6yr old dd has a cough.. doc give her inhalers AGAIN: Come & talk asthma to me!

[fireflyfairy2]

I am fuming

DD was up all last night with a cough. She was with the c/minder today who told me she coughed all day & to get her a cough medicine. I called in to the chemist at 3.30 & she asked me if dd was asthmatic. I said as far as I was concerned, no, she wasn't asthmatic but she had been prescribed inhalers when she was 3 as they said she had asthma as she coughed at night.

[coincidence that this was around the same time that the clinic was getting a grant if they had a certain amount of people attending the asthma clinic??]

Anyway she got the inhalers for a few weeks at that time & the cough sibsided.

She is a very active little girl. She plays camogie, she goes on her trampoline, she rides her bike etc... all without any shortness of breath!!

So today when the chemist refused me the cough medicine she advised me to get dd's peak flow checked with the nurse. So after going to see the treatment room nurse [who had no idea what her actual peak flow should be] I was referred to the practice nurse... who checked peak flow.. said it was 105 but she thought dd just had a bad technique.....then proceeded to prescribe fuckin inhalers!!

2 inhalers... Beclometasone Dipropionate & Bricanyl... she said to give the BD twice a day morning & night & the Bricanyl when she was struggling for breath!!

What they wouldn't listen to was... she is never short of breath!!!!!!!!!!!!

She said I had to keep testing her peak flow for a month & keep a record of it whilst giving her the DP.

She give me no indication of what it should be, what we need to be working towards or anything else..

IMO & I am no medical professional, my dd does not have asthma.. she has a cough.. all I wanted was a cough bottle I feel so useless...

I sat in the clinic from 3.30 until 5.45 with 2 very sleepy & crabit kids

Does anyone have any idea what her peak flow should be.. what a peak flow of 105 means? [even though the nurse reckons dd's technique is pants so this could contribute to the 105 peak flow

HElp!!!!!

When my daughter was a baby she was impossible to get to sleep. Every time she was put down in her cot she would cough and cry. My sleep deprived solution was to put her to bed in her car seat. This worked like magic, and although I knew that it was probably very bad for her posture it was hard not to do it. My health visitor told me she had a sleep problem, associating the car seat with bed time. She recommended controlled crying. Of course this led to more crying, coughing and vomiting. I don't think it occurred to her that my daughter sleep problem was caused by a health problem, and I was too sleep deprived to explain it properly.

Eventually dd came down with a chest infection and was prescribed antibiotics. The GP started asking the right questions, like does you daughter have a night cough. Talking to him made everything fall into place. The preventer inhaler made the cough go away in about a week, after a year of coughing. She was in her cot and sleeping, not crawling around the house in the middle of the night after escaping from her car seat.

She doesn't have asthma, and now she's four does not need the inhalers often. She has the "wheezy winters" which means that asthma symptoms are triggered by colds. Basically I have inhalers in the house to use if she needs them. She very rarely wheezes, normally the night cough is how she presents asthma. It's winter again now, so I'm on my guard.

Well, after speaking to my SIL (she is a nursing consultant but not with the practice we go to!) I decided to give dd her inhalers last night at bedtime.

I give her the brown one before bed like told to. She coughed & coughed so badly she spat up blood which I assumed was the vessels in her throat (she has done this before) So I made a spur of the minute decision to try her with the blue inhaler.

I give her a suck of it, she rolled over & went to sleep & I never heard her coughing all night. She said she felt like she couldn't breathe.

I also had no heating on in her room last night just to see if it had been the heat making her cough.

So now I dunno what to do. I id her peak flow this am & it was between 105 & 110 again.

Hi

Both my 6yo DD and I have asthma - hope the following is useful as well as the other posts.

Coughing may or may not be a symptom of asthma in your DD - for some asthma sufferers it is their only or main symptom, for others it is also a good indication that their asthma control could be better. Asthma does not always mean wheezing or shortness of breath - even on exertion. Often in children with asthma, a night time cough is one of the first signs that they are becoming unwell.

As one of the other posts says - your DD may not have asthma, but the GP/nurse have prescribed inhalers to treat her symptoms. I would follow their recommendations for a month and keep diary of medication and your D's health/symptoms - did they give you a chart or pf diary to fill in? If not, keep record each day of any PFs before taking inhalers (morning and evening), whether she coughed, did she feel out of breath or have a tight chest etc and what inhalers she had eg did she take the beclamethasone BD and did she have any bricanyl.

Also, are the inhalers pressurised cansters (MDIs)? If so were you prescribed a "spacer" for her to use to take them? If not, ask for one (NB there are different types - the aerochamber is a bit more child friendly for a 6 yo than a volumatic one as it isn't so large and can be carried around more easily).

Children of your DDs age often can not do peak flows properly - my asthma nurse does not rely on them with my 6 yo, she works off symptoms instead, as she says that she would rather not confuse her with trying to do PFs as the technique for using her inhaler is far more important and it can be confusing as they are very different.

If after a month, there is a significant improvement, it would suggest the inhalers have helped, and you could talk about "stepping down" to a lower dose or stopping them for the time being - some people only need steroids during a partiular season, and often children can "outgrow" these type of symptoms.

If she is still coughing after a month, it would suggest that further treatment or investigation is needed.

One other thing - the bricanyl (reliever) may well help with a coughing fit - it won't do any harm to try it. My reliever is ventolin (same type of drug) and you can't overdose on it - but it may make her feel a bit shaky.

Hi - just read your last post after typing my epic...

It is probably a good idea to give bricanyl first, then beclamethasone morning and night, and make sure she cleans her teeth/rinses her mouth out after. The spacer I mentioned in my other post should also help.

If the beclamethasone makes her worse, go back to the Dr - don't wiat till the end of the month.

If she is going to school, send the bricanyl with her, and explain to the school that she needs it if she is coughing, and probably worth her having a dose before PE etc too. They may well want the teacher to look after the inhaler rather than your DD having it, but they must make sure she can get a dose when needed.

Hope this helps

Hi kat, thanks for your helpful posts

DD has a spacer, it is a small chamber with teddies on it.

They give me a pf diary to keep & when I did her pf this morning it was between 105 & 110. I agree that she isn't very good at it as she has never had to do it before, so this isn't a good indication of whether or not she has asthma.

I have never sent her inhaler to school with her. But saying that, I will ask her teacher this afternoon if she has been coughing all day today & if so, then I may send her inhaler. (reluctantly)

I have watchd my sister struggle with asthma for years, it runs on my family, my gran died after having a severe asthma attack & her inhaler didn't help. It's not that I don't want her to have asthma, but after watching what asthma really is in my niece, sister, aunts etc.. dd just has a cough, always seems to be in the winter months though, so I guess it's better to be safe than sorry.

Hi

Its understandable, given the family history, that you're really worried about it all, so it really is best to be safe... asthma is very variable - some people have severe symptoms and attacks, otehrs are much more mild.

WIth kids its always a challenge as at 6, they're not really old enough to be able to tell you how they're feeling, so you have to try to gauge how they are etc, and that's where the diary is useful, but do keep notes about symptoms too cos I find that more help.

My 6 yo is now getting really good at remembering and reminding me that she needs her inhaler morning and evening - I explained to her that her medicine keeps her well rather than making her better. She doesn't worry about it at all - she has even tried explaining about it to curious children at school.

I was only diagnosed with asthma 4 years ago (around the same time as my dd) so I've been a bit fanatical about finding out as much as I can.

If you haven't already, try looking at the asthma UK site - its very good , with a discussion forum and phone line for help too.

I think i will send dd to school with her ventolin, see if we can ease this coughing over the winter this year.

I to never have the radiatior on in her room.

We have a spacer, but i used to do it wrong, ie doing a puff and expcting her to quikly inhale, like an adult would with just the inhaler.

Now its nice, easy, (deep) breathing if poss AFTER the puffs have been puffed into the chamber.

My dd hates the blue one says it tastes like old suitcases lmao!!!!

DS1 has been on a brown inhaler morning and night for 4 years. Never needs the blue. But if I drop the dose on the brown (preventer) he gets a persistent her-hum type of cough and his peak flow drops. When I put the dose back up again the cough goes and the peak flow rises.

Never been sure that I'm doing the right thing though...

Sympathy. I had this with ds1. I tried to persuade the practice nurse whom we had to see that it was only a cough - we had all had one. She replied that we all probably had asthma! Mad! I insisted on seeing the gp, to tell him that we would use the blue inhaler, but that I would not use the brown one yet, as I felt that this was a very mild dose of something, and that I would see the nurse again if it seemed more persistant or more serious. We never needed to go back.

Most cough mixtures are not effective anyway. There are some good alternatives below.

By the way, ds2 has since developed asthma and it was very easy for me, as a non expert, to tell the difference between a normal cough and a very persistant one with difficulty in breathing too.

FFF2 how is it going tonight? Interesting comments in your posts about last night, we also find that the reliever inhaler works best given before bed - we have talked to the consultant about this and she said that as long as we are not doing it all the time then this is ok. we end up using it when they have colds etc, just so they can get to sleep without coughing. This is when they seem to cough the most, i think that's what i mean about 'works best'. It is also the time when they seem to concentrate best on breathing in deeply to get it into their lungs, probably not a coincidence that 1) it's after a bath, and 2) we are not rushing off anywhere else. In spite of always trying to keep things calm when giving the children inhalers, they know that they are on the way to school / play / lunch or whatever and i don't really think they do it as well as at bed time.

Maybe it would be handy for you to continue to give it to DD at bed-time, just to get her over this cough? Even tho my two have had asthma diagnosed from an early age and have the wheezing etc to go with it, we can get them off the inhalers completely for a few weeks a year (might sound pretty rubbish that it is only a few weeks, but it is quite liberating in my world...) I do not have asthma but have been known to 'borrow' a couple of puffs of the reliever when faced with a bad cough that won't let me sleep in peace! the 'asthma cough' is not one you can really mistake for anything else though, and if you really think she doesn't have it you are prob right.

my DD has a humidifier & ioniser in her room - which incidentally is a small room with a laminate floor, thus minimal dust, tho i honestly don't think the house dust is a trigger as such but i think once she's coughing and wheezing then everything seems to aggravate it. I sometimes think the humidifier cures me ( less worry?) more than her, but whatever it takes to get us all a decent sleep

I have given her both inhalers tonight again as she was coughing up phlegm.

I have her radiator turned off & the small one in the hallway outside her room has damp towels on it to raise some steam, they have lavender on them also.

After talking with SIL I think I will give them a try & see if there's an improvement.

Thanks everyone, I was in a crap mood yesterday & for most of today.

I hate giving them medication, dd has had antibiotics about 4 times in her life & she is almost 6!

know what you mean. So careful about what you give them to eat etc and then have to put steroid inhalers on their faces

good idea with the towels & lavender on radiator, lovely calming steam!!
we use peppermint oil in the day time, in oil burners etc (not at night cos it's a stimulant)
karvol (?sp) everwhere at night.

Keep writing everything down - i mean everything... what you see, hear, think, what she eats (may sound ridiculous but we find food triggers too) you never know what will help in the longer to term to prove or disprove the asthma theory.

keep posting to let us know

From experience, can I add a quick note to please check which peak flow meter is being used, as some practices/chemists still give out the older style. Look at this page, which also has a helpful converter.

You can also download a padiatric normal values chart at this link.

butterfly )

Why are you so angry about this?

All my kids have asthma, all have different symtoms, all NEED inhalers

Child 1, coughed all night every night, didn't get wheezy, short of breath til teens. Now only has symptoms whenaround her known allergens (animals mainly)

Child 2, had a pronounced wheeze from birth, no breathing issues til aged 8. Now has symptoms only with colds and allergens

Child 3, only has asthma if hayfever isn't controlled

Child 4, has shortness of breath after activity, around allegens, every virus sends him to hospital to be nebulised. He is the only one that has symptoms between attacks but only after exercise or severe cold weather

Asthma doesn't mean it is constant nor does it stop most people running active lives (exercise actually helps)

Cough medicines do very little anyway, might as well just give honey, lemon and hot water

Asthma is diagnosed through sypmtoms, there isn't a test for it. Inhalers won't harm ad can save lives. If you child does have asthma the inhalers will help.You never know when an attack can turn nasty and to see your child struggling to breath when they do, is one THE most terrifying experiences (for you and them)

I'm angry because I doubt very much if she has asthma. There is a lot of it in my family (earlier post) so I know how terrifying it can be.

Also, I was angry because the nurse wouldn't listen to me, they habe out inhalers like sweeties at my surgery so no-one is actually sure if their child has asthma, or if they are helping the surgery make up the numbers in order to receive their grant

Thanks Butterfly

Whoops, sorry about the sad face in my post, should have been ''.

But inhalers don't just treat asthma, they help with upper respiratory problems. Childrens airways are tiny and can colds/viruses can cause problems, inhalers can help. They aren't asthma inhalers, they are just inhalers

I don't get it, you were happy to get a bottle of ineffective cough linctus but not inhalers, even though you say child has had a peaceful night after using

You don't have to give them to her, no one has to take medication the docs give out

So what is the problem?

Christ, why are you picking????

I have explained my post.

Not everyone has the same stance on things.

You & I differ that's all.

Please, leave me alone. I have been having a discussion here, I don't want someone to pick at everything I have said. Please.

Sorry, forgot to mention the cough bottle.

That would have been a short term solution to the cough she has. It would have relieved her enough to get a good nights sleep.

Now I have been asked to give her steroids for a month. That's actually where my problem lies. And the fact that when I typed my OP yesterday I had been sitting in the doctors surgery for over 2.5 hours with 2 small fidgety kids.

Have you ever looked into the ingredients of an inhaler? I really don't want to give my dd them unless they can tell me for sure that she has asthma. They say "we'll try her with this" etc.....

I'm with you FFF2. My GP hands out inhalers at a drop of a hat.

He has told me on different occasions that all three of my children are borderline asthma (whatever that is, surely you're one or the other)and then other times he has said 'well, they definitely don't have asthma'...

Maybe I should change GP?!

Good luck with your daughter. Hope she has a better night tonight. You're right to think about the medication and not just give it willy-nilly.

Most children have a cough as the main (and only) symptom of asthma.

Very few get short of breath.

Cough medicines do not work.

Most practice nurses know more about asthma and it's management than GPs.

Oh and GPs don't get paid for having more asthmatic patients they receive points for managing to review their confirmed asthmatics yearly.

If they make the target they are allocated the budget, which most GPs use to pay their nurses to review the asthmatics. So they don't really 'make' money on it.

not picking, trying to educate

inhalers aren't just given for asthma, there is no test to diagnose asthma. So, a child (or adult) with a persistent cough, could have asthma or might not have asthma, inhalers can help with the cough regardless as the cough could be causedby narrowing airways (not the same as asthma)

Cough linctus will not help a persistant cough, and contain things a lot of people would not be happy with (high sugar content)

I was told steriod inhalers do not stay in the body (unlike oral steriods) so they treat the problem and go, o lasting side effects. Was also told you can't overdose on a steriod inhaler (though you can shaky if you take too much)

Most asthma is asthmatic episodes, not a chronic problem, it doesn't always lead to a diagnosis of asthma

And one last thing, asthmatic episodes should never be taken lightly, even if it just presents as a cough, it can turn nasty very quickly

Oh and none of mine have ever had an audible 'wheeze' just shortness of breath, tight chest or coughing

Hi FFF2

Hope you had a better night in the end last night and that your DD is improving.

Try not to worry about the steroid element of the inhaler - you should have been prescribed a low dose inhaler - probably around 50 mcg per puff and as it is inhaled, rather than a tablet the side effects should be minimal. The important thing is to clean teeth/rinse mouth after taking them so as to reduce potential for oral thrush or possible damange to teeth.

The shakey effect of inhalers is also actually from the reliever inhaler (bricanyl or ventolin - usually blue) rather than the steroids and will wear off in a few mins or hours.

If you haven't used lavender etc with your DD before, I would also suggest a little caution around those - I found when my two were small that some things could make them worse - eg karvol seem to irritate them more than it helped. I find some oils, plug in air fresheners etc can be quite an issue too when my asthma is playing up, though can cope with them when well.

As I said yesterday, I would give it a try, keep a diary of symptoms etc and either go back at the end of the month or earlier if you have any concerns.

If you have any queries etc, I'll try to help if I can.

Kat

Thanks Kat.

It looks like I am going to have to eat my words re: the bricanyl. I give dd the BD inhaler befire bed, but an hour into her sleep she was coughing like a nicotine addict. So I woke her up & give her the bricanyl, she slept like a baby for the rest of the night. So I guess there's something there that the inhalers are helping.

I did her pf this am & it was 105. This afternoon it was 150. So I guess it's either clearing up or her technique is improving.

I often use lavender on a damp cloth around the hallyway area, as it's not in her bedroom, but near enough for the vapour to help her a bit. I have been using that in her general area since she was a newborn & suffered bouts of bronchialitis. She is a December baby & was born with a snuffle!!!!