8 year old with persistent cough, losing weight

[Kialla]

8 year old DD suddenly developed a strong cough 4 weeks ago. She wasn't ill in any way, no cold, temperature or other virus symptoms.

She's typically very healthy, rarely gets a sniffle.

We gave calpol, cough medicine and throat sweeties. It very quickly affected her sleep and she hasn't been able to get to sleep before 10pm since it started and then is awake throughout the night coughing before being up for the day at around 6am. She's completely exhausted, pale and losing weight, her appetite has reduced and she picks at even her favourite food. She's always been slim but I can clearly see her ribs now. I just gave her a bowl of custard for lunch in the hope of getting some calories into her and she ate about 3 spoonfuls.

We saw a nurse last week (an appointment given very grudgingly) who said her chest was clear with no crackles or wheeze. She had no signs of infection and the nurse suspected seasonal allergies, she was prescribed an anti histamine.

She's got worse in the last week, has lost another half kilogram and asked not to go to school today. She would go to school with her leg hanging off so we know she must be feeling pretty rubbish. In the last few days she has said that some food tastes funny.

I'm getting really concerned. I'm waiting for a callback from the doctor which I had to really push for as the receptionist said it was an ongoing issue and therefore not urgent. I wouldn't be surprised if I've been put on the list for the nurse again instead of the GP.

How hard should I be pushing for her to be seen again? The NHS website says that any child with a cough for 3 weeks should be seen by a GP. Our doctors are fantastic but meeting the criteria to be seen seems to be impossible.

Do you live in an area where there is TB?

I was going to say this is what we see in children with TB

How hard should I be pushing for her to be seen again?

Very hard. It’s ridiculous you can’t even get a GP appointment these days.
Try and demand a GP appointment, say she is getting worse and really needs to be seen - ime those who shout the loudest get the most. A telephone appointment is no good, they need to examine her properly.

Phone 111, they will get you an appointment.

My 11 month has just had very similar. Several weeks of us being told lungs were clear, ended up in hospital where I asked for her to be swabbed and it’s a mycoplasma infection. They nearly didn’t do swabs or bloods as they were so certain it was viral. Day 5 of antibiotics and she’s perking up but still very off her food.

incidentally, 9 years ago the same thing happened to me, I felt awful, coughing, kept being told that my lungs were clear, ended up in hospital, swabbed and it was mycoplasma - but for me this had developed into walking pneumonia. It’s an atypical chest infection so that’s why my lungs sounded clear until they just weren’t.

Ask for swabs and blood tests to be taken to rule out an infection. Hope she feels better soon.

I would push to see a GP within the next couple of days.

We need to advocate strongly to get the medical care we need nowadays. GP surgeries and A&E are under so much pressure.

My DD was severely unwell at the end of last year and I wish I had insisted on an appointment with the GP. DD is ok now but there's a possibility that if someone had taken me seriously sooner that four months of illness and hospital stays might have been avoided.

I am all for seeing a nurse with my DD for tonsillitis, ear infections etc. but a child who has been unwell for weeks on end with an undiagnosed illness needs the experience of a GP.

I'd push very very hard for her to be seen and taken seriously. When ds was a baby he coughed and coughed and coughed at night. We were accused of being paranoid first time parents, then grudgingly given inhalers which did nothing. Eventually DH took him and said 'this really isn't normal and he's been coughing for 3 months' and the GP said they'd do an x ray but expected to see nothing. He had a partially collapsed lung from a chronic infection and mucus plugging - no wheeze as it was clogged up. Thankfully it was nothing more (but he had to have some scary tests) but still took 6 months of intensive treatment to shift

I'd push to see a GP rather then the nurse again. Did the antihistamine make any difference?

If your GP practice can't see you you should be able to ring 111 and get seen by out of hours Doctors at lest that's how it works here.

Call 111 and they will say you need to see a doctor. I have had them ring ahead to a hospital to tell them to expect me and my child at A&E before and that my child must be seen face to face by a doctor, so they can a direct line to get you seen that you won't get by calling the doctor's reception.

Thanks to everyone for your replies, as soon as I have to deal with medical professionals, I forget that I'm actually a fairly competent and experienced 40 year old mother of 2. It really helped reassure me that I was right to push for her to be seen.

As expected, we got bumped onto the list for the Advanced Nurse Practitioner. I missed her call at 2pm so she left me a voicemail to say that she wouldn't be seeing us as I hadn't answered her call. So had to call reception back and start the whole process again. I told them how much weight DD had lost and that I wanted to see a GP. They made me an appointment, but when we got there it was with the nurse.

I still can't quite believe how this woman acted. She completely refused to let me speak and instead spoke to DD as though she was a toddler. Did some obs and tried to send us on our way. Asked if we had asked for help with her 'eating problem" - I had tried to avoid discussing that directly in front of DD and had actually left her outside initially so I could mention the weight loss and how skinny she has got.

She told me it was normal for some kids to cough for a while after a cold, and was annoyed when I pointed out that she hadn't had a cold. Then suggested that she was being bullied at school and just wanted a day off. She told DD that we put her to bed too early (8pm) and then asked me why I make her get up at 6am (we would love her to sleep longer, believe me).

Then she asked me if I'd considered giving her some food that she likes. By which point, I had enough and demanded to see a GP. She said the GP wouldn't find anything wrong either but if I was going to get upset, she would have a word.

Long story short, very thorough check up from the GP and we've got atypical antibiotics just in case as well as an inhaler and peak flow monitor to check for asthma.

It's the second time I've had to kick up a fuss with a nurse to get proper treatment for my children. The last time I had to refuse to leave without steroids for my son's croup because the nurse thought we should just wait and see. Weirdly, they've been great with me but seem to think I'm a neurotic Mum whenever I take the kids in.

DD has admitted that she was really worried about how she was feeling, she always downplays things. But feels much better now as the doctor was so reassuring and kind. I can't wait for her to be better and try to renegotiate bedtime terms after the idiotic nurses suggestion that she needs a later bedtime.

If she doesnt improve with antibiotics
Keep pushing, i would want her tested for TB and then other things.
If it doesnt clear with antibiotics She needs bloods and a chest xray

The comment about your daughter ‘wanting a day off’ made my blood boil. A paediatrician said that to my guardian when I was 11. Said I was faking a grumbling appendix. His exact words were ‘that appendix will never burst’. So of course it did, a few days later, in a foreign country and I nearly died.

I also recently refused to leave hospital until they treated my baby’s croup. Kept telling me it wasn’t croup (my kids are most likely asthmatic, and bothhave had croup every month for ever, I know what croup bloody sounds like!). They did finally treat it when she obliged with a deep croupy bark. I’ve learned to take photos and videos to prove it. Yes, my child is struggling to breathe, but hang on a sec while I get a video.

Anyway, glad that the GP has taken it seriously and hope she feels better soon.

I would be absolutely fucking fuming and put in an official complaint to the practice manager over that nurse. Good for you for insisting on seeing the GP, you did the right thing. Well done Mama!

Well done for persisting in such an exasperating situation.

I'm glad you managed to see the GP and the they were helpful.

I'm very fortunate that the staff at my GP surgery are brilliant but I have had to deal with hospital medics thinking I'm just an over-concerned mother on several occasions. It is extremely stressful because the more frustrated I feel the more likely I am to come across as a neurotic mother so I have this inward battle to remain calm and constructive!

Whooping cough?
There’s a lot of it about. Adults too.
My DD and husband are just getting over a very extended period of dreadful coughing.

Get her checked for coeliac disease please. Blood test.

My ds is 8 and also has 8pm bedtime. We are up at 615.

The thing about the 8pm bedtime is bizarre. At this age they're supposed to need 10-12 hours' sleep which makes an 8pm bedtime pretty much ideal.

My eight-year-olds were in bed for 8 pm on a school night.

I thought that was normal!

I really hope your daughter makes a good recovery now. I would consider putting in a complaint against that nurse. Some of the things she said were completely unacceptable.

Well done you for standing up for yourself and your DD. At least you were able to see the GP in the end.
Hope your DD improves soon.

If the initial tests don't find a cause and it continues then coeliac disease is worth testing for. Especially if its a non productive cough.

Please put in a complaint about the nurse.

I know there's a culture of reverence around the NHS but this often means that poor care and staff attitudes are ignored. I work closely with the local NHS safeguarding team and so trust me when I say that people should ALWAYS speak up if the care they have received is substandard.

I hope your little one feels better soon. I know this is an awful thing to say, and totally against what I believe, but for future appointments could DC's Dad take them? I've been in a similar situation where I felt I was being dismissed as an anxious Mum and my DH got a VERY different result when he took DS back in. It's shocking that we have to resort to these tactics though.

I saw someone recently who said they had a bad cough and it had been caused by stomach acidity, so she had been prescribed stomach meds and an inhaler.

DD also had a horrendous cough and no cold, after over a week it does seem to be clearing up today, but we went to the docs and they weren’t very helpful. She hasn’t been able to sleep, apart from last night.

DH spent a long time in hospital in the early 80s with unidentified pain, they also thought he was faking it to get out of school. He then passed massive kidney stones and they were all ‘oh yes there was something wrong wasn’t there’.

Thanks everyone. The antibiotics had to be ordered at the pharmacy so she's only had the inhaler so far and had a much better night. Got her to sleep by 9 and she didn't start coughing until around 6, the best night shes had in a month. I am SO glad that I pushed to see the GP.

I will complain, it was the most bizarre appointment I have ever attended. She didn't even ask why we had come back, she was just focused on proving that we didn't need to be there.

The practice manager is already aware - we bumped into a GP who knows me very well so could tell I was upset and he got the manager to take DD into her office while we had a chat about it all. He couldn't see her but I suspect is the reason we got to see a GP. It shouldn't be like that though.

I'm frustrated at the policy in general. It was her second appointment for the same issue and I'd been told to see the GP if she didn't get better.

Happy to hear that other 8 year olds go to bed at 8 too!

She's very busy and active, she needs sleep and is always awake early so it's the only way to make sure she gets enough sleep.

Anyway, by the time she's re-arranged her bed, read some of her book, asked for water 23 times and complained that she cant get to sleep, its closer to 9 when she actually drops off.

It was completely irrelevant to the conversation and used in an attempt to criticise me. She was convinced that I deliberately wake my children up at 6am and kept questioning why I don't let her sleep. Really didn't appreciate having my parenting criticised in front of DD, especially when I'd already explained that she hasn't been able to sleep anyway.

She also told her that she could have mcdonalds every day for a week. I'm so desperate to get her to eat that she can have whatever she wants, but not every family can afford a daily mcdonalds, or would want to do that. Just so inappropriate!