I had a wee meeting to finalise my anticipatory care plan for when I need to go into hospital. It was really good which is hopefully going to change quite a lot.
I was nervous as this consultant is new and I have not known him long but I didnt need to worry. He was so helpful. The main thing that came out of it for me was that my protocol for at home has changed. I used to have a 3 neb policy then call 999 and have the fourth while waiting on the ambulance. This has always worked but recently I have found that if I go to get help early the hospital don’t take it very seriously and I end up getting a lot worse because of the delay in treatment. However now I don’t have a limit on the number of nebs I can have at home. My consultant has said he trusts me to use my own judgment and get help when I need it. Some attacks I just need about 8 or 9 nebs and I get over it but I know pretty quickly which ones won’t respond with nebs alone. I have been told if I exploit this then I will be back to the 3 nebs at home!! I think this will help a huge amount though.
There is a lot of differing opinions about nebulisers at home. For me they are a life saver but I know a lot of people who would abuse them and also don’t really need them but want one. I have had one because of my need for regular nebs. If I was not on regular nebs then I would prob not have one at home. I know a lot of people get cross when they are denied a nebuliser because the Drs say they don’t need it and just need to use a MDI and a spacer. I think there is a bit of a psychological stigma associated with a nebuliser and many think they will get much better if they have a neb but its not always the case. It is a huge area for debate.
The other great thing that this care plan includes is criteria for ABG’s. My arteries are totally shot and so scarred. So now my con has said that I do not need them unless I have a silent chest, drop sats and getting totally exhausted and need to go to HDU. When I attend A and E generally they do a gas as soon as I get there but they are so traumatic now sometimes I just can deal with it. I am not sure if Drs will follow this but hopefully they will and my hospital admissions will go a lot smoother.
Im not planning on testing this out soon though.