Asthma diagnosed without face to face appointment

[TyneFilth]

Hi all, My DD (8y) complained of shortness of breath a few months ago and I booked an appointment at our GP via online booking request. We were given a phone call from a nurse, and after discussing symptoms she was prescribed a reliever inhaler, and a peak flow meter to track her breathing capacity. Without the inhaler she managed 90-150, out of a predicted lung capacity for her age/size of 210-220. So I am clear she definitely has a respiratory problem.

We then more recently booked an appointment for a review and I specifically asked on the booking system for an in person appointment. Nope. Another phone call with the asthma nurse, while she was at school so not even with her there to describe how she feels in her breath/lungs. We detailed the peak flow data and said she's still mentioning difficulty. So she's now prescribed the brown inhaler as well, and she must carry the blue one around. Ok, happy to do that.

My question is, should I press for her to be seen in person? It does not feel right that she can be just diagnosed and prescribed like this. I want to know what to do other than pump the medicine into her - should she exercise more/less/differently? Should we be looking for triggers? Maybe we should change our washing powder or cleaning products - I know that's ridiculous sounding but is that it, she's just asthmatic and nothing further?

Please help me phrase my letter to the practice right. I was going to write to the practice anyway as I want to know who our named GP is and some other stuff about linking the NHS records on the app. I am very good at writing letters and complicated stuff at work but weirdly it's not translating over to this.

Hi, Im asthmatic. Ok so you should ask for an asthma challenge test and a referral to a paediatric respiratory specialist.
Peak flow record is important as it helps see the pattern and potential impact of triggers or medication.
You could go to an allergist and get the proper skin pick IG tests to see if allergan, if so then you are able to try avoid.
I would get matress protectors and pillow protectors and wash pillows, sheets etc on high. Remember if its a pollen allergy you cannot line dry- tumble dry only. Your child may well grow out of this.
Its important you get an asthma attack procedure in place so you or your child knows what to do in the event of an attack. Brown daily inhaler should fix a lot of the issue if asthmatic. Blue is for irregular use, too much and your asthma is not managed. Do you think its worse at night or exercise induced?

If she was prescribed an inhaler, there is no point in pressing for an appointment at this time. If the inhaler reduces or stops the issues, she has asthma if it doesn’t, then by all means, press for a further assessment.

My son’s asthma was bad enough to require using steroids on occasion but depending on when they checked, where, the flowering season or the position of the moon, he would show signs or not at all.

I doubt asthma can be diagnosed with any kind of precision. I remember one day the GP checked DS in the i morning and apparently his oxygen level was so bad she called an ambulance. By the time we got to the children’s ward an hour later his lungs were perfectly clear!

It is an allergy, depending on what your kid has been doing or where she had been on the day, the doctor may find she has asthma or not.

@GetThatHelmetOn The bronchial challenge test is the gold standard test for asthma.
www.blf.org.uk/support-for-you/breathing-tests/bronchial-challenge-tests

Thanks everyone. To answer on what I think the cause is, I think it's dust. We did a renovation project and haven't finished it, so we have still got concrete and plaster dust from unfinished floors/walls. She doesn't seem to be much different with exercise, or at night, and so far in the pollen season I'm not seeing much change either.

I will ask for a bronchial challenge test. I hadn't considered an actual asthma attack, and what to do. I can look up on the asthma UK website with her, but this is why I wanted an actual appointment, because an asthma nurse or GP knows how to 'teach' this to a patient, whereas I'm just reading off a website and might get it wrong, freak her out, downplay it, I don't know. I don't like this "DIY healthcare" situation at all.