Frustrating visit to the dr regarding asthma. Dejected.

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RyanMW
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Frustrating visit to the dr regarding asthma. Dejected.

Post by RyanMW » Sun Nov 23, 2014 3:30 am

I went to my GP on Friday complaining of being short of breath, not being being able to increase cardiovascular endurance despite my best efforts, trouble sleeping and a general, enduring feeling of tiredness.
I inquired if it was possible that I had asthma. Maybe that was a mistake.
The Dr. was vehemently against giving me an inhaler and kept saying that I "simply could not" be asthmatic because I was not constantly wheezing.
They gave me a spirometry test in order to gauge my pulmonary functioning.
I tested 3 times and scored a "60."
I was then given a nebulizer treatment which is, I was told, like a stand-in inhaler. Then I was re-tested with the spirometry.
I tested 3 times and scored "90."
My GP then told me that the spirometry program was broken and that from 60 to 90 isn't a large enough difference.
When I inquired as to if I could still be helped by using an inhaler, the GP admonished me, telling me that Inhalers contain steroids and are for serious use only.
I was denied an inhaler.
She told me my breathing problems are all caused by anxiety and asked me if I needed more Lexapro.
This was probably my most disappointing visit to the doctor that I've ever had. I left extremely frustrated and dejected. I had hoped that I could try an inhaler and that maybe, just maybe, it would improve my quality of life.
Can anyone shed some light on this in any way? I'm just very disappointed right now. Should I see another Dr. or a specialist for a second opinion? I have medicaid so finding a pulmonologist near me has proven difficult so far.

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49er
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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by 49er » Sun Nov 23, 2014 3:44 am

Any doctor who is blaming a medical problem on anxiety and blowing off results that seem like there is a possible problem should be treated with extreme suspicion. Definitely seek a 2nd opinion.

I am so sorry as I would be very frustrated and angry also.

49er
RyanMW wrote:I went to my GP on Friday complaining of being short of breath, not being being able to increase cardiovascular endurance despite my best efforts, trouble sleeping and a general, enduring feeling of tiredness.
I inquired if it was possible that I had asthma. Maybe that was a mistake.
The Dr. was vehemently against giving me an inhaler and kept saying that I "simply could not" be asthmatic because I was not constantly wheezing.
They gave me a spirometry test in order to gauge my pulmonary functioning.
I tested 3 times and scored a "60."
I was then given a nebulizer treatment which is, I was told, like a stand-in inhaler. Then I was re-tested with the spirometry.
I tested 3 times and scored "90."
My GP then told me that the spirometry program was broken and that from 60 to 90 isn't a large enough difference.
When I inquired as to if I could still be helped by using an inhaler, the GP admonished me, telling me that Inhalers contain steroids and are for serious use only.
I was denied an inhaler.
She told me my breathing problems are all caused by anxiety and asked me if I needed more Lexapro.
This was probably my most disappointing visit to the doctor that I've ever had. I left extremely frustrated and dejected. I had hoped that I could try an inhaler and that maybe, just maybe, it would improve my quality of life.
Can anyone shed some light on this in any way? I'm just very disappointed right now. Should I see another Dr. or a specialist for a second opinion? I have medicaid so finding a pulmonologist near me has proven difficult so far.

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Julie
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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by Julie » Sun Nov 23, 2014 5:21 am

See a pulmonologist. Not us. But you may not have asthma, and you may have something or other you've never heard of, or not, but we can't possibly help you meaningfully this way after all... speculation 'on paper' by strangers is not going to help you. Your doctor does sound like a jerk, but maybe he's not, we have no real way of knowing. And I'm not sure fooling around with someone's old Cpap machine is a good thing either.

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49er
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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by 49er » Sun Nov 23, 2014 5:43 am

Julie wrote:See a pulmonologist. Not us. But you may not have asthma, and you may have something or other you've never heard of, or not, but we can't possibly help you meaningfully this way after all... speculation 'on paper' by strangers is not going to help you. Your doctor does sound like a jerk, but maybe he's not, we have no real way of knowing. And I'm not sure fooling around with someone's old Cpap machine is a good thing either.
Julie,

Normally, that is good advice but the problem is Ryan seems to be getting horsebleep care. Sorry, that qualifies when someone wants to throw Lexapro at the problem without wanting to do a thorough investigation as to why he is having breathing difficulties.

So on this case, I see nothing wrong with Ryan discussing his situation on the Internet so people can give him things to consider for consulting a doctor. And since there are folks on this board with asthma, hopefully, they can chime as to whether what the doctor has said sounds reasonable or not.

I think everyone who posts on this list understands that no one on this list is a medical professional and even if they were, they still need to consult their own doctor for advice. But when people seem to get alot better answers on this board than from their own doctors, it is totally understandable that they ask the questions that they do about their medical situation.

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Sheriff Buford
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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by Sheriff Buford » Sun Nov 23, 2014 6:26 am

here's my 2 cents: I sorta agree with Julie. When I read this thread, my thoughts were "if I was a doctor... I would maybe think the patient was being difficult". With the internet educating folks, you can be sure doctors are getting all sort of folks in their office that know better than them, and I can imagine how difficult it may be to treat someone who has their mind made up on a certain diagnosis. I am an extreme advocate for my own health! To a point where I suspect my Doc hates to see me coming. I always tell myself to let him be the doctor and I will play the patient. At minimal, I use my education to ask questions.

Sheriff

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Julie
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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by Julie » Sun Nov 23, 2014 6:31 am

You're right 49er, but I also feel there's a point at which people have to pursue answers in 'real life', and if they're suffering need to do it relatively quickly rather than going around and around checking out strangers' symptom/therapy lists for answers. We can speculate til the cows come home about what he may or may not have, but it won't expedite help for him. Yes, we can hold hands with people going through testing, etc. to find answers, but the testing should be pursued.

I realize Ryan has tried to get answers from his doctor, and the doctor does not sound too helpful, but we don't actually know either of them either physically or mentally/emotionally, and to make assumptions about diagnoses or suggest treatment or meds without knowing more is not going to help and could even be harmful, if only by holding out hope of an answer that may have no bearing at all on the reality of his problem, maybe prolonging the time he takes to see the right person and get answers he can use.

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49er
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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by 49er » Sun Nov 23, 2014 7:04 am

Sheriff,

I am perplexed by your response. Ryan asked the doctor if it was possible that he had asthma and did not insist that is what he had. Any normal patient would ask that question and if a doctor takes offense to that, he/she has the problem.

I find it interesting the doctor blew him off initially and then after testing him, it seemed it was possible. Ryan then asked a reasonable question about whether this treatment could be helpful (not demanding anything) and was blown off and offered psych meds which is sadly quite common with doctors who don't want to take patient concerns seriously.

Actually, it sounds like being a reasonable patient got Ryan nowhere although I admit that there is no guarantee that if he had been assertive, anything would have been different, particularly since it seems patients on Medicaid seem to be treated like garbage in many cases (not all).

By the way, I feel like I have been way too nice in dealing with doctors and it is time for me to start being more assertive. Hopefully, I have the courage to practice what I preach when I see the sleep doctor tomorrow.

49er
Sheriff Buford wrote:here's my 2 cents: I sorta agree with Julie. When I read this thread, my thoughts were "if I was a doctor... I would maybe think the patient was being difficult". With the internet educating folks, you can be sure doctors are getting all sort of folks in their office that know better than them, and I can imagine how difficult it may be to treat someone who has their mind made up on a certain diagnosis. I am an extreme advocate for my own health! To a point where I suspect my Doc hates to see me coming. I always tell myself to let him be the doctor and I will play the patient. At minimal, I use my education to ask questions.

Sheriff

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Julie
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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by Julie » Sun Nov 23, 2014 7:13 am

Oh, I absolutely agree that Ryan did what he could with that MD, not suggesting at all that he didn't, but now it's time to look somewhere else... I guess I could sound more supportive about his asking if he should go somewhere else, but to me it's obvious, but to others it might not be. Maybe I spent too long behind the window of doctors' offices being 'efficient' and maybe not always as much like a friend as I could have been because there was so little time to process things, though believe it or not I did try. Not an excuse, but background.

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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by chunkyfrog » Sun Nov 23, 2014 8:53 am

The problem is Medicaid. It is my understanding that asthma is not always aggressively treated (@$&!)
under Medicaid --for economic reasons-- Your PCP will likely resist investigating asthma unless you
present with "severe symptoms". --in the office. If you see a specialist (with or without a referral),
and receive a positive diagnosis, you would then be able to exert pressure to receive treatment.
With private insurance, which has a different financial model, I was sent home with an inhaler, which was ineffective,
because I did not have asthma----but pneumonia!
Consider the possibility that your symptoms may be neither asthma nor psychological.

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Post by princessbelle » Sun Nov 23, 2014 9:20 am

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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by sleepy1235 » Sun Nov 23, 2014 9:31 am

I concur with the recommendation to see a specialist.

However, don't reject your doctor outright. Doctors have an obligation to recommend what is best and steroids are powerful medicines.

The key I think is if your doctor is dismissive or merely has a different opinion.

I think that your feeling bad is a real problem. You do want someone dealing with it.

As for the specific technical issues I certainly don't know and a specialist would be the person to ask.

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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by BlackSpinner » Sun Nov 23, 2014 9:36 am

Wheezing is not required for asthma.

I have the coughing variety, I rarely wheeze, I cough until I puke and then cough some more.

Get a referral to a pulmonologist. Go to another doctor if you have to.

Oh and people with asthma are always "anxious", especially when triggered. Most people when they can't breathe get anxious. However asthma can be triggered by anxiety, I realized that at my therapist when every time we got close to any tense subject I started to cough. The treatment for asthma triggered by anxiety is exactly the same as any other asthma.

Your doctor needs to go back to school. This is not new stuff.

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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by JDS74 » Sun Nov 23, 2014 9:46 am

RyanMW wrote:I went to my GP on Friday complaining of being short of breath,... They gave me a spirometry test in order to gauge my pulmonary functioning.
I tested 3 times and scored a "60."
I was then given a nebulizer treatment which is, I was told, like a stand-in inhaler. Then I was re-tested with the spirometry.
I tested 3 times and scored "90."
...
Before doing anything else (except possibly seeing a pulmonologist for a second opinion) ask for and insist on getting a copy of the PFT. A second opinion doctor will want to see the report.

For some background reading before you get to a pulmonologist:
http://www.ccjm.org/content/70/10/866.full.pdf
http://www.acofp.org/uploadedFiles/ACOF ... e_2011.pdf
http://www.cdc.gov/nchs/data/nhanes/nha ... ometry.pdf

Do not self diagnose. These links are provided to help you frame your questions to an appropriate physician.

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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by Tatooed Lady » Sun Nov 23, 2014 10:06 am

I have asthma. Had it since I was about 17. I also smoked from 16-26, now I really pay for it. I KNOW my breathing is restricted to some degree 100% of the time. Anxiety, allergens, weather and activity are 4 things that make it spike. During testing where I used one of those blowy things (cope with my girly terms please), I was told my breathing was fine. F.U. "Fine" for others maybe...but made me want to hit my inhaler. Which after use, made me blow like a Stihl leaf blower. But then I felt able to breathe without resistance. Problem being, inhalers give me the shakes. I HATE the feeling and only use them in emergency situations. Doc once told me that regular use will help build the muscle function or something. Yeah well...

Anyhow, apologies for the "oohhhhh, SHINY!" sidetrack. Basically it's a matter of YOU know your body best. Pay attention to triggers (smoke, pet hair, emotion, exercise etc)...then approach the doc with a better idea of what sets you off.

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Re: Frustrating visit to the dr regarding asthma. Dejected.

Post by tuzacat » Sun Nov 23, 2014 10:48 am

Ryan, I have asthma - I don't wheeze and I don't cough. I feel tightness and heaviness in my chest and feel like I can't catch my breath. When I was first diagnosed I thought I was having heart problems. I'm a teacher and went to a workshop once before I was diagnosed about asthma and the nurse who was leading the workshop gave us all a straw and had us breathe through our mouths through the straw. She said that's what breathing feels like when you have asthma. It is a perfect discription of what happens to me when I am having an issue. Two things seem to make it worse for me - dust and anxiety. I would definitely get a second opinion. It couldn't hurt. Even if the opinion was the same as your current doctor's at least your would feel better about accepting it.