I was quite distraught to have forgotten to review a patient on Tuesday. The doctor whom I saw this patient last was away sick, and I presumed she had cancelled all bookings - despite this patient booking in to see me!
Oh, the horror of being reminded hours after the actual appointment by the ladies in reception who were utterly confused about what was supposed to happen.
Although it was just a routine follow up for a patient whom I was involved in starting on some empirical bronchodilators for her adult onset asthma. She had presented with symptoms of progressive breathlessness over time, with a background of allergic rhinitis especially with farm pollen. At one stage she thought it may have been a side-effect of omeprazole that she was taking for an hiatus hernia. According to the P.I., bronchospasm is an uncommon side-effect, but she has ceased taking it and was on some "internet wonder alternative" known as apple cider vinegar. I knew very little about it, but apparently she felt healthier as a result. I wondered if there were any interactions or whether this was a particular provocative factor for her breathlessness, which did not appear so. Anyways, we decided to start her on some Symbicort utilizing SMART therapy which uses the monotherapy as both preventer and reliever due to the short/long acting of the active beta-agonist.
Nevertheless, she ended up seeing the duty doctor who was unaware of SMART therapy and wrote her some scripts for ventolin as a reliever anyways. But perhaps she did know but was unsure how SMART therapy would have worked for when a patients asthma is exacerbated. I don't recall reading much about any transitional therapies between SMART regimens and conventional regimens. Of course, the reason why it's mostly prescribed is for its convenience and thus better compliance.
It would be interesting to find out what happens with her soon, if I remember to see her!!!
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