An A&E doctor treats 30 common conditions several times per week. One is the mild asthma attack - which is hardly surprising since asthma affects about seven per cent of adults in the UK.
The patient arrives, struggling to breathe because their chest feels tight. Some allergen has irritated their lungs, and caused the millions of small tubes to contract and secrete mucous. Listening with a stethoscope, you can hear a distinctive high-pitched whistle as air is forced through them.
For a doctor, this is a mixed experience: mildly boring because it is seen so often, but satisfying because the patient usually recovers quickly. The patient must spend a few minutes inhaling vaporised drugs mixed with oxygen. These open up the tubes, and breathing soon becomes much easier. The patient can then go home.
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The most interesting aspect is trying to educate the patients. I am constantly surprised by how many of them are confused about which of their 'puffers' they should use at home. Generally, the brown one is to prevent attacks and must be taken regularly, and the blue one is to treat attacks when they occur; but few patients seem to adhere to this. Presumably those who do don't end up in A&E. Other patients suck from their puffers before, but not after, pressing the button to release the drug, and so it is wasted.
Even more frustrating are those who are healthy but, through some twisted logic, join the queue in A&E to get a new inhaler, because they are "too busy to go to a chemist". And then there are those who smoke even though it exacerbates their asthma and necessitates treatment with steroids - which will ultimately make their bones brittle. 
FIRST POSTED JANUARY 24, 2007
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