Asthma (in 13 yr old). Advice sought please!

[LittenTree]

Can someone who knows tell me whether DS1 could possibly be asthmatic? The only symptom he demonstrates is coughing, almost always in the depths of the night (4.30am today) when he gets up to go to the loo. It is becoming an issue in the house as he wakes us all up.

The way he coughs is a bit odd. You know how it is when you've got or are recovering from a heavy cough and cold, or a nasty chest infection, or whooping cough; where you get the urge to cough and you cough, cough, cough, cough to the point of it forcing the last breath out of you, then you gasp inwards for air for several breaths, either for the whole thing to repeat or for recovery to start as your breath comes back under control. Well, DS does that sort of coughing but the next breath, after 30 seconds of solid coughing is either a small sniff (coughing so hard his eyes have watered) or a small throat clear, like all is 100% OK again. Am I making sense? What I mean is, it's like an immediate recovery which isn't what I'd expect with asthma or, for that matter, a normal heavy cough! He'll then repeat it for maybe an hour, on and off.

Last weekend we were visiting friends for the w/e. We allowed the boys up way too late on night one, then, sadly again on night 2 (they ranged from 11-14). When it came to getting them to settle at 10.45pm, DS1 gets this cough thing again, over and over, so I moved him from the shared bedroom to the study floor as he was preventing the other boys from sleeping. My friend, the other mum, came from her room with her puffer as she is quite asthmatic, telling me it sounded just like asthma to her, and did I think 2 puffs might help? I said let's try, and, after a moment or so, DS was 'fine'. My friend says that sometimes asthma is diagnosed via whether Ventolin works on it or not! I'm not entirely sure that 2 very late nights were The Factor here, though!

DS isn't very sporty but I don't think I've ever seen him gaspy or blue lipped at all. We climbed Snowdon a fortnight ago!

Now I will be blunt here and say DS1 can be prone to attention seeking behaviour. He hates being the only one awake (if he's awake when I go to bed at 10.45pm, he'll give a theatrical throat clear from his room which is really saying "I'm still awake, mum"). Could this be what's happening rather than asthma? A few mins ago he was sitting on the sofa near me, and started coughing. I went 'DS!' and he immediately stopped coughing and said, all aggrieved 'What? I can't help it if I'm coughing, can I?' and it struck me then that if he needed to cough, he'd've continued, not instantly shot a retort back at me.

I am also concerned that if I take him to the GP he'll automatically stick him on Ventolin- I gather you have to fight to get your DC a hospital referral! DS really doesn't need the potential growth stunting effects of steroids, either!

WWYD? I know little about asthma as we've been fortunate for it not to be an issue in our families so far!

I am also posting this in Childrens Health, hope no one minds a double post!

My son's asthma was diagnosed using a Peak Flow Meter. He will have to blow into a number of times and then the average is taken.

It is difficult to fool the nurses, who will encourage him to try harder if they think he's putting it on. I think the trying Ventolin is used more for young kids who can't use a Peak Flow Meter.

You have my sympathy, I have an attention seeker too

Coughing at night is one of the things they ask you, and frequently when I'm just nodding off, I start coughing (I'm also asthmatic).

Good Luck.

Thanks! Appreciate your input.

Yes, a nocturnal cough can be a sign of asthma though it doesn't sounds typical and you may well be right that it is attention-seeking or just a habit. I would expect a cough from asthma to affect him at other times of the night, not only when he gets up to pee.

It's worth seeing your GP. As MrsZ says, asthma can be diagnosed with a peak flow meter in a child of his age (kids can't use them before about the age of 7 so younger kids do need a "suck it and see" trial of ventolin).

Not sure why you're worrying about a hospital referral at this stage. If it is asthma, it sounds mild and any GP will be looking after dozens of kids like this. If he does need ventolin, it is an extremely safe medicine. He may not need steroids but, if he does, there is tons of evidence to show that untreated asthma stunts the growth more than inhaled steroids. However I really wouldn't worry about steroids at this stage - mild asthmatics often only need a ventolin inhaler for use as-and-when needed.

Good leaflet here

Thanks very much for that turps - I really know very little about childhood asthma! I must say I had assumed that all asthma patients really should be under a respiratory physician, not the GP, I hadn't realised that it was OK for mild cases to only be handled by a GP; I also thought Ventolin was steroidal!

I'm asthmatic, the only symptoms I have is an early morning cough.

Ventolin (AKA Solbutamol) opens up the airways, that's all.

Ventolin is a beta 2 agonist that relaxes the airways when they have tightened, not a steroid. It is taken to stop an attack already in progress or sometimes regularly in pollen season or at night or before exercise.

It is sometimes abused by bodybuilders, etc., and there is an active illegal market on the net for it but it is not a steroid. I think it is abused for the purposes of fat burning.

Please go to the doctor and have your DS thoroughly checked using a peak flow meter. Asthma needs to be controlled. It can have horrible effects, including chest deformity ('pigeon chest'), increased susceptibility to infections like pneumonia, and stunting of growth/lack of energy due to poor oxygen intake and interruption of sleep.

Becotide (now discontinued), Beclazone, Filair and Pulmicourt (iirc) are steroidal asthma medicines that can be inhaled (there are also generic versions). They are corticosteroids, not anabolic steroids. Steroidal treatment for asthma works by reducing inflammation and excessive mucus production. When inhaled, side effects in the rest of the body are reduced as the medicine goes directly to where it is needed and not circulated there via the digestive system and bloodstream. There are side effects however, and for this reason a doctor will prescribe the lowest effective dosage because it is taken routinely/daily as a preventive medicine and can therefore involve long term exposure.

Steroidal asthma medication doesn't work to relieve an attack once it has started. For that you need ventolin or generic solbutamol