الربو: شاب يعتمد على بخاخ الإسعاف وحده

Nurse: Hello Mr Castillo, I'm the practice nurse. The GP would like me to review your asthma before your prescription is written. Is that all right with you?

Patient: Yes, that's fine. I only came for my reliever, but I can answer questions.

Nurse: To start, how has your asthma been lately, and how is your breathing today?

Patient: It's been pretty okay, I think. My breathing feels fine today.

Nurse: In a usual week, how often do you need your reliever inhaler?

Patient: Not too often. I just use it when I need it and otherwise I forget about it.

Nurse: Does asthma ever wake you at night, or hold you back when you exercise?

Patient: Not really. It doesn't hold me back much, so I don't think about it a lot.

Nurse: I can see a morning-and-night preventer was prescribed last year. What has happened with that one?

Patient: I stopped getting it. I feel fine, so I didn't see the point of taking it every day.

Nurse: Could you show me how you take your reliever, step by step?

Patient: I press it and breathe in, like this. Honestly, I don't see why I need more than that.

Nurse: It makes sense to question taking something every day when you feel fine. What worries you most about the preventer?

Patient: I just don't like taking something every day when I feel fine. Isn't that a lot of medicine?

Nurse: Thank you for being open with me. The GP recommends it, and I'd like to understand your concerns so we can find a routine that fits your life.

Patient: I guess so. I'm busy with uni and I forget things. I don't really want to depend on it.

Nurse: Your reliever works quickly to open tight airways, but only for a short time. Your preventer, taken morning and night, calms the airways so they flare up less. How would you describe the difference?

Patient: So the reliever is quick relief, and the preventer calms things down over time so it flares up less? Is that it?

Nurse: Using only the reliever treats symptoms, not the cause, and can leave you at risk of a serious attack. With your reliever, use the spacer, one puff at a time, breathe in slowly, then hold your breath.

Patient: Okay, I didn't realise I was at risk of a serious attack. I'll use the spacer and take it slowly like you said.

Nurse: So you'll restart your preventer morning and night, use your reliever with the spacer, and see the GP today before you leave, then arrange a treatment review and a written asthma action plan.

Patient: Okay, I can try that. Seeing the GP today before I leave is fine. I'll give the preventer a go.

Nurse: Call 000 if you are struggling to breathe, can't speak a full sentence, your lips look blue, or your reliever isn't helping. If you're unsure, call anyway. What questions do you have?

Patient: Okay, I'll remember that. I think I understand now. No questions at the moment, thanks.