I've got asthma triggered by environmental things. Cold air is my worst trigger. Last year I ended up at the docs multiple times for the flare-ups. They would listen to my lungs and I typically ended up with Prednisone because I am already on a lot of preventative meds.
I'm trying to extablish with a new Pulmonologist. I've had Pulmonary Function Testing twice now. I have to schedule it months in advance. I had some testing today. Unfortunately, or fortunately, I was feeling fine today. My most recent flare was for a couple weeks at the beginning of December. Anyway, the doctor doing the testing told me he questions that I even had asthma because my lung function testing was over 100% of normal. How frustrating. When things are bad, I can't get in to the Pulmonologist because he is so busy so I end up going to my PCP for further treatment. They are the only ones who have heard all of the wheezing of the attacks. Now, after 3 visits with the Pulmonologist this year, they have yet to see me when I'm not doing well. I go back Thursday for a follow-up on the testing today. I anticipate that he will question how bad my asthma really is. I had a major asthma scare last January and I've worked hard this year to be proactive and not repeat that experience again. I've holed up inside alot and double layered my fleece scarfs I use so at so not trigger things. I don't want the doc to think there isn't a problem because I'm not bad at this moment. Any suggestions on how to really present my case without sounding too defensive?
Dutch-ny, I'm not sure where you're getting your information, but I don't think your source is very reliable. By definition, asthma is the inflammation of the airways in your lungs that can be caused by a wide variety of triggers including allergies, respiratory infections, cold air, physical activity, pollution and environmental irritants, even acid reflux.
There is no single cause of asthma or set of symptoms that define it, and inflammation of the airways due to cold weather - which is what MountainReader describes - is absolutely considered asthma.
the doctor doing the testing told me he questions that I even had asthma because my lung function testing was over 100% of normal.
That's a pretty frustrating response to get from the doctor, and it surprises me a little bit given what you've shared of your history. I would think that just a description of your history and symptoms would be enough to convince the doc that your diagnosis is pretty clear.
Any suggestions on how to really present my case without sounding too defensive?
Did you get copies of your records from your flare ups last year (as I recall you even had to go to the ER at one point). Maybe sharing those records with the new pulmonologist (so your description is supported by the diagnosis and treatment of the other docs) would help him/her to understand how bad things get for you when you have a flare up.
The other thought that struck me is that, before you get too far down the road with this new doctor, you might check to see how they handle things when someone has a flare up. If you have to schedule things that far in advance they may not be much help when you're not doing as well. Hopefully it's just a new patient thing.
Thank you for your reply and support. I had my appointment last Thursday. It seems that my Pulmonologist didn't feel the same way as the doc he had doing the Lung Function testing. He really does believe me about my asthma problems. He spent 20 min- 1/2 hour talking to me. Really talking. He didn't even do the physical check until the end. He asked a whole range of questions, let me do tons of talking and asked about other health issues as well so he could put things in perspective. The surgery I had last October has helped with my reflux triggered asthma.
I'm waiting for him to call me about my follow-up lung x-ray, but I don't expect much to come of it. I had a spot on my April x-ray. He had me do a TB test but it came back normal. (It was my second for the year because I do them regularly for work.) He is checking for any change. I thought it was interesting that he asked where I was born and grew up. He said he has seen spots like this, in the same location, from people who grew up in the Missouri area. He said if that was the case, I didn't have anything to worry about. Makes me wonder exactly what he is looking for. I should have a chance to ask when he calls with the results. He usually calls in person.
At the end of my appointment, my Pulmonologist basically told me that I was a knowledgeable "model" patient who knows what do and that there wasn't anything more he could do for me unless things get extremely bad. He told me I could easily follow (as I have been) my asthma plan to treat myself without having to go to the time and expense of visiting him.. He gave me refills on both Advair 250 and Advair 500, Prednisone (for when I feel I need it), Singulair, Albuterol and all of my other non-asthma related meds (not sure why on those except he said it was easier to do them all at once). I'm to monitor my symptoms and treat myself with the higher dosages when things get worse. He left it up to me to decide when to go back.
One of the comments he made that really put things in perspective during the appointment was that he has a current patient in the hospital on oxygen who has my exact symptoms. He said that by following my plan as I have this year, it prevented me from hitting that point.
I did ask him about the appointments. It sounds like there is a serious lack of qualified Pulmonologists in our area so they constantly have long waits. They would get me in during an emergency though. He does want me having regular follow-ups with my PCP and he was going to send a copy of my plan and records over to them so they can help support me too.