DD age 3 with asthma- wwyd?

[krisskross]

My DD was diagmosed with asthma in jan/ feb rather strangely at the walk in centre when i took her in with a persistant cough. the doctor said 'how long has she had asthma', i said 'she has never been diagnosed with asthma' and the doctor said 'she is wheezing with a cough, she has asthma'. I was pretty surprised to be given such a sudden diagnosis as my elder son had more troublesome symptoms but took much longer to be diagosed. However, she has a history of terrible coughs whenever she gets a cold and we have a family history of eczema and allergies. DS also been diagnosed with asthma.

Anyway- we then went to the asthma nurse at the GP who seemed rather blase about it and not very keen on answering my questions. She advised me to give DD her brown preventer inhaler at the first sign of a cold or bug and keep using til the cold finished and to use blue inhaler if necessary. This was in March. She has had perhaps three colds since then and i have followed her advice. Its pretty usual for her to get a bad cough with a cold and we generally end up using the blue inhaler as well as the brown.

However, since around may i have noticed she has short episodes, lasting perhaps a week or a few days where she will have a wheezy cough with no other cold/ virus symptoms. She might only cough two or three times in the day but you can hear that it sounds chesty or wheezy- she is not bothered by it and tbh no one else would probably notice except me. In the last few days shes had it, again maybe two to three times in the day, but yesterday i got a bit anxious as she was coughing alot running around in the park - shes never done this before and its always been virus related.

As the asthma nurse wasnt terribly helpful I called asthma Uk today for a bit of advice. I spoke to a lovely nurse who was surprised i had been advised to give the preventer only at the onset of a cold or virus , as preventers take a week or more to start kicking in. She was also surprised that we've not been advised to have a period of constant use of the preventer inhaler to see if it improves her symptoms.

So now i am a bit concerned and have two questions

1. has the asthma nurse at GP given duff advice re preventer inhalers (she has advised the same for DS age 4)

2. what should i do about my daughters minor, but niggling cough. generally it seems to go away after a few days and its not even obvious all day, so if i take her to GP she prob wont have it.

the asthma uk nurse advised seeing if a GP at the practice has a specialist interest in asthma and making an appointment with them, but they do not.

Please advise! Thanks

I am glad you spoke to the asthma uk nurse, sounds like the asthma nurse at your practice is rubbish.

I would try to go to speak to a GP in your practice, or is moving to another practise with a better asthma nurse an option?

You may find giving your Dd the brown inhaler daily will help with the cough within a few weeks anyway

I would definitely be pushing for better support. We have a GP specialising in respiratory and it's invaluable as far as I'm concerned - much better advice and support than when I've had to see other GPs as a walk-in. If you have an alternative practice accessible, I would be enquiring whether they have a GP with special interest. If not, can you get referred to the asthma clinic nurse at the hospital? GP should be able to refer you. Good luck, but I'd be pushing to get her seen before winter sets in.

thanks sirzy and tigger, am very confused really as this cough is so minimal/ infrequent (separate to the coughs during winter months) and i dont want to seem like a neurotic mother.

i would like to go back to the GP/ nurse soon- meaning before i would have time to investigate another practice. Anyone got any thoughts on what i should say to them? I dont want to tell them their job, but dont have much faith in the nurse.

is other peoples experience that you give the preventer inhaler more or less all the time, or has anyone else been advised to give it when DC have a cold?

Thanks

The preventer should be given all the time to prevent attacks, I know some people increase the doses when they are ill but still take it all the time.

mmm, as ithought. thanks

A preventer should be used daily regardless of whether she is ill or well. She may have a touch of hayfever which can cause wheezing, have you tried her with some Piriton? I don't think asthma can be properly diagnosed until a peak flow reading has been done. She could have had a viral wheeze.

My ds, (now 14),was diagnosed with asthma at the age of four. There is a massive amount of confusing and conflicting advice about. Fortunately at diagnosis, we were seen by our trusted family doctor and I have followed his advice ever since.

• Use the preventer regularly, when your child is well. It does take time to build up in the bloodstream so is not going to work immediately when your child gets ill.

• When prone to an attack, eg when suffering with a cold or virus, double up on the preventer and use Ventolin at regular intervals during the day.

*A few years ago it was suggested that my son stop using his preventer, unfortunately right at the beginning of the cold season. Within a month he was on antibiotics for a chest infection and oral steroids to control the asthma attack he was having. The GP at the Out of Hours Practice told me to give him ten puffs of Ventolin through his spacer with ten breaths between each dose. He told me that this was as effective as a nebuliser.

• The irritating cough sounds like an asthma symptom to me, but I'm no doctor. A night time cough is usually seen as a reliable indicator of asthma. My son had this before using his preventer regularly.

*Don't stress too much about using the steroids, IMO it is better to prevent an attack than not use them. They are very low doses, we used to worry about our son's growth and he is now 5'11".

• I have been told it is impossible to diagnose asthma before the age of five so this may not be a definitive diagnosis. Also,as your child gets older she will be able to tell you how she is feeling and you will learn to recognise her symptoms.

They don't like to diagnose before 5 but they will if children show a lot of characteristics of asthma and not just "viral wheeze" DS was diagnosed at 12 months because the symptoms he had left no doubt as to what it was. Still took time for the GP to acknowledge the fact the the respiritory pediatricain may know more than him on the matter!

How are you getting on krisskross? Hope she's doing better.

thanks for all your messages and sorry for delayed response tigger. the cough went (as i knew it would- it was so minor, but worrying in that back of your mind kind of way) so i am watching and waiting and will go back to GP if / when it comes back.

on another note, DS, aged 4, generally gets much worse symptoms- again, always cold related. he get tonsilitis all the time and had his tonsils out two weeks ago. my big hope is that now hes had them out, he will get less bugs, pass less bugs onto DD and both of them will have a better winter than the last two, fingers crossed!!!

Good, glad DD is better and hope winter is low stress for both of them - and you!