To be pissed off that my GP casually tossed a diagnosis at me

[bigmouthstrikesagain]

I went to doctors on Monday as I felt like death and was feeling tight in my chest, felt like I was probably getting a chest infection. I had pneumonia and was hospitalised 7 years ago and since then I have been prone to chest infections every winter. I have suspected this is somehow related to the pneumonia but at the time I was told I had recovered well and shouldn't have long-term issues. So I have just been cautious, made sure I don't ignore symptoms of chest infections and had the flu jab this year. Anyway the GP examined me and said that my lungs sounded ok but as I clearly had a virus and a temperature (I was very hot and sweating which was embarrassing) he prescribed me a course of antibiotics, he said "as you have bronchiectasis you already know you are prone to infection in your lungs" I said "huh?" or something equally incoherent and said that I hadn't had that made explicit to me he said something about damage/ scarring to the lungs meaning I am vulnerable to infection and then it was here's your prescription thank you and goodbye!

So now I am googling bronchiectasis and it is a little bit scary sounding and I am pissed off that it hasn't been explained properly to me. I am going to get an appointment to find out when this diagnosis got put on my medical records and what I should be doing to manage it. But surely I should have known this already!? Anyone else been blindsided by a doctor like this??

I went for a blood test last year and the nurse casually threw in that I'd previously had Hepatitis (spoiler alert - I hadn't). Over a long, drawn out appointment with the GP going through every single blood test result I'd ever had, and a further series of blood tests to look for markers, it was eventually deduced that either someone else's test result had been incorrectly recorded in my notes, or that a negative had been misread or incorrectly recorded as a positive. Considering the so-called positive result would have been around the date of my midwife booking appointment it was stressful to say the least.

Anyway, I guess my point is, could it be possible that the same thing has happened to you? Surely they shouldn't diagnose you with something without telling you.

You can tell bronchiectasis from a CT scan so it was probably seen when you were admitted last time.

Basically it means there are parts of the lung that are a bit pitted and ridged. This is from damage, either smoking or from repeated chest infections etc. And those ridges hold onto phlegm. So it's harder to cough up. So it sits and sits and can get an infection from not being cleared efficiently.

So people with bronchiectasis are more prone to chest infections.

You can asked to be referred to a physio for some chest physio exercises. You can use things like Exputex to get mucus up. But you can't undamage damaged bits of lung. You can only educate yourself on how to clear mucus so it doesn't sit there for ages.

But having it doesn't mean you have it all over. In fact it's frequently in patches. So the rest of your lungs could be in great shape for all you know. It's certainly not one of the more worrying respiratory conditions.

You can certainly ask for a referral to an outpatients Respiratory clinic to discuss ways to mitigate it.

To be fair to the doctor you saw they probably thought you already knew if it was on your records.

Someone has probably incorrectly coded bronchitis as bronchiectasis if you had no knowledge of it.
Ask your GP to check your record.
(GP)

When you were in the hospital 7 years ago did you ever get a scan? By the sounds of things the chest infections could be related to the bronchiectasis not the pneumonia.

My uncle had this and had to have a few scans.

Day to day it doesn't affect him. Every now and then he needs to take antibiotics.

Your GP isn’t to blame here. Either it became apparent a while ago during your earlier investigations and treatment that you had it or else your medical notes are incorrect. Either way, your GP is not to know you were unaware and that they should have kept quiet.

I had this!! I went to the GP to get a contraceptive prescription and the doc said "So, you have xxxx (completely unrelated to contraceptives) disease". I had never been told! It's something that I've had for years since a kid, but I'd never been told the name of it by anyone. I checked with my mum in case they told her, but she looked as bewildered as me. Weird. I did the same as you and Googled the crap out of it that day.

I am pissed off because I didn't know so I am not blaming the specific GP - though the one from the same practice that i saw exactly a year ago didn't mention bronchiectasis unless I also have a memory issue.

My notes had me as asthmatic. I had an inhaler once, when I had pneumonia
Kept getting invited to asthma clinics, asked them to remove from my notes, years later it was still going on. So I said fine, book me on the asthma clinic
Turned up, blew about 600 (sitting down!) on peak flow, nurse "you're not asthmatic"
Me "I KNOW now can it get off my notes?!"

It got removed

42 weeks pregnant (years ago....) seeing consultant - he examines me turns his back & addressing junior doctors informs them that its a breech & they will do a trial labour & if it doesn't work they will do a Caesarean … it was up to the junior doctor to explain & calm me down -

Once had a GP casually say to me "Yeah, so it sounds like you had a miscarriage then" in the middle of a chat. I (now) know that early miscarriage is extremely common and probably, in the grand scheme of things, not the worst thing the GP will have dealt with even that morning, but I really don't know how to describe how it made me feel.

Please don't panic. Your history is very suggestive of bronchiectasis which will have been there for a while. Look at the British lung foundation web site for reliable advice on the disease initally and ask you gp for a referral to a respiratory physio. Normally the main issues are a productive cough and increased risk of infection both of which can be managed by chest clearance exercises and medication if indicated. I work daily with bronchiectasis patients . It's much more common than people realise and while not curable should have little impact on your daily life if manger correctly.

• that's managed correctly!

@sexnotjenga - that was spectacularly unfeeling of your GP you poor thing.

@jamimmi - I have to say I don't have a persistent productive cough. I don;t cough that much even when I get chest infections - whereas my dh coughs up lovely greenies (bleugh) regularly in the morning even when he is well. So I don't really have the most common symptom of bronhiectasis but I do have other symptoms so it does makes sense - I had thought I might have costochondritis as i have regular pains in ribs and centre of rib cage.

I think I want more information about when it was added to my medical history etc. I have been looking at the information on the British Lung Foundation site which is very useful cheers.

I think my anxiety about it stems from my dad as he died in his early 50's (25 years ago now) and he had bronchitis every winter and regularly coughed up blood, had heart diease and other pulmonary issues - so I am immediately reminded of how ill he used to get when I think about lung conditions. I know rationally that I don't have his health issues.

Speaking of coding
I once had to go down into the bowels of a medical records department to retrieve something. There were a couple of young women in a dark corner next to a pile of records and a tatty medical dictionary.
One was saying to the other that if she couldn't read something she just guessed.
I really hope things have improved in the last 20 years...
It explains a few things though.

My dad had something similar. When he went to the gp for holidays jabs (back when you could) the gp said he had made an amazing recovery from a quadruple bypass if they was thinking about safari. Lead to a very weird conversation when my dad realised the gp was worried he was dillusional when he denied having heart surgery.
Patient with the same name at the same surgery and the letters were put in the wrong fill. Not the same thing at all but I like the story.

Friend of mine went to a doctor's appointment where he announced with a very pleased look on his face that he reckoned he'd diagnosed her unusual condition. When he announced it, he still looked pleased and almost seemed to expect to be congratulated. It just didn't seem to occur to him that the fact that it included the word "carcinoma" might be my friend's priority.

Fortunately, it turned out that he was wrong.

GP's can be flippant. Mine was very off with me because the hospital consultant at the chest clinic put in her letter that I ought to have been given a second course of antibiotics when the first had not cleared up my chest infection.

I had sarcoidosis as a child, it's so rare to have this as a child that a discussion of my case appears in a textbook. Fun facts aside, what it does mean is that it's hard to diagnose any future infections because of old scaring

DH had this after going for chest x-ray told by that he probably had lung cancer or TB while we were standing in the surgery reception! Not even in a consultation room. To say we were gobsmacked is an understatement. Thankfully it turned out to be neither but we had a few very worried days before seeing his excellent consultant. GPs can be such a mixed bag.

you may have been told when you were in hospital, but when you are ill, your brain just cant take everything in. so when you found out, it was clearly a shock to you. make an another appointment to have a chat when you are feeling better.

@TheNewYear I think the GP is at fault here .

Making the assumption that the patient knew about the condition of her lungs and the implications thereof and then not checking whether she had taken onboard /was ok with the explanation is poor .And has led to a further appointment .

I know this sounds a bit odd but with a paternal history as well think about asking for gene testing for alpha-1-antitrypsin deficiency

Its the lack of a gene that produces a specific enzyme that one of its functions is to protect the lung lining from damage when you have a chest infection or other irritant e.g. smoking however there are also other elements to it, but it defintiely sounds like there is a family weakness about it.

My Dad always got chest infections with a cold, Mum said it was a weakness and we just dealt with it, as older adults at least 3 of 6 siblings are prone to chest infections. Dad had some tests for some other reasons (Liver issues) and this deficiency came to light. Since then out of 5 siblings tested 5/5 have the same issue and it is shedding light on other issues we have and is flagged on our records. My doctor took it seriously enough (in combo with my other problems) to refer me to a geneticist. I also need to get my DD tested as we can head off some issues before they arrive with certain actions.

But you already knew you were more susceptible to chest infections after pneumonia, so you knew there was damage. I am not sure what difference a label makes

@perdito If it was an old diagnosis the GP would have thought she would have been informed of it at the time. Its not really feasible for GPs to spent every appointment reading out every previous diagnosis to check the person had been apprised at the time, they would be working under the knowledge this (and implications/treatments) would have been discussed with a patient when the diagnosis was made. Rarely this knowledge is incorrect and a patient may not know but it would be exception rather than rule and again it’s really not feasible to go through every diagnosis at every appt. For one of mine they would seriously be there for hours .

Sorry, after all that, I forgot to mention to OP that one of mine has this. It’s no biggie (amongst all their other issues) and is generally managed by daily nebulised hypersaline treatment with PEP exercises.