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.

I presume OP has someone called Ashma in her contact list, and her iPad keeps correcting her typing of asthma to Ashma. My iPhone corrects me typing do to Fi as I have a Fi in my contacts list. It's very very annoying!!

Thanks Amillion-will do!

x post!

Trixy isn't it just,will get the whole auto thing switched off when I have worked out how to do it.

news.bbc.co.uk/1/hi/health/8055038.stm

And I'm sure that your GP is very highly qualified BUT that doesn't necessarily mean he is the expert. For example Drs are considered more knowledgeable than nurses/midwives. However when the SHO/FY1 first rotates into an area (think Feb/Aug) and your baby is ill - who might have the most knowledge - the SHO with days of experience or the Midwife/nurse with years?

Similarly as a GP he will need to know about everything to some extent, whereas the Nurse Practitioner will specialise in a few conditions - who is likely to have the greater expertise?

Oh and I have 3 children - 1 with diagnosed asthma - doesn't qualify me to diagnose asthma

so if it worked a treat the last time and you have then gone back for more inhalers whats the problem really?

Asthma is respiratory symptoms caused by inflammation of the airways. If symptoms are relieved by a bronchodilator (salbutamol otherwise known as ventolin) that is enough to make a diagnosis.

Treatment involves longterm treatment with steroids to reduced inflammation usually in inhaled form eg becotide and a bronchodilator or reliever eg ventolin for symtom relief although when asthma is bad oral steroids may be required.

Not rocket science, even for a nurse.

Yes well Mutt as a family we rarely use our Gp (dp has only been twice in the 22 years I've known him)at all so forgive me if I book an appointment I am very much entitled to thanks.

The problem being I want more info,the nurse didn't or couldn't answer my questions.

Ok Trees!

You're being a bit weird about your approach to this. Fine if you want a second opinion, but you seem to have decided in your own mind that it's not asthma and that you don't want a record of asthma on your child's records.

The problem with both of those things is that it sounds like there's a reasonable chance that he does have low-level asthma.

There's a huge range - my DP had it so badly as a child that he was hospitalised on more than one occasion. He very rarely has any problems as an adult - occasional mild wheeziness at the most. I had very mild asthma as a child - no attacks or breathing problems but persistent coughs and wheeziness every winter. As an adult I still suffer from the persistent winter coughs and I wish I'd had more consistent care and better advice.

DS2 is showing some possible early signs of asthma - if he has it, he has it and we'll have it diagnosed and treated. I've got to say that travel insurance has never even floated across my mind during any doctor's appointment!

polkadot, I'm really puzzled by your attitude. Have you made an appointment with your GP? Please don't leave your son untreated. It is dangerous. Would you really leave your son at risk because you are worried your insurance premiums will go up? What if he had, God forbid, something even more serious, would you walk out of the surgery saying 'no, I refuse to believe it, I'm going to leave him to get even more ill?'

His symptoms are actually very suggestive of asthma. Eczema + asthma symptoms could easily be atopic asthma, i.e. related to allergies. Cough that keeps you awake at night and goes on longer than a normal cough and cold could well be asthma.

You seem incredibly resistant to having your son diagnosed and treated. Nurse practitioners* don't just walk in off the street, they have specialist training. The receptionist was giving you an appointment with the right person to deal with your ds's symptoms.

Please make your son that appointment with his GP. Your stubborn-ness and anger at seeing a nurse practitioner instead of a GP shouldn't get in the way of the treatment he may well need. That would be neglect. I'm sure you don't want to leave your son at risk or neglect him - go and see your GP since you don't want to take the word of a nurse. Untreated asthma can be fatal - thankfully this is not common but it must be taken seriously, not ignored because you are worried about your health insurance. Having insurance won't be a comfort if your son has an asthma attack and ends up very seriously ill indeed.

*I'd be very surprised if autocorrect gave you practiser for practitioner, given that practiser isn't actually a word. Check your dictionary. And if it was autocorrect, turn the damn thing off, it's crap!

Gosh polkadot- you are very snappy. Why post on here if you are clearly irritated by the responses??? Did you expect us all to just agree with you???

Yabu. Dd has a cough. A very persistent cough. After months of backwards and forwards to the gp they finally referred us to the hospital. She was given inhalers and within a few weeks her cough had completely gone. She is on the whole fine but winter months and colder weather bring her cough on again. We give her inhalers until the season is over and ease off until we are satisfied her cough as gone. I am happy that this is a diagnosis of asthma as it means I can get her inhalers on repeat without having to see a gp all the time, when she gets particularly bad she is allowed steroids to help her get over it quicker.

It is worth nothing that's she is not and never has been wheezy, nor complained of a tight chest. But the only treatment which has worked is the asthma meds. When I looked it up, there are various forms of asthma and its not always as straightforward as running and getting wheezy.

Given that your dc has also had hayfever, it's a natural connection to make.

Op i totally agree with you.

I once had painful chest and breathing, given appointment with nurse, did puff test, given inhalers and told im asthmatic although no history of this for me. 2 months later poins still there so i go back and see someone else. Lo and behold it is a chest infection that i have been suffering with unnecessarily for monthd

Also, my ds7 gets lots of coughs in autumn winter, and when he does he wheezes and cant do exercise and coughs his heart out at bedtime.
s
I saw a gp who
said (I hope you are all reading this !), it is not possible to give a definitive diagnosis f asthma in young children except my trial of medication by inhaler. I do not want to give you an inhler right now as ds may not have asthma and i do not agree with labelling children with ashma without clear need. Keep a note of any instances and triggers and come and see us again if you have concerns in the future. Do not see the asthma nurse, you must see a gp (ie for first diagnosis of child).

Have a look at the British Lung Foundation to find out more about asthma, btw.

And I'm very glad to see you are going to the GP - hadn't seen that post when I posted.

If symptoms are relieved by a bronchodilator (salbutamol otherwise known as ventolin) that is enough to make a diagnosis.

I'm not sure it's that simple. Viral induced wheezing (VIW) is relieved by same treatment, and that definitely doesn't always lead inevitably to asthma diagnosis later.

DH was diagnosed as asthmatic by The local asthma expert in 2001: it turned out to be the kind of asthma that went away after being re-diagnosed as pneumonia (by a different GP) and 3 lots of antibiotics. So I am always reserved about asthma diagnoses. That said, DH is slightly more prone to chest problems than I think most people are; legacy of competitive sport perhaps, or the pneumonia. I still think OP is being treated unfairly for wanting to query this closely. She's just trying to get her brain around it.

Sorry bout dreadful typing, phone keeps chewing bits of sentences up

I meant to add, sometimes there has to be an element of common sense. DS2 had a cough and some mild wheeziness. My MIL kept saying over the course of the day that she thought it was more serious than I did. I finished up calling her at 11pm (DP was away) to look after DS1 while I took DS2 to hospital where he was rushed through and admitted with bronchiolitis.

A different illness, granted, but the point is that she was so used to caring for a child with breathing problems that she could recognise the signs of a child's breathing deteriorating before it had got to the point when I could see that something was really wrong.

It doesn't all have to be specific tests and calculations - an experienced eye is just as important sometimes.

Edam I said he had the inhaler for 2 weeks,job done. I did exactly what I was told to do as I said.

Have listened and thanked for the info.Have certainly taken the info on board which is why I want more info particularly as said condition can clearly be serious however as I feel my questions weren't answered I want more info as any parent would.

I found turning off autocorrect more annoying!!!

Mutt you didn't read what I said. I asked perfectly reasonable and polite questions which didn't get answered.

Got to take said child to football,thanks for all the info will definitely follow it up.

Trixy