To be unsure of this asthma diagnosis?

[MrsMigginsMate]

AIBU to think my doctor hasn't quite got this one right? DD 8 is now on inhalers for asthma but her symptoms don't seem consistent.

Her "attacks" usually happen in the evening as a sort of afterthought right at the end of our bedtime routine, she very calmly says she feels like she can't breathe whilst breathing perfectly normally.

Yesterday she biked for miles in cold wet weather and didn't have any symptoms until 5 hours later at bedtime she said her chest hurt and asked for Calpol thinking it was muscular. Instead I offered the blue inhaler which seemed to instantly fix it which perhaps suggests there is a tightness in her chest from it.

For context she is a bit of a hypochondriac child and does enjoy the attention she gets when ill, so part of me thinks she is fabricating it all. But obviously i don't want to take any risks by jumping to the wrong conclusion so I will continue with the inhalers, but it doesn't feel right.

Can anyone with experience of asthma tell me if this is normal?

I’ve been asthmatic all of my life and it was a lot worse when I was a child. For many years I slept propped up with extra pillows so I was half sitting as laying down flat did make breathing difficult for me. I also noticed an improvement after my mum covered my pillows and quilt with hypoallergenic covers. I’m nearly 40 now and I’ve outgrown a lot of the worst symptoms of it (or treatment has got better over the years) but regardless of if I’ve had a good day/bad day chest wise it’s always worse at night.

My asthma was mainly at night. I dont remember ever having any issues during the day, and I was a very active kid. But I'd cough all night and had teo life threatening asthma attacks in the night. I dont think its uncommon.
Is she sensitive to aerosols? Even now I cant use aerosol body spray or deodorant because it makes my chest and throat tight.

Sometimes seasonal allergies can make it worse. My dn is sensitive to dairy which makes his asthma worse if he has it late in the day it evening.
You’ll just need to monitor her and see if there’s anything obvious, if there is.

Its definitely a tricky one. I suffer with some anxiety and it manifests as tightness in my chest and a feeling like I'm not getting in enough air. Its often more obvious when I first lie down in bed. Because my issues are around breathing any feeling of a change to my breathing escalates the anxiety and its vicious cycle. I don't hyperventilate or anything but my chest and neck muscles feel tight and I feel (but don't sound) short of breath.

My DSs have viral induced wheeze and occasionally get chest tightness and short of breath but its easy for me as they have an audible wheeze which goes after a puff or two of the inhaler. They also tend to cough when this happens so again really easy to determine what it is.

Under different circumstances I would say try distracting her and see if she is still complaining but I would be afraid to mess with something like asthma and children can deteriorate rapidly. I would do as others suggested and do peak flow readings and keep a diary of her symptoms/times/activities/mood etc to see if there is a pattern and continue with the inhalers until you get testing done.

One of my DS's has been needing the blue inhaler more often and Dr said to keep a diary like mentioned and frequency of use of blue inhaler and he will see if he needs to be tested for asthma.

Hope it all works out ok.

@Florencex

Surely the doctor has performed the usual tests? They won’t have done a diagnosis purely on what the child has said.

My doctor said that they diagnose by seeing if inhalers help. We were given an inhaler for my daughter, which never seemed to help, so we decided it probably wasn't asthma (she was regularly coughing all night). Then my next doctor said that inhalers often don't help cough variant asthma. My son has never been tested for asthma, but has both the brown and blue inhalers, although it took a while to get a doctor to take us seriously (he was hospitalised once, and then kept having episodes). The brown inhaler was literally life-changing - he went from sitting on a bench every time we went to the playground to running about like a loon. Long story short (too late), I don't think there is a standard way to diagnose asthma in children!

Two of my DC have asthma. One is triggered by dust mites, pollen. The other has exercise induced.
Agree with PP, nothing you’ve said support it not being asthma, in fact the opposite. It seems that something about her bedroom environment is triggering it. Whether it’s dust mites in her pillow or duvet or mattress, laundry detergent or fabric softener perfume, horizontal position of lying down, particles airborne from a carpet or pet dander....etc.

You just don’t know her specific triggers yet. So I agree with other PP track her symptoms with a peak flow thingy and keep a diary of where/when she feels short of breath. That will help you find out her triggers.

@Zilla1

Did she have a review and peak flow before and after inhaler?

No they just listened to her symptoms and then prescribed inhalers and told us to do peak flow morning and night. They said something about a hospital test but she can't have it due to local services being closed for covid.

@Soundbyte that's interesting, you've reminded me she does insist on extra pillows to alleviate it

Just wanted to say thank you to everyone for the responses so far. It seems like asthma isn't a simple set of symptoms and can be very different for each child. I've got some great ideas from you all so far. Will buy hypoallergenic bedding, stop all bath products and any sprays (she really goes overboard with air freshener after using the loo) and of course I will do a more detailed diary and peak flow before / after blue inhaler. Thanks so much for all your advice x

I have allergic asthma and 95% of my attacks are at bedtime too. Never really worked out why but using a humidifier has helped.

I had childhood asthma too (also had problems getting it removed to join the forces). Always happened at night, I can still remember the panic feeling now about 30 years on. Turns out I was allergic to my sister’s pet rats (only the female ones 🤨). My pump got me through, the relief! It was a good few years before the cause was known though.

With me, change of temperature can exacerbate it. So change of season, going out into cold / back into the warm, steamy bathroom to cooler bedroom, heating dipping down at certain point in the night...

I also have extra pillows and hypoallergenic bedding - no feathers. Friend of mine had to strip out all soft things inc carpet and curtains from her son's room - no teddies in there. Tiniest bit of dust set him off.

Just to add as well, I remember being told as a child that it can be not just one thing to set it off. So imagine a horizontal line halfway up a page of paper. That's the threshold for an attack. You could have two or three small steps up before reaching it eg the exercise earlier in the day, then perfumed bath stuff, then dust mites in room. None on own serious enough to cause a problem, but in combination could push over into asthma attack.

You’re auscultating with a stethoscope?

It’s actually reasonably common for asthma symptoms to be worse at night.

If you’re suspicious of it, try making absolutely no fuss when she gets these attacks, almost nonchalantly toss her the inhaler without looking at her (obviously you’ll really be on the alert in case it did actually turn into a full-blown asthma attack) and see if these ‘attacks’ get fewer and further between.