Cough variant asthma - tell me it gets better!

[Itstheimplication]

DS is nearly three and was diagnosed with potential cough variant asthma earlier this year. We have a brown inhaler and a blue inhaler and do each twice a day morning and night. He also has montelukast granules before bed

things have improved significantly although the cough never fully goes but every single slight sniffle he gets turns into a cough and it’s horrendous overnight when he’s unwell.

I’ve got a humidifier, vicks, olbas oil, propped the cot but because he can’t blow his nose (can’t quite work out the mechanics) and because he swallows back the mucuous (we encourage him to spit but like a stubborn toddler he refuses) the cough seems to linger.

he also has coughing fits so bad he’s sick when he’s got a cold or infection.

i guess I’m just asking if it gets better as they get older and can blow their nose etc? Being felled by a cough when he has allergies in summer, due to the different temperatures when there’s air con etc, and then every sniffle or infection is so wearing for both of us.

Hi op, my eldest used to be like this. As a tiny tot he used to cough practically continuously from September to April & was frequently hospitalised due to his asthma. Over the yrs he began to improve & he is now a fit 22 yr old who since the age of 16 has needed no inhalers on a day to day basis.

Thank you for this @Badgerstmary this is what I needed to hear today. We’ve had a good run of two months with only
occasional coughing so I think returning to the constant coughing all night/coughing til he’s sick has been a bit of a shock to the system and made me really worry about all the winter bugs!

I was exactly like this as a kid. It did seem to go into remission for awhile. Resurfaced when I lived in a mouldy flat (was on many inhalers)

For the most part I grew out of it.

Are they happy there is no element of acid reflux or allergies? Is the bedroom and bedding rigorously clean ?

Has he been allergy tested

My son had cough variant asthma when he was young as well.
It was awful, we bought a nebuliser in the end.

He has loads of allergies as well.

Hes 11 now and has totally grown out of his asthma, but will get wheezy as a result of an allergic reaction rather than being asthmatic.

He grew out of the cough variant by the age of about 8.

check for allergies and ask if there's a different inhaler he can have, the brown isn't always the best one. I can't use them they make my asthma worse.

aging helps immensely.

we have our house air conditioned and totally sealed to keep out pollen. We change the filtration monthly. Thankfully this isn’t rare for our region because it is essential for dd. Fresh air is her enemy.

if it is really bad, there is a good chance it is actually VCD, vocal cord dysfunction.

If so, the biggest difference is going to be occupational therapy. Once they are old enough to learn breathing techniques, they can train the vocal cords to stop reacting.

when dd was really little, but old and enough for honey, I used to give her honey straws. The honey would soothe her throat, but it turned out breathing through a straw is a trick to get the throat muscles to relax. I didn’t learn that until we got to OT, but that is why the honey straws worked so well for a little child.

developing a tea habit is also a good idea. Herbal is fine. Never give cold drinks or ice lollies during an attack or a cold. I used to go up to school and the nurse would have given her a cold water to sooth her coughing which just made it worse. I would have to send the nurse off for a warm drink to counteract the damage. Thankfully she learned quickly.

with cough variant asthma, also ask your doctor about using the rescue inhaler prior to exercise.

I still get the asthma cough that I had in childhood. It’s really hard socially and I have got a perforated ear drum on more than one occasion because of it.
I smoked for 20 years and that was the only stretch of time I didn’t get the cough. Clogged up cilla can’t trigger it I guess.

Sadly it’s back this year. No sleep and my ear is killing me.

Interesting.
no allergy tests they won’t do them because everything points to asthma.

so I keep the house and bedding as clean as I can but it’s a dusty house and a losing battle tbh.

the brown inhaler (clenil I think) did seem to be making a difference it’s just that whenever he picks up a cold or something it still immediately turns into a cough I don’t know if that’s normal.

weirdly he’s never had a chest infection to my knowledge only ear and throat

He has eczema and hayfever as well (eczema just flaring up again after being mostly clear all summer due to places putting heating on)

Are you using a spacer? Does it have a mouthpiece or a face mask?
have you been shown how to use it properly?

Yes we are using a spacer it has a tube and a little face mask and we were shown how to use it by the pharmacist

Should the inhalers stop the cough altogether then? Even when he has a cold/is unwell?

Both of mine had it and both grew out of it.

My dd is now 12 and hers was the worst. Like you say she coughed non stop for 6 months of the year. She learned to sleep through it (although I didn't!) And then when she went to school she learned how to use the inhaler herself. Things that helped.... starting using the brown inhaler religiously at the first sign of a sniffle and for several days after all signs of a cold had gone. And vicks helped (feet and chest). It probably disappeared at the end of infants with her and now she barely gets a cough and hasn't used an inhaler for years.

My son showed signs of similar and we used the granules for a few years but his disappeared fairly quickly and is now 8 with no signs of asthma at all (he had endless chest infections as a baby and toddler but outgrew these too).

I found they shortened the cough and made it less persistent.

Okay that’s good to know. I think they do shorten it he seems to recover quicker however he does always seem to have a slight cough. We are only two weeks into the montelukast so need to give it another four to take effect so hopefully that will help.

I will try and be even better at keeping the room clean.we’ve found it’s also been better since changing his nursery as I had issues with the others stand of hygiene!

@mewkins yes hes learning to sleep through it im not though!

im going to order him new pillows I’m sure the one he’s got is hypoallergenic but I’m wondering if there’s something better. I wish our house wasn’t as dusty as it is

This is me and my son. Try using baby antihistamines every day, my world changed once I had been using them about a week. Made a huge difference for my son too.

Also if anyone has any tips on teaching him to blow his nose or spit out the mucuous rather than swallowing it back (boak) they will be gladly received!

Humidifying the room (just a glass of water on the radiator) can really help. As can saline drops up the nose (good luck with that)

Montelukast is brilliant at that age. It will get SO much easier as his little airways grow though.

do you have a reliever inhaler to use when he is coughing at night?

My son has this, started at 3 too, he was on many drugs montelukast, clenil (brown inhaler) and ventolin but also an antihistamine as he’s quite a Snottery allergic child so that’s helped. His asthma exacerbations presented as coughing and he also had that asthma cough over night. The brown inhaler settled that down but the blue I used to treat any flare ups or more severe exacerbations.

the exacerbation cough has settled and he now wheezes too. I don’t worry too much about the phlegm he would swallow it too but it’s harmless. Asthma uk is great for asthma plans and correct space/inhaler usage for daily use and exacerbations and it’s handy to have a plan handy, mine used to be on the fridge. School now has a plan also, all family members know what to do, he’s 11 now so he knows too. Damp dusting is good and light hypoallergenic pillows etc plenty hoovering, don’t hang their washing outside inc bedding.

Interesting that they refuse allergy test?

I thought ecsma could also be a sign of dust mites?

Is there anywhere you can take him to be sure re allergies?

What if he has asthma and allergies?

It might be worth getting some allergy pillows, deep cleaning room etc.the pillows protectors...

As he grows he should get more used to it and it will disturb him less (and hopefully you see it improve anyway). Here's to better sleep for you all x

I had it as a child and had several times in an oxygen tent in hospital as a result. Mine was triggered by an allergy to cut grass and passive smoking. Mine improved when my lung capacity got better and I was encouraged to swim by my doctors