Asthma Diagnosis - How?

Gingham_R

I've been awake for a couple of hours because my asthma has had me coughing much of the night.

I have type 2 brittle asthma. Cheap diagnosis? I wouldn't like to think how much my asthma has cost the NHS. Or me.

Laughing can set me off. Before I went on symbicort (a not cheap drug) I remember starting to laugh while sitting at the dinner table then realising there was very little happening when I was trying to breathe in. Fortunately, my inhaler and spacer were sitting right next to me because I couldn't walk to get it. Eventually, it passed enough for me to recover with oral steroids and no trip to A&E.

It meant that I was bed bound during my pregnancies and it meant that I have been advised to have no more children.

My cousin died at 7 months pregnant, and was buried on her 30th birthday because of an asthma attack. A little boy I used to teach ended up having to leave school and be taught at hospital because of his asthma.

I was labelled as lazy for years by PE teachers and my parents and various other people because I couldn't keep up. On the days when I couldn't get off the sofa, I was told I was 'depressed' (I wasn't). Then it got bad and I found I could barely walk and it was diagnosed. I was terrified by the diagnosis to tell you the truth because I know exactly how it could end up.

Gingham_R

Gingernutty wrote: »

COPD AND Asthma can occur in the same patient. I know this - as a clinical coder, I've coded J44.8 many times.

Good, interesting post, Gingernutty, but are we meant to know what this means?

Is this going to be my number when I cark it?

Gingernutty

Gingham_R wrote: »

Good, interesting post, Gingernutty, but are we meant to know what this means?

Is this going to be my number when I cark it?

Nope. It's a diagnosis code:-

Acute Bronchitis J20.-,
Bronchitis (not specified as chronic or acute) J40.-,
Simple and Mucopurulent Bronchitis J41.-,
Chronic Bronchitis J42.-
Emphysema J43.-,
Other and Unspecified COPD J44.-
Asthma J45.-,

and if you arrive in hospital in the throes of an asthma attack

Status Asthmaticus J46.-

They're codes for statistical and accounting purposes.

atrixblue.-MFR-.

people here donst know what reversable means here, asthma isnt reversable it is a progressive illness, how do i know, over the years ive gone from mild, moderate,severe,brittle,brittle type 2 next in line would be COPD for me if one preventer doesnt work for me Qvar.

spirometry tests, peakflow monitoring, asthma consultants,lung function test, allergy tests, are just the begining of a diagnosis, CF can also be confused with asthma not just COPD, all have different treatments, the wrong treatment can be fatal in these area's also the wrong treatment can mean the difference between managing everyday life, or just scrimping by on oxygen in later life people who smoke, live in cities can also develop asthma when they have been fit and healthy in early life as supposed to living in more cleaner area's but its not just limited to cities and smoking anyone can develop lung problems.

I suffer everyday with my brittle asthma:

.excersize is not on the cards for me, ive struggled all my life with activities such as PE in school, school seen my diagnosis as a get out of PE card when i handed in notes when PE was football rugby cricket or athletics, i was the first person always to go out in a BLEEP TEST when i was forced to take part because my teacher would tell me i'd be in trouble and detantion on the cards if i brought another excuse note as he called them.

.allergies, i'm not allergic to cats, i'm severely allergic to dogs, so much so ive been hospitalised when i satyed over at my OH sisters house with the germanshepard when they had her, i always had to take my nebulizer and extra nebules when visiting because the ventolin didnt work around dogs. i'm allergic to grass pollen so i cant even cut my own grass. doctors will allways tell you animals will affect your chest and to rid the house of pets, but i insisted on a allergy test wich proved them wrong after telling me my cats were my problem.

.sexual relationships, hell if you cant catch your breath how you going to perform? something allways sticks in your mind when suffering with asthma if i have kids will asthma be appart of their lives too? will they have the same problems as me? luckily my kids suffer with asthma only when they have a cold.

.Work, i started work in factories, often being sacked for time off due to asthma, got so bad prospective employers saw me as unemployable in the factory sector.
i worked in motor factors delivering car parts, stocking shelfs,and manning the phones, i struggled in all aspects, stocking the shelfs was hard labour there, no pallet truck so everything like batteries, oil drums were all man handled all had to be done and put away this often rendered me breathless, if you breathless how can you speak on the phones, if your dizzy from pumping the ventolin too much how are you supposed to drive to deliver? also anyone who cuaght a cold i got it straight away, but worse as my immunity to infection is next to nothing. i was sacked from this job. i then got a job with a water authority contractor as a leakage technitian, i was out in all weathers digging out fire hydrants if they were buried out in all weathers, needless to say 2 years into the job i caught phnewmomia scarred my broncal trees in my left lung (that already has airway scarring from infections) resulting in me officially being relived from my contract and consultant ending my working life, i tought myself mechanics when i was 23 i enjoyed it up untill my inhalers started to fail to work for me, now i just diagnose, and instruct and teach friends and family ill do the very odd work on my own car when i have to, and then a simple thing like changing the brake pads take me a day or two rather than a hour because i can only do so much at any given time, i have to wait for good weather conditions in order to do it and make sure i have my meds at hand at all times.

.hot and cold! for me just being in the cold air sets my chest off, so when i walk into a warm or verry warm house from the cold i prepare myself for an attack summer months are not too bad but if the weather gets too hot i strugle to catch my breath.

.hospital, its my second home!! ICU 3 times cardiac arrest 3 times, HDU 4 times, resus too many times i lost count and endless amount of addmissions, i can be fine one minuate and on the floor turning blue the next gasping for dear life the next, my usual stay is about 3 days to 6 days depending on how i respong to iv steriods and antibiotics, nebulizers. i can tell when an ambulance or doctor nurse etc has missed my vein to put a line in, i know what course of treatment they will take, i know what ward i will be on and who's sister on that ward.

is asthma cheap hell no a nebulizer could cost £500, if you live in england prescription charges for you inhalers then theres antibiotices. you have the flue jab every year wich deadens your armf for a week or so, then pnewmoniajabs to boot, then you have fuel costs for regular check ups with asthma clinic at you surgery and then with you consultant ever 4-12 weeks not to mention if your breathless like i am i have to travel everywhere by car (have a genuin phobia of public transport) so thats extra miles wear and tear i have to pay for in a vehicle, plus if you chose to use public transport it wouldnt be much cheaper either, some asthmatics food types can trigger attacks, i was dairy intollerant untill my lungs fully developed in my teens, so you have to read every label of ever product for any dairy produce thats used, special milks like soya milk for a basic coffee, you have to memorise every products labels to remeber not to have it, i can remember my mum treating me to a fish and chip dinner for being good at the asthma clinic, 5 mins after the first mouthfull mum was calling 999 and being rushed blues and 2's into resus, batter had cows milk in it wich sent me in.

for asthmatics like me it dominates your life, so no suprise you can lose your mental health along the way, i suffer with agraphobia and severe depression to go along with my illness.

so to call asthma reversable, non progressive i would most certainly invite you to see my 5 thick files of med notes and past treatments and tests, my docs have done everything possible for me over the years and still it cant be managed accurately as the treatment works for so long then it slides back down hill and were back to square 1.

people are ignorant towards asthmatics, unless they have witnessed its damage and suffereing it can cause to a family and not just the sufferer. and doctors and proffesionals alike can be ignorant to the condition also.

Blackpool_Saver

In my opinion, asthma is when you don't have coloured phlegm ie infection, of course it is worsened when you do. In my opinion it is all the time, and has triggers, dust/cold/damp/mould etc, if it's bad it has to be dampened down/controlled by steroid inhalers which can mean less airway opener is needed in an accute attack. I am an asthmatic, I take singular(Montelukast) a steroid inhaler and an anti allergy med, as mine is often triggered by allergy response. Sigulair has changed my life, if you are still struggling with a steroid inhaler ask your dr about it.

Oldernotwiser

Person_one wrote: »

I've never met anyone with COPD who was capable of much exercise, walking always seemed like an ordeal, but I'll admit I'm no expert.

Asthma isn't reversible, asthma attacks can be treated and there isn't usually permanent damage, but if you are an asthmatic you always are, even when you aren't having symptoms.

I thought asthma didn't come under COPD as its not of the 'obstructive' variety, its most certainly classed as chronic.

My husband has very severe COPD (less than 20% lung function) and he exercises, with breaks, for nearly an hour every day, which is absolutely vital. One of the most helpful treatments he's been prescribed was a course of pulmonary rehabilitation which educates patients about lifestyle changes and the importance of exercise.

http://www.patient.co.uk/doctor/Pulmonary-Rehabilitation.htm


Regarding reversibility, to quote from


http://www.netdoctor.co.uk/diseases/facts/smokerslung.htm

"The difference between COPD and asthma is that the airway obstruction in asthma is reversible with treatment such as bronchodilator drugs, whereas in COPD it is largely irreversible."

Blackpool_Saver

Oldernotwiser wrote: »

"The difference between COPD and asthma is that the airway obstruction in asthma is reversible with treatment such as bronchodilator drugs, whereas in COPD it is largely irreversible."

Yes, and another reason not to smoke

mountainofdebt

Didn't see the OP when it was first posted and so have missed the bits that seem the relevant to the argument.

However - and this depends on the age of the sister obviously - it may be that a diagnosis of asthma could be the end of a career choice, especially if the sister wanted to join any of the Armed Forces for example. You only have to have a quick look on some of the other armed forces board to find posts where the candidate has a condition (not only asthma) which is stopping them from joining up and they are desperately trying to get a diagnosis altered.

mrs_marty

My DD (8) has very very mild asthma in summer come winter it is extreme and is also trigged by allergy my nephew is the same. I had asthma as child but thankfully grew away from it. Sadly my friends big sister didnt and died aged 19 from asthma. Asthma is a silent misunderstood condition and one thankfully doctors take very seriously.

atrixblue.-MFR-.

Blackpool_Saver wrote: »

In my opinion, asthma is when you don't have coloured phlegm ie infection, of course it is worsened when you do. In my opinion it is all the time, and has triggers, dust/cold/damp/mould etc, if it's bad it has to be dampened down/controlled by steroid inhalers which can mean less airway opener is needed in an accute attack. I am an asthmatic, I take singular(Montelukast) a steroid inhaler and an anti allergy med, as mine is often triggered by allergy response. Sigulair has changed my life, if you are still struggling with a steroid inhaler ask your dr about it.

singulair didnt work for me. had a 6 month trial on it with no response peak flows the same with or without it.

i'm living proof asthma is not reversable. excersize comes in many forms when excersize is mentioned people think of the gym and running and weight lifting you do excersive everyday walking etc.

you can take quotes from many sites but most of that garbage is outdated. the earlier the treatment the more possability you have of being sympotom free, the later in life you go on the less likely you be symptom free many consultants considder if you "havent grown" out of astma by the time your 21 then your not going to and thats from my own consultant. many of those who have suffered in the past will have a return of in some degree in later older life.