Gp not interested in helping ?

[Brighton5555]

Hi since May last year I have had a cough/ wheeze that I approached the gp for help with. Initially told long covid affects then a couple months later provided a asthma pump blue one, then I pushed for a chest X-ray which I got quickly and was clear .

i approached again october last year given a rescue ? Brown pump steroid to help … I was reluctant to use it with the steroids and possible side affects but eventually did as coughing / wheezing increased a lot .

i have never been seen in person since May by the gp. Nobody has ever actually listened to the wheeze . It’s not there all the time it’s on and off all day and I’m coughing more ( if I talk a lot if I’m active going up and down stairs ) the inhaler works immediately but it wears off .

nobody has diagnosed me with Asthma despite the pump. The pump makes me feel odd / like I’m not quite with it….

not sure what to ask for next? It’s been 7 months and no improvement . Any advice greatly received

Keep at the GP at the very least you should be referred to the respiratory clinic. Good luck

Yanbu but you need to take the steroid inhaler consistently to get the results.
The "rescue" inhaler should be a blue one as this would relieve symptoms. The steroid one would prevent symptoms longer term
Ask for them to do asthma assessment on you to confirm diagnosis. A nurse will do this. If you do have asthma you'll get a plan.

Brown pump is a preventer inhaler. You have to use it regularly, usually 2 puffs twice a day, every day whether or not you have a wheeze, and then at the end of that assess if your cough/wheeze is any better. they may ask you to take peak flow readings at the start and end of that period. 'I don't want to do it because I'm worried about steroids' is your right but then they can't progress with finding out what is going on.

If you have used the brown pump as prescribed, with the spacer if it has one, every single day without fail for 6-8 weeks then you need to go back for review. If not ,start today and go back in 6-8w.

most practises have an asthma clinic or asthma nurse. I would get an appointment with them. If they think it isn't asthma that will give you next steps and if they think it is you will get advice on managing it.

Nonsense. Sounds like the OP isn't engaging with basic primary care management of this problem, which may well be entirely manageable in primary care. If everyone was referred, what do you think would happen for wait times for those who really do need to see a respiratory physician?

I an asthmatic and I agree with @monitor1 about the correct use of the blue and brown inhalers

It sounds like you are likely not using the inhalers properly to actually get the benefit of them, particularly as you went to the gp and they prescribed the steroid inhaler but you didn’t want to use it? Why did you phone the doctor but you didn’t use what the prescribed?
You need to call your gp and push for an appointment to discuss the inhaler use. You might be able to see a nurse instead of a dr.

Are you taking the brown inhaler?
How often do you use the blue one?
Have you checked your peak flow?

OP,

To clarify, sometimes the brown pump may be prescribed at a higher dose than what @monitor1 said. But it is long acting, not short acting. Unlike the blue pump it won’t give you quick relief and overusing it is a bad idea

At prescribed doses, inhaled steroids do not carry the risks of steroid tablets

Please consider making an appointment with someone at your surgery to talk through your concerns and make an asthma treatment plan, if you don’t have one. At my surgery there is a nurse who specialises in the management of asthma. She is excellent, and refers any tricky cases to the GPs

They need to listen to your lungs, try again and push to be seen in person.

OP I think you would benefit from being seen at the asthma clinic, most surgeries run these. Perhaps ask if you can be referred for this?

Ideally Spirometry would give a clue as to whether it's asthma. But this has been contraindicated due to Covid.
In the absence of this, get a peak flow meter from the pharmacist and download a peak flow chart from Asthma UK to record pre and post inhaler readings for six weeks. Alongside this, use your preventer twice daily as prescribed, don't forget to rinse your mouth afterwards each time.
Then take your readings back to your GP for review.
It can take up to a month for a preventer to be working at maximum effect and it's no good used on an ad hoc basis. Consistency is key.
If no better a higher dose may be needed or a swap to a combined inhaler with a steroid and long acting reliever in one.
Practice nurse.

Ideally Spirometry would give a clue as to whether it's asthma. But this has been contraindicated due to Covid

It may depend on area. Ours has started up again.

OP book an appointment with the practice asthma nurse to discuss your inhaler use and ask the nurse about spirometry.

Also not really true. Spirometry can give a picture of asthma, but can also be normal in someone with asthma. It's not necessary in the initial diagnosis and PEFR readings are usually better. It stopped during covid but has been available as normal for at least 6 months.

Agree with others you need to be taking the brown inhaler every day as prescribed not just whenever. It can take up to 6 weeks for it to take full effect when using it properly.

Also don't be concerned about it being a steroid. It's not the same as taking steroid tablets.

It must be area dependent? We've not restarted yet.

are you sure? in some areas it has been decided not to restart in individual surgeries but to move to a few hubs in an area offering it.