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 IS linked to hayfever, excema and allergies. They are called 'atopic' conditions.

If your DS needs inhalers when he has a virus, then he probably DOES have asthma.

My DS2 has chronic asthma, and for the last 9 years it HAS interfered with his life.

He IS a lot worse when he has a virus.

Isit, that advice that advice really only applies to children under the age of 3. Possibly 5 at the max. The OP's child is 9. Refusing to even trial an inhaler on a child that is wheezing, can't do exercise and and 'coughing his heart out at bedtime' is dangerous to the point of incompetence IMHO.

OP, in terms of insurance, it doesn't matter whether you get a label of asthma or not. The fact is your child has been prescribed an inhaler twice and they will see this as indicative of asthma. You need to make sure you mention this to them otherwise they may not pay out should you need them to.

Can't a pulmonary function test show it's definitely asthma?

I got one of those and they could rule out lots of things and I thought confirmed asthma based on the spirometry results.

Hmm, he indicated that the age limit would be higher.

Surely we dont think that every child in the land that gets a breathless winter cough should be trialled on an inhaler just in case they have asthma?

Clay. I will,I always declare everything hence paying more for his brother.I 'd never risk a payout for a few ££££ more premium.

Is that was exactly my reason to question.

He was never breathless by the way just had a persistent cough.Gp felt it was irritated and inhalers would cut the cycle-they did.

Isithometime. I find it touching all this faith only in doctors. I'm a nurse who could tell you of misdiagnoses in hospitals by doctors that could make your toes curl and which are often saved by the nurses. Also lots of nurses are crap. Let's not turn this into a nurses vs doctors slagging contest.

Also if asthma can only be definitively diagnosed by trial of bronchodilators why wouldn't your GP trial them and get a definitive answer especially as there is virtually no risk and lots of potential benefit.

Lastly, please everyone be very wary about children coughing at night this is a clear pointer to uncontrolled asthma and can soon escalate into more serious respiritory distress. My advice would be to seek medical advice if a child starts coughing loads when in bed at night. Don't take chances with potential asthma.

The point surely is in this case that it has happened more than once, which clearly indicates a susceptibility.

Blubberguts- exactly. I've cut and pasted from my earlier post below......

A Nurse manager colleague told me the tragic story of a boy who was sent into the hall at school for persistently coughing and 'disturbing the class'......he was found 15 minutes later dead in the hallway as he was having an undiagnosed asthma attack.

Have only read the first three pages, but I would agree with the need to get a GP appointment, particularly if the GP is a specialist in paediatrics. Then you can ask the GP all the right questions and get the answers you need.

I don't think it's unreasonable to respect the view of a doctor more than a nurse, by the way. Doctors undergo a medical training that is both broader and deeper than nurses. All other things being equal, of course the OP would prefer to get a diagnosis from a doctor than a nurse.

Blubber, no offence intended regarding dr v nurses, was merely wishing to underline the fact that a cursory and slapdash diagnosis can happen, especially if you are being seen by the wrong person for the job.

Also, i very strongly believe that the os right in as much as it is parents not dand nurse
who must take responsibility f or thei
childrens health, so op must question as much as she needs to.

Thank you for comment sbout adthma and coughing in bed. We have ha d 4 wheezy breathless type cougs sinceh august, 2 including cghing in bed, so perhaps the next instance will be the end of my record keeping and i will go back togp

Stupid phone

2nd para was trying to say that parents must take responsibility for tgeir childrens healt and not jyist defer to everything any meducal professional says

YABU - dgs(4) has always had coughs that won't shift. last winter he was diagnosed with cough-variant asthma after nights of literally non-stop coughing. He has since had nights in hospital on a nebuliser when inhalers werent enough.
It is usually one of the practice nurses who run the asthma clinic so I would certainly say they know what they're talking about. Just because it's not the classic wheezing that you may associate with asthma, it doesnt mean it's not asthma!

My DD suffers from chronic asthma, she coughs more than she wheezes. She's been hospitalised several times because it escalates very quickly.

By all means see a GP for a 'proper' diagnosis but please keep inhalers in school and in your handbag, just in case.

My DD actually sees a specialist nurse at the hospital for her asthma and she has suggested meds that Drs haven't which have vastly reduced the need for oral steroids and this was the first winter without a hospital admission.

Op - it doesn't matter what anyone says to you, you clearly have a bigotted attitude towards nurses so no amount of informed argument will persuade you otherwise.

I find your blind faith and devotion towards your GP concerning. No matter how fantastic a doctor is, they can never be an expert in everything (medicine is a vast and rapidly changing area); that is why you have specialists (one of which is asthma nurses). All health professionals make mistakes occasionally (doctors and nurses), so I would never take the word of one doctor or nurse as gospel.
In regards to the receptionist, she would have been following protocols about what types of problems the NP can see. These protocols would have been agreed by thr drs at the surgery, who recognise the competence and expertise if their NP colleagues - but f course, you are a better judge of that than they are (even if "they" includes your GP - oh hang on, that would mean disagreeing with him!)

Nurse Practitioners can be very VERY good - they can also be a bit pants, though, as is the case with doctors (& indeed people in every profession going).

It very definitely sounds like asthma to me but agree you need more information. Best place for that is Asthma UK - as well as the wealth of information on the website you can order various publications from them (for free) & they have an adviceline you can call for free in office hours on weekdays. Said adviceline is staffed by Nurse Specialists, mind you - but if other healthcare professionals trust their expertise you might be as well to?

Asthma that is (currently) so mild & easily controllable & has only the one trigger shouldn't cause any problems with getting Travel Insurance. Insurers will ask questions about hospital admissions, amount of medications & ability to walk on the flat without becoming breathless to determine if there's a substantial risk of their needing to pay out for treatment. Most people I know with asthma have zero problems insurance-wise because insurers recognise it's a very common condition (especially in children) & that for the majority of people it won't require emergency treatment.

You really don't want to your stubbornness to accept this diagnosis to put your son's life at risk. There are plenty of stories above to illustrate how that can happen & leaving asthma untreated & unmonitored massively increases that risk. I once took a girl on Brownie Holiday who was thought to have outgrown her asthma: she really REALLY hadn't. She got asthma symptoms when she contracted a virus & someone had brought along a lovely multisystemic lurgy with them. The last night of the holiday we had half a dozen girls spiking temps & feeling sick (plus one complaining of same in interests of getting attention); including one whose body produced an allergic reaction on encountering a new virus and then the wee lass who developed asthma symptoms when she picked up a virus. Thankfully we could get through to her mother (helpfully, a nurse) on the phone & she agreed to our treating the attack ourselves in the first instance. Luckily 10 puffs of salbutamol through a spacer worked & our scared little 8 year old was spared the additional stress of a trip to hospital.

When you say she measured "puff" do you mean a peak flow reading or spirometry? With the latter, the shape of the graph produced can give a good indication of an individual's having asthma even if they are well. With peak flow, whilst there are expected ranges based on age, height & gender (IIRC) it is possible for people with asthma to have a better PF (when well) than would be expected: I generally do. Turns out that's (partly/mostly) down to the connective tissue disorder I have, but before that was diagnosed it was assumed to be down to the fact my lungs were "trained" by playing woodwind instruments. You should have a PF meter at home to keep track of your son's lung function at the most basic level - another classic indicator of asthma is having lower readings in the mornings than in the evenings.

Anyway, YABU to have felt the DX should have come from a doctor & to be so hostile towards the idea of your son having asthma. YANBU to want information about asthma & advice on the management thereof, but it doesn't sound as though you were in any way willing to accept it if it had been offered.

Dp took him(yay there is some benefit to MN whilst lounging in your pjs).

Just one last question which I will ask the doc too but until I get an appointment which could be some -time could you go from being a child with zero wheezing or breathlessness and just 2 winter coughs in recent years to a full blown scary asthma attack out of the blue ie do I need to alert school and give them our only inhaler before then?

Zebra he had to puff into a thing which she said was over 100% the first time,even higher the next and very good in her opinion.

What's with the cost of the inhalers being relevant? Are you not under the NHS for some reason? Your DS would get his free and yours would be whatever the current prescription price is (£7-8ish I believe) surely?

You seem to have very little respect for this person because they were a nurse....ime nurses are often much better to see than GPs, they tend to have more recent practical experience at treating conditions. I do not like the snobbish attitude towards being "entitled" to a GP appointment when the nurse would be fine.

My dad had asthma and can blow the peak flow to its maximum, probably because he plays the trumpet.

Tidy you didn't read the thread properly.

Nurse wasn't fine,my questions weren't answered.

Cost was for me,I had the same virus last year and pay for prescriptions.Had to pay best part of £30 for 2x meds and the machine thing.I don't have asthma,'twas first time any of us had to use an inhaler,'twas to get rid of a cough.Several others had the same for the same virus.

polka I was diagnosed with asthma at the age of 15 - no problems before then but I had a cold and found it progressively difficult to breathe. I went to the GP and was put on a nebulizer. My mum was not sure whether to take me to the GP or hospital. At the time I couldn't get my breath to walk between rooms. It happened very quickly so, yes, I would say that it's fairly unlikely, but possible that your DS could have a serious attack.

My GP's kids have eczema. Doesn't mean he knew how to treat my ds's eczema. Infact the dermatologist we saw completely rubbished everything he said.

If your GP says yes he has asthma, are you going to smile sweetly and say 'yes doctor?' as obviously his word is gospel.

A lot of clinics are run by specialist nurses, something you are going to have to get used to. You may not even be seen by a doctor!