Asthma and so upset

[Sunshinefor4]

My just turned 4 DS had bronchitis as a baby and was hospitalised on breathing and feeding equipment and was kept in for a week. Since then every winter he gets terrible chest infections. Normally end up in a&e and with steroids. Last year my gp said although it’s very young to diagnose asthma she felt he was so gave him a blue inhaler and Montelukast to keep in the house for future. Had occasional flare up but nothing major until this morning. He woke up at 6am having a terrible attack. Really scary I gave him 4 puffs and the Montelukast. It seemed to help so at 8am called my dr. The earliest appt they had was with the prescribing nurse so I took that.

When we arrived we were 5min late (ds had been coughing so much and threw up so had to clean him up just as we were leaving the house) the nurse was very angry about this but then allowed us to see her once the reception staff explained my reason.

She was very off during the appointment. I explained the situation of why we were there. She listens to his chest and says she can hear nothing. Didn’t look in his mouth and was sharp with Ds. I told her every year it is the same I have seen him like this before and he is about to need an ambulance. I explained I was very very worried. Also explained I have 4 children so would like to prevent a hospital admission if possible not to mention how distressing Ds finds it. I was calm and respectful she was not. In a rude manner she said I can see nothing wrong with your son. If you don’t trust my judgement see someone else. So I said yes I want to see someone else.

Waited for the duty dr who looked in ds mouth and found enlarged tonsils and noted that the meds I had given were probably working and at this stage nothing else was needed.

Went back home and was very worried. Within 10min his breathing was so bad and this time the inhalers were not helping. Called back to the dr took hours for a call back and then was told to come back in. Dr took one look at son and said he is having an asthma attack and he needs steroids. He also informed me it was never written on DS notes that he is asthmatic. Hence why the nurse thought I was making it up and wouldn’t listen to me. It took a total of 11 hours 3 dr appointments and 5 phone calls to get the medicine he needed. By the time we got the medicine from the chemist DS was really not well. Gave the steroids as soon as I got home from chemist at 8pm

Now 1am DS has just had the scariest astmah attack so gave the 10puffs and 30min later it has calmed down. He has gone to sleep and is snoring loudly but I don’t see laboured breathing.

I am so tearful I don’t really know why I’m posting this. I have spent the day knowing that he was about to get really sick and that he needed steroids but no one would listen.

Is this just how it is? DS has never had any kind of clinic for asthma and after being given a stash of inhaler and pills a year ago we have just been left to get on with it. I realise now that he should have been given a brown inhaler too and regular check ups.

Even this morning with the nurse she gave me no advice of how to care for a child that had an asthma attack only hours before and she clearly didn’t believe me

[antimatter]

What they say doesn't make sense.
Your don got blue inhaler. Can a non asthmatic child be prescribed that?
Someone made a mistake by not following up with correct treatment .
I would call in the morning and ask to speak to a gp to know if you are to do anything else.

[TiesThatBindMe]

Did you mention that he was asthmatic and the medication he is on?

I'm asthmatic and doctors have told me that my lungs can be clear when they listen but I can still be having an asthma attack (I don't understand it either).

I hope your little one is comfortable now and has adequate medication. It's a horrible condition.

[TiesThatBindMe]

An inhaler is never far from my hands. Asthma is a pain in the hole to be quite honest.

[TiesThatBindMe]

Is your son on any of the brown or purple inhalers or just the blue ones?

[Sunshinefor4]

Antimatter - that’s what I thought couldn’t they see the inhalers on his medical record or read that last time he was in the surgery for the same reason the gp called an ambulance herself as his breathing was so bad?? It felt so confusing. Like I was speaking a different language.

Tiesthatbindme - yes I gave them a full history of his meds and past hospital admissions. The nurse laughed at me when I told her about the bronchiolitus he had as a baby and said well four year olds can’t get that. I wasn’t saying he had that I was just trying to give his history. She was so condescending. I actually embarrassingly cried while talking to the gp because I was so worried and frustrated and cross for how she had treated us. I knew he had a bad attack that morning and I recognised where this was heading and knew he needed steroids but no one would listen. Thanks you for the info about lungs being clear but still have an attack. I didn’t understand how he could be showing no signs when he was so bad hours before and then got so very bad again hours later.

[ilovevenice]

I have an 8 yo DS2 with an asthma diagnosis and although my 6 yo DS3 has had very similar symptoms of wheeze, persistent coughing, rapid breathing, tracheal tug (sucking in the neck while struggling to breathe) etc and has a blue inhaler, they haven't diagnosed him with asthma officially. I haven't pushed for it as it isn't enough to need a brown inhaler/Montelukast, so mild compared to his DB. Also I know what to look for and it hasn't affected his treatment, unlike your poor DS... Hope he has a good night, and don't hesitate to seek help again if you feel he's getting worse.

[ilovevenice]

Sorry, cross post - that nurse sounds awful

[Sunshinefor4]

He is just on a blue inhaler he has never been given anything else. Thank you for both of your help I have no clue about asthma. I only knew about the 10 puffs in an emergency because I had just been reading up on asthma uk website trying to educate myself. Feel anxious to be looking after a very sick child without the proper meds or education.

[TiesThatBindMe]

My GP practice brings me in periodically to the asthma clinic. Basically the nurse gets you to puff on the thingy that measures the strength of your breath and asks how often you need to take the blue inhaler. I'm on pretty much the strongest steroid inhaler though. I'm a lifetime with asthma though.
Has your little lad one of those spacer things to ensure he's getting all the medicine in? The only thing I will say to you as an asthma sufferer and not remotely a medical professional is that if you're in fear at any point and are getting him to hospital, don't be afraid of overdosing with the inhaler while you're getting him there.
If you're needing 10 doses of the blue inhaler, he should probably be on a steroid one too (brown or purple ). You probably know this already but the steroid ones don't provide any immediate relief but they prevent attacks. The blue ones are for immediate relief.

Other than that, have you animals in the house? Birds? Cats? Dogs?

[BigBairyHollocks]

OP you need to stay with your child tonight,awake and watch him carefully.Two attacks in one day is not good.If he starts to breath like that again,requires more blue inhaler within half an hour of having been given it already,you need to take him to a&he.im sure I don't need to tell you how serious asthma is,unfortunately it still isn't given as much attention as is required by gp's and some other doctors,but it can kill,If you need to keep fighting and shouting to get him treated each and every time this happens,then that's what you must do.How is he breathing now?

[BigBairyHollocks]

Agree with previous poster,don't stop at 10 puffs,keep giving it when he needs it.At worst,he'll be a bit shaky,at best it will save his life.

[TiesThatBindMe]

The reason I ask is because I'm allergic to anything with feathers or four legs. If you have pets, you may need to reconsider. If you have carpet in the room, hoover every single day or switch to laminate flooring and mop each day (dust is another trigger). Aerosols, plug-in fragrances, they all set my asthma off.

[VforVienetta]

OP my DS2 had a lot of Bronchiolitis as a baby, and now has what they’ve termed ‘Viral Induced Wheeze’, which last Spring saw him in A&E every fortnight.
Basically whenever he picks up a cold it goes to his chest and he gets chest recession/tracheal tug, wheezing, and coughing that can’t stop.
We use Montelukast daily through cold season, and use Brown inhaler daily as soon as he gets a runny nose or his brother gets a cold.
When he gets ill we start at 10 puffs of Blue, then step down as per the wheeze guide.

This is now our standard system, as advised by GP, A&E docs, and a twice-yearly consultant appointment.
And no, he isn’t dx with asthma either!

[Sunshinefor4]

Ilovevenice I noticed the tracheal tug tonight while he was sleeping. I didn’t know what it was so thanks for that info too. He is sleeping with me in bed tonight. I’ve just ordered a finger pulse oximeter from amazon just to help reassure me if this happens again tomorrow. It’s all so worrying. I know I can call an ambulance though if I get too worried. He seems more settled now he is sleeping with me. I might try get some rest and stop watching him breathe. Even though he is on steroids that he started tonight I’m thinking I will call the gp again tomorrow morning and let them know he had a bad attack in the night.

[TiesThatBindMe]

Poor little thing. I hope he's breathing easily soon.

[Sunshinefor4]

Thanks for all of your posts sorry I didn’t see them before I posted previously. I appreciate all of the advice as I know nothing about asthma. I do know that it is scaring the hell out of me. I won’t leave his side tonight. Thanks for the info on giving more than 10 puffs in an emergency. I didn’t know any info but had decided that if he needed anymore blue inhaler before 6am I would give it and then call an ambulance. It’s good to have some reassurance and advice thank you.

His breathing is normal at the moment and I don’t see laboured signs on his tummy or neck. Im annoying him by using my phone light to look but I’m just so worried.

We do have pets I asked the gp about that today. He felt it was a virus bringing it on and wanted the course of steroids to run for the fives days and daily Montelukast for 7 days. If no improvement then then he would consider allergies to pets. I love the pets but I would have no qualms re homing them if they were causing this.

We only have carpets upstairs and hardwood downstairs that is mopped daily with a steam mop. However upstairs is only vacuumed a couple of times a week so I can try daily.

Vfor - that sounds like my son this tends to happen when he has a virus. I wonder if this could be what is happening to him

[Gumbubble]

Sorry to hear your son is having so many attacks. It sounds scary and like you haven't been given enough information to properly manage his asthma. I think you really need to book a long appointment with the gp who originally said he has asthma or another sympathetic gp and get a proper asthma management plan in place. I live abroad so our experience may be different to how asthma in children is treated in the UK, but here when my ds was diagnosed (at 6.5 years old) the gp ran through what to do in each level of attack (eg if he's slightly wheezing, if he's got a virus but no perceptible wheeze yet, if he's really wheezing badly etc), how many puffs, how often, and gave us a printed plan for us and for his school. He also prescribed flixotide (steroid puffer prevented, helps prevent attacks rather than treat them when they're happening) for use morning and night every day during the winter months when ds is more likely to get ill and develop post-viral asthma.

Asthma needs to be properly and actively managed on an ongoing basis rather than just reacting to attacks, as then you are in a potential crisis situation that can at worst be fatal. Any childcare/nursery or school also should know the plan and what to do, as should babysitters.

It is also worth checking re the Montelukast as my understanding is it is for prevention/reducing attacks, ie take before exercise if asthma is exercise induced or on a daily basis for general prevention, not as a reliever to resolve an attack as it's happening. I may have that wrong though. I hope he feels better soon and the gp is able to get a proper management plan in place.

[guineapig1]

My experience with DS1 is very similar to that of Vfor. No formal diagnosis but an extreme tendancy towards viral induced wheeze. Basically every cough or cold would require steroids and/or a hospital admission.

My Ds was prescribed Montelukast daily about a yeat ago and we were told it would take about 6 weeks of daily use to reach its desired effect for his treatment plan and he has continued with the daily dose ever since. His use of the blue inhaler (we have never been prescribed a brown one) has reduced to very very infrequently, maybe once every three to four months.

That said I am very conscious that he could need it at any time and have always got an inhaler nearby. The GP has also issued one to the school.

I agree that if he worsens again tonight, get urgent medical advice. I'd also ring the GP tomorrow and ask for an urgent appointment with whichever GP specialises in asthma. Push for a referral to the paediatric outpatients regarding his wheezing and enquire about daily montelukast in the meantime.

Good luck, I realise how scary it is and it is so difficult when you have other little ones too. I had to stay overnight in hospital with DS then aged 2, when we had an 8 week old baby. It wasn't ideal but the baby took a bottle and I figured that DS needed me more at that particular time!

[endofthelinefinally]

Isnt montelukast supposed to be taken every day as a preventer?
Do you give it daily op?
Willing to be corrected as it wasnt around when my dc were small.

[Trampire]

My ds was constantly in A&E for 'viral wheezing' even though half the time he'd had no cold/virus that I'd noticed.

It was after the 5th time in one month at A&E (after he was admitted) that I doctor said to me that my ds should be under a Asthma consultant. She said she put in a request for an appointment. After 2 weeks an appointment came through to see a consultant.

At 4 he was given blue inhalers, brown inhalers and was told to a Montelukust tablet every night before bed. This was the turning point for us. He's now 10. He rarely has a wheeze. He still takes Montelukast every night plus brown inhalers (more puffs in the run up to Winter). He manages it well.

He has to go Asthma clinic at the local surgery every year to check his medication is still right etc. He's no longer under the consultant.

I know how scary it is OP. A 4 yr old can totally be diagnosed as Asthmatic. Go back to your GO and demand more preventative inhalers. I'm amazed they haven't issued them as they are so important.

[antimatter]

Have any of you tried air purifiers for bedroom? I know is not the same bit they helped my kids with their hay fever. I was using one from John Lewis. De Longhi which costs round £200.

[Sunshinefor4]

Thank you all so much for all of the advice and experiences. You have all helped me so much I’m so very grateful. I didn’t sleep last night i just sat watching him breath. I called asthma uk helpline today the nurse was so fantastic. She told me that I need an action plan like many of you have explained about. She also confirmed that the surgery is very negligent. She was also so informative I really recommend calling them if anyone has concerns about asthma. She told me that the gp should have listened to me when my child was in the amber zone and given medicine straight away. The waiting 11 hours was totally unacceptable as was giving me no action plan or advice.

Before yesterday I was told to give montelukas at the first sign of a cold not as an every day thing just for the first few days of the cold. It seems most people are taking it as a preventative daily. Right now we have been told to take it every night for 7 days.

My sons breathing is settled today so far. I’m giving him his blue inhaler every 4 hours as directed by the dr. I dread to think what would have happened if I had trusted the nurse when she said he didn’t have any breathing difficulties and there was nothing wrong with him and tried to send me away.

Feel very upset about the whole thing. Even when I eventually got the prescription after begging for it all day the pharmacy making me wait 30min to get the steroids. All the time he was deteriorating.

Well I know now that I need to make a bigger fuss listen to my gut and not be so passive and believe me I will.

Just an extra thing the asthma specialist nurse mentioned not under any circumstances to buy a nebuliser. She said many times they make the oxygen in the blood level drop very low and very quickly and they were dangerous for home use in asthma. Maybe this is well known in the asthma world already but I didn’t know (but then again I don’t know much about this) I asked as I thought it might be helpful. She did say the finger pulse oximeter was a good purchase though. They are around £10 - £15 on amazon.

Thank you all so much for the invaluable advice in the early hours of the morning x

[Sunshinefor4]

I forgot to ask about the air purifier though but will find out thanks x

[Trampire]

Gosh Sunshine. I didn't even know you could buy home nebulisers! I agree they're not a good idea to use at home. They need medical supervision as they're such a big hit of Salbutamol.

I used a purifier gif my ds's room if he had a cold. I think it helped a bit but mine was only cheap. I might have got better results with a better bit of kit.

[blueberrypie0112]

It happened to me. I rarely get asthma so I can go years without a checkup because I have been avoiding triggers like heavily scented cleaning products and chemicals/smoke.

one time I could feel I was struggling but wasn’t quite wheezing yet (I do wheeze if it gets really bad) so the doctor didn’t think I am having asthma. But he deciddd to do a pulmonary test and there he decided I did have it.

So ask them if they are willing to check your son oxygen level and pulmonary test (he may not be old enough though) or ask to see a specialist since you mention that he keep getting lung issues.