Please help me understand dd's suspected asthma

[Schulte]

Hello lovely Mumsnetters. I need some help please with understanding DD's 'suspected' asthma. She's 7 1/2 and had a very bad cold/cough recently which made her wheezy at night for a couple of nights. Because she had been wheezy twice around cats before, the docs were fairly quick to say she must have asthma, and we've been given a peak flow meter plus the brown and blue inhalers.

Now, DH and I both felt they had jumped to the asthma conclusion a bit too quickly.

DD's peak flow is fairly consistently the same and didn't change when we reduced the brown inhaler to just once a day. She was symptom free for quite a while and I was planning to stop the brown inhaler completely but then...

She started another cold/sore throat/phlegmy cough and had the flu jab on Tuesday. Her peak flow was still the same but yesterday she came home from school saying she had got wheezy when running around with a friend and she had had to go into the school office (for the first time) to have two puffs of the salbutamol.

When I asked her what it felt like when she was wheezy she said it was like pins and needles in her throat. Not her chest. I asked whether her chest felt funny and she said no. Just her throat.

So, sorry for the long blurb, but here's my question: Could it be that it's not asthma at all if the symptom is in her throat and not her chest? Could it be that it's just all that mucus from her cold that she is struggling to shift, rather than a 'real' asthma wheeze? I know that when I have a cold with a lot of phlegm, I can sound wheezy too but it's definitely the phlegm and I don't have asthma.

I am a bit reluctant to keep her on the steroid inhalers if she doesn't really need them. At the same time of course, I don't want to deny her medication if she does need it.

Those of you with more experience - please can you help?

Thanks!

Anyone?

I don't know much about children's peak flow, but I would have thought they'd try blue inhaler first and see if that helped, then add in a brown (steroid/preventer) if it did (to prevent the need to use the blue regularly). But I could be wrong. When do you go back? Is there an asthma nurse at your surgery you could see to talk to? Also I think the nurses at Asthma UK are supposed to be very good for advice.

I was going to suggest asthma uk, they are very helpful.

I'd also ask to have an appointment with an asthma nurse or asthma clinic as they often know more than GPs.

If you're not sure, go back to the asthma nurse before reducing the medication.

Both ds2 and I are asthmatic. Most of the time we are completely symptom free, unless we hit one of our triggers. Our peak flow is pretty even, when we bother to do it.

In ds's case, he starts with a cough in his throat, rather than a wheeze. He never complains of tightness or wheezing. The cough is relieved by the blue inhaler.

Then, a couple of weeks ago, he got a cold, and within 12 hours was in a terrible state. Ended up on oral steroids.

I honestly feel that it is a continuing balance for us. We don't think about it (other than taking inhalers) for 99% of the time, but we have to be prepared for the 1% when the inhalers aren't enough.

I'd honestly make an appointment, rather than try and work it out yourself.

We are seeing the asthma nurse next week but by her very nature, she will treat DD as if her asthma is confirmed, and I'm not quite convinced. I mean I do understand that they want to be on the safe side and they give you all the inhalers etc, but this asthma would have come completely out of the blue. DD does have a dust allergy and used to have eczema (grown out of now), but if she was going to get asthma I would have expected her to show signs at a much younger age, surely?

Not necessarily, I started with asthma completely out of the blue, aged ten. Dust allergies and eczema may point to her being susceptible to asthma - they are all atopic conditions.

I have already spoken to Asthma UK too but again they treated it as if it was confirmed asthma. Not every cough is asthma, right?

What puzzles me is that she says it's 'pins and needles' and in her throat. I obviously have no idea what asthma feels like but it doesn't sound like it should be a funny feeling in the throat?

It can feel like constriction in the throat. I'm like your DD. Fine most of the time, but after certain triggers I'm hopeless. After a cold it takes me ages to recover, to the point of feeling quite scary.

Why are you so convinced she doesn't have it?

I was diagnosed at 25 years. In hindsight, symptoms started at around 18 years old.

I get a real tickle/need to clear my throat, particularly in hayfever months, but it is the asthma.

The thing that has always stayed with me is my asthma nurse saying that many many deaths from pneumonia in older people were actually caused by undiagnosed and untreated asthma. I have a tendancy to get chest infections in my upper chest/lower throat, caused, I'm told, by untreated asthma, which has caused damage.

I simply don't want to risk this for my Ds. The side affects of the inhaled steroids are minor. Far better to treat as asthma and avoid this cycle of infection, and risk of serious illness later.

I'm not convinced that she doesn't have it, but she has already had so many things wrong with her (partly connected and partly unconnected) that I am not sure we can handle yet another thing. If that makes sense. I just don't want her to have asthma. DH claimed he couldn't even hear the wheezing when it happened so if it was him in charge, she wouldn't have seen the GP and the asthma nurse and we would continue life as it was.

I also think with any of these atopic issues, the doctors are very quick to assume the worst. DD had allergy tests when her eczema was really bad, and they showed a borderline peanut allergy so we carried epipens around with us for a couple of years on the advice of her consultant. Eventually she had a peanut challenge and she was completely fine. I did wonder whether she ever actually had an allergy in the first place.

Coughing excessively damages lung tissue, which can't be repaired, so protecting it makes sense.

I didn't have a diagnosis until I was in my thirties.

I have two children with asthma.

I found that the asthma nurse was keen for them to be on as low a dose of medication as was needed. One of them still needs two inhalers but the other has now been inhaler-free for the last couple of years.

If you have an asthma nurse, I would definitely speak to them about the possibility of a supervised reduction in medication.

I have allergic asthma. and when I have a cold it goes down in my chest as well.
before my chest tightens my throat itches/scratches.

we were told that an improved peak flow after using a ventolin inhaler was diagnostic of asthma

your dd sounds like mine...her triggers are hayfever and a cold and she's wheezing and coughing away. We also had cats, but they seemed not to provoke it, although we more or less banned them from her room as much as possible.

Main things are to use the brown inhaler often to reduce longer term inflammation, especially after having to use the blue one, I think we were advised at least three months of brown to ensure the airways get back to normal as soon as possible

DD's 21 now, so manages herself but it's only in the winter if she is getting a lurgy I hear her asthma....she has a particular cough, and sound to her voice

Thanks all. Good to know that the throat symptom can be a sign then, although I would have expected that to happen more with allergic asthma than a cold perhaps?

I have read that too about improved peak flow after the blue inhaler, I tried that with DD the other day but it didn't seem to make a difference. I will ask the asthma nurse about it.

I'm still wondering whether DD's issue is more of a post nasal drip thing. She produces an incredible amount of snot, even when she's well.

With those of you who have mild asthma to deal with then... have you ever had a bad asthma attack? Is it something to worry about, or do you feel your asthma is more of a mild nuisance than something that might potentially become dangerous?

Ive had it where I have to stop what I am doing, get out of the wind, sit down and concentrate on relaxing (not something a scared child can do). I've also been scared when I have a cold because if I move I start to choke, if I lay down I start to choke. It stupidly didn't occur to me to go to the doctor. I am so used to putting up with it, that I just suffer weeks with no voice, unable to use long sentences, walk ore than a few steps. Basically I ought to manage my inhalers better/go back to the doctor when it is bad.

Your DD sounds like my DS1. He's 7.5 years and we've recently been given a blue inhaler for suspected asthma.

He's always coughing, throat clearing and full of snot. He's done this for years. In summer he has hayfever but I'm not sure what causes it in winter. I thought maybe postnasal drip but a few weeks ago he was coughing and sounded wheezy during the day, when he did the same at night a few weeks later we went to the doctor.

She didn't have him do a peak flow or any other test. Gave us a blue inhaler based on my reported symptoms (he was fine when we saw her but coughed at night most nights, also when really giggly and then a couple recent wheezy episodes) and family history (his hayfever, DH asthma, my hayfever).

The blue inhaler has helped immensely. He can actually sleep now. I always thought he was just a wiggly, fidgety sleeper but since the blue inhaler he sleeps like a log. He doesn't cough all night, nor does he wake up full of snot. The wheezing hasn't happened again.

I'm not really sure what this means, I guess he has asthma since the blue inhaler has helped. Though he hasn't done a peak flow (DH wasn't surprised by this...he says there's a knack to it and he's not sure a 7 year old would be able to). We haven't been given a brown inhaler. The doctor said she'd give one if he needed the blue inhaler a lot, so far he uses it before bed every night and in the morning, so twice a day. A couple of days he's needed it three times. The second time we saw her she seemed to think this was OK. I'll be booking him an appointment again in Jan/Feb when his blue inhalers should be running out and asking her what we do now (e.g keep using blue ones? Book in with asthma nurse from now on? Etc).

So, only a qualified medical profession can really answer these questions for you. But as others have said, it can certainly feel like a tightness in your throat and upper chest, and a feeling of choking. That's exactly how my current episode is playing out at the moment and it's really horrible.

And then...I don't want to sound like I'm having a go, but why are you doing things like reducing her brown inhaler if a medical professional decided she needed a particular dose? What is the benefit in minimising it?

You say you were thinking of taking her off it altogether, and then bam, she got a bug and needed her reliever. That's exactly what preventers are for - to build the lungs resilience against triggers like exercise and prevention.

I know some people are, like, 'ooh steroids' but really it's a small dose delivered exactly to the site it's needed. Unlike a course of oral steroids, which is what she'd need if she was really ill, where they do then affect you systemically. (I'm feeling pretty shitty myself, at the moment.).

It's making me quite cross, actually, that you're putting your daughter's health at risk because you'd prefer if she didn't have asthma.

And to answer the question if your last post - all asthma is potentially fatal, if not well enough controlled, under the supervision of medical professionals.

I agree with rain don't fuck about with lungs.
I have permanent ling damage because my parents 'treated' my asthma with homeopathy.
luckily it's now well controlled and mild because it's well controlled.

My asthma is mild, but I ended up on oral steroids two years ago, after a virus. I literally couldn't walk, I was so breathless.

DS2 has mild asthma, but ended up on oral steroids two weeks ago after a virus. It was only the second time that I have been properly scared - I was up all night with him, using his inhalers. His asthma is well managed, but he deteriorated so quickly.

As above, why on earth take the risk?

I didn't reduce the brown inhaler on my own steam. It was discussed and agreed with the asthma nurse. After DD had been to the school office for her blue inhaler, I asked the office lady whether she had heard DD wheeze. She told me she thought that DD was actually fine, and that they find children sometimes come in for their inhalers because it's fun/a distraction. I wouldn't dream of putting DD in any danger but I'm trying to work out how bad or real this is.