what does asthmatic breathing sound like?

[greenbananas]

For the last few weeks, DS seems to have had difficulty breathing during the night. He sounds wheezy, and there is funny 'catch' in his breath when he tries to exhale. He tosses and turns all night, and sometimes 'moans' in his throat while he is asleep. At first I thought it was just a cold, but it has been going on too long now.

He has a blue inhaler (following one rather frightening episode about six months ago) but he hasn't used it much until recently. Now he asks for it nearly every day.

I've kicked the cat out of the bedroom permanently (she used to sneak in at night) and have also spent the morning dusting and hoovering in the hope that this will help.

DS is 3 years old and has multiple food allergies, so his chances of developing asthma are quite high, yes? Is this the start of it? What should I do??

greenbananas I read the start of your post thinking "I don't remember writing that"
My ds2 had an episode about 6/7 months ago where he was rushed to hospital with breathing difficulties and was given a blue inhaler. Although he has not been officially diagnosed as asthmatic, he does when poorly get the symptoms and I find myself using the puffer.
He also has eczema too, so is probable he'd also have asthma.
Ds2 isn't on the brown preventer either, but I have had to use the blue one lots these past few days.
For us signs that he is struggling seem to be, his breathing gets very deep and loud and fast. He starts pulling the collar of his top away from his body, his laugh and breathing become more high pitched in sound. He takes breaths between words when talking. He wheezes either on the inhale or exhale, and his ribs become very prominent when he breathes, the skin gets all sucked in.

I don't know what else I can do for my ds either. I called the doctor this morning and he said to keep giving him the blue inhaler (but didn't say how often), and if he got worse to take him in, but I think it;s bad enough to warrant being seen now so I'm prb gonna take him down there after lunch.

The thing to watch for in asthma is the bit of the throat just above where the collarbones meet. If that sucks in with the inward breath, you need a medical opinion (and probably stronger meds).

also watch out for coughing/clearing throat, especially at night.
asthma nurse told us to come back for preventers when the blue spray (salbutamol) is used more that 3x a week.

also, as you have a cat, I would ask for allergic testing and seriously considering rehoming it. if he is allergic, hoovering and keeping it out would not be enough!

Does he breathe through his mouth or his nose?

It's very important for him to breath through his nose, as that filters out things like cat hair.......

We have a cat too.
My ds2 only needs the inhaler when he has a cold, not all the time.

so, yes, make an urgent appointment with asthma nurse or gp (reception should be able to tell you what's their practice).

my ds scratches his throat just before he gets breathing difficulties (allergic asthma here). and I remember the itchy throat (outside) from when I was a child, too.

Thank you so much for all your replies.

I think DS mostly breathes through his nose, but have noticed a fair bit of mouth-breathing when he has a cold.

He has been pulling and scratching at his throat a lot, especially at night. I have also noticed that sometimes his voice gets higher in pitch. Oh dear... I'll watch his throat above the collarbone...

silverymoon, that sounds really scary... good luck with the GP!!!

Thanks, I'm trying to get a look at his neck without getting him to look at the ceiling to get a more natural look at it. He is being uncooperative though

greenbananas - it does sound like you need a fairly urgent review with your GP and a preventer inhaler. Don't be fobbed off because he's too young - if his 'asthma' (although they don't like to officially diagnose until they are older) is not under control then there is a risk it gets worse and worse until you end up with a full blown attack. And in the meantime you are all getting a bad night's sleep!

Night time is the classic time for asthma symptoms to present themselves as well.

Our DD had a blue inhaler when she was about 1 or 2 after one A&E day trip which was attributed to post-viral drip (ie a cold). We used it increasingly often in the months after that. I eventually went to the GP, saying I thought she actually had asthma, and he fobbed me off as she was too young and 'he didn't like to label her'. She was hospitalised for 3 days just a few days after the GP visit with an incredibly scary attack that took them hours to get under control. I'm not saying this to frighten you - I just wanted to say that now she is kept under review by an asthma consultant and is on the preventer inhaler and we have very very few problems (apart from the food allergies...!).

So correct diagnosis and the appropriate medication is incredibly important - means that you shouldn't need to use the blue inhaler frequently (i.e. once a month, not a week or a day - and I don't know about you, but the blue inhaler makes DD go totally hyper, so the less we use it the better!). Also you all get a better nights sleep! (apologies to anyone who deals with acute asthma - I know not all cases are so easily controlled).

In addition, poorly controlled asthma can have a damaging effect on the chest. I was reluctant to put DD on long term regular meds, but after reading up on it, they are by far the best thing for her.

So basically - after that long rant (sorry!) - I would say go to the docs!

silverymoon - just seen your post as well. It does sound like you need a review, and a trip now to the GP or A&E might be the best way to get that, especially if he is bad right now.

Don't worry about it only being triggered by a cold - my DD's is as well, but that doesn't mean she doesn't need the preventer inhaler all the time. There's a possibility that we can stop using it in the summer months, but we tried this summer and she then got a cold!

FWIW - we were always told to give up to 10 blue puffs, every 4 hours. But if we needed to give the full 10 puffs, then we needed to go to A&E.

Well, the past 3/4 days I have been giving him about 6 puufs every 4 ish hours, although I'm not timing it, just giving when I think he needs it.
I have told the nursery to give it to him 4 hourly for now until I feel it can be stepped down gradually.
He seems ok, his ribs aren't showing when he breathes atm. He had 4 puffs at about 10am.
I have asked for anoth inhaler as not sure if ours is running out, so will collect that later and see how he is in a few hours/tomorrow.

I've been taking him to the gp everytime he's had a cold and said the same thing, that I've been using the inhaler and should he have a preventer, what else should I do etc, but they say because i don't use the blue one all the time, they don't want to give him anything else as the more it's given, the more it'll be needed or something.

Don't know whether to get him down there now or wait to see how he is later. What do you think?

(sorry greenbananas for the hi-jack)

We-ell, I don't know really. If its under control with that amount, then that's fine for now I guess, but no harm making an appointment for later to be sure. It sounds like a lot to be using on a regular basis, to me anyway.

Each GP practice should have a specialist asthma GP and nurse, so I guess you could find out who that is, to make sure you are talking to the right person? Sounds like you will just get the same answer again from your usual GP. I have to say, I've never heard anything along the lines of 'the more its given, the more its needed'. If asthma is properly controlled, then you shouldn't need the blue one at all, so just the opposite!

I am no expert at all though I very much hasten to add - you could try calling [http://www.asthma.org.uk/ asthma UK], they've got a number on the homepage for a nurse, who should be able to help more.

(PS if my DD had 6 puffs she'd be bouncing off the ceiling, trembling and wild eyed and staring! A very good reason, for me, to avoid using it all!)

silverymoon - this page here also gives good guidance on doses and triggers for a medication review.

I also want to add, my allergic asthma as child was treated with homeopathy, which absolutely doesn't work for asthma.
unfortunately this has left me with lung damage (scaring) which will make me prone to further problems later in life and affects my breathing badly each time I have a cold.

Will look at link when back at home.
Took him to gp anyway and was told to give ds 1 puff 4 times a day.
I don't notice a difference in his behaviour after blue puffer. That's a worry, he must be so hyper naturally that there is no difference at all!
Will reduce the dose and see what happens

lukewarmmama, thank you for your incredibly useful posts.

DS has used his inhaler about five times today, and I've got him a GP appointment for tomorrow. I no longer feel guilty for wasting their time - can't bear the idea of it getting any worse. His voice has sounded a bit weird all day.

I'd not realised the blue inhaler might make him hyper, but that does explain why he was jumping around and bouncing on the bed at 1am this morning!!

I would write more, but he is pulling at my clothes and telling me to leave the computer alone. Again, thank you.

when I take the blue inhaler too close to bedtime, I can't sleep as salbutamol (the active ingredient) has an effect on the heart.

I mean, it can make the heart go faster, which makes people hyper.

greenbananas - you are most welcome. I've had so much useful advice from MN over the years that it is nice to pass some of it back. Good luck with the docs.