My story - Asthma tests (coming in for the difficult asthma protocol)

By Emma Bearfoot

The difficult asthma protocol is a chance for you to have your breathing difficulties looked at in great detail.

The team at Royal Brompton will admit you on a Tuesday for four days and turn you inside out to see what is going on. On the Friday they will give you the results of all the tests and let you know whether you do indeed have asthma or if it is something else.

When I had my difficult asthma protocol, I was transferred from my local hospital. I had received a letter a few weeks earlier letting me know when they were hoping to admit me.  On the day you will receive a phone call from the bed manager confirming that you are to be admitted and which ward you will be on. 

What to bring in with you  

You will need to bring all your medication in with you; you don’t need to bring your own nebuliser as they will provide you with one.  The hospital, as all hospitals, is quite warm so light nightclothes are something that I would recommend.  I would also recommend light casual clothes to wear during the day.

There is a small shop located in the main entrance, I wouldn’t bring a huge amount of money in, but what you do bring in should be in smallish change as the shop is not really able to cope with large notes, ie £10s or £20s.

Once you arrive on the ward, the nurses will show you to your bed and then go through the various admission forms that are required.  This does take a little bit of time.  You will also be swabbed for MRSA; this is routinely done on any admission at the Brompton so there is nothing to be worried about.  The nurses are always around and happy to answer any questions that you might have.

You will also see a doctor that afternoon/evening who will have a quick chat with you and write up your drug chart.  They will also go through the kind of tests that you will be having during the week. 

The tests

Blood tests - there are a huge amount of these to be done as they check for all kinds of things like allergies.

X-rays and ECG - these again are just routine and are nothing to worry about.

Lung function - this is one of the tests that most people dread and hate.  Blowing into lots of tubes especially as you are asked not to take your preventer and reliever medications (the nurses will let you know when you can take your last doses before the tests).  They will also do a ‘capillary blood gas test on you.  The sample is taken from your ear lobe and is a lot less painful than having it done from your artery in your wrist.

CT scan – this is done to give the doctors a more detailed picture of what shape your lungs are in.

Allergy tests – these are done in the form of prick tests, which do not hurt and are quick.  The longest bit is waiting for the allergies to show on your skin and obviously not being able to itch!!

PH test – this is to see whether you have acid reflux, they insert a nasal gastric tube down your nose and that is attached to a little monitor which you can carry around easily.  You have to keep a note of certain things like if you lie down, sit up, eat etc. 

The people you will see

As I have said you will generally see the senior house officer (SHO) on the day that you arrive who will write up your drug chart and generally make sure that you have everything that you need.

You will also meet the registrar either that day or the next day.  The SHO will take a detailed history from you at some point during the week, this really can take some time as they go into great detail over it.

You will also meet the asthma nurse specialists who will look at your history and generally have a chat with you about your breathing difficulties.

Ear, nose and throat (ENT) is another department that you will have a chance to visit - they will look at your nose and throat to see if there are any problems there. Many of us do suffer with problems and they are sometimes overlooked when dealing with breathing difficulties. 

You may also see a psychiatrist. No, the team is not trying to say that you are mad! But it is a good chance to see whether there are any background emotional triggers for your breathing difficulties.

So that, in a nutshell, is pretty much what the difficult asthma protocol involves, as I said Friday is ‘D Day’ in regard to the diagnosis. This is when you will meet the consultant and they will let you know what all the tests have shown and ultimately what they consider is going on. It may be that you will need some further tests, which will mean a future admission.