Why Didn't I Say Something?

By Andrea M. Jensen CHES AE-C

3 min read

Has anyone else ever had a tough time with a different doctor? I hope you have a great doctor who knows your medical history and the treatment plan that's right for you!

Sometimes you need to go to urgent care

But sometimes, it's after hours and you can't reach your doctor – or maybe they are out of town. So, you drive to urgent care.

That's where I found myself last week with my middle son.

My middle son has severe asthma and was in the hospital a lot when he was younger. His asthma was so bad that he was on the first biologic for asthma. He had monthly injections for 7 years. That biologic helped keep him out of the hospital.

So when my middle son was sick, he asked me for help. He was worried it was going to be another battle with pneumonia. Since I have been managing my kids' asthma for the last 19 years, I have become an expert on them. I know their asthma triggers, what daily inhalers work best for each of them, how they act and sound when they have a flare-up, and what treatment works best for each of them during their flare-up.

We talked to the urgent care doc and gave him a little medical background about my son's severe asthma (because if we are at urgent care, it's because I want to prevent hospitalization). I told the doctor that my son gets really sick, really fast.

Not everyone with asthma wheezes

The urgent care doc listened to my son's lungs and said, "Well, I don't hear any wheezing..." For all of you with asthma that don't wheeze, you probably want to do a face-palm with me, right? I said, "He doesn't wheeze." The urgent care doc looked at me and sharply said, "What?" (Like how dare you have an opinion on this, I'm the doctor.) I said, "My son doesn't wheeze, he has cough-variant asthma. Usually, when he's sick, he will have a lack of air movement in his lower lobes." The urgent care doc looked at me like I was completely annoying him.

Asserting yourself with an emergency doctor

Yes, he is a doctor – but I am an asthma educator by profession and have spent 19 years with asthma. The urgent care doc said he didn't see very many patients with asthma. So, I knew he wasn't that familiar with different types of asthma. I finally had to say something. I said, "Look, I know what I'm talking about – I'm a Certified Asthma Educator and I have managed my 3 kid's asthma for 19 years. I am an asthma educator by profession."

"Hmph." Was all he said as he turned back to his computer. He then told my son to use his rescue inhaler to help him breathe deeply to expand his lungs so he wouldn't get pneumonia. My son and I exchanged glances, and I could tell my son was thinking, "Obviously this doctor doesn't have asthma – or he would know that you cannot breathe in deep enough to use your inhaler when you are sick! I'm going to have to use the nebulizer instead."

At that point, I just wanted to get my son's prescriptions for an antibiotic and oral steroid and head to the pharmacy. I knew it was no use trying to talk to the urgent care doctor.

Advocating for the best asthma treatment when seeing a new doctor

For the record – I am not a doctor. And I know that the urgent care doc is a trained professional. He treats people with asthma, diabetes, seizures, car accidents, etc. He has probably spent the night giving stitches to a child, helping someone that fell and broke their ankle on the ice, or prescribing antibiotics for a baby with an ear infection.

However, I am an asthma educator, and I know my son's asthma and what he needs. Even though I am not a doctor, I do not need to be treated like I do not know anything about asthma. Even after I tell them that I am an asthma educator.

Has anyone else had a tough time with a different doctor? And feel like you have to let the doctor know that you actually do know how to manage your asthma, but you probably just need antibiotics and steroids to get through this flare-up? Do you say anything?

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shellzoo Member
We can advocate all we can but, if it falls upon deaf ears, it goes nowhere. My guess is that urgent care centers see so many people that exaggerate their symptoms to get antibiotics and such that they don’t always take time to really listen to what you are trying to communicate. 
1. Andrea M. Jensen CHES AE-C Contributor
 Yes, I'm sure they are tired at the end of the day. But - when he told me he usually sees 2 patients with asthma, I felt confident I was a little more knowledgeable about what my son needed (especially with my training and certification.) At that point, I just wanted to get the prescriptions and leave! 🙁
sarahlee23 Member
I have this issue all the time, even with my current primary care provider. To the point where I just try to get through until I can call my pulmonologist now. Especially since now that I've been diagnosed with an immune deficiency, I can't even get prednisone from anyone other than my pulmonologist or the doctor who manages my immune deficiency.
1. Andrea M. Jensen CHES AE-C Contributor
 That's frustrating! It's so nice to have a good doctor, but if they are out of town or it's after hours, it's hard to get the help we need. WE know what we need, and our doctor knows us well. But sometimes at Urgent Care, you are just another patient to a tired doctor. I know they do the best they can, but most of us with lung problems know what we need and when!
bbdgh Member
I recently had the worse sinus headache ever. I have Chronic Sinusitis and with all I do to manage it I rarely get Sinus Headaches. With a sinus infection it quickly jumps to an asthma flare-up and a bacterial infection if it started out viral. Antibiotics always work, and I need at least a 14 day course. My asthma MD to far out, my nasal MD no appt for 3 days, so I went to my primary, who was out so I got someone new. She seemed to listen, then said it was probably viral, if not better by end of next week call or come in. I couldn't change her mind. This was a Fri, a terrible week-end, asthma getting worse and worse. Able to see sinus MD and got in the antibiotic. With in a week I was better, but my asthma took a month to return to baseline. Fortunately following my plan I was able to keep it non emergent. It's hard to advocate for yourself when you are feeling sick. I think I need to give primary MD a clear statement about my sinus and asthma issues and what should be done to prevent unnecessary exacerbations.
1. Andrea M. Jensen CHES AE-C Contributor
 That's so frustrating. We know our bodies so well, but the doctors feel like they know what's best for us. But you know your usual treatment program - and if it's not followed, you end up with a long asthma flare up! Good thinking to meet with your doctor and set a plan in place!

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