Can we talk about Asthma?

[IHopeYouStepOnALegoPiece]

I am of course aware of Asthma and always thought I knew how serious it was but I don’t think I really got it, or understood how quickly the situation can deteriorate until I watched a little boy go from running round the park to being blue lighted to hospital yesterday.

So educate me about asthma please. The inhalers, signs of an asthma attack and things to do or not to do.

I don’t need eye rolling about my lack of knowledge, just education!

DS was in hospital several times when he was under 5 with asthma. Fortunately it has been controlled since then. He takes a preventer inhaler twice a day and a sachet of Montelukast once a day to control it. He has 'brittle' asthma, he can have an attack very quickly. Attacks used to be triggered by colds.
I was diagnosed with asthma in my early twenties. I too take a preventer inhaler to manage it. I used to get wheezy if I exercised.

Asthma patients are usually symptomatic if peak flow drops to around 80% of their 'normal', if PEF less than 60% seek review with Asthma nurse or GP, PEF less than 40% constitutes an acute exacerbation and usually requires additional treatment.

If you find someone having an acute asthma attack, they need their blue (salbutamol) inhaler, give 10 puffs, 30-60 seconds apart, ideally through a spacer device. If symptoms not settling, they need to go to hospital...

That's really helpful clyde. I need my plan reviewed to clarify things. Glad it's not just me Rafal, I feel like I'm over thinking it but I think it's helpful to understand at what point I really do need to see a Gp and take extra medication. I think I had steroids recently when I didn't need them.

@IHopeYouStepOnALegoPiece i would have thought a child has an asthma plan that should be shared with relevant staff. Thinking about it, we should have them at school but I'm not actually aware of them. Will ask relevant people.

Scarily, I do paediatric first aid and cannot remember it ever being covered other then a quick “they know what inhaler to use”!

I really appreciate all your responses, I’ve copied a lot of them into my notes on my phone to have to hand. I’m embarrassed by how completely uninformed I was.

Schools in my experience vary from being very poor at dealing with asthma to being absolutely dreadful at dealing with it. Partly through lack of time and training, but also because so many people having well controlled asthma or "mild" asthma has made people very complacent about how dangerous it is.

It's not uncommon for parents to have to fight against a policy that all inhalers are kept in the medical cupboard in the school office - often a flight of stairs away from their child.

There's a terrible lack of knowledge in the UK about asthma imo.

I have asthma ... didn't affect me as an adult until I moved to the UK and had the misfortune of renting a damp shithole.

I had a persistent cough I sounded like an ex smoker it was horrible. That was end of winter this year... then spring came along and apparently pollen isn't good for me either... and now it's winter and I have a cough again, although living in a different property.

Strangely when we lived in Scotland it never bothered me.

I now have an inhaler that I must use.

I'll be moving back to the tropics where life was simple and my asthma was non-existent.

I wish school staff were better informed. Especially PE teachers.
Thank goodness ds's friends stayed with him when the PE teacher made him do cross country in the middle of winter.
They probably saved his life that day. Teacher was useless.

My dd will be in 8 in February and was diagnosed the week after she turned 5.
Apparantely, doctors do not like to diagnose younger children and call it "viral induced wheezing" which is frustrating when it's clearly asthma.

Dp is 42, he has severe asthma and has suffered his whole life, spent much of his childhood in and out of Alder Hey so when I had dd and she started with the wheezing etc around 18 months he knew what it was.

She was given constant steroids, inhaler and antibiotics for chest infections and was seen at AH several times and it was during one of these emergencies that we were referred to an asthma consultant who finally diagnosed her the week after she turned 5.

The consultant was angry that dd had been made to wait for a diagnosis when it was clearly asthma. She now has Clenil inhaler via spacer twice a day which has kept it under control and sees the asthma nurse at our clinic every year for a review.

School have her asthma plan. She has inhalers at school and there is a list in the staff room of children with medical conditions ( along with photo of child ) so all staff are aware.
Dd is also allergic to certain dogs and we found that out when she went to her best friend's house for the first time and had a bad reaction. Luckily bf's mum is a nurse and knew what to do.

Sorry that was long

Kids with asthma can seem fine and still be walking about and talking even in the middle of a severe attack. My neice has been hospitalised several times with asthma and when she was younger she used to get so sick of going to hospital she wouldn’t tell us she was ill until she was ready to be blue lighted. On her worse admission she was kept in for a week and nearly had to be put into a coma to stabilise her. I think the image of an attack is that you are gasping for breath unable to move when actually it’s more likely to be a constant cough and a bit breathless. The signs can be hard to spot if you don’t know what you are loooking for.

I actually think it’s right in most cases that it isn’t diagnosed young because the viral wheeze is so common in under 5s and it isn’t asthma! Obviously they should treat it as needed but tjah doesn’t mean it is beneficial to give a false diagnosis!

Ds has been on preventer inhalers since 6 months old and was actually diagnosed formally before he was 1 but even though he was having big attacks the diagnosis came because of how he was having issues day to day (so obviously not a viral induced wheeze)

By the time ds started at school he was on high adult doses of medication so before he started the school nurse came in and did special training so we have been exceptionally lucky with the school. Sometimes I have been called in when not really needed but I would prefer over cautious to under!

@IHopeYouStepOnALegoPiece

I would honestly raid everything asthma uk has on its website and give them a ring. They're trained nurses and really should have an idea of what should be happening for youngsters in schools etc.

I'm remembering a colleague being dismissive of parents who were saying they were having problems with their child coughing all night - she kept saying, well he's ok in the day (eye-roll). It sounded like that he'd been diagnosed with asthma when young but possibly not using regular inhalers. They saw Gp and he brought an inhaler in to school but again I felt coughs were ignored and I kept having to insist he used it before going outside during that phase.

DS2's life has been massively improved by montelukast. It's a real game changer for asthma control and he hasn't needed hospital since starting it. The worst experience I had with him was the GP being dismissive. I knew he wasn't ok. He'd had a cough and sounded wheezy. But when we got there he was playing with another boy in the waiting room and didn't look too bad. I started to wonder if I was being over cautious to be honest. The doctor made a really bitchy remark about me basically being a time waster but agreed to look at him anyway since we were there. She agreed he seemed a bit tight chested and then took his SATs which were 91. Then he started to struggle for breath and it went from her being annoyed with me for bothering her to ringing for an ambulance. His SATs were 87 and they were putting him on oxygen when the ambulance arrived. I never got an apology and my advice with asthma is never ignore your instincts. If you think you/your child need help then get it.

For me it always feels like I can't breath out, mine is usually ok but cold air or having a cold/flu can be a trigger. My sons been hospitalised a few times with his, combined with pneumonia twice! Nothing like trying to get a toddler to keep an oxygen mask on all night long and I'm an expert on reattaching sats monitors to toes...

I've become a bit paranoid now and get him to docs as soon as he gets a cough.

@Drcoconut my ds has also had no hospital admissions since he started taking Montelukast.

That's awful dr. It's so worrying to have a poorly child and you know something isn't right and so hard when gps are dismissive.

I had a battle to be diagnosed as it similarly came and went. it wasn't until I had a coughing fit in the gps office that he took me seriously but a nurse pal had already suggested I spoke to asthma uk who suggested making an appt with the asthma nurse at the surgery. I was told that Most gp surgery's have delegated asthma management to nurses so aren't always up on what to do. The Gp had suggested i just always use a blue inhaler when I had coughs their nurse actually marched out of my first appt with her to tell him off!

I'm severely asthmatic and had to sit down with my housemates and educate them on what to do if I'm ill what it looks like/sounds like at different stages and when they may need to call 999. Each of them have an inhaler in their room, there are a couple stored in the lounge, bathrooms, utility room and kitchen and if we go out as a group at least one of them has them with them. They know what foods can set it off, if my eczema flares they know to be alert and that sometimes I can have an attack because I've laughed or took a breath the 'wrong' way. There have been times I've woken up having an attack for no reason and without a trigger so I can't lock my bedroom door because in a bad attack, I won't be able to get out.

I never realised how scary it is to watch or how little people knew about it until I had to sit them down to explain. I'd been ill with a chest infection and slow going attack and they were all freaking out while I was unphased because it's my normal. They explained when I was better, three nebs and two weeks worth of steroids and antibiotics later that it looked like I was suffocating on air and the zoning in and out of conversations and the lack of awareness of where I was and who I was talking too was actually quite frightening.

They felt a lot better after the chat of what to do when and where all my medication was and now they have access to some of it so they can at least feel like they're doing something when I'm ill by finding my inhaler. I've now put my 'go-bag' in the lounge where they can access it should I need to go to the hospital and I have been banned from calling for an ambulance and traveling alone to hospital at night without telling them because either one of them or one of our friends who lives down the street will go with me and call my family and talk to the doctors, nurses and paramedics on my behalf as there's a whole host of medical issues and allergies that I may not be physically able to verbalise without assistance. (Friend across the street is adamant that he be the first point of call for help because he's never been in an ambulance , plus he's studying law and great at communicating and remembering what needs to be remembered, he also hero worships my mother so I think he'd be quite happy to be 'saviour' in her eyes ).

I have life limiting conditions and asthma is the one that scares me the most, I'm always aware of it and how careful I need to be, but I know how to deal with it.