Does my 5 year old need to see a Dr ASAP?

[Dabrat21]

Hi all,

I need some advice please on what I should do with my DD. Who has ‘difficulty’ breathing ‘episodes’.

my DD is 5. She had been in nursery since she was about 17 months old. Since starting nursery she had cough after cough, illness after illness. She has had really bad chest infections and also had bronchitis when she was about 3, which she had an X-ray for but did not have to be admitted to hospital. I was very worried at the time.

our GP then suggested she have an inhaler - a blue one, and if her coughs got really bad to try a few pumps to see if this helped. We use the blue inhaler for about 10 months but honestly I didn’t feel it made a difference. When she would have coughs sometimes it would be with a temperature, sometimes it wouldn’t. Coughing was worse at night and she would vomit from coughing so much.

since starting school, her coughs have got so much better. The first year she only had about 6-8 coughs/infections. Compared to previously a cough every few weeks. Then towards the end of term, she started doing this thing where she takes a deep breath, and look like she’s catching her breathe, but not necessarily after exercise. This could happen when she was just sitting down watching tv. I filmed her doing this and showed the dr, who prescribed a brown inhaler to be taken once in the morning and once at night ongoing. At this time my DD was 4 and the Dr said that she was too young for an asthma test to confirm. I read up about asthma (as no one in my family has it) and I decided to cut out nuts, she would often eat these whole as a snack. Since cutting them out, the breathing ‘episodes’ stopped. So we cut out using the brown inhaler and I had hoped she had grown out of it.

However this past week, the last three days she has complained to her teacher that she is finding it difficult to breathe but doesn’t look like she is struggling, no signs of wheezing or going red etc. but the teacher has of course given her the blue inhaler. I’ve contacted the doctor for an appointment but could only get one on the 20th March.

tonight the same thing has happened. Whilst she was going up for her bath, she wasn’t running or anything like that. She said her chest hurts and feels like ‘someone is stabbing her heart’ and that it feels tight. I gave her the inhaler and I believe it helped but only after administering it twice.

she hasn’t had any nuts and there’s nothing I can think that might have caused this to flare up.

she is otherwise well but has a dairy intolerance. Her chest bone does ‘indent’ a bit, I would say a little more than ‘normal’ but many doctors have seen this and never said it look abnormal.

what I’m asking here, is if I should get her to a doctor/a&e or a walk in centre over the weekend? I’m worried it’s getting worse and could lead to a full on asthma attack.

Does anyone have children with asthma? Does this sound like that? Any advice would be great appreciated.

thanks

Surely this post is a wind up? I can't imagine any responsible parent not getting immediate medical help for a child whose breathing is abnormal and is complaining of chest pain!

I'm also bewildered by giving of a brown inhaler rather than ventolin.

OP, you must take responsibility for your child's health. Asthma is very serious and can be deadly. No family history does not mean your child does not have it. I have severe asthma and rarely wheeze, but I do a funny gasp and a coughing until I'm sick.

Once you've been checked out and athsma causes have been (hopefully) eliminated, perhaps look up precordial catch - I used to get that a lot ,and it was a stabbing pain in the chest and you have to breathe really shallowly for a few minutes to avoid the pain. Then a kind of deep breath makes it 'pop' and then it's all back to normal. It's totally harmless, but painful for that short time and a bit scary if you don't know what it is. So it could be something like that.

Also op chance there could be anxiety too. Don’t mess about with chest pain and obviously approach it as if it is physical but good to check out other things too alongside. The breathing this sounds reminiscent of sigh syndrome just to flag that as a potential. The poster above said another possible condition. I have no idea and of course you can have asthma at the same time as anxiety too so even if there was some element it wouldn’t rule out physical.

The early days of having an asthma kid when you have no experience of it are tough. It’s not like other medical issues, there’s no black and white answer for any of it. No ones symptoms are the same. There’s a whole bunch of stuff you wouldn’t recognise as asthma but the experts know. There’s so much trial and error especially in young children. There’s a lot of trialling stopping inhalers altogether to see if they’ve grown out of it yet. There’s a lot of trying different inhalers and different doses and I didn’t understand any of it at first. The best thing to do is to try and get an appointment with an asthma nurse. Get some clear instructions of how many puffs of the blue inhaler you can go to when she’s symptomatic and when you should seek further medical advice.

Asthma can occur in cycles, as a child mine would always flare up badly in September, I'd have chest infections in December and a bad flare up again around March, like clockwork from age 7-13. Much better with no really episodes unless I had an infection through my teens and 20s, now in my 40s I have hay fever too so on an anti histamine for a lot of the year, have to up my preventative inhaler to 2 daily puffs Feb-April ish and often again mid July to Sept.
Her patterns aren't unusual, and could be exacerbated by any allergies, did you get her tested for a nut allergy? If it's believed she has asthma the preventative is an ongoing every day medication, the blue reliever is an occasional thing and shouldn't be relied on as the only medication to sort a flare-up or attack.
Tbh I can understand your confusion, I don't know if it's better in the UK but here GPS will throw out inhalers with no really information about how and when to use them effectively

Do You have an Sats monitor?

I have read every post so far @Dabrat21, but I haven't noticed you or any PPs mentioning if you have checked the dates on all of your dc's inhalers. Reading that you have several brown inhalers available, just reminded me that some inhalers can go out of date relatively quickly, so please do check the dates on all of the inhalers, and keep them in a chronological order, if you do not already do so. Good luck in getting everything that needs to be sorted, sorted very quickly now.

I have an asthmatic child, and some of what you describe sounds like asthma - my child rarely wheezed, it was the coughing that gave it away. They too can go for long periods without an issue and we’ve had trials of being on and off a brown preventer inhaler (on the advice of an asthma nurse and weaning off slowly).

You have a child who’s needed their blue inhaler multiple times in a couple of days. That alone is an emergency GP appointment or, given the chest pain, an A&E job.

Longer term I advise an appointment with an asthma nurse to talk about triggers, red flags that you should get medical advice for, how to use an blue inhaler during an attack and to explore whether your child needs nut allergy testing.

My daughter has had asthma since nine months when she first encountered a cat (she got her first blue inhaler then they didn't say asthma but over time it became called asthma brown inhaler from one). Overtime we've figured out it seems to be allergy related and also worse when she has a virus /Hayfever. Monteleukast and age have been a game changer and we haven't had a hospital visit in a few years but every time she stops the brown and the monteleukast it comes back (she's a teenager now and "forgets "). The main point I wanted to make is she never wheezes she coughs to the point of vomiting /turning blue /unable to speak. Lots of people with asthma cough please don't think she doesn't wheeze it's not asthma. The inhalers are fairly benign way more benign than uncontrolled asthma. Please don't drop them without medical input.

I don’t think all asthma comes with wheezing, my husband had asthma as a child and it came back 20+ years later. He doesn’t really wheeze and his mum said he didn’t as a kid, he just cant catch his breath. He also stopped his brown inhaler (it was irritant induced so thought it would be fine) and after a while it gradually returned.

Hope your LO feels better soon, asthma is very scary if you don’t have any experience of it - I didn’t and used to get really worried when my adult husband was unwell with it so it must be awful when it’s your child ❤️

Have her checked for pectus excavatum too (chest indent)

I wouldn’t be too hard on yourself about stopping brown inhaler. We stopped it for my 3 year old over the winter (albeit on doctor’s advice) as he had no episodes for around a year, and then suddenly had a very bad one a few months ago. We also hoped he had grown out of it, but clearly he wasn’t ready to go off the brown inhaler.

Also, you can be on the brown and blue inhalers at the same time. Brown is a preventer whereas blue is a response to an attack / wheeze. Surprised your doctor said one replaces the other.

That’s harsh. Doctor or not, there’s no real need to word that as judgey as you have. Advise by all means, but hold off on the snark.

Omg just why why why do people write posts like this .
and you are a doctor? Words fail.

Also, getting to the bottom of asthma in kids is an absolute minefield!

You don't stop the brown inhaler unless a Dr tells you to. It literally prevents the asthma. She may well grow out of it but for heavens sake do what the drs tell you to do. Asthma can kill children. It shouldn't be taken lightly.

Asthma kills people don't seem to get that it's not just a bit of wheezing it's deadly

The story told to teenage dd by the asthma nurse was A teenager was having an asthma attack he walked past a different Dr's surgery and a pharmacy to get to his Dr's collapsed and died he didn't realise he could go into a chemist or a different Dr's surgery to get help he thought he had to go to his own whether this was real or illustrative it effectively made the point not to mess about with asthma (pretty sure it was based on a true story tbh because there was a lot of push about emergency asthma services around the same time)

I would just book her in for a routine GP appointment. This doesn’t sound urgent.

It sounds like they are treating her as if she has asthma, but without a formal diagnosis. She needs to be properly assessed and have a treatment plan.

As for her inhalers, I rarely take my preventative inhaler. I am a really non-compliant patient. I can easily go 6-12 months with no problems and then I have a problem. It can be an infection or exposure to bonfire smoke or whatever. And that will trigger my asthma. So her being totally fine and now suddenly having problems sounds normal to me. It would probably be alleviated by taking the preventative inhaler properly.

The stabbing pain is very likely just muscle pain. I’ve had it my whole life. I don’t think it’s necessarily related and all else being well, I wouldn’t think it warrants an A&E as long as it’s sporadic.

You should buy an oximeter. They are cheap and available on Amazon at chemist etc. (ca£15). Really good for small children where it is difficult to understand how they feel. Then it’s clear. Clip it on her finger and read the number. If it goes too low a&e it is.

not that helpful to you today but stopping the brown inhaler is what has done this. It’s often the way that you think they have grown out of it but actually it was just the brown inhaler working and eventually after stopping the preventative effect wears off. Look up the scarring that can happen to lungs with long term uncontrolled asthma. You need to use the brown inhaler to protect her lungs. It’s typically a lot older before they grow out of it - if ever.

So she was unwell over Spring and Summer, her symptoms improved whilst cutting out a common allergen and taking her steroid preventer (clue's in the name) and then she didn't have further issues during Autumn and Winter. Then she's started having symptoms once the effect of the preventer have worn off AND trees have started releasing pollen. Oh, and with it having been winter, the house is more likely to have been less well ventilated and dust mites have built up in the time.

Have you heard of hayfever at all? Or pollen allergies? Or dust mite allergies?

She needs medical treatment, she needs preventer medication, she needs reliever medication (both taken properly as directed using a spacer) and quite likely needs somebody to read you the Riot Act for deciding symptoms of potentially severe allergies and asthma can be 'grown out of' in a few weeks.

Me too, I hope they don’t speak to their patients like this!

OP please don’t let this put you off seeing a doctor or A&E tonight or tomorrow or an urgent care centre if you have such a think locally. I’d be amazed if you were referred for what you’ve described.
We were told to wean my child off her brown inhaler when her episodes stopped to see if she still needed it. If you’re at all worried about her tonight though definitely ring 999 or 111. I’d have her seen either way tomorrow. It’ll put your mind at rest if nothing else.

lol, you didn’t need to say you were a doc the high and mighty tone already gave it away.

She doesn’t have asthma, because doctors no longer diagnose children that young with asthma. And they have obviously been given no advice for asthma.

They haven’t done anything wrong to warrant social services, flipping ‘eck, and every child who goes to A&E is reported to their health visitor - for support - unless you opt out of the Health Visitor service (because it’s optional). Deary me.
OP please don’t worry about social services, you have done nothing wrong.

She didn’t just decide she was cured, she doesn’t have a diagnosis and it was stopped 6 months ago, and the GP has been seen since then.

OP call 111 or try get an OOH GP appointment. 111 will triage and you are much less likely to be Sitting in A&E all night. They can likely funnel to a OOH GP, hopefully at a minor injury clinic.

I’ve been chronically asthmatic my whole life, my child is also asthmatic, and I feel compelled to do my first ever post in the hopes that my experiences help you.

Asthma comes in cycles, and has many triggers. For a lot of people it’s affected by the weather, and many find that seasonal changes in particular bring on episodes. I personally see my symptoms flare far more in Autumn or Spring when the weather changes from warm to cooler or vice versa. It’s so mild outside that it probably wouldn’t occur to a non asthmatic, but this can be a key trigger.

Colds and viruses often affect asthma sufferers worse as we find it hard to shift the symptoms from our chests. They can very often turn into chest infections or just linger for ages. You get used to it, and learn how to manage those additional symptoms. I sometimes feel like I’ve had a cold for a decade, but I’m otherwise healthy and I crack on. It’s become my normal.

When I am having asthma symptoms, they sometimes manifest as a wheeze, sometimes a tight chest (which could possibly be what your child is describing, although I’m in no way a medical professional), sometimes a bit of a creaky rattle that isn’t quite a wheeze, sometimes just shortness of breath. These never for me completely disappear with a blue inhaler when I’m having an episode. There is just some relief. I only mention this as I remember my OH expecting our child to stop wheezing completely after using this blue inhaler, and depending on the episode that won’t always happen.

I can sometimes go for weeks (and, on a couple of very rare occasions in my life, months) without touching an inhaler. I too have been guilty of forgetting or abandoning my brown inhaler in those times. It always returns, often worse for a bit, because I am asthmatic. I’m asthmatic even when I’ve had absolutely no symptoms for weeks and having taken my blue inhaler. So is your child. There’s a chance she might age out of it. She may not. But I promise you asthma is better when it’s well managed. I’ve learnt all my triggers over the years and I’ve learnt how to look after my asthma. And once you crack that, it’s really not so bad.

You sound like a great mum. I really hope you find any of this helpful. Good luck with it all!

Yes I get that I have asthma.

OP is a mother worried about her child and asking for advice on whether and how to seek medical support.

Replying to OP from a standpoint of superiority judgement and blame and making an assertion that if she seeks medical advice she will be “reported”, possibly to social services (!!!) (especially from someone claiming to be a doctor) is a goddam disgrace, and the opposite of helpful or , frankly, in any way protective of this child’s health.

Honestly the thought of doctors with an attitude like that pp working in A&E does not make me feel the least bit safe seeking medical support: