What next? 20mo coughing and wheezing herself sick for 3 months

[MordredsOrrery]

Really need some advice on how to proceed from here.

DD developed a wheezy cough at the start of January. It is worst at night. The coughing fits include a lot of wheezing and she quite often ends up being sick as a result.

We've seen: OOH doctor, emergency appointment with the nurse practitioner, emergency GP appointment and routine GP appointment.

There's no infection.

On the third visit we were told bronchiolitis, given a salbutamol inhaler and told it would be fine in two weeks. No improvement in two weeks.

This time we were given ventalin and told to see the asthma nurse. The ventalin is making no difference either.

DH and I are really worried. This isn't normal but we don't feel it's being taken seriously as DD seems fine when she isn't coughing. Although she is becoming increasingly clingy.

Please help, where do we go from here?

Keep taking her back.
Has whooping cough been mentioned?
Have you done all the damp dusting, removing soft toys, not using fabric softener etc?
I assume nobody in the house smokes.

DS2 had a huge asthma attack not long after we moved house.
The cause turned out to be a tree in the neighbour's garden that was growing up against his bedroom window. He was 2.5, but subsequently turned out to be allergic to tree pollen and feathers.

I am so sorry your dd is experiencing this.
How old is she?

Thanks for responding @endofthelinefinally

DD is 20 months.

Nobody has mentioned whooping cough.

We've dusted and cleaned. We don't smoke but she does still have soft toys (nobody has suggested we do any of that though).

Since we don't have asthma in the family I'm not sure I'd recognise it. They've also said she's far too young for them to diagnose even if it is asthma. I'm just so worried.

It must have been very frightening for you and your son for him to have an attack so young - did he have symptoms beforehand? How is he now?

He needed to go on a nebuliser at the surgery.
He was diagnosed with asthma and was on inhalers for the next 14 years.
Nowadays they won't diagnose asthma so young. Doesn't mean they don't have it IMO.
I subsequently read a very good article in the BMJ that stated that children who had RSV bronchiolitis tended to be wheezy for an average of 10 years afterwards.
That fitted with our situation.
Ds2 was in hospital with RSV bronchiolitis at age 4 months.
He is in his mid 20s now and completely well. He stopped needing the inhalers around age 15/16.

Can you film your DD during a coughing fit OP? That would really help the drs to diagnose. My DD had whooping cough at 9 months (between the 2 parts of the vaccination). The coughing was awful and often resulted in her bringing up white frothy sick and phlegm, which is a classic symptom. Small children tend not to whoop.

There was no treatment for our DD as she was diagnosed late. They only give antibiotics if diagnosed within the first couple of weeks. DD coughed like this for weeks and weeks (maybe months) and was left very prone to night time coughing, which she finally outgrew aged around 5.

Asthma can cause night time coughing and vomiting too, but I don't know how likely that is if the inhalers haven't helped.

If it is / was whooping cough, at least you must be near the end by now.

Thank you both - we'll try and film the coughing today for when we see the nurse/if we need to see anyone beforehand.

Your description of the sick is making me think whooping cough is a distinct possibility

If we can film it I may just take her back again anyway because I'm so worried. Three months is a very long time

Does she have a constant runny nose and does she stop breathing in the night? If so might also be worth looking at obstructive sleep apnea - DS had this about the same age and needed his tonsils out. Took a year to diagnose as actual vomiting isn't often a symptom but it can be! Sorry - so stressful going through all this isn't it?

DD was definitely worse at night, but did have the coughing fits during the day too. She was absolutely fine between coughing fits, which the Dr also said was typical for whooping cough. She would cough and cough and cough going bright red then bring up white froth then return to normal... then repeat.
We were all exhausted for months, but DR said DD was coping well and no treatment was needed. She's a tough cookie now aged 7 :)

This is exactly my dd (4). Were on ventoljn inhaler and tomorrow having blood tests for whooping cough.

This has been my dad since she was 9 months old (she is now 6). NHS were pretty rubbish. Ended up going private to see a paediatrician who diagnosed cough variant asthma. Did a full allergy screen (not allergic to anything). He basically explained that the excess mucous from colds was causing irritation to the lungs. She had some lung scarring after pneumonia when she was 9 months old. She is now on montelukast tablets to reduce mucous along with brown and blue inhalers.

When she is particularly bad in winter, we find that a combination of the following helps

1. Snufflebabe/vicks on her feet with socks on over the top (helps reduce the coughing)
2. Piriton - helps with the irritation (also recommended by paediatrician)
3. Ibuprofen - helps reduce inflammation (also recommended by paediatrician, but sometimes not recommended for some asthmatics)

Hope you get some answers soon.

Meant to add - she was also tested for whooping cough and investigated for cystic fibrosis.

@pizdets no runny nose, oddly enough, but she's always had a habit of holding her breath at night/when she's asleep

@BlackInk that sounds very, very familiar. How did you get to a diagnosis? Did you have to keep going back? I'm glad your DD is doing well now

@jamtart30 I'm sorry your DD is having this too. Good luck tomorrow. When did they switch from thinking asthma/ventolin to trying to test for whooping cough? I feel like we keep being fobbed off

@threesocks that's a long journey for your DD. If you don't mind saying, how did you find a private paediatrician? It has crossed my mind that we need to see someone but I haven't clue where to start

I am lucky and have private medical insurance and so just rang them and explained what I wanted. They gave me list of options. One was a name I recognised as he saw dd when she was small.
I would suggest calling your local private hospital as a starting point.

The test for whooping cough is very simple - they just sample some saliva. But the test only shows positive within the first two weeks of the infection starting. We were told that antibiotics were only effective if started within the first two weeks too (unless a secondary infection takes hold). GP diagnosed DD on symptoms - she was absolutely classic for whooping cough - there are lots of (not very nice) videos online that you can compare to.

DD had already had the cough for a week or two when I first spoke to the dr. She was well enough in herself, no fever, not dehydrated etc. so I thought at first it would just pass. Dr basically diagnosed her from my description over the phone. We did then go back to the drs several times over a couple of years about her coughing. The initial illness lasted a few months (gradually getting better in that time) but for years after every time she picked up a cold the awful coughing would start again. I swear I didn't sleep for about 2 years! I think the whooping cough must have damaged her lungs a bit.

However, she's now 7 and it's been a couple of years since we heard that persistent relentless hacking cough.

Was your DD vaccinated OP?

Basically, if it is whooping cough and she's had it more than a few weeks there's no treatment. Just TLC and keep an eye open for any worrying changes.

Thanks @threesocks I'll look ours up

@BlackInk I'll look up those videos as she was sick with coughing again earlier. DD's had all her vaccinations, which is possibly why this seems so unlikely? Her brother has chicken pox at the moment so I'm just dreading her catching that on top of whatever is causing this cough (and it seems that whooping cough is very likely from the symptoms)