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Exercise induced asthma?

My 12 year old is breathless on minimal exercise - this has been deteriorating over the past year. Previously he was physically fit and energetic.

He's being treated for asthma- on monteleukast (also has allergies - nuts/ grass/pollen), and is on a combined steroid/ long acting beta agonist. He doesn't like using ventolin because it makes him shakey,

He gets breathless very quickly when he exercises - but he is not wheezy - his chest is clear. His peak flow also doesn't reduce - around 300 (although I've only tested this after a short period of exercise).His heart is racing with minimal exercise. There's no nocturnal cough. He settles down again after about 10 minutes of rest.

Could this still be asthma?

Any ideas/opinions?

Thanks

23 Replies
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I was exactly the same when I went to the doctor and got a diagnosis of asthma. Sometimes I wonder if I really do have asthma, but over the last year I’ve noticed I have more triggers so whether I’m just noticing them more now or whether it’s just generally getting worse I don’t know.

But I’ve never had a serious attack, and quite often I can breathe through my ‘attacks’ without using my inhaler. Although I have noticed when I do use my reliever often my symptoms reduce quicker. Good luck to your boy :)

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You should go back to the GP and if you get no satisfaction there, insist on seeing a specialist. Your son is having a miserable time and something must be done to help him.

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Thank you, you are right.

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Hi I’m so sorry that your son is poorly,first let me say that he should see a specialist who can do lung function tests in a laboratory,

As for the shakes after using ventalin,,,,that’s usually because he’s taken too much , ( that happens to me when I have ventalin through my nebuliser) ask your gp to prescribe a spacer they’re not as big and bulky as they used to me , if he’s using the old fashioned inhaler where you have to breathe in press and inhale it can be difficult,there is another way of getting the ventalin that’s with an accuhaler which is a dry powder inhaler and you just breathe in with that one ,but I would definitely ask for referral ,,,best wishes to your son ,

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Thanks

He seems to get shakey even with two puffs of ventolin. I do remember that happening to me when I had to take it for a Uni experiment

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I would go to the doctors, they have all your sons history and are highly qualified to give you medical advice

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I’m sorry, but what do you think I’ve been doing?

I’ve been to the GP several times with him, and they just keep increasing his inhalers, but he’s not getting better - currently getting worse. The one yesterday said she didn’t know what to do with him! Completely disregarding the fact that he’s breathless on minimal exertion.

I’m not sure whether this is asthma or not. But I think a Specialist can hopefully investigate and diagnose accurately. The only reason I’m getting him seen so quickly is because I’ve contacted his old Consultant myself.

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I am completely the same. The only thing that relieves it is the inhaler. Unfortunately you might have to have him do it, but look into Levabuterol vs. albuterol as it might decrease the shakes? Also try doing it every six hours versus four. But when I can’t exercise the only thing that helps is the inhaler. also try doing it every six hours versus four. Sometimes I take Benadryl to decrease the anxiety and increase my protection from allergens with the anti-histamine. We are still trying to figure mine out in what my triggers are. We can’t find them ! I don’t test positive with pollen but we have high pollen now and I’m having a really hard time. I am also getting pains in my rib cage. Good luck.

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Thanks. I’ll ask about levabuterol, I have wondered if there might be an alternative to salbutamol

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What is salbutamol? I’m still learning !

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I just looked it up it’s albuterol ! Do you have blood pressure cuff to keep an eye on his blood pressure? That’s what causes the anxiety . Makes the pulse go up maybe the blood pressure ? The good news is that it does come down. So if he gets temporary anxiety, and knows it’s going to come down, and he checked his pulse and blood pressure and it’s not too high, then he can lay down and relax and meditate or whatever until it comes down ?

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Thanks - I’ll just ask about alternative drugs to salbutamol. Salbutamol is a b agonist - opens the airways - used to give relief from asthma - but not for chronic treatment/ prevention

He doesn’t get anxious, just breathless

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Good day

A few questions how do your son take ventolin?

Do your son suffer from acid problems?

Have you tested his oxygen levels during his problem?

Do son have any problems at night problems?

Sorry to hear about your son.

Nikolay

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He does take ventolin if he has too, sometimes helps

Don’t think he has acid problems - but I saw online that could matter

Not sure how I could test his Oxygen levels - the hospital may be able to

No nocturnal cough/ wheeze

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Thank you for your reply.

To use ventolin he will need AeroChamber plus this will help.

I have my own the cost under £20 pounds to test Oxygen levels.

Have you had a full blood count?

Keep safe and well

Kikolay

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An FBC has been done. I don’t have the result yet, but the lab will have processed it. Thinking it’s probably normal since haven’t had a phone call from GP.

I will phone and get the actual result

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He has just been on a BMX bike for an hour. Breathless, but his peak flow is 340. No reduction. Can that be asthma?

The exercise was indoors - shouldn’t be any allergens. He says not as breathless as if he’s running outside

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Hello Lalala, I am no asthma expert but wonder if he is exercising in a different environment and that is causing part of the problem? e.g. outside when it is cold or pollen is high?

However I know that asthma can be triggered by exercise and I suggest you phone the Allergy UK helpline as I have found the nurse to be very well informed and helpful. It is important to understand what is happening with your son in orde to get the right treatment. They will probably be able to suggest alternative medication for your son to try.

I have never been to the clinic but I found the information on the Surrey Allergy Clinic (private) useful in terms of understanding different types of asthma.

allergy-clinic.co.uk/allerg...

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Thanks, I’ll have a look at that (Surrey info)

We are now seeing a Specialist on Thursday - so hopefully he can advise

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Morning, may ask whether your son has had a heart scan an ECG or echocardiogram. Shortness of breath during exercise is not always limited to airways disease/conditions. Children do have a higher heart rate than adults but if the heart needs to work harder to exercise there could be a reason for that. Allergies and a low peak flow do all support asthma but its also best to look at the heart and lungs as they can both affect each other.

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I have the same concerns. He had an ecg which is apparently normal. His haemoglobin Level is also normal, but iron stores are slightly low.

Seeing the specialist this afternoon

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Hi Lalala;

I'm sure that these days at least some of the Drs and Nurses don't really know what they're doing; sure they've been trained but do they really know and were they taught by people who really know this is something I wonder a lot.

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I think everything is so rigid nowadays- they only have so long for appointments, everything’s time tabled and to be accounted for. I don’t think Drs are allowed to think anymore - just trying to get us in and out.

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