If you’ve been referred to see a respiratory consultant, it’s natural to be a bit nervous but there’s really nothing to worry about. In this article we’ll cover some of the things that happen during a respiratory consultation with Dr Shalin Diwanji. Most consultants will follow a very similar process. And please remember, it’s fine to ask questions so if there’s anything you’re concerned about, why not make a note and take it with you to your appointment?
Why you’ve been offered a respiratory consultation
Normally you will see a respiratory consultant because you’ve been experiencing ongoing symptoms, such as a persistent cough, chest problems or breathlessness. The aim of the appointment will be to explore what might be causing your symptoms, to carry out a physical examination and to arrange further diagnostic tests, if necessary.
Here’s what to expect, step-by-step:
Taking your medical history
Once you arrive for your appointment and have let reception know you’re here, you’ll be called in to see the consultant who will take a detailed medical history. You will be asked to talk about your symptoms, including when they first started, how often you have them, what they feel like and anything that makes them worse or better. Your consultant will also want to explore whether you’ve been exposed to any pollutants or allergens, either at work, at home or elsewhere. This will include whether you or a member of your family smoke, as well as any family history or respiratory disease.
A discussion of your symptoms
Dr Diwanji will talk to you about all the respiratory symptoms you’re experiencing, including wheezing, shortness of breath, chest pain and so on. He will ask about the impact of these symptoms on your everyday life – for example, Does shortness of breath make it hard for you to climb stairs? Have you been forced to give up certain activities you used to enjoy like jogging or walking the dog? Certain symptoms, such as a persistent cough lasting more than three weeks, may require further specialist assessment to rule out a potentially sinister cause. This will be treated as a priority.
Physical examination
Following these discussions, Dr Diwanji will carry out a physical examination. This includes checking your vital signs – heart rate, oxygen levels, peak flow reading etc. The consultant will listen to your heart and lungs using a stethoscope which will enable him to detect anything abnormal, such as wheezing, crackling or murmurs.
Possible diagnostic tests
After these initial discussions, the respiratory consultant will identify whether further diagnostic tests are needed. Some of these may be done on the day while others may require longer. The diagnostic tests might include:
- A lung function test: This is a common test that measures how much air you can breathe out and how quickly. It is used to diagnose conditions like COPD and asthma.
- Chest X-rays or CT scans are used to look for abnormalities in the lungs, such as infections, tumours or scarring. In some cases, a CT scan may be used as part of lung cancer screening to detect potential problems at an early stage when they are most treatable.
- A blood test might be used to check for infections, inflammation or other underlying causes.
- If the consultant suspects an allergy may be contributing to your symptoms, you may be given skin tests or blood tests to check for certain common allergens.
- A suspected case of sleep apnoea may be diagnosed with an overnight, at-home sleep study.
Discussion and diagnosis
Once Dr Diwanji has carried out all the necessary tests and assimilated all the information about you and your symptoms, he will explain his findings to you. At this point, he may diagnose a particular respiratory condition and will able to tell you how severe it is and what the implications are for your health. He will then recommend a treatment plan.
Treatment
The treatment you are offered will depend on the condition you have, how severe it is and other factors, such as your general health, age and lifestyle. Common treatments include:
- Medications, such as antibiotics, steroids or inhalers.
- Lifestyle changes, such as a recommendation to quit smoking, avoid certain triggers and allergens or improve your diet and exercise regime.
- Further tests, in which case you will be referred to the relevant clinical specialist.
Following your initial consultation, you may need ongoing monitoring if you are diagnosed with a chronic condition like COPD or asthma. You may be given an action plan to help you manage your symptoms at home along with guidance on when to seek emergency care.
Frequently Asked Questions
Should I bring anything to my initial consultation?
It is a good idea to write down any questions you have in case you forget to ask them during your appointment. Also, it can be helpful to write down details of your symptoms and any medications you’re taking.
I’m embarrassed to tell the respiratory consultant I smoke, should I just keep quiet about it?
It’s really important that you’re honest about your symptoms and lifestyle so the consultant can make an accurate diagnosis and offer you the best possible care. Please don’t hide anything important, like the fact you smoke, as this could hinder your care.
How do I know if I need to see a respiratory consultant?
If you are experiencing symptoms like unexplained breathlessness, a persistent cough or recurrent chest infections, if you have had an abnormal chest X-ray or CT scan or if your GP is concerned about your respiratory health, it is a good idea to seek advice from a respiratory consultant. If there is an underlying cause, the sooner it is diagnosed, the more effective treatment is likely to be.
For advice or to arrange an appointment to discuss a wide range of respiratory symptoms and conditions, contact us. We see patients in locations in and around London.