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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To not agree with the nurse practiser's view that my DS has asthma and to think a diagnosis should come from a doctor?

572 replies

PolkadotCircus · 17/02/2013 08:15

Soooo my v healthy but skinny boy 9 has had a nasty winter virus that he has had problems shaking off,symptoms involve a cough that won't go away.Loads of other kids and adults have had/got it here.

The same happened last year and our fab doctor gave him temp inhalers to calm his airways down which worked a treat and were never used again.

His grandad is the same(very skinny and some times gets a chest infection in winter it takes a whole to shake off) but still cycling 16 miles a day at 80.

Anyhow dtwin 1 keeping dtwin 2 awake so tried to get an appointment with our fab GP but because he is so fab it is nigh on impossible so was offered an appointment with a nurse which I reluctantly accepted as all I wanted were temp inhalers and ds better ASAP.

Anyhow after a very lengthy appointment when his puff was measured,history looked at,records filled in,weighed etc she finally gave us some inhalers.Puff was poor(errr yes he has a virus and a temp) and we were told to come back for a follow up asthma review.I said but he doesn't have asthma only to be told well this happened last year etc,etc.

So we went to the review puff beyond normal now and very good,virus over so no surprise.Nurse then said as he had asthma she'd like to see him again,keep him in her records,how many inhalers did he have etc,to keep him topped up when tight in the chest etc etc.

I said very firmly he doesn't have asthma and never gets tight in the chest.She then asked if he had eczema or hay fever.He had eczema as a baby and gets a bit sneezy in the summer ahhhh then they are linked so he does have asthma.Me-no he doesn't he just gets a cough he can't shake some winters.
I don't want asthma on his records unnecessarily.We politely agreed to disagree.

So aibu to think a)he doesn't have asthma and b) a diagnosis should come from a doctor.

OP posts:
MousyMouse · 17/02/2013 15:37

'asthma' like responses when he gets hayfever

it is asthma, one of the many kinds.

MorganLeFey · 17/02/2013 15:38

swisscottage = I used to be a trained asthma nurse in a GP practice and as I understand, all asthma nurses have to pass the diploma in asthma at the national asthma centre which involves a considerable amount of work and studying , plus two 2 hour exams. Therefore, the GPs give us autonomy to be able to diagnose and see asthma patients because most of the time we are more experienced than them - we can specialise in areas of interest whilst they have to be more broad spectrum.

Does that sort of diploma cover much about the differential diagnosis of asthma, especially in children or evidence basis for treatment by age groups..?
That's what would make me nervous - another underlying condition being missed e.g. cardiac wheeze, cystic fibrosis etc. when it's not barn door obvious etc.

Original poster
PolkadotCircus · 17/02/2013 15:39

Clay he had the brown and blue one just one of each.

OP posts:
ClayDavis · 17/02/2013 15:41

So when you say by the second inhaler do you mean they gave you the blue one first and then the brown when that didn't work?

weblette · 17/02/2013 15:42

Polka please separate what happened to you from what happened to your child.

Prescriptions are free for children, that is not an issue. The very simple fact is that when older children present with wheeze/reduced peak flow/tug/compromised breathing on more than one occasion the usual protocol is to treat it as asthma. Up to about the age of four it's seen as viral-induced wheeze.

If it happens again, having the appropriate medicine in the house will reassure you. If you want another opinion go and see your gp but I doubt they will question what the NP has said.

Asthma is a nuisance but my dses play tons of sport, yesterday was swimming and cricket, today is rugby and tennis. It's not a stigma, it's just an awareness that when they have a virus they respond in a particular way which needs to be dealt with in a particular way.

Original poster
PolkadotCircus · 17/02/2013 15:43

If he took the inhalers without really needing too would it be a bad thing ie do they have any side effects?Can you take too much and is this a bad thing?Should I give them every time he is under the weather?Does the effect get lessened if you give them without really needing to?

OP posts:
blubberguts · 17/02/2013 15:43

Polka do you know how to use the inhalers and what each one does?

GreatUncleEddie · 17/02/2013 15:43

Funny how asthma meds are so helpful for a boy who hasn't got asthma.

Wheresmycaffeinedrip · 17/02/2013 15:44

And why is she paying?

Original poster
PolkadotCircus · 17/02/2013 15:45

No you use them both don't you,one opens the airways and the other treats it Confused

Web but he has never had compromised breathing ever or ny of those other symptoms,his twin had croup badly twice so I know what compromised breathing is like.

OP posts:
weblette · 17/02/2013 15:47

There are absolutely no side-effects from taking them, they reduce the reaction in your child's lungs so can minimise the effect if your child does then have a respiratory virus which triggers a response. They have no long-term detrimental effect.

Wheresmycaffeinedrip · 17/02/2013 15:47

The blue ones opens the air ways when the chest gets tight. The brown one is the preventer

amillionyears · 17/02/2013 15:47

I dont understand the paying either.

Wheresmycaffeinedrip · 17/02/2013 15:49

You take the brown one daily and the blue one when it flares up and the chest gets tight and they r struggling.

harryhausen · 17/02/2013 15:49

Blimey ZeebooShock Uncalled for!

If this has happened twice annually to your Ds OP, I would have thought they'd have suggested he continues with the brown inhaler throughout the year.
The brown inhaler is a preventative measure that's the most important part of the treatment of asthma. It takes a few weeks to build up in effectiveness so if prone to asthma, it's best taken regularly even when well.

Trazzletoes · 17/02/2013 15:51

OP, generally one will be taken daily, or twice daily, as routine. The other one is just for when he needs it because he has symptoms. It's pretty hard to overdose on it - if it's not working and he has breathing problems then you would need to get him to hospital.

Coughing is a symptom of asthma - it's how my sister was diagnosed. She never had a "classic" asthma attack either. Give him the inhaler as and when he needs it - it sounds like it wouldn't be very often.

Are you aware that, with asthma, the problem isn't generally with breathing in (as most people think it is) but with breathing out, hence the coughing. (Someone is probably going to tell me that's wrong now!!!)

ClayDavis · 17/02/2013 15:53

They blue inhaler contains salbutamol. This is a short acting reliever and will act immediately when symptomatic e.g. wheezing, coughing etc. This is normally taken when symptomatic but can be taken regularly e.g. 2 puffs every 4 hrs if going through a it of a rough patch. Your prescription will tell you when to take it (as required or a specific dose).

The brown inhaler contains contains a steroid. This reduces inflamation in the lungs which should prevent them from reacting to an irritant (dust, virus etc). If its well controlled using the brown inhaler should mean that you don't need to use the blue one.

weblette · 17/02/2013 15:53

Croup and asthma are two very different things. I've seen both in my dcs (I have 4)

Polka you sound very scared. Asthma is something that really can be lived with. It's not a label, it's recognition of something that can make your child feel really rotten but there are so many ways to treat it and deal with it. The fact they're taking it seriously and trying to help I'd take as a positive.

As I said, it's a nuisance. Ds2 has had an awful Winter with a chest infection he simply couldn't shake which has lead to at least four attacks but we know what to do and we have complete confidence in how our local surgery can help us.

So you take the meds and it never happens again? Fantastic! So you take the meds and it does come back but because you know what to give him, fine. I can't see a negative in this.

Original poster
PolkadotCircus · 17/02/2013 15:54

No just once Harry,one virus/bug this year,one last year but will check.

Re the paying it was for my scripts last year,don't know why. I threw that in just to show I had had the same treatment and at 45 know I'm not asthmatic. I explained further downSmile.

Would just like to add if. I had had. Gp's referral to said clinic. I'd have been less sceptical in the first place.

OP posts:
higgle · 17/02/2013 15:57

Is it not the case that a history of asthma prevents you from becoming a pilot? I remember being very concerned not to have anything recorded on DSs medical records that I wasn't 100% happy with incase there were repercussions later on. Personally I expect to see a qualified doctor when I need advice, wouldn't trust a nurse to diagnose anything.

JugglingFromHereToThere · 17/02/2013 15:57

Do people sometimes just get given the short acting blue one ?
Am wondering if this could help my DD when she has nasty night-time coughing attacks during a cold virus ?
Something to talk with doctor - or Nurse Practitioner ? - about ?

weblette · 17/02/2013 15:58

But you're an adult, it presents differently in a child.
I know you're unhappy but actually your child has had very good care. IMHO GPs can downplay asthma. One of the GPs at our surgery does and I now know not to go to him.

Original poster
PolkadotCircus · 17/02/2013 15:59

Web can asthma cause concentration lapses,whiteness,tiredness etc?Can you have it during periods of zero cough or wheeziness?

Also now wondering if the summer runny nose etc should be looked at.can hay fever cause concentration lapses?

Starting to think about a few things.

OP posts:
amillionyears · 17/02/2013 16:01

You cant go in the army with asthma, as far as I know.

amillionyears · 17/02/2013 16:02

PolkadotCircus, cant remember if you have made the GP appointment yet.
If you have not, I think you had better make it a double one Smile