DS has an appt with the 'asthma' Gp this afternoon - what should I push for ?

[cmotdibbler]

Background - DS started coughing when he was 6 months old. At 1 (after trying Atrovent etc) it was discovered that he had clogged up his lungs, collapsed part, and had a deep seated infection. Loads of antib's, chest physio and salbutamol later that cleared. Consultant said he thought he had asthma, and to keep an eye on things.

Since then, DS coughs more in the winter, less in the summer, but it never goes away. He wheezes fully at times, but almost all the time you can track where he is in the house by the sound of him breathing.

This winter he's had one chest infection, but has just coughed and coughed and coughed. Ventolin helps, but the beclomethasone doesn't seem to really reduce it. GP just keep saying that he'll grow out of it

When I saw the triage nurse (who is the asthma specialist nurse) about my chest infection, she suggested that DS should see this particular GP as she is the one best at chests.

I'd really like to get DS onto some sort of medication that would reduce the huge amount of mucus he seems to produce, and that would let him get a really good nights sleep and stop sounding like an old man on 40 Woodbines a day whenever he runs around.

Any ideas ?

I think you could try this method of breathing retraining.
It's called the Buteyko Method and has been responsible for cutting down asthma drastically in Russia and in Australia where it is widely used.

I had pneumonia for 6 months last year, and developed adult asthma as a result.

By breathing more shallowly, ONLY inbreathing through my nose, with a longer outbreath through my mouth, (even when talking) I have reduced my puffs from 7 puffs of symbicort (combined steroid and dilator)a day to occasional puffs of a dilator - IF I need it.

My Respiratory consultant was delighted, and saw thee Buteyko method as complementary to his own methods. I've reduced my drug bill by 100 quid a month, and can breathe - it's wonderful!

Try also to reduce the amount of mucus forming foods your DS would eat - less milk and bananas and nuts. More water and fruit.

Best of luck with it.

I forgot to say that DS is 2.8, and doesn't eat that much mucusy foods, so not much I can do there.

Thanks though

The Buteyko method is taught in the Uk also: here's the link to that site.

Also a neti pot for clearing his nose would be a good idea if he gets a blocked nose a lot.
It's a little ceramic teapot looking thing which is used to pour water into the nose when he's lying down. Been used in India for 1000s of years.
HTH!

Try the buteyko method - even if you just remind him to nose breathe.

See if he's breathing through his mouth a lot, and gently close his mouth for him. It's really made a difference to me not to over breathe. It will take a while to retrain him, but so so worth it.
Steamy atmosphere will help clear the mucus - let him into the bathroom when everyone is having their showers for the steam.

My respiratory consultant was so pleased with my progress on Buteyko as my sister died from an asthma attack, so they were going to treat me with the full arsenal of drugs (as they had done her).

Buteyko nose breathing means that I can get up and go without puffing my inhaler, nor wheezing like an auld wan.

I can't tell you how fabulous it is to be able to breathe again, and not have to think about breathing or my breath.

HTH

OK - DS1 has a chest condition (not asthma, as really that can not be diagnosed until 3ish), he has been ventilated twice, needs ventolin when having an attack and also hospitalisation.

He doesnt respond to inhauled steriods like bechotide etc and was a nightmare on montilucast (singulair), however, I do know that it works for loads of people. DS1 has a full antibody test at the hospital and it came back that he sis not have the specific antibodies that he should have developed from his childhood imms. So we have just spent the last 8 months having them all again and are due the blood results back ion a couple of weeks.

They call what DS1 has Transient esposodic viral wease - as it does not seem to come from infactions, but visus.

We make sure he has multi vits and lots to drink, he has a humidifyer in his room and also lots of excercise - swimming is espically good for wheazy children.

I would ask to be referred to a chest/respistory speicalist at the hospital.

Sorry for the essay - hope this helps

See what the gp says, the standard escalation of asthma treatment if the beclamethasone isn't working is to add montelukast as MadHouse says.

I'd also second asking for a referral.

Thanks all - he had loads of tests when it all kicked off with the lung collapse, so we know there is nothing terrible underlying it.

We spend hours in the bath, and go swimming every week. Exercise isn't a problem as he is always on the go - but sounds terrible whilst running around.

My frustration has been this continuous 'he'll grow out of it' response from the GPs, which doesn't help him now. My only regret about moving has been that we can't go back to his consultant who we saw before

They tend n ot to do the specific antibodies initally as it is an expensive and takes ages to grow the stuff. So it might be worth asking again.

We had loads of tests for CF, all sorts of things.

The truth is that as they get older their airways widen dramatically, so lots of children do grow out of it and unformtunaly there is not masses of treatments out there.

I get really pissed off when GP asume he has ashma - he def doesnt.

Have you been offered tests for allergies?

Push to see a consultant if you want some reasureance.

He had testing for cf, allergies, and for an assortment of immunological things initially. No allergies at all showed.

He is very runny - permanent snoticle (he did show enlarged adenoids, but they weren't big enough for the ENT surgeon to want to take them out)

DD responded really well to montelukast, DS did not but the I understand that's the way the drug works. In my experience they don't 'grow out of it' but the I also found that lots of GP's don't really understand asthma terribly well.

Can you ask for a referral to an asthma clinic at a hospital?

motekulast has changed my ds's life from one fo constant wheezing to ..hardly ever needing the ventolin even when he has a cold

ask whether that is an option

tbh I don't think you should push for anything ...if he is an experienced GP

It turned out to be a reasonably good appointment - GP actually listened to us, but we still had to go through the 'yes he looks well right now. No, he doesn't have a chest infection or is wheezing. But he coughs like a heavy duty smoker. No, I really don't think it's just post nasal drip' routine, which is our essential problem that all along he hasn't presented with the symptoms that GP's recognise, but just more this very persistent and disturbing cough.

She felt that he could do with having his mucus dryed up for a bit to see what happened, so we have pseudoephidrine to try for a few weeks (which will stop his runny nose for a start) and allow him to clear his lungs of crud properly.

She's going to pull all his paper notes out and read them properly too, so that she can understand what went on before. And will refer if this course of action doesn't work

Good to hear it went well. Having a sensible gp is half the battle won IMHO. Hope you see some improvement (and have a sneaky non-MN hug for your ds )

That's great to have a good appointment cmot. A good GP who's up on asthma and wheezes is such a relief.

I paid to see the top private medical consultant in top teaching / research hospital here (not in UK) and spent 45 minutes with him discussing solutions.
He said that Buteyko (shallow, nose breathing) helped some, and recommended that I do it. He also prescribed symbicort (combined preventer / reliever inhaler), which I've been able to reduce to one puff a day, down from 7.

I was suprised he was so 'complimentary'.
I've found Buteyko method breathing has reduced my wheezing no end.

So nice to be able to breathe without getting exhausted!

Hope this helps.

Hi,
My 6 year old son has been taking Montilucast for 2 years and it is wonderful for his asthma but he also has terrible tummy pains possibly from the drug. Anyone else had the same problem?

Metalsmith-Not tummy pains but DD did have her first ever migraine once she went on to Montelukast. Have you filled in a yellow card at the GP's to report the side effect?