Has anyone ever heard of "hidden asthma"?

[IlanaK]

I have been reading about this after a google search and was wondering if anyone has experience of it?

Basically, my 4.5 year old has struggled with continuous respiratory infections his whole life. GP's have always said he does not have asthma as he has no wheezing. He now has such extreme tiredness during the day that I had his blood tested for all sorts (all negative). He coughs a lot at night (which I have always put down to a post nasal drip type thing) and I think this must be the cause of the extreme tiredness.

Anyway, a search online brought up this "Hidden asthma" thing which apparantly is in children with no signs of wheezing, but a persistant cough and many respiratory infections.

How on earth do a convince a GP that this might be the explanation? The stuff I read was all american and said the only way to diagnose it would be a pulminary funciton test - whatever that is. Would they treat with an inhaler?

Any thoughts??

[3cherubs]

Most Asthma (and excema/hayfever) conditions are caused by an allergy to something - possibly in the environment or food, whatever. I sent my son to have pin-prick allergy tests done which I asked to have done privately (NHS would not pay!) and we found out he was allergic to grass pollen and dust mites! This was after two years of me trying to work out what was wrong with him!

It was the best £125 I ever spent - we now know how to treat his allergies and he has become so much better since.

[IlanaK]

I am fairly sure my son has allergies too - I certainly have many. But I don't think this accounts for the extreme tiredness. How do you treat your son's allergies?

We see a cranial osteopath regularly and they say his chest is very very tight - which they try to loosen with treatments. This seems more in line with asmtha.

[edam]

Some asthma is caused by allergy, but not all by a long chalk.

Wheezing is not the only symptom of asthma. You can have asthma without wheezing - a persistent cough is in fact a key symptom in the absence of wheeze. I'm not a doctor but your son's combination of tiredness and coughing sound like strong indicators of asthma. Has your GP any other reasons for ruling asthma out? Has your GP tested your son's peak flow with a peak flow meter?

Try again with the docs, and check out the National Asthma Campaign for more advice: www.asthma.org.uk. They work with docs so should be able to tell you what investigations should be done and maybe why your GPs don't think this is asthma/other possible explanations/how to persuade GPs to investigate.

[IlanaK]

Thanks edam, I will definately check out that website. The GP's have never really investiagted asthma as such. They have previously asked if he has wheezing, but thats about it.

[coppertop]

Ds1 is 5yrs old and was diagnosed with asthma 2 years ago after he was hospitalised for the 2nd time. I don't think I've ever heard him wheeze. Before he started using his preventer inhaler he used to cough a lot and had a few chest infections. You don't need to wheeze to be asthmatic.

[katymac]

Try the practises Asthma Nurse.......just make an appointment and see what she says?

[foxinsocks]

our doctor went to the other extreme - dd had persistent coughing, especially at night but no-one ever heard her wheeze. We were prescribed the inhalers and they definitely make her better however, we still don't have a diagnosis of asthma. Because of that, I'm very hesitant to give her the inhalers all the time.

It's v hard to diagnose young children with asthma especially when they don't have the typical signs. In your situation, I would go back to the GP and emphasise what effect this coughing is having on your child's energy levels - this is what I did because dd became so tired she could hardly walk to school. Once they realised it was affecting her day to day life, they took it quite seriously.

Also, if you search the archives, you might find quite a few people who's children were treated with paediatric codeine for a persistent cough (where they had a persistent cough and it wasn't asthma) - I think this was diagnosed by X-ray. Can't remember who's child this was but I'll have a look for you.

[edam]

Definitely go back to your doc and push for them to investigate asthma very seriously. I'm surprised if the surgery has been doing all these blood tests and you've pointed out his history of persistent cough/chest infections that they haven't come up with this themselves.

[foxinsocks]

aaarrgh who's = whose (sorry brain switched off!)

[IlanaK]

Thanks everyone. I had a look at that site. The more I read, the more I think it may be asthma. I have battled with his symtoms all his life, but the last 6 months his energy levels have been getting worse and worse. We are pulling him out of nursery and stopping things like football class as he just can't cope. He regularly goes into major meltdowns over small things as he is so tired. And he sleeps 12 hours at night. I felt so upset about it all today as nothing we do is helping and I really feel that his quality of life is affected.

[edam]

Just remembered, coughing that is worst at night-time is a classic symptom of asthma, too. Bug the hell out of the surgery on this one because they need a bloody good reason to exclude asthma given this set of symptoms.

[IlanaK]

The blood tes was only done as I specifically asked for it to rule out possible thyroid problems (I have them) and low iron levels. The GP was newly qualified and really didn't have a clue.

[IlanaK]

Yes, I think we will be on their doorstep monday morning. But what treatment will they give? Also, should I push this with the GP or try to get a referal to a consultant of some kind? (we have health insurance that would cover it)

[edam]

I do really feel for you and your ds, if it is asthma then it is desperately sad that he's been left without the treatment he needs (I'm sure it is, but am not a doc and haven't seen your son, obviously).

On the positive side, if it is asthma, there is something you can do about it. And proper treatment will make his life MUCH better.

[IlanaK]

But what IS the treatment? I mean, I thought inhalers were for asthma attacks - whcih he does not have.

[foxinsocks]

they can give you inhalers - ventolin to help ease the tight chest and normally the other one is beclomethasone, a mild steroid that he would have every day to help his chest (also an inhaler). The doctor may just give you the blue (ventolin) one first to see if that makes an immediate difference.

[katymac]

DD only has asthma when she gets a cold - but DH has only ever had one asthma attack

He takes an inhaler morning and night ( a preventor) and a releiver if he gets chesty or does exercise

[foxinsocks]

if his cough is caused by asthma, the inhalers will relieve it. If it is quite bad, you may have to wait for the brown inhaler (beclomethasone) to kick in - that can take a week or so but the blue one can work quickly.

[edam]

Well, sounds like your GP's surgery aren't very clued up on asthma (or haven't been listening properly). Maybe once they realise what it is they'll swing into action but for your own peace of mind you might want to see a consultant.

Standard treatment would be two inhalers, a reliever and a preventer. Reliever opens up the airways (which are inflamed and constricted) so you can get more oxygen into your bloodstream. Preventers as the name suggests help to prevent attacks/limit symptoms. Preventers are inhaled steroids and I can't remember how they work off the top of my head, but they do!

[foxinsocks]

here's the old persistent night time coughing thread

[IlanaK]

Thanks for that link. I read the netdoctor bit about how codeine works and it definately describes it as being for a dry cough. Ds's cough is not dry at all - his chest always sounds rattly. Though the GP always says it is clear. I am pretty sure now that he has asthma and what we need are inhalers.

[highlander]

do you wash his pillow frequently, or use an allergen cover? My morning cough cleared up completely when I washed my pillows. I now know that they're due a wash when I get a bit coughy in the morning.

[suedonim]

My 9yo dd has asthma but I've never heard her wheeze! Her three siblings are also asthmatic but they've all wheezed at some point or other. Dd's is mild and kept under control by occasional use of a blue inhaler, esp before exercise, which tends to trigger it.

[GeorginaA]

I have asthma. It's a bit like an iceburg - the wheezing symptoms are really only the very tip of the problem, I've let my symptoms get WAY out of control if I've let it get to the stage you can hear an audible wheeze. My lung capacity can halve before you'll hear me wheeze and believe me, I'm feeling pretty uncomfortable and scared by then.

Agree with all the others - coughing at night is a CLASSIC asthma symptom as is being prone to chest & respiratory infections.

One of the big problems with diagnosing v. young children is that one of the key tests (peak flow) is almost impossible for them to use until they're about 7 or 8 years old. There are also several other similar conditions which can resolve themselves as they get older. However, treatment for those conditions is the same as for asthma anyway, so in my experience, most GPs will treat suspected asthma as asthma but not give an official diagnosis for the child's records until after they're about 7 years old.

One of the best sites to get information off is Asthma UK .

[foxinsocks]

did you manage to get back to the GP ilana?