Finding out what is causing continuous exacerbations ?
I have had three exacerbations over the last three months. I am getting conflicting information from my doctors. Now my GP is sending me to an
immunologist to possibly get the biologic Dupixent. He thinks because I have taken so many steroids, that it has kicked up fungus in my system and that is what is causing my exacerbations. My Pulmonologist says the fungi that I have is limited and normal.
Part of the problem is accessibility . I have easy contact with my GP through a portal, phone calls to the nurse and the office. My pulmonologist has no portal, no easy access and the only way to contact him is to leave a message for him to call me. When he calls pretty much all he does is read me what he has written from my last visit. I'm frustrated and scared.
I hope you pulmonologist calls soon. A suggestion unless you already do this is to have any questions or concerns written down. When sometimes you have to wait for responses I can forget questions I had & that leads to more frustration!
It sounds feasible to me that all the steroids are causing your infection & infections could very well be causing the exacerbations. Until you get that resolved seems to be a major reason for continual flare ups which causes anxiety and depression. It seems as though your Dr is on the right track.
Please try to be gentle with yourself.
Hate to say been there done that as it sounds callous & there’s no way I want to seem like that. I think most of us go through this & other ordeals when we have anything else happening besides having COPD. All I can say is when your copd gets managed & you get the correct medications for you personally, then & only then can you move on and not be frightened.
If the pulmonologist when you call has any other options like talk to a nurse or whomever manages the office do that. I’ve done it. If I’m a pest oh well. I really don’t care as sometimes I use to wait a week! That’s part of unfortunately being an advocate for yourself. I think the health system has really took a turn for the worse. Perhaps some due to not enough staff but I pay for my health care & have for years & I want and need some satisfaction.forgot to say try to be patient as being calm is so important with copd. I try to always speak nicely & clearly and magic words, excuse me are so helpful if your pulmonologists continues to just read his notes. Sometimes they do this as they are overwhelmed at this time with so many they are trying to familiarize themselves with your case. Just be sure to get in your concerns as well. 
Hi
. has given you some good advice. How is your pulmonologist in person? Do you feel that you are being heard and treated with compassion? If not, would it be worthwhile to find someone new? When is your next in-person appointment?
I understand your concerns about the biologic. The good news is that the immunologist is unlikely to simply take your GP's word for it and write out the prescription. This is yet another doctor on your team, taking a look at your health from a new perspective. That might be a good thing. The immunologist will likely review your history and your tests, do a clinical exam and order more tests, and then review all that before making any determination.
Hopefully, at that point, you will feel confident in the immunologist's recommendation whether that involves the biologic or not. Regardless, I hope you find some relief. Keep us posted, if you don't mind. I will be thinking of you. - Lori (Team Member)
