I'm new to this forum and have been looking for somewhere to get help and advice. Our son is 2 years old and has lots of episodes of wheeziness sometimes managed by GP, us at home and hospital. It always seems to happen at weekend or in the middle night. I absolutely hate going into hospital with him as everything takes so long - before he is allowed to discharged he must go 4 hours between inhalers. I feel I have become a little complacent and was so desperate to get him out of hospital yesterday - one dr saying one thing and another saying something else. They kept moving the goal posts. A plus point this time is he is being referred on.
I'm just never sure when to take him in and if I took him in every time he needed inhalers before the 4 hours is up - there would defo been more admissions. I try my best to keep him home.
At what point should I take him to A&E? Should i buy a home oxygen monitor to give me some guidance?
Out of hospital last night at 10pm still wheezy today or is he just full of cold? What is normal respiratory rate?
i am not an expert by all means and do not have a child, but i will attempt to answer your questions from personal experience?
I am glad to hear that he has been referred and hope this helps him get his asthma settled. I understand that you are reluctant to take him to hospital all the time, but until his asthma is under control it is probably the safest thing to do. What the doctors have said about the 4 hour thing sounds logical and i suspect that he has a an infection or a cold at the moment that has made him worse maybe.
You say he tends to be bad at weekends and at night? where does he spend his weekdays? have you tried allergy tests and do you know what his main triggers are?
depending on what step he is in his treatment, he might benefit from a home-nebuliser, HOWEVER this would be a last option i believe as doctors are reluctant to give them out these days. Do you have a spacer? this is said to help.
when outside make sure you wrap him well up around the face area so that he doesnt breathe the cold air as much.
PM me if you want to talk more. I am sure others with children will add to this post and correct me also if im wrong
Sorry to hear about your son. I know from experience how worrying it all is, also things worsening at weekends and at night. I often take my (now teenage) son to the GP on Fridays, knowing the weekend is coming up (ie if I think something is brewing or he's coughing a lot).
I have re-read your post several times, and to be quite honest, I would advise you to discuss all your concerns with your GP (and certainly with the consultant when you get an appointment). Asthma is a variable condition and everyone is different, I think even doctors find it difficult to treat sometimes! That is probably why the hospital doctors have had differing views on how to proceed with your son's treatment.
We can't really answer your specific questions but I advise you to err on the side of caution in seeking medical intervention. I have always found out of hours and hospital staff to be very good in dealing with my concerns, they always say they don't mind my checking. It has got easier with my son in the sense that he can now tell me if he thinks he needs a doctor. But when they are very small it is best to check things out with the medics.
Please feel free to PM me.
Edit. You ask about buying an oxygen monitor. I have wondered about buying one, but never done so. Again, I would ask your GP what s/he thinks.
My daughter is also 2yrs old. She is often in hospital with episodes. We too are at a loss as to when to take her. We are usually found to be having a ""what shall we do"" conversation at 3 in the morning! We never know if its bad enough to take her in etc. However whenever she sees a gp or out of hours doctor, they end up calling 999!
My daughter is under 2 consultants and both say that we should call for an ambulance if ever we doubt ourselves. They say she is better in hospital than at home if we are loosing confidence in treating her. If we are nervous or scared, we should dial 999! We have now been told not to take her in our car to hospital as its a 30 minute drive that could make a difference.
Its a hard decision to make as if you're like me, you'll probably have a sense of denial when things take a turn for the worse. I often think 'noo, its just us not coping'! Yet when we get to hospital we always get told off for leaving it too long!
Maddie was blue lighted last week and we really did have a fright. We have promised each other that from now on we wont doubt in calling for help. We also have an open access to the paediatric ward so I guess that should help.
As for the normal respiratory rate, I was told 24 for a 2yr old. Thats 24 breaths per min. Maddies went up to 44 which caused alarm. As for oxygen monitor, ive often wanted one, however last week when her resp went to 44, the out of hrs doc didnt use one. He simply counted her breaths! Id still like to buy one though as to me, the oxygen level shows whether theyre struggling or not.
What was your sons oxygen SATs levels while in hospital and on discharge?
Were the staff concerned by them at all?
Im glad hes been referred.
If you ever want to pm me, feel free.(I cant seem to pm you) I know how scary it is. I spend my life on eggshells.
Take care,
emily.x
Thanks for replies. they are very useful and have made me think. On reflection I don't think I have aken his 'viral wheeze' seriously and every time i think it can't happen again then it does.
We have cats and I'm not sure whether we get rid of them but it does seem to be when he gets a cold.
When we was on the ward the other day his oxygen levels went down to 84 on oxygen but I could not get him to wear his mask when asleep so spent the whole night positioning it in front of his face and turning the bleeper/ alarm off. The nurses didn't seem concerned though.
My other son who is now 5 had 3 admissions with viral wheeze but so far this winter he has been good. grown out of it or becotide working?
Any I could keep writing but I won't
victoria
4hr salbutamol
Hi victoria34
My son is in a similar boat to yours. When he was 18 months old we were told by our GP it was fine to give him his blue inhaler at home every two hours if he was struggling. This was very BAD advice.
He ended up in intensive care for five days with a major chest infection. Since then, we have always been told, if you can't stretch him to four hours on his blue inhaler, bring him in.
We now have open access at our hospital and it means things run more smoothly. We call, we take him in, he starts his nebulisers and prednislone and is normally discharged the next day.
I also carry a copy of his asthma plan from his consultant. It's in bullet point form, briefly explaining his condition and what he needs.
The medical staff seem to act in a more consistent way when they have something in black and white from a fellow doctor.
I'd love a SATS machine at home, but I think machines are only half the story. You also have to observe the child to see what's going on. And machines can give false readings! This has happened in hosp. before.
Regarding Sats machines / pulse oxymeters at home.
It is stronly advised against, unless recomended by a consultant, to have a sats machine at home because once the oxygen levels have started to drop, you or your child will be quite ill. It is much better to go on the basic signs and symptoms that you know, and instinct if you are a parent.
If you wait until the sats have dropped , by that time your child will be seriously ill. It can take quite a time sometimes for levels to drop, plus this only gives an indication of oxygen levels.
Carbon dioxide levels can also rise dangerously and this is not shown on a sats machine.
The best thing is to get a good written asthma plan written up by your GP or consultant in conjunction with you as to what constitutes needing help.
e.g. 10 puffs of ventolin not lasting 4 hrs, peak flow, tired, withdrawn child, change in behaviour, pale, etc etc etc ........
I am brittle asthmatic and have home oxygen for emergency use at home and at night but I don't have a home sats machine. I go on my symptoms and my sats don't usually drop that much at first but if I waited until they did, I would be in serious trouble as my will drop suddenly (I have had a couple if resp arrests in the past)
It would be tempting therefore not to get help early enough if the sats appeared within the normal range.
I hope this helps.
Kate
x
New to this Forum aswell. Joined when I read your post. I have 2 year old twin boys. Both have had 4 admissions since October 2010. Your comments (and others who have sent you messages) are exactly how I am feeling and it is good to know others feel the same way and I am not alone. When the boys become ill, there is no rhyme or reason for it. They are well one day and then the next coughing and wheezing. The hospital are fab but I don't have open access, which would make life easier. They have a Respiratory Nurse now who I can ring when ever I need. However, at the end of the day, it is our responsibility and judgement that counts - and I find it very very difficult to know when to go to A & E.
I took one of the twins to my GP Christmas because he was coughing constantly and was worn out. The GP saw him at 10.00 a.m. prescribed Prednisalone and antibiotics and said to bring him back the next day. By 1.00 p.m. I was in A & E with him gasping for breath and vomiting.
Thanks to you and everyone who has posted. It has made me feel more confident and I will have no hesitation from now on in taking the boys to A & E if I feel they are deteriorating.
I don't know about you but It's also very difficult coping with the tiredness.
Thanks again guys.
Lisa
I would like to say that Oscar has been great recently. But today he developed a cold and I thought - its going to happen again, so fingers crossed for tonight.
After joining this forum I too feel more confident as to know when to seek medical attention and won't feel bad if I do need to take him in.
When my son was tiny, my GP gave me some great advice: ""we're paid to worry, if you're at all concerned then bring him to us or A&E and let us check him out"". Yep, I got it wrong once or more but they were fine, I was right for a very large percentage of visits.
There's not much better than a mums gut feel, I think this was what the GP was saying to me - am no expert though.
Update
Oscar developed a cold on Friday morning. His breathing became worse yesterday (saturday) we thought last night we may have to take him in but decided to settle him down and if he wakes up wheezy then take him to A&E. He slept all night - but woke him up at 10.30pm to give him 10 puffs. That seemed to work and this morning he is a bit chesty but still lively. he seems to be managing on 5 puffs of ventolin every 3 hours.
What should I do now - If he needs his inhaler every two hours take him to out of hours doctor? or keep managing at home until he needs to go to AE because he needs frequent inhalers.
Oscar is just eating fruit and seems quite settled.
Hope everyone doesn't mind me asking for advice and you think I should know by now.
I hope you and Oscar have a good night and he is much better in the morning.
Clare X
thanks everyone
thanks for everyone's support
Although it's awful for you I'm so glad to read of other people in this situation. I am led in a hospital bed right now with my two year old son. It's our second night and this is his tenth overnight stay in hospital. He gets bad every time he has a cold or cough, although perfectly healthy in between. It worries me that he's had to have so much medication in his young life.
I feel I control well at home but just nothing works when that cold is in his system. Use brown inhaler every day and blue at the first sight of runny nose.
Oscar is doing really well now on the Montulkast (not spelt this way) and brown inhaler. Only had a couple of wheezy times but managed on blue inhaler. I was really surprised didn't think it would work. I hope things get sorted out for you, let me know how you get on.Victoria
Oscar is doing really well now on the Montulkast (not spelt this way) and brown inhaler. Only had a couple of wheezy times but managed on blue inhaler. I was really surprised didn't think it would work. I hope things get sorted out for you, let me know how you get on.Victoria
nice to know i am not alone. i am a brittle asthmatic myself so kept my fingerscrossed that lottle man would not follow in my footsteps. he was a prem baby and had a little bit of help with his breathing when he was born but after that was fine. at 3 months he developed bronchiolitis and was admitted to hospital for a week. sats wete 79 on admission and he was really quite unwell. I had taken him to the gp who made me feel like a hysterical mother panicing over nothing. I should have trusted my judgement. he has been admitted twice since with a viral wheeze and had several wheezy episodes that we have muddled through at home. As many of you have said i have been given very different opinions by healthcare professionals which has left me very unsure of how to manage my little man. Following his last infection in february he still coughs continually at night and sounds like a forty a day smoker.Gp 1 said dont use inhaler for cough. Gp 2 said he shouldnt have been given an inhaler for use at home. Gp3 said well what do expect he has asthma not sure when that diagnosis was made news to me. Hospital consultant didnt return my calls. have an action plan for a cold but no guidance as to persistent cough and wheeze. he is now awake most nights and i am exhausted. He has a follow up appointment in july, because he was prem, it seems like a lifetime away. He is coming upto 18 months and is just such a happy chappy. Be nice for us all to get some sleep before he turns two!! hope everyone is well..chell.x
oh chell
i do hope u manage to get some sleep!!
is there any way you can bring that july appt forward as like u say, that seems like a lifetime away...
as i know only too well, its awful wen u got differing view from diff docs, you never know where to turn too and who to believe ...
maternal instinct is strong and you know your child best so go by wot u think is best, maybe?
what have you been doing? is it workin? how is your lil man doing?
being as he was born prem and has had previous problems in the past and with ur asthma problems, wouldnt it make sense that he would need to use an inhaler at home - i.e. advise of gp 2 i think u said...
as for GP 3... diagnosing of asthma is relatively uncommon, but not unknown until children at least 2 years old or more... but can be assumed based on family history, frequency of wheezy episodes and eczema/hayfever etc.. and allergies.
thats awful that your cons isnt returning ur calls i understand that cons are busy, but they have other staff to help them, inclding secretaries?
hope u get some answers soon and ur lil one is on the mend
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i understand that cons are busy, but they have other staff to help them, inclding secretaries? 
what does your school do with asthma?
Asthma and allergy advice for 9 year old
