Update on hidden asthma

[IlanaK]

Just wanted to say thanks to the people that responded to my query the other day. I took ds to the doctor who would not diagnose asthma and told me that all children get lots of coughs and colds which they grow out of. I pushed her a little and she did prescribe ventolin. We have been using it for a few days now and I can't believe the difference in him. Although he has developed a cough and cold, his energy levels have gone through the roof. He is still coughing through the night, but he must generally be taking in much more oxygen as he has sooooo much energy. He really is like a different child.

Thanks again to all who helped.

Hiya - I didn't see your other thread but sounds like you have the problems as I did with my dd. Did you get a blue ventolin inhaler? If you did and it makes a difference, go back and ask for a preventer (a brown inhaler) which he can use throughout the day and save the blue one for 'attacks'.

Glad to see it helped though - it is an awful thing for them isn't it?

I am confused. I thought the blue one was the preventor? It is ventolin he has been given. He does not have asthma attacks. Just to recap, he has total exhaustion which we think is from not getting enough oxygen and working hard to breathe. Symptoms are persistant cough and continuing respiratory infections for 4 years.

Ventolin (blue) is a reliever which is usually used for attacks. They say at our clinic that if you are using it more than once a week you should be on a steroid (preventer, brown) inhaler. I didn't think it was advisable to use ventolin too much to be honest. I'm glad he's feeling so much better though

I find that quite worrying. The GP said to use it twice a day for a montha nd then go back for a review. SHe said nothing about limiting its use.

Maybe it's just being used almost as a diagnostic aid then? She surely can't mean him to go on using it like that indefinitely, but just as a way of establishing whether he has asthma. Incidentally, not all children with asthma have what you would think of as an attack- ds has only ever really had one in 10 years as a child with asthma, but he can be very like the way you describe your ds when his is not being controlled.

Ilana - no that sounds standard procedure. A friend of mine also had the same prescription for her little girl who had a series of persistent night coughs. For one month, it really won't harm (ventolin has been used for a very long time and has an excellent track record for a drug).

I think the general idea is that if the cough is responding well to the ventolin, then it is the airways going into spasm. After a month, it'll be easier to review and see if he does need a longer term prescription/diagnosis.

If you're at all worried, book an appointment with the asthma nurse at your local surgery - in my experience, they're actually a lot more knowledgable about all the asthma drugs and how to make sure asthma is being controlled well than the GPs! Also, she will be able to make sure your ds is taking the ventolin effectively to get the most out of the dose.

Oh also, do give the asthma nurses from Asthma UK (formerly National Asthma Campaign) a call. The nurses on the advice line are exceptionally well trained and are more than capable of asking any query you have and a few you didn't think of too You may find that easier than going into the surgery.

I agree with Georgina- asthma nurses usually know their stuff. She has also explained much better than me what I meant about using it as a diagnostic aid!

Also, as an additional reassurance, it's common practise to take a "pretentative" (yes, I know I can't spell that ) dose of ventolin before exercise in exercise-induced asthma, so it's not a "no-no" using ventolin that much. I believe the warnings are for not using more than a couple of times a week to relieve breathlessness - i.e. it's a sign your asthma isn't being well controlled. In a way, your ds is using ventolin as a preventer - if that starts being inadequate then there are more efficient ways to help keep the airways open (and that's where the brown inhaler comes in).

Oh, another thing to watch out for. Sometimes I can feel quite hyper after a ventolin dose (can find it hard to sleep sometimes too) - it increases your heartrate slightly. So if he does react a bit hyper, don't panic - it's normal and passes quickly

(sorry for spamming your thread!)

There's an excellent information guide for Asthma in the Under Fives - I forget how old your ds is now, but it does explain why diagnosis is difficult. It's also one of the better explanations I've seen about what asthma is, what all the different treatments are and what to do in the event of an asthma attack.

Important part in that document:

" Can my child overdose on asthma treatment?
The reliever medicines (eg Ventolin or Bricanyl) are very safe. Even if your child takes a very high dose of their reliever inhaler, it will do no harm apart from increase their pulse rate for a while and make them feel shaky.

There is an upper dose limit on preventers (inhaled steroids) and you should check this with your doctor."

VERY glad to hear this Ilana. When you go back I do hope the GP finally admits that your ds does, in fact, have asthma. It should be blindingly obvious to any GP that asthma doesn't always present with wheeze.

I just felt so sorry for him reading your earlier posts because it looked horribly like he had untreated asthma. I'm not a doctor, but I spend a lot of time with docs, particularly those who specialise in asthma and it was leaping off the page at me.

So glad it is making a difference. Good on you for pushing them.

HI,DIDN'T SEE YOUR ORIGINAL THREAD BUT THOUGHT I WOULD LET YOU KNOW ABOUT MY EXPERIENCE WITH 4YO DD.
FOR THE PAST TWO YEARS SHE HAS HAD A PERSISTANT COUGH,IT MAY SUBSIDE FOR A WEEK OR TWO BUT IT ALWAYS COMES BACK WITH A VENGEANCE AND WOULD SOMETIMES RESULT IN HER WORKING VERY HARD TO BREATHE. SHE HAS HAD 3 STAYS IN HOSPITAL WITH IT ON NEBULIZERS AND ORAL STEROIDS TO STABILIZE HER O2 LEVELS BUT NO ONE SEEMED TO WANT TO DIAGNOSE HER WITH ASTHMA AND I DIDN'T REALLY KNOW WHAT I SHOULD BE DOING OR AVOIDING AND SHE WAS BEING GIVEN A DIFFERENT INHALER AND DIFFERENT REGIME TO FOLLOW BY EACH DIFFERENT PROFESSIONAL WE SAW.
FINALLY I SAW THE ASTHMA NURSE AT MY GPs THAT I DIDN'T KNOW EXISTED, SHE EXPLAINED TO ME WHAT MY DAUGHTER COULD BE SUFFERING FROM AND RECOMMENDED SHE GO ON STEROID INHALER TWICE A DAY FOR A MONTH TO QUELL ANY INFLAMMATION IN HER LUNGS WHICH COULD BE CAUSING THE PROBLEM. SHE TOLD ME VENTOLIN, SALBUTAMOL, SALAMOL WERE NOT A PREVENTITIVE AND THAT THE STEROID INHALER NEEDED AT LEAST 6 -8 WEEKS TO EASE THE INFLAMMATION BUT THAT I SHOULD NOTICE A SIGNIFICANT IMPROVEMENT IN HER COUGHING. SHE'S BEEN ON IT FOR 3 WEEKS NOW RELIGIOUSLY AM AND PM AND SHE' BEEN BRILLIANT, NO COUGHING DURING THE NIGHT(WHICH WAS THE WORST TIME)AND MUCH BRIGHTER AND MORE ENERGETIC(WAS ALWAYS COMPLAINING OF BEING TIRED!)THE OTHER THING THE NURSE TOLD ME WAS THAT SHE MUST ALWAYS CLEAN HER TEETH OR HAVE A GOOD DRINK AFTER TAKING THE PUFFER AS IT CAN CAUSE A SORE THROAT AND THRUSH IF NOT RINSED AWAY.
HOPE THIS IS OF SOME HELP, I KNOW I WAS AT THE END OF MY TETHER WITH IT BUT NOW FINALLY IT LOOKS LIKE WE MIGHT HAVE IT UNDER CONTROL AND IF SHE CONTINUES TO IMPROVE SHE WILL BE ABLE TO COME OFF THE INHALER AND ONLY USE AS AND WHEN IF EVER!

Draper's right, Ventolin is a 'reliever' in that it helps to calm inflamation and open the airways. Steroids are 'preventers' ie help to prevent asthma attacks.