advice sought for 6 year old daughter

I normally post on here for myself, but this time I'd like advice for my daughter

.

I took her to the gp this evening because for the last 3 weeks she's had a cough. When she wakes in a morning its a chesty phlegmy cough, but as the day progresses it 'whistles' when she coughs ( like Wheezer on toy story she told me) . She cough first thing in a morning, when she runs/skips to school, and she said at playtime and PE. The gp listened to her chest but said its clear, but will give her some syrup to try. Now I didn't mention that I am asthmatic, or that her dad was as a kid as I didn't want to guide a diagnosis, in fact it wasn't until I put together all the information that I realised it COULD look like it. So the syrup she's been given is ventolin syrup, he never mentioned asthma to me, just said 4 x 5ml a day,should get rid of the cough in a couple of days. He also never said (nor did I ask, duh) what I should do when she's finished it.

So I guess my question is, is this a 'trial of medication' or is ventolin used to cure coughs in kids? Also, how long from taking it, to it working? I will find out what were supposed to do when she's finished it too.

Another interesting thing is that she's tested her peak flow on my meter ( you know, mummy's doing it so I want a go) and she could only get 140, her younger brother always managed higher. I've checked it again tonight 15 mins after the night dose and its 180, a 30% increase. Also she's been complaining of tummy ache for about 6 months, she's seen a consultant and they can't find anything wrong, tonight she said it doesn't hurt as much, maybe coincidence but some kids with asthma do complain of tummy ache dont they?

Sorry for my long message and ramblings, any advice/comment would be greatly appreciated!

28 Replies

oldestnewest
  • After reading your post, I have realised Thomas has been complaining his tummy hurts for weeks but we thought he was trying it on to avoid things. I didn't realise it could be linked?

    Again I didn't realise you could get ventolin syrup, I guess you just take the dose and the cough should go but if it comes back once the course is completed perhaps that means an inhaler is required?

    Sorry can't offer much advice maybe phoning the asthma uk nurses may be worthwhile?

    Jenny x

  • My daughter used to have syrup when small but progressed onto an inhaler when we could get her to have the mask over her face.

    I don't think the syrup is used much these days but perhaps the GP thought is might help with lubricating the throat/upper airways too as she is mainly coughing rather than SOB or wheezy.

    Personally I would give it a couple of weeks to see if everything settles down and then go back to GP to discuss whether an asthma diagnosis is possible and having a ventolin inhaler for her just incase she needs it. With both you and your DH history of asthma it is likely that she may have mild asthma that has been triggered by something such as the mad weather changes or possibly pollen?

    Of course, go back sooner if she is still ill or worsens but as you are asthmatic yourself I am probably telling you things you already know-sorry!!

    My youngest daughter often complains of a sore tummy just before she has an attack/flare up but didn't realise this was connected until her chest consultant told us its quite common for tight chest feeling to be relayed by a young child as a tummy ache rather than complaining of a sore/tight chest-why is that not in any books......we also thought she was having us on/not wanting to go to nursery etc!

    Hope the med works soon and she is feeling better and as I have just read on another thread-look after yourself and get that chest infection sorted!!

    Take care x

  • Thank you Jenny,yes I will give the AUK nurses a call, why can't GPS just give you more information instead of you having to try and extract it??

    Fb - thank you for your reply, good thought re: syrup rather than inhaler to sooth the cough too, its just the way he said 'I'll give her some syrup, it should clear it in a couple of days' so I was expecting cough syrup, obviously the PIL says its for asthma, if I wasn't asthmatic myself I might worry more about it. Actually, the fact I have asthma makes me worry that I will miss something another parent wouldn't if that make sense? Also mine was adult onset so I don't know what its like for a child!!

    It seems to be help in her anyway, to start with her cough got more phlegmy, but I find my dry asthma cough does this after ventolin, I haven't heard a peep out of her tonight at bedtime, and she slept like a log for the first time in quite a while, she really wasn't getting enough sleep. I haven't told her what the medicine is, just said its cough medicine, especially with me being I'll, I don't want her to worry.

    Thanks again, and I'm hoping to battle this chest infection now I have antibiotics and pred ...no improvement yet though ;-(

  • No decent GP should be giving salbutamol syrup to lubricants things :/ particularly as salbutamol side effects are more likely with oral syrup than inhaler as the med is absorbed systemically and not just mainly in the lungs like with inhalers. I suspect it's why it's not used much now.

    His thinking may have been that it would open her airways and allow her to cough stuff up more easily, which from what you say, also seems to be happening. :) if Im struggling to cough stuff up, talking salbutamol helps as it opens the airways and stuff is then less 'stuck' and easier to cough up.

    It's a shame he's not been very forthcoming with his thoughts! I hope her chest clears soon and she's feeling better :)

  • Ah I never thought of the side effects being greater, she hasn't mentioned anything but does get a little hyper/silly about half an hour afterwards, not sure if that's coincidence or not?!

    That makes sense re: opening up her airways to allow stuff to be coughed up. Would it have this effect on a non-asthmatic?

    Yes I wish he'd have been more forthcoming, I like to stay informed and are interested on their reasons for doing/trying things, and would have though if he was suspecting asthma, would have mentioned it or at least asked about family history of it. Mind you it seems doctors are reluctant to label 'asthma' in young children, maybe this is the case?

    Thank you for your thoughts xxx

  • I doubt very much that its coincidental! I remember having it as a kid, its ghastly stuff, sends you all over the place. I can also remember finding it so hard to write, as it gave me such a bad hand shake, much more so than inhalers ever have.

    Dont know about non asthmatics, in theory I would think not, as their airways arent constricted and narrow like an asthmatics, but thats just my theory ;)

    Hope shes feeling better soon! x

  • Hmm, guess I just need to suffer the silliness for a while then!

    Have made another appointment with he gp for next Friday anyway, this way we'll have had a week with it, then a couple of days without it. The squeaky cough has definately gone, she still has the morning cough, but she has her last lot at 7pm, so its been 12 hours since her last dose, so I guess it would make sense? The tummy ache isn't as bad, however she's had that for 6 months bow so I suspect a lot of that is habit more than anything now, she did comment that it wasn't as bad now tho.

    So now I need to work out my questions for the gp, i will write them down so I don't forget! Any siggestions? I don't want to make any asumptions from my own asthma!

    Thanks again or everyone's help and advice xxx

  • Ps the AUK nurse said that from her symptoms, it does sound to be asthma, and that using the syrup is an old fashioned method and that really she's getting a high dose of Ventolin but obviously rather than the effets being almost instant, she has to wait for it to be digested first. She said at 6 she capable of using an inhaled and spacer and shpuld be encouraged to et used to this rather than mummy giving her medicine, which I totally agree with. I have issues around using my inhaler in front of people, and I don't want her to go that way too, if it turns out she needs one

  • Hi i'm doing a project on raising awareness of children with asthma. just wondered if you could complete this >

    <removed by moderator - you need permission from Asthma UK before posting research-related items. Please email webeditor@asthma.org.uk for more details>

  • I saw the gp again tonight, so I told him the squeeky cough had gone and that she only coughs in a morning first thing and that she's sleeping much better,so he's told us o reduce to 5ml in a morning and bedtime and hopefully the cough should go, if it does stop altogether and see what happens. If it comes back I should go back to see him,if not then she's sorted. He said the theory is that the syrup should calm the 'allergic component' WHAT does that mean? Now I realise I should have asked for more info but my mind went blank so I took the prescription and went. Any thoughts?

  • Surely if it's an allergy wouldn't it be antihistamine that would be needed rather than ventolin? I'm not sure.

    I totally understand what you mean about your mind going blank, happens to me too. I tend to write stuff down to take with me to the appointment. How is your little one doing now?

  • Surely if it's an allergy wouldn't it be antihistamine that would be needed rather than ventolin? I'm not sure.

    Yes, that's what I'd have thought!

    In glad its not me, I feel real daft leaving with no answers, a list is a good idea! Silly thing is we go on holiday in a few weeks so I need to find out what he thinks is the problem, for the holiday insurance! I am going to ring the gps tomorrow and try and find out!

    She seems much better with the syrup, the squeeky cough has stopped but she still wakes up coughing before her morning meds, and since stopping the 11am and 3pm ones, she coughs more after running around, so its likely we'll be going back as stopping it altogether isn't going to be an option without the cough returning. Also the syrup turns her into a little devil!!

  • And the squeaky cough is back! Tried to get her an appointment, nothing till a week on Wednesday when we are on holiday, and can only book two weeks in advance so can't make one for when were back off holiday, until Monday grr.

  • Surely they do urgent appointments for things that can't wait two weeks...?

  • They do, but wasn't sure it was that urgent? I have enough syrup to start her on 5 ml x 4 times a day again as that did sort out the cough/squeakyness, until we get an appointment

  • Well If it were me, I would go back rather than increase the syrup since this is what he advised. And if that means you need an urgent appointment so be it ;) x

  • Yes, you are right, and I suppose we ought to go before we go away, thank you

  • Hi,

    I read your post and registered to post my reply as both my daughters have asthma and i was facing the same problems as you. The oldest one who is 5 also has eczema and started coughing frequently when she was around 4 years old. The doctors prescribed 'Ventolin Syrup' for the cough but she finished 2 bottles of this and also simple linctus and nothing would ease the cough. After trawling through the internet I suggested that she may have Asthma when we went to the doctors and they prescribed her inhalers which have done the trick.

    I had the same problem with my youngest daughter and i asked for the inhalers. Now they are both much better and the cough has subsided and I am at a point where i dont need to use it all the time.

    just for info - i have both the blue and brown inhalers.

    best of luck and i hope she gets better soon.

  • thank you for your reply noor, I,m glad I'm not alone in this! I have an appointment this afternoon to discuss this further with the gp and hope to get some answers, I also hope to stop the syrup as it sends her psycho half an hour after taking it!! It does seem to work when taken frequently though, so I'm hoping a steroid inhaler will ease the cough permanently. I will let you know the outcome this afternoon, thanks again for your reply.

  • no worries :)

    best of luck

  • She's been given a month of montelukast, and 5 days of 10mg pred, he hopes this should stop the cough and we won't need anything else after they're used.

    Any advice on potential side effects etc?

    Incidently, we are due to go on holiday soon, so I asked what I should declare on the insurance, he said 'nothing, she a fit and healthy girl with nothing the matter with her, its just a cough', now I'm feeling a little oversensitive due to being I'll myself, do you think he means there really is nothing wrong and Im making a big deal out of a cough...or just that for the purpose in the insurance company, there's nothing that should prevent the insurance?

  • hoping all goes well with the appointment for your daughter.

    Oops missed your follow up post.

    My guess re insurance is that this isn't the sort of asthma that the insurance company needs to be/is concerned about when they worry about insuring asthmatics. I think they are more worried about things like hospitalization expenses.

  • Hiya Butterfly,

    Where abouts are you going on holiday? Is it in Europe, if so do you have an EHIC card? I *think* that if you do then you are entitled to the same sort of treatment you would receive at home?

    As Beth said, I wouldn't imagine that is would be the sort of asthma they would not cover through the insurance, I would imagine that it would be those severe/brittle asthmatics who would have to declare it for insurance purposes. Another thought, could your GP perhaps be holding off giving an *official* diagnosis for this reason?

    I hope the montelukast and pred help her. Is she on any preventer/reliever? Is she still on the ventolin syrup?

    I hope you start to feel better soon, I am so sorry that you are having such issues with your GP. Its the last thing you want when you're feeling ill.

    Look after yourselves!

    Laura x

  • Thank you lollie88, yes I do hope I pick up soon, I am feeling down in the dumps at the minute feeling sorry for myself, I'm sure this negativity isn't helping my recovery :-/

    . Another thought, could your GP perhaps be holding off giving an *official* diagnosis for this reason?

    Yeah, I wasn't very clear in my post, this is what I wondered? I'm seeing him for a cough, nothing the insurance company would be corcerned about.

    We are going to Europe and have insurance arranged already, I just wondered if I had to declare her condition. To be fair, they weren't concerned about my asthma.

    She's stopped the ventolin syrup, and is just on the montelukast for one month and pred for a couple of days, and then he hopes she won't need anything. That's what I can't understand, he doesn't seem to think its asthma, yet is treating her with asthma drugs?

    Bless her, she's eaten everything in sight today, I never get pred munchies, but she appears to have!!

    Also, anyone know why peadiatric montelukast has to be taken on an empty stomach? I've been giving it to her on the way home from school, and having tea at 5pm, if she has it after tea, she's in bed before 2 hours have passed after her meal, plus she likes a snack and drink at bedtime.

    (Sorry, don't think my posts are making much sense, my brain is fried lol)

  • She's stopped the ventolin syrup, and is just on the montelukast for one month and pred for a couple of days, and then he hopes she won't need anything. That's what I can't understand, he doesn't seem to think its asthma, yet is treating her with asthma drugs?

    It seems to me that he's treating her for airway inflammation - which could be chronic (which would then be diagnosed as asthma) or acute (from a virus, bacterial infection, allergy or irritant or some combination of those). Of course we know that most people with airway inflammation have 'asthma', but not all. In fact, the reason we know that is because we classify things as asthma based on chronic airway inflammation symptoms.

    My friend who is a GP said to me recently that she thinks that 10 or 20 years from now we're going to have tests that allow us to see that this 'asthma' bucket actually contains dozens if not hundreds of quite different conditions which share a pattern of symptoms centred around airway inflammation.

    My suspicion would be that while your GP would be an idiot not to be holding asthma in mind, especially as it runs in families so often, he'd need to see symptoms over a longer period with different triggers before he was confident that asthma was the underlying pattern.

    Once a diagnosis (of anything) is given it's very hard for it to be take away again, so I can understand why docs are a bit slow in labelling acute symptoms with chronic condition labels.

    Also it would be easy for him to say ""oh yes, familial asthma"" and just send you away with a brown inhaler and a blue inhaler (or syrups) and paediatric spacer, and then you'd be on the asthma-meds-train of upping the ICS over time and so on, when actually this might be something more specific or short lived. I'm sure - certainly based on the meds he's prescribed - that he's already thinking 'this looks like asthma' - so I think it's unlikely that he'd hold off on the diagnosis (or a referral if they no longer diagnose it under a certain age in the GP office) if it happens repeatedly.

    If you want to reassure yourself, you could read the BTS guidelines on diagnosing asthma in children, which do advise a delay in diagnosis to avoid over-diagnosing in children with symptoms that aren't severe. Many children have 'chronic cough' but don't end up with a confirmed diagnosis of asthma. I expect if you weren't so well informed about asthma the GP would be saying directly ""this could be asthma - watch out for X, Y and Z"" but he knows that if she has an acute asthma attack you'll recognise it and seek help appropriately, so he's probably going the other way and attempting to reassure you.

    The whole reassurance thing is weird. Some people like to be told things that play down risk and severity, and others (and I'd put you and myself in this category) find that approach worrying because it feels like the person trying to be 'reassuring' either hasn't appreciated the situation fully or thinks we are being silly to worry about it. I suspect that actually he's sensing your (understandable) anxiety that she might have a chronic health problem, he knows that recently they've not been able to 'fix' you with the same problem, he's feeling uncomfortable with your discomfort and he's trying to magic it away instead of just acknowledging it as valid and explaining his approach.

    Good luck with it all - and don't be afraid to ask your GP directly what criteria he is going to use for ruling asthma in or out. (Yeah, I know that's harder to do than to advise someone else to do!)

    Cx

  • It's hopeful that they are hoping she won't need anything else treatment wise, so hopefully she will pick up :-) I also think that they will be vigilent with her with your history of asthma. I know they have a thing about genetics and asthma. But hopefully she can avoid the asthma diagnosis!!

    I don't know much about paediatric montelukast really, only the adult dose because I take it. It's probably due to side effects it can have?

    Also hope you pick up soon, especially before your holiday!! The warmth and sunshine might dampen asthma down :-) are you going to go back to gp before you go?

    Laura x

  • Wow, thank you for your reply curiouser, that was the much needed sanity check I needed. Your reply all makes sense of the situation now, and yes I'm definitely from the 'I want to know all the information' - camp. And if he'd have explained all this from the start, it would have prevented all the confusion on my part, so thank you again, my brain is definitely not at its best at the minute, and any rational though has gone out of the window. I really would rather this be a temporary issue with her, and don't want her labelled asthmatic just coz its the obvious choice, its just I have lost my faith a little I the gps and was concerned that they thought that maybe I was overreacting, not good when I already feel that my symptoms are maybe psychosomatic.

    Thank you once again for everyone's support and advice,it is much appreciated!

  • Glad to have been of help! It's hard when you're in it sometimes. Especially when you're not well yourself.

    Cx

You may also like...