Do you think this is the start of asthma?

[SweetApril]

Hi there. I'm posting here first rather than on asthma thread as I'm really hoping someone is going to come along and say their LO had these symptoms but didn't turn out to be asthmatic. This is long, sorry.

Background: In October DD (nearly 4) experienced an episode of wheezing/ breathlessness. Felt tired and unwell in morning then breathless by afternoon. Was sick through the night with what seemed like tummy bug and breathing worse so we called an ambulance. She was nebulised at home and then twice more by GP in the morning. GP sent us to A&E cos still not happy with wheezing. A&E nebulised three times more plus gave prednisolone and chest x-ray (clear).Finally sent us home with ventolin (6 puffs down to 2 puffs by end of week then stop) and prednisolone (for 5 days). Suggestion was that she had a nasty virus. She got better quickly and her chest was completely clear by the end of the week.

Roll on Nov/Dec - DD gets filthy cold and quite nasty chest infection. No antibiotics taken and no asthma symptoms developed at all - I took her to GP almost every day to get her checked (paranoid mum!).

Roll on to today: DD had bit of a runny nose and chesty cough yesterday. Was sick at nursery and was breathless when I picked her up. Was nebulised twice at docs but still wheezy. Prescribed prednisolone (7 days), ventolin (7 days) and antibiotics as they think she has a chest infection. The sickness symptoms are the same as before, like a bug. She can't keep anything down so can't even start the antibiotics.

So, does anyone think this sounds like the start of asthma? Docs have a variety of opinions but none willing to say anything definite. GP thinks not as she would have shown asthma symptoms much sooner than age 4 (like a cough) and also that she would have got symptoms with the first chest infection. DD has had her fair share of coughs and colds and mystery viruses but none ever affected her like this. Sorry if this sounds ridiculously paranoid but I am really hoping these are one-off incidents or bronchiolitis (sp?) which nurse mentioned. TIA.

i think the reason that the doc gave about sympoms before 4 is bullshit. if she is only having trouble when she gets a chest infection - then maybe not , but if this is becomong a regular occurance iw ould rather have her on a steroid preventer than taking prednisolone fairly frequently tbh.

asthma kills. it is not to be underestimated.

fyi caffeine helps with asthma - cup of coffee might help - not a lot of people know that

obv coffee shouldn't be used instead of medical means

Bronchiolitis? Whenever Ds has had that they have said it is something that only really effects under 1s.

I think two incidents is to soon to say either way really. As a child I often got asthma symptoms with a cold but wasnt asthmatic a week or so of ventolin and I was fine again.

I don't see why she would have shown signs before 4 though as it can start at any times.

Yes, someone in our family (not blood relation) died during an asthma attack in the most tragic circumstances and it's haunted me for most of my life. I can't tell you how devastated I am by today's events. Can you give caffeine to a young child? I thought they couldn't metabolise it very well. I don't think she'd drink coffee but maybe tea.

I can understand what your saying and feeling (my aunt died of an asthma attack 14 years ago) but IF she is asthmatic then it is best that you know so it can be monitored and controlled. When Ds was confirmed as having asthma I was actually relieved as it meant he would get the right treatment

Nurse today said bronchiolitis can still affect them when they are older but I think really he was trying to make me feel better.

Sirzy, were you very breathless with the symptoms? Are you asthmatic now?

agreed pixie, i said as much

Yes breathless coughing and tight chest generally.

Not asthmatic now, although full of a cold at the moment which seems to have gone onto my chest so off to drs in morning!

Hope your daughter is better soon. Agree with pixie I would go for a and e over coffee!

If she is completely well between these episodes then it probably isn't asthma. She may well have viral wheeze, which is often associated with other viral symptoms, or she could be one of the unlucky children that suffers lots of chest infections in the early years (especially when at nursery/preschool) but then 'grows out of them'.

If you can keep a really detailed diary of her respiratory symptoms that could be helpful. Note any episodes of coughing (especially at night), wheezing, chest tightness and shortness of breath. Write what she was doing at the time, was it hot/cold/windy/someone smoking etc.

It may be worth asking for a review with an asthma nurse or respiratory paediatrician. It is VERY difficult to diagnose asthma in children especially those under about 6 that can't really do the diagnostic tests, but a trial of an inhaled steroid may well show some benefit.

Sorry for delay just trying to comfort colicky baby!

Yes, she is completely well between episodes. She does appear to have a mild hayfever-type allergy for a few weeks during each summer but it doesn't seem to bother her.

Does anyone know whether the sickness is significant in any way? It's the one thing which seems not to fit with the other symptoms because it's so like a sickness bug.

Thank you everyone for your helpful advice so far. I know asthma can be perfectly easy to manage it's just that my own experience of it is, frankly, terrifying.

I am not sure to be honest. My eldest daughter is nearly 5 and is asthmatic. She had constant wheezing ,was coughing and breathless at night and also when running around etc. She was about 2 when she was diagnosed- which was not a huge surprise as it runs in both our families- but the majority only had it till about 7 then it cleared up ,i sadly have had it all my life but luckily not bad.

It took a while before she was diagnosed as they did not want to at first. They tried her with the inhalers in the end and she improved, but when we stopped using them it returned. So she is now on the blue and brown inhalers plus tablets at night. It seems to be a lot better though and she hardly ever uses her inhalers now.

She also suffers bad with hayfever. And also had ezecema which has now completely cleared. so hoping she grows out of it soon

DD is hardly coughing at all and definitely not coughing till she vomits. She'll have a drink or food then two hours later brings it up again. Although since 8am she's managed to keep down water and toast and prednisolone so that's a good sign. Seen GP again this morning who says stomach lining can be irritated by a chest infection. He also said to maybe hold off on antibiotics for a couple of days and just do ventolin and prednisolone and see how she is cos he thinks the infection could just as easily be viral.

Thanks again everyone. I do feel a bit less panicked at the moment.

Coughing can cause asthma-like symptoms if she breathes in any vomit particles which is quite likely even for a grown up and as the foreign particles get into the chest it can then turn into chest infection (this was explained to me in hospital when I accidently breathed in a piece of food).

SGM is right,
I was told that normally lungs are sterile, but if something gets beyond the throat area, you can't just cough it up coz it's too far down and the cough reflex only works around the top of the widpipe. And that can lead to infections and even pneumonia.

Ah, I didn't know that steroids lower the immune system. I'm not a fan of antibiotics, as I guess most people aren't. Neither am I a fan of steroids. So I really didn't want to give both at once. I suppose I was thinking that antiobiotics would wipe out the 'good' bacteria also potentially leaving her immune system vulnerable. But maybe not giving them is worse if the steroids are damaging to her immunity too. Jeez, you're damned if you do and damned if you don't, right?!

StewieGriffinsMom - can a doctor tell the difference between an asthma wheeze and aspiration pneumonia just by listening to the chest? I don't think she has the pneumonia but it would be good to know how they diagnose it, iyswim.

I'd be inclined to ask for a referral to a paediatric respiratory specialist who will be able to look at the history, examine your daughter, and view the X-ray that was taken.

They are much better placed to either diagnose asthma (and get your dd sorted out with a care plan if necessary) or rule it out.

Just wanted to thank everyone again for the support/advice. I've done a bit more online research and the symptoms do seem very like a viral wheeze especially since she is completely fine in between. I didn't even know there was such a thing as a paediatric respiratory specialist. I will ask the GP about a referral. I have to say I'm a bit wary of it leading to taking regular inhaled steroids simply because there is not much else that can be done at this stage. It would seem a bit much to me after just two isolated episodes. But I'm (probably very naively) hoping that it's not likely to happen again.

Incidentally, I was reading about some research that was done a few years ago which seemed to conclude that prednisolone given for a viral wheeze wasn't any more or less effective that not giving it. Anyone know any more about that? Certainly none of the docs in the hospital mentioned it even when I questioned giving prednisolone (mainly because I don't want to fill my lovely DD full of horrible chemicals - again, excuse my naivety). Thanks again. Sorry for wittering on!

My dd is only 20 months old but has had a few episodes of this. Wheezing, rattling and coughing. She's had oral steroids twice and is on Clenil Modulite twice daily. They won't say she's asthmatic but have said it looks likely but still early to tell. It's frustrating and more than anything it's scary. I know how u feel. I hope she gets better soon.

I was dx as asthmatic at 6 yo, with relatively few symptoms before that, but I have never been hospitalised and am considered v mild. I do hope you get some answers and your dd gets well soon.

Thanks, Pixie. I don't suppose you know whether Ventolin does any damage in the long term or whether the body eventually becomes dependent on it? I shouldn't fuss so much I know. I've always been very anti taking medicinces unecessarily, even stuff like paracetamol, but, of course, a breathing problem is not to be taken lightly. I so badly want to do the right thing for her - not overmedicate or undermedicate. Wish they could give you a crystal ball on prescription!