My son will be 4 in March and has had chronic coughing since he was about 18 months old. It is always worse when he has a runny nose (I suspect allergies, although he has not been tested yet) and typically only causes problems for him at night. The cough is dry and not very productive. He has an albuterol inhaler, but only uses it when the cough is really bothering him. He has not been diagnosed with Asthma, although his pediatrician has used the term "bronchial spasms" The only thing that seems to help him get through the night is Benadryl. He goes through this everytime he has allergy/cold symptoms. Does this sound like asthma? I appreciate any input.

Mom to 2 boys

Albuterol acts to open the airways.... its effectiveness in helping your son to breath is not a guarentee that he has asthma.

It actually sounds like allergies.... especially since Benadryl works for him. I am asthmatic myself and I and a few other asthmatics I know cannot use benadryl, as it actually exaserbates my and their symptoms.

I really think you should take him to an allergist.

Why hasn't your doctor already done tests? He is young, and asthma is dangerous.

Please keep us posted.

Blue

Thanks for your response Blue.

Interesting about the Benadryl. The only reason I give it to my son at night is because I think the diphenhydramine helps him sleep. I tried giving it to him during the day yesterday because he had a runny nose as well as a cough and it didn't help at all-may have even aggrevated the cough. He had a terrible night though, cough turned into croup. I've heard children with asthma are more likely to develop croup when they have a cold.

The last time I spoke with his doctor, he mentioned Zyrtek. I didn't get the prescription because he has been on Claritin before and it did nothing. I assumed it probably wasn't allergies. I'm learning not to assume anything. I will talk to his doctor about allergy tests though. How do they test children for asthma? Nobody in my family or my husbands has allergies or asthma, so this is all new to us.

Thanks for your help.

Mom to 2 boys

I am not sure about tests for children, as, my daughter is too young....

But, I wonder about the allergy thing.

I am sure you have gone through the list, but, have you any:

pets
smokers in the house
cleaning supplies
new work in the house
new carpets
drycleaned clothing
dust
mold (children are especially sensative to this)


Have you changed or modified his diet to rule out certain allergies?

Claritin didn't help me either.

HAs your doctor detected any wheezing in your son?
do you think his condition gets worse in certain weather?

CAn your son explain what he feels like?
And finally, has your doctor considered a low dose steroid?


Blue

I just realized you said that this problem bothers him particularly at night... sorry about that.

What position does he sleep in generally, and, where does he sleep?

Maybe he is allergic to his blankets.... either the material,or the soap.

OR it could be dust mites. They LOVE beds.

BLue

If your 4-year-old can accurately follow directions, he might be able to go for a PFT to diagnose asthma perfectly.

The problem with these little guys is their little airways cause so much wheezing outside of asthma and are sensitive to bronchospasms without actuallY HAVING asthma that it's difficult to make a diagnosis, especially since they're often too young for pfts.

See if you can teach him to use a Peak Flow meter, they even have training devices for use with kids. Do a search for the "Mini-Wright" (that's my PF meter).. they've great examples of things you can do to help kids learn to use a pf meter.

Once he can use a PF meter, he should be able to go for full asthma testing with no problems.

Thanks for the input.

Our doctor suggested over a year ago that dust mites may be the problem. We bought the mattress and pillow case covers. I dust and vacuum regularly and wash his sheets in hot water.

I've also been thinking about toxic mold since it's been in the news lately. (where we live). We're going to be moving to a new house in a few months so it will be interesting to see if anything changes at that time.

I don't really notice it being at a particular time of year. He seemed to be okay last summer, then in September I thought he had gotten a cold, but he has never fully recovered from the cough. His doctor has not detected weezing. I have to mention, it doesn't seem to bother him at all, he's very active and eats/sleeps well. But obviously there's something "not right"

Wrin, is that peak flow meter something that his doctor can do or would he need to be referred to a specialist? Also, with asthma do you always have coughing/weezing after activity? My son doesn't have that.

Mom to 2 boys

Most of the time you can buy a peak flow meter at a pharmacy without a prescription -- they'll cost you $20 to $40, depending on which brand you get. Like I said, I have the Mini-Wright, they're not the most reliable ones out there once they get older but for training purposes? ... Shrug.

Make sure you get a low-range one, designed for kids. There are ones with adult ranges (usually going up to 880 L/min,) and ones with child ranges (going up to about 350 L/min). The Assess ones work good, another good brand is the one made by Airlife. (I can't remember the name of the peak flow meter off the top of my head.)

Are you moving to a new house like Newnew brand-new? I wouldn't hold out much hope for things to get miraculously better right when you move if you've just built the house -- the kinds of chemicals they use to glue down linoleum and carpet (and heck, even just to make the suckers,) aren't great for anyone with a respiratory problem.

Going to his Dr would ... Yeah, his doctor could probably teach him how to do a peak flow with a meter he has in his office, but the full pulmonary function testing (PFT) is something he'd have to go to a seperate office, possibly in a hospital, to have done.

[This message has been edited by wrin (edited 01-22-2003).]

Hi Momto2boys~
My son (now 12) has had asthma basically his whole life. He constantly was at the ER and was diagnosed as having bronchitis,colds,and croup. They never heard wheezing. It was so frustrating that I had to take him the ER so he could get some sleep after they gave him the albuteral breathing treatments. It was a tough time! Finally, the right doctors saw him and when he was about 1 yr old, he was diagnosed and treated for asthma. His asthma wasn't a classic case where they could hear the wheezing.After so many years of dealing with this, I have learned a lot. Many doctors don't diagnose a small child because they don't want them to be "labeled" with asthma. Some doctors still believe that if you aren't wheezing, then you don't have asthma. It is so aggravating so I feel for you. I agree with learning about peak flows. I learned that I could almost predict when he was going to have problems breathing because of the time of year (October-Feb) and ANY time he had a cold. I don't know much about allergies so I just wanted to share my story. Try hard to not get frustrated and feel like giving up. Best of Luck!

12 years ago, they believed that you had to wheeze to have asthma.

They now know different, especially since by the time you hear a wheeze, 80% of that airway is gone.

The funny thing, Wrin, is that there are still doctors that believe this to be true. My most recent encounter was during the Thanksgiving holidays. On the trip to the ER, the doctor insisted that the problem was "a virus or light case of bronchitis". My son was struggling and it infuriated me that the doctor said that his "asthma was fine" since he "didn't hear any wheezing". His oxygen SAT rate was 73% when it was finally tested. This was only one of many instances that taught me that there are still doctors and nurses that believe that if you aren't wheezing, then you aren't having an asthma attack.

Then they don't know what they're doing.

Was your son seen by a respiratory therapist? If anybody knows asthma, it's a respiratory therapist who works in the emergency room.

In most of the hospitals in and around where I live, it's the respiratory therapists that assess the kids who come in with respiratory distress. Nurses are generalists -- they're great for some things... but...

It's a good thing you insisted on having sats monitored -- I honestly don't know why they're so hesitant about doing Sa02 checking, it's non-invasive, relatively reliable (90% of the time,) totally non-painful, quick, easy....

I have a question ~ actually several ~if a child of say two has asthma, bad enough that the mother put him on one of those things you have to hold infront of their little mouths and they breathe this steroid ~ anyway my sister-in-law says that her son has such horrible asthma, but I have seen her chase him "playing" through the house to where he is just laughing and panting with laughter. Is this possible, and why would you do that to an asthmatic child, isn't it dangerous? And after this he is fine and never seems to be in any pain or has any trouble breathing. She has hinted that my mother's house is not clean enough and that he is always sick after he comes home from there. Mind you my parents are retired, the house is spottles and there are no house pets!! This woman sleeps on the floor in her living room, with both kids and they have dogs that pee all over their house and he's fine there but not in cleanliness? She also took him to an allergist who only found him allergic to dustmites and pet dander. And no, she does not sleep with her husband~ I wonder if she is weird. Their first kid was very sick and had failure to thrive, but this baby is fat and healthy, I sometimes wonder if she isn't trying to make him sick like the other one was, munchhausen (sp?)?????

The point of giving the kid the steroid is to treat his asthma so his symptoms are not so bad.

The goal of any asthma therapy is to reduce symptoms to the point where a person can live a normal life, and not let their asthma run their life for them.

Things have come far since 25 years ago when kids with asthma had to sit out all the time and the bronchodilator of choice was epinephrine, since theophyllines were the first-line choice for treatment.

The fact or belief that the kid is sick after he comes home from his grandparents' house could be for any number of reasons -- but I'm not going to delve into it since that's not something I can say without having actually seen the environments and assessed the child. But the answer to your first question, is no, it shouldn't be dangerous, and if the kid's asthma is so out of control for it to be dangerous, a readjustment of treatment is in order.

Asthma is a serious disease, but it doesn't have to be a debilitating disease.

As the mom of a child with asthma, it can be confusing to try to figure out what their "triggers" are. Sounds in your case that there are MANY things going on besides your nephews asthma though. My son's asthma has been horrible at many times in his life...and we struggled to get it under control. Even when he was at his worst healthwise, he was still a little boy who wanted to play. I think that we know their limits and so do they. He has been on medications for the majority of his life and he lives a normal life. He plays trumpet in the band and plays any sport (especially football, baseball and soccer year-round). Occasionally, he may have problems but we deal with them and move on.

What really worries me about this is, what if he doesn't have asthma? What can treating him for it do to him in the long run, I mean physically? I have a nephew on the other side of the family that has terrible asthma, there's no stopping him, he's a ball of energy. I have seen him at his best and his worst, and he has had to make more than one trip to the ER.
I guess what my real concern is, is that the two year old is being treated for something he does not have. The nebulizer (I hope I got that right) was given to her by her sister who is a nurse's aide. It seems that he's only asthmatic when it is convient for her. What are the serious side affects for these "sometime" treatments that she gives him. To my knowledge she has only taken him to an allergist not a respitory specialist. Should I be more concerned, or graciously butt out? I have children of my own and don't want to overstep boundaries, I guess I wouldn't be so worried if he wasn't always being treated for something "new". First it was lactose intolerance, then it was severe allergies, then every infection from bronchial to ear, now it's asthma. Mind you this little boy is only two, he is a picture of health, he even outweighs his 3 year old cousin, my daughter, who was a nine pounder at birth! He has had to have oral surgury on his two front teeth because she constantly gives him gatorade instead of milk, water or juice, that they had to be capped because of the cavaties.
I'm sorry to be babbeling like this, but what can these "sometime" steroid treatments and other asthma meds she has him on do to him if he does not have this? And the unfortunate thing is that technically there in NOTHING I can do about it, I know, just wanted some input and to vent~ thanks http://www.healthboards.com/ubb/smile.gif

[This message has been edited by onewithgreatspirit (edited 01-30-2003).]

Don't apologize for being concerned about a child. You do raise some interesting questions but, the medication had to have been prescribed by a dr who believes the child has asthma. They don't usually hand these things out without a fair bit of evidence that the child will actually benefit. If his asthma is well controlled, he should be able to run and play symptom-free and do everything a child without asthma can do. As someone else said, there can be a lot of reasons why a child's asthma flairs up - it might not be the house he visits so much as the stress of the trip - or the excitement of the trip. Its very difficult to identify triggers for little folks. It gets easier when they are older and can begin to recognize their own symptoms. In the meantime, your nephew is lucky to have family members like you who care enough to ask questions on his behalf.

Barb

The thing about neb drugs is yes, they do have side-effects. But I highly doubt the nurse's aide woman is giving her these drugs along with the machine -- that many? THAT is when I'd be worried, yes, they do have side-effects, the steroids, anyway. I mean, the particular one you're talking about that's available commonplacedly by nebulizer is considered exceedingly safe for kids, hence why it's available like that, but it DOES have side effects, mostly stunted growth and oral thrush.

But when we talk about those drugs, you're looking at two bucks a shot, literally, to give those drugs to the kid, and that's the cheap stuff. Generic ventolin, 60 ampules, $120. Pulmicort I can't imagine is any cheaper -- in fact, I'll bet it's more expensive.

Honestly, though, if you really are that worried, talk to social services. They might know what to do -- because honestly, without proof, ... no legal right.


[This message has been edited by wrin (edited 01-30-2003).]

Thank you soooo much, you've been most helpful! So is it possible that anxiety and stress can cause his asthma? There is LOTS of stress in his house. It's definately not Leave it to Beaver there! He does, even for his age, seem to figit and act out. He also has really terrible eating habits. That combined with his stressful home life could be the cause of his asthma? Almost like an anxiety attack only worse? I never thought of it this way. Thank you so much, I will definately try to do my part and when he is with me to keep him stress free, of course that's what aunts are for anyway!! http://www.healthboards.com/ubb/smile.gif Thank you again everyone!!

Yeah. Almost anything can make asthma worse.

I mean, some people's asthma is so bad that I swear if you looked at them funny they'd have an asthma attack.

Onewithgreatspirit - I hope things work out with your nephew. I didn't mean to imply that stress 'causes' asthma. It certainly can trigger an episode but the asthma itself is caused by a chronic inflamation in the lungs. Once you've got asthma, then a vast and often confusing array of things can set off an attack ... allergies, viruses, strong smells, strong emotions ... there are many possibilities. It can take some pretty good detective work to figure it out. In the meantime, keeping things as stress-free as possible around your nephew can't do anything but help.

Barb

Runny nose can cause drainage down his throat which in turn can make him cough. Definately sounds like allergies which asthma development is sure to follow. They go hand in hand most of the time.

I just found this thread today, so I'm sorry if I am joining in a little late. Last year, my 6 year old son was couching a lot and had a sniffly nose. The whites of his eyes were also red occasionally--or rather he gets red lines in them (mine were getting the same way-and I was told mine was from allergies). I made him an appointment and as it happened that day, he started to "wheeze". The doctor said he might have asthma as he was wheezing a little. The chest x-ray looked ok. His saturation was just hardly low at all. I think about 95%. He put him on albuteral with a nebulizer for 2 weeks and also on Zyrtec for allergies. I noticed one day after I forgot his Zyrtec, that he seemed to cough more and he coughed most of one other day. I called his doctor (mostly just to see if I needed to put him back on the nebulizer again) and they put him on Singulair. I am not sure if he needs this or not or if this is just allergies or asthma--I know they are closely related. I hate to put him on something long-term that he may not need, but I am not sure if he needs it or not. We haven't had to use the albuterol at all since then. Do you think it is alright to just keep giving him the Singulair, or do you think I should investigate whether or not he truly needs it?

Thanks for any help.

Don't know, sounds to me like it's helping.

Singulair is one of the safest preventer drugs they can give to a peanut his age. It's better than fighting with inhalers, that's for sure.

You might want to send him for scratch testing to see what exactly he's allergic to, then see if you can avoid it to reduce his symptoms rather than just medicating the hell out of him.

By all means, investigate whether he needs it, but if he's getting worse when you take him off, put him back on the stuff. Letting him get to the point of having an asthma attack is kind of counterproductive.

Originally posted by momto2boys:
Thanks for your response Blue.

Interesting about the Benadryl. The only reason I give it to my son at night is because I think the diphenhydramine helps him sleep. I tried giving it to him during the day yesterday because he had a runny nose as well as a cough and it didn't help at all-may have even aggrevated the cough. He had a terrible night though, cough turned into croup. I've heard children with asthma are more likely to develop croup when they have a cold.

The last time I spoke with his doctor, he mentioned Zyrtek. I didn't get the prescription because he has been on Claritin before and it did nothing. I assumed it probably wasn't allergies. I'm learning not to assume anything. I will talk to his doctor about allergy tests though. How do they test children for asthma? Nobody in my family or my husbands has allergies or asthma, so this is all new to us.

Thanks for your help.

Mom to 2 boys
I have a 2 year old son who coughs so much, which his dr. told me it was asthma, he has been allergy tested, reflux tested and cystic fibrosis and all were negative. He is on flovent, albuterol and claritin. I have seen a pulmonolgist an allergist, and i can't find out why my child keeps getting sick. I have missed an enormous amount of work taking care of him. there any other alternatives foe him?