Another A+ for Dr. Smartypants: An Awesome Asthma Clinic Visit

I had my biannual asthma clinic appointment yesterday. They are always pretty good, and I have been reflecting a lot lately on how excellent my entire care team is right now, but yesterday’s respiratory visit was just another level of awesome.

I have been slowly gathering notes and questions in my phone since my inappropriate sinus tachycardia (IST) diagnosis in early February. I am always worried about not having enough time, but I went in organized and determined, and it was probably a combination of factors but it definitely made a difference!

Pro-tip: Printed notes!

When I began seeing my new family doctor, I brought him a written summary of my health history and medications that he loved, which I have been doing for ER/urgent care visits since 2013. I have since continued with "since we last met..." notes, and brought this habit over to my specialist visits as well. It allows me to keep my ADHD brain organized but also gives me a place to collect my questions and notes about symptoms as they pop up between appointments.

The bonus of this is you can also print a second copy to hand right to your doctor, or you just look organized. Reading the questions off my phone does not seem to have the same effect!

I went in yesterday with a brief summary of what has been going on lately, my current medicine, a few notes on my general health, and my questions with writing space underneath and it was, at least for this appointment, a game-changer. Which is pretty remarkable since I have been seeing Dr. Smartypants since about 2012!

Smooth sailing at this asthma clinic visit

I flew through COVID screening and wound my way into the back door of the respiratory clinic. I forgot my health card, so I was awkwardly calling numbers at the receptionist (who can be a bit gruff but she seemed okay yesterday, too). I did not even get to sit down and she took me into a clinic room, despite that I was checking in for a 2:00 appointment at 1:45!

Within a few minutes of being seated in front of the inhaler chart, Dr. Smartypants came in. We did the usual where she asked about my general symptoms, asthma control, and overall health. We talked about my IST and treatment options since she agreed I should avoid beta-blockers, and she suggested trying to taper off some of my inhaled steroids (Qvar) a month at a time, as some of my tachycardia might be the systemic effect of what she called a “hefty” dose of inhaled steroids that I’m on -which I thought was fascinating - but that other heart rate meds like calcium channel blockers might be an option if I choose. She wrote a prescription (on an actual prescription pad!) for an air purifier/filters so I can claim them on my taxes, we discussed the wait time for allergy testing (in case my new sub-specialist gynecologist wants to investigate this), and we discussed COVID treatment eligibility and if she’s heard anything about it expanding. I sensed her immense frustration that asthmatics do not currently qualify for treatment if we have been vaccinated in Manitoba (I prefaced my question with "Now I'm not planning on going out and getting COVID..."), but she did note that a couple of her severe asthmatics did get COVID, and she was super worried because they had had past intubations (which I thankfully have not) and they were totally fine. I know this is what the literature says but it was still reassuring to hear from her! And finally, we discussed some cool new tech they are hoping to get in the clinic, which may help inform some more of Dia's questions about my phenotype—exhaled nitric oxide testing, and oscillometry may not be new everywhere but they are certainly new to our province! Finally, I got her to refill my Zenhale (because Dr. Awesomesauce gave me a zillion refills of everything), and that was that!

After all that, I left the clinic at 2:08! It was a great visit and I left feeling super informed—it was absolutely one of the best clinic visits I've had!

Building a good clinic visit

Maybe it was just a coincidence, but I have found lately that probably over-preparing for my appointments has led to them being really good. Heck, my visit with my gynecologist (which later resulted in him referring me to another sub-specialist mentioned above when the ointment he prescribed did not help), I super prepared for, but then my family doctor’s referral notes were so good I did not need to consult my notes! Even in my cardiology phone appointment where he was super rushed, the notes helped me stand my ground and keep saying "hold on, I have a couple more questions"— that appointment still only took 5 minutes, but the notes ensured I got everything answered efficiently!

Of course, the fact that this time the respiratory clinic seemed quiet and was running ahead of schedule likely helped, too—but when you only are scheduled every 6 months like I am, it is helpful to be organized and informed. I’ve found I get the most information when I ask questions in a way that tries to confirm what I already believe I know--while conveying I'm totally open to correction!

And of course, the all-star care team I have right now helps a lot in this equation, too.

What do you find helps you have the best visit with your asthma care provider?