DD coughing every night and after physical activity persistently.

[Modestly]

DD is Covid negative. It’s been around 2 weeks since she’s been continuously coughing throughout the night and after any physical activity. I’ve been going back and fourth with the GP just to get her examined in person. They told me it’s most likely asthma but have no way of confirming this. They gave her a blue pump (which doesn’t seem to help) and some chewable tables (Montelukast) which i later realised has serious side affects (depression anxiety to name some). It also has an article on the serious side effects and in just so furious how the doctors are not confirming a diagnosis and assuming it’s asthma or irritation and prescribing her such a serious medication. She’s suffering every night and with the treatment I haven’t been able to see any improvement. Her cough has just gotten deeper and has now turned into a Phlegm cough. The GP who did see said it doesn’t sound like a chest infection and do continue giving the treatment. See I’m just so helpless I can’t bear seeing her like this Especially when my instinct tells me it’s not asthma and something else . It doesn’t seem to go away rather it’s just getting worse. To top it up she also told me it can last for years (her assumption is that it’s asthma) but I’m sorry what ? I know a lot of people around me who have asthma. It does not sound like this and neither does the cough continue EVERY night continuously. We are tired and just so desperate. I’m just so worn out :( any advice would be appreciated. Do you think it’s worth going privately ? Do I watch her suffer for a year or so

Sounds exwctly like asthma!
Ive never heard the risk of that with Montelukast and i suffer with mh!
Montelukast HAs vastly improved mine, though im also on other inhalers too.

@Powerplant nope nothing. She’s 3 so they said during covid and her age they aren’t doing it

Sounds like typical asthma symptoms. I had the same sort of attitude from GP. Given a blue inhaler, told if that works it's hayfever and if it doesn't it's asthma. Went back a week later having used it all up, I'd took it so often!

They put me on the brown inhaler then, but didn't monitor me and it wasn't under control for about 10yrs until I moved house, changed GP to one who was hot on monitoring. I was a bit of a zombie in muggy weather, constantly felt like I was struggling to breathe for hours at a time, until it was under control. Turned out I needed automatic inhalers because I wasn't sucking it down right otherwise.

The blue one doesn't do much. I find it loosens phlegm making it easier to cough up, opens the airways if my lungs are tight and I'm having a coughing fit. Basically it stops me needing to go to hospital but doesn't fix the problem.

The steroid brown/red ones are the preventer inhalers. I'm a nightmare for checking if they've run out, my asthma always gets worse after I've been sucking nothing but air for two weeks!

If the asthma is under control you should hardly need the blue reliever one. I mainly need it if I've a cold virus or in hayfever season. But she might need it before playing sports, I do too. In that instance the blue one works as a prevention for exercise induced asthma.

Mould will definitely make it worse. And damp environment generally. Mould spores are in the air long before you can see any mould. Bleach is a major trigger for my asthma too so you might need to experiment with cleaning products to find something suitable. I'm fine with Dettol and Flash.

Find the room in the house with the minimum damp problems and let her sleep in there. Open the windows lots in the day. Use a hot water bottle and extra blankets and crack the windows open a little even at night. Use a dehumidifier to reduce the damp. But you're going to need to sort the damp problems permanently or move home, you'll never get the asthma under control otherwise.

@Wavescrashingonthebeach this makes me so sad 😭 I honestly didn’t think her cough would turn into asthma and this bad too . I feel so guilty too as there was mould in this house (we recently moved) we tried air purifiers, de humidifiers etc. She was fine in her room but recently has been co sleeping a lot and I feel it’s quite bad in our bedroom. It really sucks and mum guilt is making me feel so much worse 😞 we are planning to get the windows changed but until then I can’t bear to see her coughing every night

@Modestly

Ahh bless you this must be so distressing for you i hope it gets sorted!
All i can suggest re mould is attack with bleach! Get someone to take LO out for the day & have a day with heavy duty gloves on & bleach every inch of the place with all the windows wide open!!

I know people have very polarizing views on bleach but as far as i am concerned its a life saver in destroying mould!!

You can purchase a peak flow meter yourself from the pharmacy if the GP doesn't prescribe one. Maybe they've given her tablets because it's hard to get children to take inhalers properly. You've got to suck it down at the right speed so it doesn't just coat your throat and gets into the lungs, then hold your breath a few seconds. Using a spacer can help, you can buy one of those from the pharmacy too if it's not prescribed.

Watching with interest as my DC is the same. Only coughs with a seasonal cold but then coughs with exercise and cold weather. Proper awful smokers cough. Blue inhalers last year didn't do anything but this year got brown and a course of antibiotics and that stopped it. Just did the inhalers for 2 weeks as advised then stopped and no cough since. Never coughs in the summer either. Does this sound like asthma? GP says not as never wheezed and no asthma or allergies in the family, only happens after a cold.

Are there are feather pillows or duvets in her room? Both DH and DS have asthma and both well under control for yeards. DH uses brown inhaler twice a day and only has symptoms when he gets a cold. DS hasn't needed any inhaler for several years. But feather pillows/duvet trigger symptoms in both of them so would be worth checking and swapping to anti-allergy bedding if she has feathers.

As I understand it the blue helps when you get symptoms (bronchodilator to open the airways when struggling to breathe), the brown stops you getting them (preventer with low level steroids).

My youngest was diagnosed with asthma at about the same age and same symptoms. She would cough at night and whenever we went swimming she would have to come out of the pool as she was coughing so much. One holiday to center parcs we had to leave the pool as she was so bad. Once we went to the Dr she was diagnosed with mild asthma and has the brown and blue pumps. She only really uses the brown one and only has the blue one if she is swimming. She is now 10, plays lots of sport and has her annual asthma review using her peak flow monitor.

It does sound like asthma (I'm asthmatic). I don't know about treatment for children so can't really comment, but I'm surprised she hasn't been given a preventer (steroid) inhaler. Also were you given a spacer to use with the reliever (blue) inhaler? That might help it work more effectively.

My main point though is to suggest you ring the Asthma UK helpline and speak to one of their specialist asthma nurses. I have always had excellent advice from them. They are really helpful and knowledgeable.
www.asthma.org.uk/advice/resources/helpline/
Good luck. Hope you get her some help and relief soon. Asthma can be lifelong but it can be treated and lived with.

@Sheepareawesome

Good mention on the feathers! Ughh they set me off something TERRIBLE!!!!

I also dated a guy once whose room set me off so bad i asked him about his bedding & he said he only washed it at 30° to be eco friendly ! Im vegan & 'save the planet' in many ways but honestly avoiding allergy triggers around the home is so so important!

No one has ever suggested anything other than an inhaler for my DD. I certainly think the brown inhaler with the blue for flare ups is worth a shot first based on the medication side effects you mention.

Please don't think you have caused her asthma though, yes possible something environmental has triggered it, but it was there anyway.
Also it isn't necessarily life long, lots of children outgrow it.

This sounds like classic asthma, esp in a child. Lots of children do not wheeze but cough is their prevailing symptom.
Night time cough and exercise induced cough also absolutely classic. Is thete asthma, eczema or hayfever in the family?

The blue inhaler is what's called the 'rescue' one, it opens up the inflamed, constricted airways to produce relief, but it doesn't get rid of the underlying cause, which is inflammation of the airways.
It is often prescribed by Gps to see if it makes a difference to the symptoms, but often it doesn't, and it only lasts 4 hours. It can be helpful to give before exercise or in the midst of a coughing fit, 2-3 puffs via a spacer ( the spacer is really important, otherwise the medication does not get delivered properly to the airways and that is THE most common reason people don't see a response.

The brown inhaler ( or "preventer") is a mild steroid ( it is so mild and only delivered to the airways, virtually none is systemically absorbed).
This will treat the underlying inflammation.
Now, the important thing to remember here, is that it will take about 3-4 weeks, often to see an effect. This is because the dose is low and is not systemically absorbed.
You HAVE to take it regularly, 1 or 2 puffs ( depending on what's prescribed) twice daily, via a spacer ( remember, the spacer is vital).
A puff here or there is utterly useless when we're talking about the brown inhaler. It is dependent on regular dosing to the affected area to reduce the inflammation. ( it's like only applying a cream to an inflamed area once or just when you remember, it won't work).

Asthma can ebb and flow over a lifetime, sometimes children "grow out of ir", only for it to be triggered later in life by a cold or something.

Don't fret about the montelukast, it is first line treatment for asthma in children, no medication is without any risk at all, but during trials and on the data sheet you get, they HAVE to report all symptoms while the people involved in the trial were taking the drug whether they are as a direct result of taking it or not.
It has been used for 2 decades or more and is very safe.

Hope this helps.
It's horrible to see your little ones struggling but hopefully, if you understand the mechanism which is what I've tried to do here, it will be a completely overcomeable problem. It's v common, but it's also commonly misunderstood and therefore not optimally treated.
Best of luck

Asthma?

As others have said

Once established on the brown inhaler, she probably won't need the montelukast unless her asthma is not controlled.
Asthma is an allergy to the house dust mite. It is almost impossible to eradicate this without living in a chalet in the arctic, they are a fact of life.
Damp CAN exacerbate it, but does not usually cause asthma in children anyway.
If diagnosed, as a PP suggested Asthma UK is very good.

Yep my DD’s asthma comes out as a night time cough after a virus, she hasn’t had the issue for a good year or so though as now takes brown inhaler every day. She had to be nebulised as a toddler but the asthma diagnosis is just circumstantial because I have asthma, and because the brown inhaler prevents it. No need for a referral we’ve only ever seen the asthma nurse after a doctor originally prescribed inhalers several years ago. We have also tried piriton in the past when it’s been bad.

Please tell me they gave her a spacer as well as the inhaler?

My children were some of the first to use Montelukast, for DD it was a lifeline and at 30, she still takes it twice daily. For DS it was useless.

@Foamee

Watching with interest as my DC is the same. Only coughs with a seasonal cold but then coughs with exercise and cold weather. Proper awful smokers cough. Blue inhalers last year didn't do anything but this year got brown and a course of antibiotics and that stopped it. Just did the inhalers for 2 weeks as advised then stopped and no cough since. Never coughs in the summer either. Does this sound like asthma? GP says not as never wheezed and no asthma or allergies in the family, only happens after a cold.

It could be really mild. Cold viruses and really cold air, like on snow days, are two of my triggers. But if the GP says not then I guess you have to trust them 🤷

@Foamee Your GP needs some updating in asthma, cough variant asthma is now well recognised, not all asthmatics wheeze.

I'm a coughing asthmatic. Echo almost everything everyone has already said.
Various triggers, cold especially, worse at night, mould spores rather than damp per se.
Technique with inhalers for kids really is crucial. I use a spacer with my brown inhaler and it means you can't really get it wrong.
Does your practice have a specialist asthma nurse? Some do. Definitely worth an ask for a consultation post Covid.
Other little things that might help, wear something like a Buff over her mouth on cold/damp days as that might also help a bit.
Asthma does come and go and she might grow out of it.

My daughter, somewhat older than yours, was diagnosed and given the blue inhaler, however her new GP isn’t convinced she has asthma and couldn’t believe that peak flow readings hadn’t been carried out.

It is always good to have a peak flow meter with your first aid kit. They can be great at determining how bad breathing is with chest infections etc. It will also allow you to keep a record of DDs breathing and to see of there is any improvement.

@bloodywhitecat we've seen 4 or 5 GPs over the years plus a paed ENT reg who have all sent me away with a flea in my ear as it's 'just a cough'. (I still don't know why we were sent to ENT either.)
I need to see if they have an asthma nurse. I tried Asthma UK and just got advised to contact the GP. I guess as it's relatively infrequent they don't see it as an issue. He might not cough for 8 months of the year but the other 4 he doesn't stop. And my god, the dirty looks I get for having a coughing child these days!

My DD was prescribed Montelukast and had to stop taking it after a month with the Dr’s agreement as she developed chronic diarrhoea and started having severe night terrors (she was 5).
A brown inhaler really helped, she hasn’t had a bad overnight cough for around 2 years now (used to cough overnight for pretty much the whole winter).

@bloodywhitecat @Foamee I agree ! My DD did not have any wheezing and this made it even more confusing but it most likely seems like asthma now.