Can anyone give me an idiot's guide to asthma?

[strawberrycornetto]

Hello. I've posted lots here about my DS and his chest problems. He was cleared re cystic fibrosis but he still has chest problems which seem to have got worse again as we head into autumn. He is being treated with asthma medicine but at 19 months he's a bit young to be diagnosed with it. Anyway, assuming its asthma, I am really struggling to understand it and would really appreciate any advice or information you can share if you have a DC with asthma.

In particular, I don't really understand whether there is a stage between having no symptoms and having a full blown attack. If you have any symproms at all, is that an asthma attack or does it need to reach a stage where you need emergency treatment? My DS's main symptom is coughing and if he is struggling with it, we give him ventolin, but I don't know whether that means he has had an asthma attack.

Sorry, I haven't explained this very well. It just all seems very vague, I don't even really understand what the doctor means when he refers to wheezing.

Thanks for your help.

[colditz]

SOunds like he could do with a steroid inhaler.

[strawberrycornetto]

He has monteleukast/singulair granules, which I believe fulfil the same role as a preventer, is that what you mean (sorry, I find the terminology very confusing. . It seems to work, in that he gets ill when it is stopped. We had a trial stoppiing it about 8 weeks ago and that was the only time he had what I would think of as an asthma attack, eg struggling to breathe and wheezing.

[OhYouBadBadKitten]

There is definitely a sliding scale of severity that some kids go through. It can be really hard for parents to work out whether it is an asthma cough or a just a stupid annoying cough.

dds asthma cough is very tight, very repetitive and just little coughs, with no prolonged inhalation or expiration in it . This week has been a good example which may help you see how it can work for at least one child.... She started off with scattered tiny tight coughs (sounded like her chest was sneezing) They became more frequent and we saw a gp who said 4 hourly inhalers. Her inhalers were giving some relief for 3-4 hours.

Two nights in, in the night she couldnt speak a word without coughing. I then just gave loads of inhaler puffs, it settled and we saw the gp in the morning. It turned out her asthma was becoming too bad for the kind of inhaler she was on. She was moved on to one with a chamber, to be taken every 2 hours.

The difference was extraordinary. Within 20 minutes or so she was coughing proper coughs with proper breath in and prolonged cough after. For us, it demonstrated in a very startling way the difference between an asthma cough and a poorly cough.

I guess, what I'm trying to say in my rambling (and very sleepless) way is that if it is an asthma cough and he receives effective medication you should really notice the difference.

Don't be ever afraid to phone the gp, or out of hours what ever the time and say 'my son has been diagnosed with asthma, I'm having a hard time working out whether it is flaring or whether its just a bad cough. Can you look at him please.'

[OhYouBadBadKitten]

blimey I went on a bit

[Horton]

But that was a fab explanation (speaking as an asthmatic).

[Horton]

One thing I have always been told is if the reliever inhaler is not relieving symptoms for at least four hours, it is worth seeking medical help.

[Ivykaty44]

wheezing, it can be a small sound as the air is going in through the tubes or it can be a really loud sound similar to a mouse as the air goes into the tubes and any type of whezze inbetween.

As you try and get air into the lungs it can be a struggle and you heave you chest as it fells like the airways are restricted.

Hope that makes sense.

Do you give your dc cows milk?

[RubberDuck]

You need Asthma UK - they have a great website and a very helpful advice line which is manned by asthma nurses ( 0800 121 62 44, Monday-Friday 9am-5pm).

I would also get to know your asthma nurse at your local GPs surgery - while the GP is obviously the key person to speak to in regards to diagnosis issues, it's the asthma nurse who is often the most practical in the day to day issues of dealing with asthma (when to worry that it's getting worse, how to take the drugs, warning signs that you need to come back, etc)

[strawberrycornetto]

Thanks all, that does help.

We have a paedaetrician, but like rubberduck says, somehow the advice he gives is kind of too technical/textbook, so it never really seems to sink in. I will try our surgery I think to see if they have an asthma nurse and also speak to asthma uk.

Ivykaty, DS was allergic to cows milk. He is no longer properly allergic (i.e. now passes skin prick), so its being introduced slowly but he can't deal with it fresh, only cooked and hard cheese otherwise his eczema gets worse. I haven't noticed a partcular tie in, except the only time he had a proper asthma attack (I think) was when we stopped the singulair but also when we were trialling him with 50% cows milk to drink. We stopped the cows milk for the eczema anyway shortly afterwards.

OYBBK (great name!), it is the cough thing I find so confusing. He constantly coughs so its hard to tell what's normal, what may be asthma and when he then ends up with an infection. This all seems related to chest infections he picked up last autumn/winter and the dr has mentioned it could be post-viral wheeze rather than asthma.

Anyway, he's coughed all day today. Last night he coughed in his sleep lots and lots from about 8 - 11 on and off until we gave him ventolin. Tonight, I gave him ventolin before he went to bed and so far, no coughing despite being worse during the day, so I think that it worked.

I think I will take him back to the doctor though, because today is the 4th time in a week he's needed ventolin, although only 2-3 puffs. Am I right in thinking you should not routinely need to use the reliever inhaler, even in small doses?

[OhYouBadBadKitten]

I would take him back and tell the gp what you have told us. I think if nothing else it will give you a bit more confidence in how your ds is.

(that kind of ventolin dose is not bad I don't think in a bad week as long its a temporary thing but perhaps actually if its helping the cough you aren't giving it to him often enough, you'd need to talk to a nurse or doc about that)

I second the asthma nurse, I'm phoning ours today to make an appt to review her asthma management.

Huge sympathies for you though. It is difficult, especially when they are little.

(think I should change my name to OhYouVeryVeryTiredKitten after another asthma/cough/nosebleed sleepless night with dd. It is a nasty bug doing the rounds around here)

[RubberDuck]

As an adult, the rule is that if you are using your inhaler more than about twice in a week on a regular basis it's a sign that you need to up preventer dose.

For a very young child though, I'm guessing that Ventolin is better tolerated than many of the preventers, so they may well prefer to keep it to Ventolin only for a while - hard to second guess, so my advice would be to go back to see your GP or asthma nurse if you're in any way concerned.