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Monday, January 18, 2010

How to know if you have a good asthma doctor

Many times we tend to trust our doctors, being confident they are doing what is best. However, when it comes to being a gallant asthmatic, it's important that you not only keep up on your asthma wisdom, but you make sure your doctor does too.

The following is my latest post from where I describe how to know if you have a good asthma doctor.

24 Signs of a Great Asthma Doctor
by Rick Frea Wednesday, November 11, 2009 from

For those of you new to this asthma disease -- and even some of us longtimer asthmatics -- it's good to have an idea of what to expect from your asthma doctor.

Yes, it is true that most asthma doctors are
gallant asthma doctors. Still, it is your job as a Gallant Asthmatic to make sure you have a top notch asthma doctor who's going to do the best job of managing your asthma.

So, with that in mind, and based on my personal and professional experience with asthma doctors, I've come up with a test for you to determine if your doctor is a gallant one.

Essentially, there are 24 signs your doctor is asthma wise:

  • She does more than just sit in her chair and ask you questions. She actually assesses you.
  • He takes out his stethescope and listens to your lungs.
  • She orders a pulmonary function test (PFT) at some point. This is the only definitive way to diagnose asthma.
  • During your initial visit, he orders lab tests and possibly even a chest x-ray. He also orders tests to rule out other diseases, such as if you're a kid, a sweat test to rule our cystic fibrosis. Or if you're an adult an EKG to rule out cardiac asthma.
  • During your initial visit, She asks you questions like, "Does asthma run in your family?" This questioning is important for diagnosing asthma because asthma is believed to be genetic.
  • She discusses with you the importance of having a quick-relief inhaler like Albuterol with you at all times and encourages the use of a spacer with your rescue inhaler. (The medicine is proven to work 175% better with a spacer, while exibiting fewer side effects).
  • She teaches you proper use of all your asthma inhalers and has you demonstrate the techniques to make sure you got them right. She will answer any questions you might have.
  • He explains that you should only use your rescue inhaler for relief of acute asthma symptoms, or as premedication before exercise.
  • She explains that the ultimate goal for you is not to have asthma symptoms more often than twice in a two week period. If you have to use your quick-relief inhaler more often than she prescribes, then you need to call her because your asthma is likely not controlled.
  • She works with you on creating an Asthma Action Plan.
  • He gives you a peak flow meter and shows you how to use it in accordance with your Asthma Action Plan.
  • She answers your questions about asthma: what is it? what causes it? what are YOUR asthma triggers? What are YOUR early and late signs of asthma? Or at least shows you how to learn more about asthma, like telling you about sites like ours.
  • He makes sure you know that asthma has two components: chronic inflammation that is controlled with controller meds, and episodic airway narrowing that is reversible with rescue medicines.
  • She makes sure you know the difference between quick-relief meds like Albuterol and controller meds like Singulair, Advair and Symbicort. If she determines your asthma is not well controlled, she prescribes for you an asthma controller medicine (or two).
  • He makes sure you understand the importance of taking your asthma controller meds exactly as he prescribes.
  • She makes sure you understand you must continue taking your controller meds no matter how good you feel, and not to stop taking them without calling her first.
  • If he prescribes corticosteroids (the most common asthma controller medicine), he makes sure you understand the importance of rinsing after each time you use it to prevent systemic side effects, and to prevent oral thrush.
  • For any new medicine she orders she explains why she's ordering it and goes over possible side effects.
  • He makes sure you know to call him if you experience any side effects to your medicines.
  • She tells you that you can live a normal active life with asthma if you follow the Asthma Action Plan she worked out with you, and come to see her twice a year, as per the new asthma recommendations. You should at the very least see her once a year.
  • If you have allergies (which 70% of asthmatics do), and once your asthma is controlled, he refers you to an allergy specialist who can perform appropriate allergy tests so you can learn what to avoid. He may also recommend some medicines (like Singulair, Accolate, Claritin or Zyrtec) or allergy shots.
  • If your asthma is still not controlledl, she refers you to a pulmonologist or other appropriate physician who can help you.
  • He is open minded about answering your questions and considering any suggestions about new asthma meds and wisdom you might have as you learn more about your asthma and asthma in general.

Overall, within a relatively short period of time she should have your asthma well controlled, and have you on your way to becoming a gallant asthmatic (if you're not one already).
Of course no doctor is perfect, which is why it's especially important to stay up to date on your asthma wisdom (which you're doing by hanging out here) so you can challenge your doctor from time to time. After all, it's your life and your asthma.

So, how does your doctor fare? Mine got a perfect grade.


CajunGal said...

I am on the highest dose of Advair and my pulmonologist diagnosed me as a mild asthmatic. I have symptoms almost daily and lately am finding them harder and harder to deal with.

I went to him and explained that and he said it was because of my weight and that there was nothing else he could put me on. I gained 20 poinds with 2 rounds of systemic steroids so he didn't want to put me on them long-term.

I can't exercise if my asthma doesn't respond well to Albuterol; therefore, the weight gain was inevitable. Now I'm caught in a vicious cycle of symptoms and weight gain.

How can I impress on my doctor that I want to do a trial of steroids to see how my asthma responds?

Sorry this comment is so long but I don't know who else to get some insight from.

Rick Frea said...

I understand your battle. Sometimes it can be very hard to get a doctor, who doesn't have asthma, to understand it. It may be necessary for you to find a new doctor. Or, perhaps you should call this doctor on it, and ask him to refer you to an asthma specialist. Just one idea.