About 3 weeks ago now a few of my colleagues at work came down with a nasty cold which for most of them lasted around a week. As we all share a small office it quickly spread and I caught it also. I am asthmatic and after just a few days the symptoms quickly spread to my chest causing me to have an audible wheeze, however I am used to this happening and contacted my GP to ask if I could increase my steroid inhalers. I continued to work through it and although I felt rubbish I didn't think it was serious. After a week of wheezing I contacted the GP again by phone as I didn't want to take time off work and asked for a course of prednisolone hoping that would clear it and the GP was happy to give this during the phone consultation as I had given him my observations and although my sats and peak flow were slightly reduced they were not unacceptable.
Then last weekend, I went to my kids swimming class and maybe it was the humidity in the room but all of a sudden I felt awful and could barely catch my breath, I used my rescue inhaler and it helped but I decided that I should probably see the GP the next day as it had now been going on a little too long at almost two weeks. I called and booked off work, fully expecting that I would be seen by the GP and back to work the next day (I have never taken more than two days off in my life before!).
That wasn't to be, the GP saw me and took some observations, at this point my sats were down to 94, my peak flow less than half of my normal and I had a raised heart rate, resp rate and a slight temperature although I had taken paracetamol a few hours before. The gp sounded my chest and couldn't hear anything, told me that my peak flow was still in normal limits, even though I told him more than once that mine is normally a lot higher as I swim a lot and said that my temperature wasn't significant even though it was likely being masked by paracetamol at that stage. He thought that it was an exacerbation of my asthma causing the reduced sats and raised heart rate and he gave me another weeks worth of steroids with instructions to call back for another course if they didn't help by the end of the week. I trusted his judgement and gave the steroids another chance.
Over the course of the week, I felt more and more rubbish and ended up not going back to work as I could barely pull myself up of the couch to get a drink let alone climb stairs to my patients houses. It peaked on Thursday morning when my husband came home from his nighshift as a paramedic and took my temperature, it was sitting at 39 even though I had taken paracetamol about an hour before. I felt really awful but really didnt want to end up in hospital and so I called the GP again and this time saw a lovely young Dr who took all my observations and listened carefully to what I was telling her in regards to my normal levels. My sats were down to 90 after walking to her office but again when she sounded my chest she could hear nothing. She decided that as I was completely against a hospital admission that based on my observations and that she felt that I knew my asthma symptoms better than she could, she was going to give me a week's worth of antibiotics and trust that my husband would monitor and take me to hospital at any sign of deterioration.
I am pleased to say that two days later other than a slight temperature and a small decrease in my peak flow, all of my observations are back to normal and I am feeling 99% better after what has felt like a very long 3 weeks. Had that Dr not listened to me and what my normal levels are as opposed to perceived normal I would probably be in hospital by now and could have had a lot worse outcome.
Observations on Monday
After one day of antibiotics!
So I suppose that the lesson to be learnt is that as a healthcare practitioner it is really really important to listen to your patient...they know themselves and what is normal or abnormal better than you, their physical presentations or any textbook can tell you.
And from a personal perspective...I will definitely be taking more time to self care if I am ill in future! I've had to have a week off work after pushing myself for two weeks of feeling awful at work and had I seen about it quicker then it may have meant that my body had a chance to rest and recover quicker.
Lynsay x
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