help - advice on athsma (?) needed

[midden]

relatively new to mumsnet, trying to search for threads but page going blank like i've asked too much at once or something

dd (18 mths) diagnosed by gp this morning and we were given becotide (2 x daily) and salbutamol plus mask thingy. She has been pretty snotty since birth with lots of chesty coughs (quite loose sounding) but I just feel like this is very hasty - my instincts are to wait and see/ treat alternatively/not to give her drugs but am I being irresponsible?

[maisystar]

my ds developed excema ot 3 mnths old, used steroids for a while and it went but came back worse. then went to homeopath. first homeopath helped but wasnt brilliant but the second one we saw was great. he is now 3.6 and has been free of it for 2.5yrs at least.

anyway.....! i expressed concerns to both homeopaths about him developing asthma and both said steriods are just not nessacery and can make the long term situation worse.

tbh i think if he had devoped it i would have treated homeopathically but maybe seen the doc if there was a bad attack.

hth

[midden]

thanks maisystar - I was considering homeopathy as ds had nosode immune booster when he was about the same age as dd - maybe thats all she needs? Still love to hear from anyone with experience of these drugs or athsma symptoms.

[nightowl]

Hi midden,
what is it you would like to know exactly? Apparently at that age it is hard to diagnose asthma and so they will give inhalers anyway. The salbutamol is a reliever and will help in an attack but the other is a preventer (i think, is it brown or orange?) the preventers build up over a period of time so do not work effectively unless used regularly. I too refused to believe ds had asthma when diagnosed with it at 5 months as he never wheezed (just had very fast breathing when he had a cold) but not all asthmatics do so im told. Im no expert and can only go on experience but personally i wouldnt like to risk not giving my child the inhalers. We've had too many frightening experiences.

[midden]

thanks nightowl - I think i'm just worried that dd will become dependant on inhalors when she does not have athsma but don't even know if thats possible. Her symptoms just don't seem to warrant such heavy duty treatment yet, she is not having attacks, did your ds at this age? Inhalors are brown and blue. It just seemed an open and shut case to the gp when he heard there was athsma on my side of the family.

[nightowl]

from what i can gather midden, its often a precaution. I was under the impression that a child having an asthma attack would wheeze, gasp for breath and go blue. It was never like that with ds and i had a very hard time accepting it. It only ever happened when he had a cold and the fast breathing would start, his chest would start pulling in and he would look awful. It was always worse in the early hours of the morning and i would sometimes sit up ALL NIGHT watching him. The times we had to rush him to hospital and watch him screaming because he had to have a nebuliser were unbearable, as was sitting there watching his oxygen levels on the monitor. Im not going to lie to you, it was VERY frightening and at times i felt i was going insane with worry. If your ds isnt having attacks then i think it is best to control it before it happens...it is horrible. I dont mean to scare you...i just wouldnt want any parent and child to go through what we did. If its any consolation, ds is 6 now and although still on inhalers, he hasnt (touch wood) had a bad attack for two years...im hoping he's grown out of it. I had some very helpful booklets printed off, i could find you the website address if you're interested?

[nightowl]

sorry, i meant your dd....im tired

[midden]

yes - any help welcome! what age was your ds when be had first attack?

[nightowl]

5 months and they got worse from theron. There is a history in both parent's families of hayfever, excema and asthma which doctors always ask about. What advice did your gp give you?

[midden]

none apart from take inhalors and not much info either - maybe this is what freaked me out

[nightowl]

ds started on brown inhaler but was then changed to orange. We were told to keep these up as they wouldnt work otherwise and just to give the blue as needed, or for such things as before excersize, cold weather etc. We explored the possibilities of ds's asthma being linked with allergies, dust, pet fur, etc. We washed all his soft toys on a regular basis and later on when he was a toddler i bought anti-alergy bedding for him. (ive no proof or guarantee any of these things worked, we were just told to try them) We were also told to wash the spacer device and mask once a week in soapy water and not to rinse, just let dry as it is (helps stop the medicine "sticking" to the sides) i would also wipe your dd's mouth and chin after using the mask as it can cause a rash in some children (ds being one of them!) im trying to think of everything now! do bear in mind though that i can only tell you what ds's consultant told us and believe me, some of them do differ in their opinions! i will look those sheets out tomorrow for you...im sure they're a lot more helpful than me!

[nightowl]

and probably other MNers will be a lot more helpful too!

[midden]

nightowl thanks so much for your advice. I've got to sleep now. Maybe speak tommorow eve?

[nightowl]

yep i'll be on. must go now too...so tired. Nite

[gothicmama]

• we were told asthma can not be diagnosed until 3 years - we used steam in bath room from kettle lots of towels on radiators to raise humidity and it all appears to have cleared up

[robinw]

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[robinw]

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[coppertop]

Ds1 (3.10yrs) had his first attack last year. He often used to cough if he'd been running but apart from that there was no other sign. I'm asthmatic myself so I knew what to look out for. During his first attack I found him in his room on all fours, obviously struggling with his breathhing. He had a couple of nebulisers and was fine. Asthma wasn't diagnosed until the second attack. He'd had a cold and again he struggled to breathe. His little shoulders were moving up and down very quickly and his breathing was very fast. This time he needed about 15 nebulisers and constant oxygen for almost 24 hrs. He was diagnosed with asthma and given a blue inhaler and an orange one.

Doctors are unwilling to keep children on steroids unnecessarily and ds's progress is carefully monitored. He has regular appointments at the asthma clinic where they check his progress and also his height. We use the clinic at the hospital but our GP's surgery also has a similar clinic. Does your surgery have anything similar? They will be able to explain things to you, monitor your dd, and also lessen the dosage if necessary.

[misdee]

dd1 has had asthma since around 1yr old ithink. (trying to remember when it started) but she is an atopic child so has ezcema, hayfever, other allergies as well. we give her inhalors twice a day, once when she wakes up and before bed. she will cough all night if she doest have her inhalors. she has a blue one at nursery which is used occasionally and they do help. the handful of times she has had full blown attacks have been scary. she gets scared as she cant breathe which makes things worse. she has spent a night in hospital being mointered after a bad attack (was 2.5yrs then) and wowed the hospital staff with her big brown eyes and how good she was. to say a child b4 the age of 3 cant have asthma is not true in my eyes. its harder to dx in small children as they cant get them to do peakflow tests etc, but it is possible to have asthma from a very young age.

[stamford]

midden, both mine are on those inhalers (and exactly the same dose). My dd (4 in August) has never properly wheezed but has a constant night time cough and gets terrible coughing fits when exercising. My ds (3 in Nov) wheezes but he had bronchiolitis straight after he was born and I think it weakened his chest -(my dh is asthmatic and we both have allergies so loads of family history unfortunately!).

My dd isn't on the becotide constantly. Whenever she is having a bad patch (and she has months when she doesn't) we go off it and then start again for a period of time (this time 2 months) until she becomes better. She has been on it now for around 4 weeks and I have noticed an enormous improvement. We go back to the doc in 2 weeks and I imagine we will go off it again. As they have never heard her wheezing they are hesitant to diagnose asthma though my GP said in the under 4s often there are no signs other than a constant cough like hers.

I would ask the GP whether your dd is wheezing all the time (or is it just because she has a cold?). My ds only wheezes noticeably when he is ill. It may be that your dd will not be on those inhalers for long but just for a month or so to see if they stabilise her condition. It may be that once she's better, they will try her without them to see what happens (this is what the paed did with us). Its also possible that your dd will get better with age. My ds is MUCH better than he was (at 18months, I was probably up with him about once a month watching him breathe at night).

I would try the inhalers to see if she improves and then go back to the GP to see if he/she thinks they are still necessary. Hope this helps!

[twiglett]

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[Slinky]

Firstly I just want to say DO NOT stop giving him the Becotide WITHOUT medical advice.

I have asthma myself and was having a particularly bad time the same time as Twiglett (remember posting to each other on same thread).

The Becotide (brown inhaler) is the Preventative which works by keeping the airways open and relaxed, therefore if used and working properly should mean that you will not be using the Salbutomol (blue) at all, or at least not frequently.

In my experience, GPs are a waste of time when it comes to asthma. Most of them just throw inhalers at you without checking that you are using them properly and don't bother with follow-up appointments to assess you.

I have a wonderful Asthma nurse who insists I call her at any time if I'm suffering and likes you to attend regular clinics to monitor.

My friends little boy has asthma and she kept stopping his Brown Inhaler, but then he was regularly having attacks, the last 3 he has been hospitalised. Also needed oral steroids regularly. She has been told she MUST keep up with the Brown in order to keep the asthma under control.

The National Asthma Campaign website has been VERY useful to me - my friend also consults this now.

Like Twiglett, I'm currently at 1 X 1 puff of Brown 2 times a day and haven't used my Salbutomol for about a month. My 2 triggers are cigarette smoke and colds (most common apparently) and have been advised to increase my Brown at the start of a cold and to have 2 puffs of my Blue inhaler if I'm about to go anywhere smoky.

I really DO NOT recommend stopping the Brown then relying on the Blue in the event of an attack - and I talk from experience (used to become very slack with the Brown).

[suedonim]

In some ways an asthma diagnosis is a bit of a red herring. Whatever the problem is called, it needs treating, and inhalers are used for other conditions too.

As has been said, the brown inhaler is a preventative medicine and acts by damping down inflammation. The blue one helps open the airways if they narrow. Careful, regular use of the brown inhaler should keep the requirement for the blue inhaler to a minimum. The amount of steroid is very small and IME outweighs the awful effects of asthma many times over.

The Asthma Campaign folk have a helpline on 0845 7 01 02 03 Monday to Friday 9 am to 5pm and you can email them. Best wishes.

[twiglett]

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[midden]

thanks for all the advice so far. Should stress that I am not stopping any treament as she hasn't started it yet, just questioning the need for it as her symptoms are so mild and she is so young. Still like to hear from anyone with anything to say on this.

[hercules]

We had a similr sitution with ds and we never had it confirmed as asthma for sure. What worked for him is getting dustmite allergy bedding, removing all oft toys and keeping his room as bare as possible to cut down on the dust.
The best thing was using a fan ad keeping the windows open at night unless really cold. We made sure room was aired during the day as well.

It worked for us and he has outgrown it now.