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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To expect DS' asthma to be better, not worse after a three day stay in hospital?

34 replies

funkypigeon · 18/02/2013 18:36

DS has chronic brittle asthma. We got home about 2 hours ago after his 8th admission in 12 months.,he was in since Friday. They gave him the usual- burst therapy, involving multiple dosing if salbutamol, oxygen when required and prednisolone (oral steroids). But today and since we got home he has been coughing almost non stop and lethargic- just wanting to lay on the sofa. His sats are around 90-93%. He is 4.

Argh, I don't know, it's just so frustrating. I expected some improvement by now. He had a temperature this morning, and the doctor just assured me it's a virus that he has that's causing this. He's on antibiotics as well. AIBU? And what do I do? Surely they wouldn't have let him out if he wasn't ok, but clearly he's not again now. I've given him his pump and he's now in and out of sleep.

I don't want to overreact but I'm finding it hard not to be worried. Please could someone share their experiences of having an acute episode like this with their child? I know it isn't the first time, it's just that he was in all weekend so I thought we'd be going in the right direction about now.

OP posts:
CwtchesAndCuddles · 18/02/2013 18:41

I think you need to take him back to hospital, it sounds like he has gone downhill again and needs more treatment as his sats are low.

ClayDavis · 18/02/2013 18:43

Has he got worse since getting home or is he about the same as he was when he was discharged? If he's got worse I'd give the hospital a call to see what they say.

Original poster
funkypigeon · 18/02/2013 18:48

I'd say he's got worse in that he hasn't wanted to play, just lie down. I'll give them a call. And also the coughing.

OP posts:
Original poster
funkypigeon · 18/02/2013 19:01

I just called the ward and they said he sounds ok. I explained that I think he's worsened but the nurse told me he's probably just tired himself out with the coughing and that's why he's lying down a lot. His breathing is 40 per minute. Advised me to keep an eye and if he has recessions under his ribs to come back in.

OP posts:
mummymeister · 18/02/2013 19:03

Take him back to hospital. ask to speak to a consultant and get a second opinion if necessary. start doing some online research to find who is best in this field. go with your gut instinct. you are his mum you know him better than anyone and if you think he is worse then fight for him to get the right treatment. dont be fobbed off by a nurse on the phone who cant even see him.

pinkpaperpiggy · 18/02/2013 19:06

His SATs are quite low. That would concern me at this time of the evening because in my experience with dd's asthma at that age her SATs always dropped once she was asleep.

Can you see any recessions under the ribs or at the bottom of the throat?

Is he lying flat or well propped up?

Hatescolds · 18/02/2013 19:12

His sats are low and if his respiration rate is really 40 a minute then I would take him back to be honest - hope he settles soon

Original poster
funkypigeon · 18/02/2013 19:13

Thanks all.

He does have some recessions, although they were there this morning as well. He propped up, saying his chest hurts now.

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Original poster
funkypigeon · 18/02/2013 19:15

They are 40, yes. Is that very high?

OP posts:
Wheresmycaffeinedrip · 18/02/2013 19:15

Take him back ! I assume you were released with a 24 hr bounce back notice? Sats that low he shouldn't be home :(

Original poster
funkypigeon · 18/02/2013 19:16

Ok sats 87 I'm taking him in

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ClayDavis · 18/02/2013 19:17

If he's saying his chest hurts I would think he's making quite a lot of effort to breathe. I think I'd be taking him back to get properly checked out.

Hatescolds · 18/02/2013 19:19

Usually in 4 years old would expect around 20- 25 breath/ minute. In sign acute asthma guidelines acute severe asthma in a child between 2- 5 yrs would be characterised by sats < 92 and resp rate over 40, would worry about him becoming tired if resp rate was that high , am surprised hospital did not suggest reviewing him.
I still think I would take him back but is difficult when hospital saying otherwise!

pinkpaperpiggy · 18/02/2013 19:19

20 -30 is considered normal at his age. Anything in the mid to high 30's would have caused us some concern. He is still very young - I think they released him too soon.

At this stage I would be taking him back in - it happened to us once with dd. We took her home and had to go back within a few hours. The hospital were fine.

It's the thought of the night ahead - you won't sleep a wink watching and wondering and then you might end up having to take him urgently.

I know it gets to a point where you would love to be able to ride it out at home but my gut says take him in.

Hatescolds · 18/02/2013 19:20

sorry took too long to post glad you taking him back, hope he settles

pinkpaperpiggy · 18/02/2013 19:20

Just saw your last post. 87% not good. Glad you are going in.

Best of luck.

Doyouthinktheysaurus · 18/02/2013 19:25

I think you are right to trust your instincts and you should have the confidence never to ignore that.

You are doing the right thing going back in, I hope everything's ok.

TicTacSir · 18/02/2013 19:26

Anything under 95 for sats should be considered as a reason for hospital. Glad you're going in. Best of luck and get well soon mini pigeon.

grants1000 · 18/02/2013 20:10

Funky pigeon hope you and him are ok. Your post made me cray, both my DS's were exactly like this, so stressfull and upsetting, watching their little bodies working so hard and looking so wiped out.

If it helps any, both have grown out of it, now 10 & 6, 6 yo was dreadfull, viral induced wheeze, was put on a daily tablet called 'monte lu kast' and it made a huge difference, as your consultant, specifically for under 5's. he's been off it for one winter now and he's been fine, had lots of coughs & colds but they have not turned into anything serious/hospital admissions. Tablet is instead of brown inhaler.

Please let us know how you both are.

grants1000 · 18/02/2013 20:11

Sorry for bad iPod fumbling typing!

giraffesCantFlipPancakes · 18/02/2013 20:19

hope he better soon

Original poster
funkypigeon · 19/02/2013 08:08

Just a quick update. He settled down last night as soon as he fell asleep properly. Maintained his sats above 92%. They seemed to improve after a big cough. I kept a close eye on him and he seems better this morning. If he doesn't start to improve a lot today I'll be taking him back.

Thanks for all your replies and support.

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MerryCouthyMows · 19/02/2013 08:26

It's awful seeing them like this. Don't you have 'open door' to your children's ward? Where you can just go straight to CW bypassing A&E?

Here they trust the parents to bring them in if they see ONE of these signs : recession at the bottom of the throat. Intercostal dip (the recessions at the bottom of the rib cage). SATS below 95%. Unusually tired and lethargic. Maximum dose of salbutamol inhalers not helping.

I can't understand why your hospital is telling you not up come back in. Is Children's ward particularly busy? It's the only reason I can think of for them discharging him when he doesn't seem ready to be at home?

Sirzy · 19/02/2013 08:40

Hope he is better this morning. I hate the "should I shouldn't I" moments with regards to going to hopsital

Original poster
funkypigeon · 19/02/2013 10:08

He has bronchomalacia, so narrowing of the tubes going to his lungs, so they said he's 'bound' to be saturating below 93% anyway. But sod it, I will take him back if I'm not happy with him later. sirzy has your child ever needed IVs? I hate that 'should I, shouldn't I' thing too, more often than not I feel a bit I a fraud when we get there because he's perked up on so much salbutamol and they do tend to do this in front of HCP!

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