Going to see specialist tomorrow evening about DH's Chest - what do I need to remember to ask?

[Katymac]

DH has had 12 lots of A/B's & 3 lots of oral steroids in 12 months

I think enough is enough so what do I need to say?

I am a bit brain dead/ punch drunk after a Christmas party so need sane & sensible advise

Don't know but bump!

Don't know, but when you do know, write it all on a list so you don't forget. Write a list of the medications (names, doses, how long etc) he has taken so you can show the specialist.

Not seen your other threads katy but quick thoughts are...

Why is he getting so many infections?
What can you do about avoiding them/lessening the effects?
Is there a possibility of an immunity problem? Can he have tests for this?
Is this really one infection that is not being cleared properly?

Take a list of questions and a notepad for the answers.
Don't be afraid to ask even a 'daft' question. If you don't ask it you'll kick yourself later.
Ask for a copy of the letter that goes back to your GP - sometimes this throws up further questions.

Hope this helps.

ask for spirometry
ask for chest x ray
put him on a special diet to boost immune system
banish anyone with germs from him
ask if gp should give him the pnemonia injection
sound like he is being treated for asthma
does he smoke?
hth
print htis list and take with you
sorry spelling too much brandy in mince pies

This is to prep my list of questions

He has had Spiro / X ray & CAT

He has had flu jab & pnemonia jab (that's every 2 yrs?)

He has been asthmatic since 1993

Never smoked

Banish germs....ha....I'm a childminder (he can't work) & the main breadwinner so that out the window

Like the idea of investigating his immune system

I don't know if this is relevant, but after many many chest infections and loads of steroids and antibiotics, my DH was diagnosed with asthma a few years ago. Now that he's on medication for it, he is so much better. Has this been investigated for your DH?

He is a chronic asthmatic - but I think something else is going on

I'm not sure whether this is applicable to adults, but DS's consultant said that many people with asthma who get really recurrent chest infections have manky adenoids that are chronically infected, and kind of drip infection back into the lungs, and unless a long course of antibs is given, the chest infection clears, but not the adenoids. DS had 6 weeks of antibs to sort his out, which worked nicely (too young to have them out).
Presume your DH has had comprehensive allergy tests, and that you are already doing the hard floor/blinds / general dust reduction plan.
Has DH had any cultures done with the chest infections, or was he just given broad spectrum ?
Consultant also said that a bronchoscopy and lung washout which was then cultured could be really useful in getting to the bottom of things.

No recent allergy tests

He does cultures (that's where they grow it right?)

General dust mite/mould reduction etc

Thanks for the bronchoscopy idea

A really comprehensive allergy test would be a good thing then - any pets ? The most unexpected things can be an issue - one of my mums major air allergens is guinea pigs!
A review of the cultures (yes, thats when they grow the bugs) should show whether its the same things over and over, or different things.

It's always opportunistic bugs (the ones that get old people & children/babies)

Most recent

Streptococcus Pneumoniae
Haemophilus Influenzae
Moraxella Catarrhalis

Cat we have had for 12 years

I can't think of anything else - too long since my asthma was really bad and I was well read on the subject, and DS's is a bit weird as he's so little.
Good luck for tomorrow, and I hope you get some help.

asthma uk website good
could try leukotriene antagonist
eg montelukast
Asthma, for him could have allergic component
needs rast test
possible antihistamine helps
maybe inhaled steroid nasal spray

Agree with galaxymummy

Sounds like poorly controlled asthma, exacerbated by allergy or infection.

I would advise long acting beta2 agonist if not on already, with possibly montelukast. Have allergy testing, maybe a longer course of antibiotics to "zap" persistent infection.

Hope you get answers

He is on Singulair (is that a leukotriene antagonist?), serotide, ventolin (of course), cetirizine (for hayfever)

What's a rast test

A/b but one ago was 2 weeks worth of A/B (great big blue buggers)

Going to start typing list later - any more ideas?

rast test is allergy patch testing
singulair is montelukast
big blue buggers sound like cefradine 500mg
for dreadful asthma chest physicians start aminophylline s/r tablets
think about how inhalers delivered if quick puff into mouth may not get it try large volume spacer like kids gets more medicine in right place
hth and visit ok

DH uses a spacer

The 3 lots of steroids were prednisalone

I am sure he has had animophyline I'll go & ask

A full timeline/description about what has been going on (symptoms and meds) for the past x months.

What tests does the doc suggest, and why?

What are the pro's and con's of the tests?

If you can get as much information from them as you can, and if your try to get an understanding of their thoughts on the problem, this will help you to understand what may be going on with your dh.

Lots of questions, however silly you may think they may be (which they probably won't be), will help you and your dh.

he has had animophyline - but years ago

Should I get a list of all the med he has had from the Dr?

Or will he have sent this to the specialist?

I would take a full list of his meds.

I get those bugs you have listed a lot, I have bronciectasis (a chronic lung disease) which can only be detected by CT scan, has he had one of these? Also would be worth getting sweat test to rule out CF. Bronchoscopy would be a good idea. Also someone suggested about immunity, ask to see someone who specialises in this and get full bloods done to see if there are any immunity problems.
Has he had the blood test for Aspergillosis? (sorry bad spelling there!) That's a kind of fungi which breeds in the lungs, worth ruling out.
Lots of good ideas here. Go in with it all written down, and good luck. Sounds like more than poorly controlled asthma to me, they said thats what I had for years until they found this disease on a CT scan.
Lots of sympathy to you and your dh, know what it's like not being able to work due to dodgy lungs. Hope it goes well.

The consultant was fab

He had all DH's cultures, his CAT scan, his X-rays, everything

The Chest Infections have nothing to do with DH's Asthma, it could just be bad luck but he is sending DH to Pappworth, to a Lung Defense Clinic to have his lung immunity - we should be seen by the end of January

So that is quite reasonable, I guess

Good to hear KM, you sound a bit more positive about things. Did the Consultant give you any pointers to what he may think it will be?

I have just read your details and really cracked up at your anti sweetners stance. It is the same in our house, although dp is worse - he checks everything for sweetners and gets really annoyed when he finds it in things like crisps!

He is leaning towards bad luck - which is a bit of a bugger

Dear KM
You sound better now after visit
papworth is fab sure he will get good investigations there have happy xmas