How do I get the most out of my GP appointment?

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I'm seeing the GP tomorrow, and need to get my head straight about what I want to get across and what a good outcome would be.

Any thoughts on how to explain how I'm feeling without bursting into tears. I also want a referral to respiratory (if that's the correct path), and maybe repeat bloods.

I'm not great at the doctors, i tend to get dismissive of my own symptoms or emotional. On a GP phonecall last week I rejected a third round of antibiotics without being seen in person, so I feel like I'm being difficult already!

I'd quite happily advocate strongly for my disabled daughter, just not myself!

Background: long period of worsening shortness of breath (am asthmatic), turned acute a month ago, couldn't walk without getting chest pains and out of breath. Asthma normally well controlled, no virus other than regular colds.

Had 2 ECGs - normal.

Chest x-ray - not had the report yet, but ED doctor said it showed asthma and infection

Bloods: raised inflammation markers, high white blood, low red, anaemia.

Seen multiple GPs 😬 different one each time so each has had their own theory (they've been making appointments with me, as they've been concerned about results and symptoms).

First round of antibiotics and oral prednisolone had no impact. In fact I got worse over that fortnight.

Second set of antibiotics (after ED visit - GP wanted to rule out a pulmonary embolism), did help.

I'm now 4/5 weeks on from initial GP appointment, but 4 months on from start of symptoms.

My breathing has improved but not by enough to be able to return to normal activities.

I'm still exhausted (physically find it hard to sit up).

I've got a lump on my neck that needs investigating. I don't know whether that's related or not.

I'd write it down like you have here, maybe in bullet points under titles like symptoms, treatment so far, current issues. Go in, say you are still feeling crap and because quite a lot has happened you've written it down for clarity. Hand it over. Stay quiet and let them read. And then say you need the lump investigating and also why the treatment hasn't worked and want to know potential diagnosis such as COPD or whatever and what they can do about it.

How bad is the anaemia? Do you know your ferritin level?

Definitely write it all down. I find that really helps.,

was about to say the same as @Mygardenisaswamp .

Write every thing down - symptoms, when they occurred, what you have done to treat them, previous tests, if any etc, plus any questions you want to ask, and what you want out of the session. For example, if they don’t mention further investigation for xtz, then ask for it. I did the recently, and got an ultrasound scan as a result.

What exactly are you worried abut and what are you hoping for? It seems as if there are several things going on although the timeline isn’t completely clear.

From what you’ve said it seems you are concerned about

• breathing still being poor
• still being exhausted
• a lump on your neck

You’ve had a chest infection
You are asthmatic
You know you are anaemic

So you’re asking the GP to start the process of disentangling what is causing what, and treat you for it.

Definitely write everything down. It sounds like a lot for the GP to take in and think about in a standard appointment

Thank you so much, this is all super helpful.

Part of the issue is I don't know quite what's wrong. I feel as though there's something else going on underneath, and that the asthma didn't respond to medication.

My thinking is it could be post-viral, auto immune or worse case, cancer. I want the GP to give a steer.

12 for ferritin.

Graphs below. Not massively anaemic.

*So you’re asking the GP to start the process of disentangling what is causing what, and treat you for it.

Definitely write everything down. It sounds like a lot for the GP to take in and think about in a standard appointment*

I totally agree about it being a lot to take in and plan.

12 is really low it needs to be above 70 to be optimal. Have you had other bloods done such as thyroid b12 etc? How high was the crp?

I'd be asking for at the least repeat bloods, and a referral to rheum plus also an x Ray or ct scan of your chest.

Maybe you have the type of asthma that is brought on by any respiratory infection. Apparently Ventolin does not manage this type of asthma.
I read this on a blog post. The women was tested for allergies and exercise didn’t affect her asthma either.
The pulmonologist put her on Innovair and that worked.

Thanks for the advice, really useful. Had a great GP, who was really thorough and reassuring.

I'm having repeat bloods next week, and an appointment with the asthma nurse to look at other inhalers. He also wants to see me again if things don't improve.