Does this sound like asthma?

[KTD27]

Hello all
My DS (5) started with a cold and cough right around new year. Not covid (and he’s had it already) and after ten ish days it was hanging around so we called the GP. He has a heart condition which causes tachycardia so they’re always quite cautious - fine by me,
No temp clear chest but prescribed antibiotics. No change after the week so called back to ask what they’d like me to do. Another doctor wanted to see him and said his ear was red - prescribed a second course of antibiotics. He heard the cough which was quite phlegmy.
The cough seemed to go away for a few days after that but it’s back. Or at least he’s got another one if it’s not the same one.
This one sounds dry. Annoying. Not coughing asleep at all but is coughing on waking up and sporadically through the day. He coughs a bit around 5pm.
Doc suggested we try antihistamine. I’ve also asked for a paed referral for asthma as if it is, treating it could be an issue. Most inhalers raise the heart rate and that’s a potential danger for him.
He isn’t wheezing (that I can hear!) it doesn’t seem to be triggered by exercise or the cold. But he defo coughs morning and around this time.

Post viral? Asthmatic? What do you think?
Would appreciate any experience of anything similar.

I think you would hear wheezing if asthmatic.

Oh really? Ok well I definitely don’t. It’s just been 7 weeks of a cough and everything on Google (I know I know) suggests asthma. I’d be relieved if not - only because treating it would be tricky for him

No, my asthmatic son is cough variant, so no wheeze. Just a dry continual cough. Has had his peak flow tested, mine was diagnosed with a peak flow over a week and then kept checking it when he was prescribed an inhaler.

My daughter’s mild asthma is characterised by a post-viral cough that occurs mostly during the night. Might manifest differently in different children, but they won’t diagnose from one instance post virally I don’t think. My daughter’s was diagnosed circumstantially really, in fact I’m not sure if it was officially diagnosed but she was treated with inhalers and it seems to prevent it from occurring which probably confirms it is asthma.

See that’s the thing that’s worrying me. Most of what I read suggest it’s a case of diagnosis by treatment but we can’t do that. I worry that if it isn’t treated and it IS asthma it could manifest in an attack. I might give them a(mother) ring today and see what they suggest

Another not amother I’m guessing peak flow might be something they can test/check at the surgery?

My DS never had a wheeze.
He was throat clearing throughout the day, with a cough on going to bed.
He has asthma.

That is not always true. My dd has cough variant asthma and doesn't wheeze. She will cough and struggle to catch her breath, it tends to be worse at night. Dust mites make her worse so I steam her mattress and then hoover it, wash her bedding on a high temp wash as well as washing soft toys and dusting/hoovering really well. You could try this alongside an antihistamine to see if it helps as they can be a trigger for many people. Pollen, bark, mould (like black mould or leaf mould) and food sensitivities such as dairy would be other possible triggers, so it might be worth observing to see if symptoms are worse if exposed to these.

I’ve tried to keep a bit of a diary to see if there are any links. There doesn’t seem to be any pattern other than in the morning on waking (though today it’s been much less) and around 5/5:30. There’s nothing when he runs around or is in the cold. Nothing at all while he sleeps.
It isn’t a struggle for breath at the moment. Just an annoying cough. It does sound dry now but initially it wasn’t. Eugh. I hate the worry!
No dairy today and will see how we get on with that.

Might be post nasal drip. Try something with guaifenesin in it as it thins the mucuus. Then try a mattress and pillow encasement for dust mites as an allergy to them is a very common cause of post nasal drip. Lastly try a week of antihistamine at night. If none of that works push for an asthma referral. Just avoid medicines with pseudoephedrine as that can exacerbate tachycardia

@caringcarer

I think you would hear wheezing if asthmatic.

Not necessarily. I could never hear my son wheeze but the doctor could with a stethoscope.

@caringcarer

I think you would hear wheezing if asthmatic.

I don’t mean to butt in but this really isn’t true. My sons asthma attacks are more about a cough, an attempt at throat clearing, lots of physical visible “sucking in” areas on his chest, but the wheeze is inaudible. It’s terrifying.

They always write something like “exacerbated asthma” on my sons hospital admission, and it is often pneumonia, a viral infection, or an unknown, that triggers the overall declaration of “asthma”. Sometimes it feels like a catch all phrase.

It is always worse so much worse at night.

Thank you @SeaToSki this is so helpful!

Does your gp check his oxygen saturation (sticking his finger in the crocodile!)?

Just to settle your concern, a lot of ventolin does increase heart rate most definitely, but an asthma plan is usually steroid combination anti inflammatory inhalers, and they don’t really have that effect. And a well controlled asthmatic shouldn’t need their blue inhaler.

My sons’ asthma is severe and it’s under control now thank god, he rarely takes the blue ventolin inhaler.

Ds has mild asthma that is predominantly triggered by his food allergies but when he was younger he always needed his inhaler when he had a cold.
Every time he was poorly he would end up with a persistent cough, which was almost immediately relieved with ventolin.

I meant to say he's never been wheezy with his asthma, a persistent dry cough has always been the only sign.

@WhereIsMyMojo

Does your gp check his oxygen saturation (sticking his finger in the crocodile!)?

Just to settle your concern, a lot of ventolin does increase heart rate most definitely, but an asthma plan is usually steroid combination anti inflammatory inhalers, and they don’t really have that effect. And a well controlled asthmatic shouldn’t need their blue inhaler.

My sons’ asthma is severe and it’s under control now thank god, he rarely takes the blue ventolin inhaler.

Yes he has it checked regularly whenever they see him. He’s a bit of a tricky customer in terms of his heart so they’re always belts and braces. I’m waiting for a callback from one of the senior GPS and will ask what they think. God bless the NHS they’re so so brilliant with us.

Oh also thank you for the reassurance. I’ll ask about a plan and see what they suggest.