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07 · Special Contexts

Questions to Ask Pulmonologist

Questions for an appointment with a lung specialist, covering your diagnosis and test numbers, what each medicine is for, inhaler technique, a written plan for flare-ups, and when to seek urgent care.

20 questions · each with a note on why · conversation guide

The questions

Open any question for the note

  1. What is the name of my diagnosis, and how certain are you of it?

    Why ask it

    Ask for the term written down, and whether it is confirmed or provisional. Several lung conditions overlap in symptoms, and a provisional label means the plan may change once further tests are back. Knowing which you have affects how much to read into what you find online.

  2. What did my breathing test show, and what do the numbers mean?

    Why ask it

    Spirometry gives figures for how much air you can move and how fast. Getting them written down gives you a baseline to compare against next year, which is more informative than being told the result was mildly reduced.

  3. As far as you can tell, what is causing this?

    Why ask it

    Sometimes the answer is clear, sometimes it is a combination, and sometimes it is unknown. A clinician saying plainly that the cause is not established is being accurate, and it can still be treated.

  4. Is anything I am around at home or at work making it worse?

    Why ask it

    Dust, fumes, mold, birds, and some hobbies matter in specific conditions, and the specialist may not know your circumstances unless you describe them. Mention your work history explicitly, including jobs from decades ago.

  5. Is this likely to get worse, stay stable, or improve?

    Why ask it

    The three answers lead to different plans, and many lung conditions are stable for long periods with treatment. If the honest answer depends on how you respond over the next months, ask when that will be reassessed.

  6. What is each of my medicines meant to do?

    Why ask it

    Ask which are for daily control and which are for a sudden worsening. Mixing the two up is one of the most common problems in respiratory care, and taking a preventer only when breathless makes it far less effective.

  7. Could you watch me use my inhaler?

    Why ask it

    Technique errors are common and easy to correct, and poor technique means much of the dose never reaches the lungs. Bring every inhaler and spacer you use, since each device works differently.

  8. How will we know whether this treatment is working, and by when?

    Why ask it

    You want a marker and a date: fewer night-time symptoms, a walking distance, a repeat test in three months. Without one, a treatment that is not helping can continue unchanged for a year.

  9. What should I do at home if my breathing gets worse?

    Why ask it

    Ask for it in writing. A written action plan setting out what to increase, what to start, and who to call is standard practice for several conditions, and it is much harder to follow instructions recalled from a conversation while unwell.

  10. At what point should I go to an emergency department rather than wait to speak to you?

    Why ask it

    Ask for specific thresholds you can recognize: a symptom, a reading on a home monitor if you use one, a duration. General advice to seek help if worried leaves the decision to be made at the worst moment.

  11. What side effects should I expect, and which ones mean I should stop and call?

    Why ask it

    Separating the ones that settle from the ones that matter prevents both unnecessary worry and delayed reporting. Ask specifically about steroid effects if you are prescribed them, and about what long-term use involves.

  12. Do I need oxygen now, and what would make that necessary later?

    Why ask it

    Oxygen is prescribed on the basis of measurements rather than how breathless you feel, which surprises many people. Asking what triggers the assessment removes the fear that it is decided arbitrarily.

  13. Would pulmonary rehabilitation be useful for me?

    Why ask it

    It is a supervised exercise and education program available for several chronic lung conditions, and it is often underused. If it is suitable, ask about the waiting time and where the nearest program runs.

  14. Which vaccinations do you recommend for me?

    Why ask it

    Respiratory infections cause many flare-ups, and recommendations differ for people with lung disease. Ask which ones apply to you, how often, and whether your primary care practice or the specialist arranges them.

  15. Does this affect flying, altitude, or being around smoke and dust?

    Why ask it

    Cabin air is at reduced pressure, and some people need an assessment before a long flight. Ask before you book rather than after, and ask what to carry with you.

  16. How does this interact with my other conditions and medicines?

    Why ask it

    Heart conditions, reflux, sleep apnea, and anxiety all overlap with breathlessness, and treating one can change another. Bring a complete list of what you take, including anything bought over the counter.

  17. Do I need further tests, and what would the results change?

    Why ask it

    The second half is the important part. A test that will not alter the plan may still be reasonable for monitoring, but you are entitled to know which it is before agreeing to a scan or a bronchoscopy.

  18. What can I do that would make the biggest difference?

    Why ask it

    Asking for the single largest factor gets you a priority rather than a list. Depending on the condition, that may be stopping smoking, an exercise program, an inhaler change, or removing an exposure at work.

  19. Who do I contact between appointments, and how quickly can I be seen?

    Why ask it

    Find out whether there is a specialist nurse, what the phone line hours are, and what to do outside them. Knowing the route in advance is what turns a deterioration into a phone call rather than an admission.

  20. If this is long term, what does the next few years usually involve?

    Why ask it

    You can ask this at whatever level of detail you want, and you can say plainly how much you would rather not know yet. Most people find the practical version, appointment frequency, monitoring, likely treatment changes, easier to use than a general outlook.

Preparing for a lung appointment

Practical guidance for the conversation itself

What to bring

  • Every inhaler, spacer, and nebulizer you use, in the original boxes
  • A full list of medicines and supplements, including doses
  • Any previous breathing test results, chest imaging, or hospital letters you hold
  • A note of your work history, including exposures from earlier jobs
  • A short symptom record: how far you can walk, whether nights are disturbed, how often you use a reliever
  • Your three most important questions, written at the top of the page

During the appointment

Describe function, not just symptoms

"I stop halfway up the stairs and I have stopped walking to the shop" is more useful to a specialist than "my breathing is bad." Changes over months matter more than how you feel today.

Ask for the plan in writing

Names and doses of medicines, what to do in a flare-up, and when the next review is. Clinics can usually print a summary, and it prevents confusion between what the specialist and your primary care practice have advised.

Bring someone if you can

A second person remembers different parts of the conversation. If that is not possible, ask whether you may record the explanation on your phone.

Say if an answer was not clear

Asking a clinician to repeat something in plainer terms is ordinary and expected. Leaving with a word you cannot define is how instructions get followed incorrectly.

Afterwards

  1. 1Check that your primary care practice has received the letter and the new prescriptions.
  2. 2Book the follow-up and the repeat breathing test before you leave, if the clinic allows it.
  3. 3Keep your test numbers somewhere you can find them, so the next result can be compared.
  4. 4Note down anything you meant to ask and did not, and put it at the top of the list next time.
  5. 5If a new medicine causes something you were not warned about, report it rather than stopping quietly.