Monday afternoon is asthma clinic. All is going well. Everyone can remember what inhalers they use. Most can do their peak flow ( a hi tech blowing test) without dissolving in fits of coughing. Many can work their inhalers properly AND seem to be managing to take them regularly and correctly at home. Little things I know. But enough to make me happy
Then in comes old Joe Grundy. He's got bronchiectasis as well as asthma. This means he gets chest infections at the drop of the hat and coughs up great buckets of phlegm even when he hasn't actually got an infection. (Welcome to the wild and whacky world of the chest physician folks). So first we get an in depth description of his secretions. (Glad I didn't go with the guacamole at lunchtime now).
Next we get to review his asthma (not too bad despite the cigarettes- "that purple ihnaler really helps, I don't cough up half so much after a fag now doc"), and his inhaler technique, which remains idiosyncratic, but plainly works for him....
He agrees to try to cut down the ciggies and I agree to renew his repeat prescription. We mutually agree to do the whole thing over again in six months. Then he puts the boot in.
"Ere Doc, you know them stomach pills you gave me last week?"
I do. They're called PPIs . Very good for ulcers, acid reflux and the like.
"They worked a treat. I can eat bacon and eggs and curries and such no problem now. Thanks a lot!"
Mens sana in corpore sano, eh.