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

[PolkadotCircus]

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.

Asthma can present in all sorts of ways, I have asthma, but hardly ever need to use inhalers, as it is only triggered by certain things.

But I always keep a blue inhaler on me, after having a sever asthma attack on a train when I was a student. I had no inhaler on me, but fortunately a lady nearby did. The train was stopped and I was blue lighted to hospital.

I understand your worry about insurance, but if your ds has asthma, it is important that he knows, so that school can be informed, and if he ever needs medical treatment the hcps are made aware.

Our dds have asthma, one is triggered by grass pollen, and the other is worse in the Winter months, virus induced and worse when the weather is frosty. They have an inhaler kept at school and an asthma card kept with the inhaler, that explains when they may need it. They are 5 and 6 and know when to ask for it.

Oh, and it is possible to develop asthma later in life, dh developed it when he was 35.

I was not informed of any of the below,risk of blue lighting etc.Absolutely zilch.Said nurse gave me zero info re Ashma,zero areas to watch,zero triggers to look out for,zero info on what to do if an attack occurs nothing,zeo info on symptoms-just a label.

That isn't good enough.

If my son has Ashma. I expect a proper diagnosis not a referral to a nurse by a receptionist who hasn't even seen him and isn't medically qualified then a diagnosis by said nurse on the fact he had a cough last winter and now this winter(never previously) along with half the town.

I don't want my son taking meds he doesn't need and if he has a serious condition I'd like a bit more info.

Will get an appointment with my gp,shame I couldn't get that in the first place.

You can't compare cough mixture to inhalers. Cough mixture is essentially sugary rubbish. Inhalers help open the airways and suppress inflammation, depending on which ones you have.

Nurse practitioners have extensive training and can prescribe. Don't knock them. Also, many kids have asthma, it's not a stigma.

YABU.

Insurance is more expensive? I've never noticed that I'min Ireland where private health insurance costs a fortune. You're right about the inhalers though. One I got once was ?95 (sabutemol?) You can get a cheaper equivalent becotide which is only about ?35 afaik.

Sorry another thing!

The idea that people with asthma are somehow weedy and unhealthy is not true, dd1 is very sporty, and run's around like crazy, dh is very fit, and works outdoors everyday and plays sports.

There are many famous sports people with asthma, Paul Scholes and Paula Radcliffe off the top of my head!

My DD seems to suffer with lots of coughing at night and occasionally being sick when she has a nasty cold virus. Maybe we should ask GP more about the possibility of asthma type symptoms ? However she is now 13 and seems to have coped OK without inhalers so far.
Am wondering if it's more of a spectrum type thing than a black and white has asthma/ doesn't have it situation ?

So because it's a nurse the diagnosis can't be right? Only a doctor can be correct?

I agree that you need some follow up, advice and care under the asthma team, which is run by nurses btw.

scarletforya - salbutamol and becotide are 2 different drugs.

YABVU. You seem to think that gp's are all knowing, they aren't. And worrying about cost implications ahead of your childs health, wirds fail me.

Oh and your gp will probably refer you to an asthma NURSE.

But op, you didn't really allow the nurse to give you information - you were categorical that he doesn't have asthma.

Based on your op, you weren't interested in hearing the facts. The nurse probably thought you knew, YOU should be asking for more information. Not blaming the nurse for not giving you information on something you told her he doesn't have. Chances are you would not have listened anyway.

I'm wondering if the word asthma is already on his notes, put there by the doctor, but the doctor just hasn't told you. And that's why the nurse assumed you knew.

Clearly he does need the medication if it works. Which it does.

Your job is not to protect their records, your job as a parent is to ensure that your children are protected and if that means one of them is 'labelled' medically as asthmatic, then so be it. Children can and do die from asthma. Better that it be on his records, even if diagnosed by a nurse, and appropriate medication taken than not recorded or treated.

It is wrong that you've not been given more information though - perhaps you'd be a bit less U if the nurse had told you a bit more about asthma instead of prescribing and sending you off.

"ne I got once was ?95 (sabutemol?) You can get a cheaper equivalent becotide which is only about ?35 afaik."

Salbutemol is a reliever and Becotide is a preventer. They fulfill to entirely different functions.

Yabu.

I'm not at all sure how you being cross that she was so thorough and took a very full history, and you feeling she knew nothing correspond. It comes across that ypu'd have been much happier with a gp throwing meds at the problem but not examining the recurring nature of this problem.

This type of virus related asthma is very common, and can be headed off at the pass by starting preventative measures in the autumn. With proper care and supervision, it may be tgat ypur ds can gave a cough free winter. It sounds as though the NP was trying to provide this for you. NP gain tgeir asthma qualifications from a national training centre in the midlands, and are almost always far more up to date than doctors, hence them running tge asthma clinics. Maybe you didn't get the full benefit of this knowledge due to you insisting she was wrong.

In terms of insurance, tge label makes no difference. If ypur ds had a chest infection/cough/needed inhalers and ypu clained and it was found tgese were recurring symptoms with inhalers previously prescribed, you would have xover issues regardless. Odd that these concerns come ahead of your ds' need for appropriate care.

Sorry not salbutemol, the purple disc one, it's Steroid one.

No support is pretty standard where I am. I only found out by accident that they actually considered my dd asthmatic and we get blue inhaler and that's it. No follow ups no fact sheets nothing. My friend on the other hand in a different counter was referred to asthma clinic and given all sorts of advice. Depends where you are I guess and gps can be rubbish anyway. Nurses are just as capable and know more half the time as they run the clinics.

YABU and snobby.

Nurse practicioners are very very experienced, qualified and knowledgeable

YABU and you sound like an absolute loon.

'Protect their records' WTF? Who even thinks about this stuff if their kids are unwell?

FWIW - my DS1 is 4.6 and has very similar symptoms, and I am pushing for a diagnosis of asthma (I am asthmatic myself) so that he can be prescribed steroid inhalers to use during winter so that we don't have this problem every year of any viral thing going to his chest and laying him low for 2 weeks.

I think you have received very good care, despite your best efforts to avoid it and rubbish it.

I cannot begin to understand your mindset and motivations.

You seem to be in denial OP sorry, as you keep repeating you got prescribed inhalers for a virus, no you didnt, you and your DS got prescribed inhalers for difficulty in breathing caused by narrowed airways. I have 2 DSs the 5 year old has asthma and the 10 year old doesn't. The 10 year old catches the same bugs as the youngest but doesn't need an inhaler whilst my youngest does. Of course go back to the GP but I find your attitude about not wanting it on his records a bit odd at the expense of his health. My DH has asthma and has never had any problems with insurance.

Based on your last post, although it sounds like communication has been a problem in that nobody spelled it out to you that there is a continuum between childhood virus-related coughing and asthma, I think your attitude stinks.

You can read. You have internet access. Take some responsibility for your child's health.

And perhaps if you'd spent less time arguing with the nurse about her diagnosis she'd have had the time to explain all of this to you. As it was I imagine she could little see the point of trying to educate you on a condition you'd already decided your son didn't have.

You're being obstinate and self righteous and unreasonable. Go back. Apologise and explain that you have a better understanding having verified the diagnosis on the internet and ask for more info. Don't be a dick about this, it's important.

You can buy two blue salbutamol inhalers for £7 in Asda (think you need a prescription or repeat). Why are they so expensive in other countries?!?!

Excuse me for being dim, but if you're in the UK, and DS gets NHS prescriptions, why do insurance costs matter?

Salmeterol not salbutemol! ! Doh!

Does seem a bit odd to worry about protecting their records and the cost of insurance for a child in UK (where we have a free NHS ?) Agree that getting the right advice and treatment where necessary is more important !

I can understand though that you feel the process of diagnosing asthma in your child could have been handled better OP - with more information and a proper consultation and explanation - perhaps by your GP. Perhaps the nurse could have said that she feels there are some asthma type symptoms and book you an appointment with your GP to discuss further, especially when she could see you weren't so happy with things in your appointment with her. Or she could have taken more time to go through things more thoroughly herself ?