS3's multiple, severe, life threatening allergies, he sees the allergy nurse (she's a NP too) far more frequently than the allergy consultant, and it is HER who diagnoses the allergies through the skin prick tests, NOT the consultant!

Nurse Practicioners do extra training in certain things, they DO know what they are talking about.

To be fair though, the asthma nurse doesnt seem to have given the op any leaflets.

Cant work out whether that was because the op agreed to disagree with her about the diagnosis.

But I would have thought that the asthma nurse would have or should have still tried to give her info?

Oh and the pharmacist told us to give the inhalers in a completely way than she did too so we were even confused as to how to give them.

(gives up)
(hides thread)

I got no info about asthma either in my first appointment. I did some research on Asthma UK and then asked pertinent questions at a follow-up appointment I booked with the Nurse Practicioner.

This is going back 8 years ago now!

Right. Practical help. How did the NP tell you to give the inhalers, and how did the pharmacist tell you to give the inhalers?