FUNNY HANDS, 1ST attack at school, measles, colourings and other things......

I haven't been on the forum for ages but turned to it after a VERY BAD DAY yesterday. My youngest, 5, has never had an asthma attack at school since starting last September. Her 1st 2 attacks (3 years ago in Easter 08) were exercised induced and since then until June this year her asthma was under control beautifully.

June was the holiday from hell, coughing all night long and all day for the whole 10 day holiday despite seeing a Dr and adjusting medication. The holiday, in Cornwall, was same place and area we go to at same time every year! It stopped suddenly when we got home.Thats when this bad year started though symptoms have always flared up gradually, usually with a night time cough which everyone in my area does not take seriously - until yesterday, the reason I am writing.

Basically, I received a call from the school, get here asap, her asthma has flared up quickly and badly, ventolin doing nothing, they've called an ambulance. I could hear her in the background in a terrible state.

Luckliy I'm 5 minutes away, dash down and ambulance is already there, she's being assesed. Lady paramedic, 'this coughing doesn't seem like asthma, more of a cough' am too involved in calming and comforting daughter who is in a bad way, coughing and and crying and shaking. School staff brief me on what they have done so far. I try more ventolin with spacer - nothing. Her Dad arrives. In ambulance paramedic 2 makes comment about it being more of a cough than asthma. I supress the urge to punch him, stating firmly it is her asthma symptom, she doesn't get breathless and wheeze, probably as she is on a lot of preventitive medication already. (BECLAZONE 100 brown 2X am & pm, SINGULAIR PAEDIATRIC 4mg GRANULES, pm) Paramedic 2 sees my efforts have no effect - in fact she's getting worse now and beginning to shake uncontrollably. He offers use of nebuliser - the first time youngest has been offered this as always in essex or Cornwall, at GP or previously A&E 'she's just coughing not wheezing or breathless'.

Nebuliser is FANTASTIC - IN NO TIME AT ALL THE COUGHING HAS CEASED. She is calmer and begins to look about the ambulance and ask questions such as why has the clock stopped!!! Childrens A&E fantastic on this her second vist there this year. Straight in, seen a consultant in 10 minutes, lots of advice, prescription for PREDNISOLONE (5mg 4 for 3 days) steroid tablets (never offered before as its 'just a cough') another 'dose' of nebuliser and we are discharged. fingers crossed she has been fine since. She is to stay off school till Friday, Thursday clear of steroid tablets to give her body a chance to get back to normal. Saw GP today and got a referal to see consultant at hospital as lots of little episodes . This is on 2nd Jan! My 3rd child due on 7th Jan so as you can imagine I am stressed beyond belief. Eldest has just got over 2 week illness, a chest and ear infection, recovered just over 1 week ago. Youngests asthma flared up for a few days at the same time.

She has never had such a severe attack before with no exercise involved. She had been working quietly at her desk on a poem when it happened. She has said her hand felt funny and her work kept going wrong which we were worried about and GP said it is the lack of oxygen in the body and an early warning sign. Spoke to my adult friend who has mild asthma and she gets this. She describes it as pins and needles.

Triggers? Cold has seemed to be a new trigger. When eldest was ill we noticed youngest asthma stopped when heating was left on low. We turn it off, it flares up again usually at midnight- 2am. Yesterday we couldn't find her scarf which she pops over her mouth at playtime (though it rarely stays in place) but she didn't have a scarf when out and about at the weekend.

Eldest has an intolerance to artificial colours causing vomiting within 30 minutes followed by night time asthma cough. Neither child has colourings. Youngest had a party on Sunday afternoon, I left her for the last half an hour to take eldest to dance exam. A friend took youngest home (though I will never be able to leave her anywhere again except school after yesterday). At home she was very honest and said she had ate a pink iced cake, a yellow iced cake (I have 'trained' them to stick to white if we don't know the make) and a blue lollipop which usually has yellow in it (yellow is her sisters worse colour and we usally keep all the sweets and go through them at home). So a possible trigger is artifcial colourings. Though it doesn't explain the little episodes the rest of the year though as I say they were completely different to yesterday.

Finally, to complicate things further and worry me to distraction, after avoiding family for 8 weeks as 3 nephews aged 11, 18 months and 3 years, (two of whom had MMR) had confirmed cases of measles it is now in the school. Not just in the school but a child in eldest class was sent home with it last Monday (she, aged 9, also has had her MMR and was really ill with it) . And her sister is in youngests class. So youngest was sent for blood tests today and I have to watch them both like a hawk and school is to inform me of further cases which should start next week as the incubation period is 2 weeks. Absolute nightmare!!!!!!!!

I write here to get this all off my chest and in the hope that someone, somewhere has gone through this too! It is a rather flat joke that every antenatal appointment I have had (excepting 1 and my scans) one or the other of my children has been ill (and yes I did have one today, I visited the GP, the hosp for blood tests, then GP again for antenatal) I am dreading the grand finale they have in store for me when the baby is actually born. I worry who will look after them and how they will cope if their asthma flares up. It is usally worse at night so none of the famly has any idea what we go through. My Dad had a severe stroke 2 years ago so my Mum who was a great help when my girls were born is his full time carer and not around and I am finding it really hard to stay positive and cheerful and have not been sleeping very well. I know it is pointless worrying but after yesterday I just dread what is coming next. I have visions of the baby arriving just as the girls begin measles and them being seriously ill because they take steroids. My midwife has been very supportive and everyone has tried to reassure me but is is such a huge worry.

To end on a positive note (see I am trying) it was also suggested youngest change her spacer to a volumatic which ensures a better doasage being inhaled. Previously her spacer was the yellow and clear one with teddies on - her sister has this too so I must change hers (she is 9!!) It is more suited to toddlers so I've been told!!!!

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Crikey what a nightmare time you are having. Have had all 4 kids being ill at once. I once had one on PICU with another on the kiddies ward recovering from an asthma attack it was a nightmare I did not know who to be with. There is certainly something called cough varient asthma which not everyone knows about which sounds possible.With regard to the pins and needles and funny hands that could be hyperventilation often associated with panic attacks atteck. Many asthmatics get them which is not suprising since not being able to breath is enough to panic anyone. It is certainly worth getting checked out if it keep happening. With luck one of resident Drs will be along soon with more coherent advice and explanations.Fingers crossed the steroids do their stuff. Also asthma can change and the things you react to can alter too so it is possible for something that fine before to set an attack off another time.Anyway good luck hang on in there I know it is scary watching your child suffering but it is important for you to be as calm as possible, hard when you know they need help and no-one is listening.Bex

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Thanks!

Thanks for the reply Bex.

She took her last dose of steroid tablets today and used the new spacer.

So far she has been okay so I hope it continues.

Four ill at once sounds a nightmare - 2 is bad enough!!!

Dreading leaving her at school on Friday - never dreamt anthing like this would happen, her symptoms always start at night and build up gradually, but, being positive she loves school and seems very positive about the episode so fingers crossed she'll be fine!

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hi barbara im in the same bowt as u at the moment where all 3 of my boys are ill they have been off school for a week now,,,, my middle son is a severe chronic asthmatic and is on alot of meds and he has an emergency appt tomorrow at the hos (gps not aloud to mess with his asthma treatment) also my youngest has suspected asthma and like yr little girl just has a cough and no wheeze tht is why i wont allow them to put him on a preventer as i thought asthma symptoms is wheeze and cough,,,,,but not nessercarrly it seams and eldest was sent home today after having a coughing fit he is 13 and still suffers from croup from time to time and was accually put on oxygen at school as he couldnt get his breath so i have to get him to the gps tomorrow afternoon after iv been to the hos with the middle one and to top it off my central heating has been off since sat and is getting fix tomorrow but if u wanna chat i will just pm me if im not on here

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Hi Barbara,

I'm so sorry you're having such a nightmare time at the moment with your kids getting ill one after the other - I have severe asthma myself but don't have children, and I've always thought I'd much rather go through it myself than watch one of my children go through it.

It certainly sounds that, despite the scepticism on the part of the paramedic, this was an asthma attack - the dramatic response to the neb pretty much confirms that. It is often hard, with young children, to piece together what is going on - it could be that your daughter is experiencing other, more typical asthma symptoms, such as shortness of breath and tight-chestedness, but doesn't really know how to explain these to you. It could also be that she has cough-variant asthma, which is asthma where the predominant symptom is a persistent, usually dry cough, often worse at night. Sometimes this can be the only symptom, with no wheeze or breathlessness apparent at all. It can be extremely distressing and difficult to treat, and is often misunderstood as 'just a cough'. The triggers of cough-variant asthma seem to be much the same as most asthma - allergens such as dust, pollen, molds, animal fur and food colourings, as well as irritants like cold air. It sounds like you're pretty aware of potential triggers and what to avoid.

In terms of the 'funny hands' before the attack - again, it is a bit difficult to know how to interpret that. The 'pins and needles' sensations that some people get in their hands (and sometimes around their lips) associated with an asthma attack are usually due to hyperventilation (over-breathing). In a severe asthma attack, we should automatically breathe faster, to a degree, to compensate for the reduced air entry and maintain our blood oxygen levels; some people, due to panic or just habit, over-breathe more than necessary and develop pins and needles in their hands as a side effect of this, as one might in a panic attack. This is relatively uncommon, though, in young children, who are not usually aware enough of their breathing to over-breathe in this way. The alternative explanation, as your GP said, is that it could be the effects of lack of oxygen - this would usually only be an issue in a fairly severe attack, though, and the paramedics would probably pick up on an attack that severe even if the symptoms weren't quite what they were expecting.

As I said, it sounds like you are thinking along the right lines in terms of avoiding potential triggers. Other things to think of - sometimes gastro-oesophageal reflux can contribute to these sorts of symptoms in children; this can be 'silent' reflux, ie you can get it without any of the usual reflux symptoms such as heartburn or indigestion. It might be that your GP would be willing to trial a course of anti-reflux medication (which is usually very well tolerated with few side effects) to see if this improves things. Post-nasal drip from an inflammed nose (due to rhinitis) can also contribute to cough-variant asthma - an antihistamine can help with this. These might be possibilities to mention to your GP or consultant.

In terms of dealing with attacks in the future, it's great news that your daughter is seeing a consultant soon. If they decide it is cough-variant asthma (or even if they don't), it might be worth asking for a letter from the consultant stating that coughing may be her only symptom, and that if this isn't resolving with the salbutamol and spacer, she should still be treated as if she is having a severe asthma attack - ie, with nebs, steroids, etc. Your consultant may even suggest a treatment protocol for other doctors to follow in an acute attack.

As for the measles outbreak - I am very sorry to hear that you have an additional thing to worry about when you have so much going on already. Unfortunately, with the reduced uptake of the MMR, we will probably see more and more cases of measles in years to come (as the uptake of the MMR goes down, the vaccine becomes less effective at protecting even the people who have had it - it requires a large number of the population to take it up to give effective protection). Nothing really that I can specifically advise about the measles virus - it sounds like you have had the right advice in terms of the blood tests and watching them closely. I can understand how anxious it must make you, though, and am thinking of you and your family.

It sounds like you have so much going on at the moment - I am not surprised that you are feeling very stressed. Do you have someone to talk to who can support and look after *you*? - you say that your midwife is supportive, I hope you are taking advantage of that. Of course, you can always come on here and vent, we all understand one way or another - but that is not quite the same as face-to-face support!

Do take care, and I hope things improve for the whole family soon

Em H