Advice needed on another issue!

[Fuschia]

As if the transverse pregnany isn't enough to worry about!

Twin II had a problem w th breathing 3 weeks ago.. had had a cold and cough , I noticed her panting very rapidly, called NHS direct who sent paramedics, nebulised her to no availa, called ambulance who took us to Kings with blue lights. After about 6h, and more nebulisers, steroids, inhalers, her o2 levels came back up so we were sent back home with antibiotics and reliever inhaler, told to see the GP. Dx was vital wheeze.

Had trouble getting appt, when saw GP, GP said prob seh had a second virus (as still unwell)

Very next day problem recurred, called ambulance, her O2 levels were even below first time ... back to hospital.. admitted this time as even after all the treatment her o2 levels hovered round the 85% mark. Scary thing was she was just pale, weak and coughing on the level (dr said reslly she should have clearly been in distress!)

Now got preventer inhaler as well as reliever, should get appt with astham nurse at Kings in a month, told to see GP in the meantime

My dilemma is, she is coughing all the time, very tired and pale, off her food. Is there any point me going to the GP? I think she needs her O2 levels monitored again. I am thinking of taking her to a and e very early tomorrow while it's quiet.

I can't really risk MrF having to call an ambukance next week, if I am in hospital myself, plus she is sleeping so badly I feel awful leaving her.

Am I over-reacting? Will a and e think I should have gone to the GP?

[Ruth_Baldock]

I'd take her to a&e personally. I suffered from asthma as a child (still do) and after a while my

mum realized it was quicker and more productive to bypass gp altogether

[EDmummy]

Oh gosh, poor you. You are having a terrible time.

I would certainly be tempted to go to A&E but it may be possible for your GP to provide the support you need. If you can't get an appointment, have you tried asking the receptionist to have one of the duty GPs call you at home to discuss the issues? I know my GPs, Forest Hill Road, are very good at offering telephone advice like this. If your daughter is struggling to maintain oxygen levels then they must be able to provide you with some sort of support (advice or equipment).

Have the doctors actually diagnosed asthma? Does your house contain any potential allergen that may be excacerbating her briefing problems or do they think it is only viral? If there is a possibility t may be triggered by allergens, have you noted details of when she suffers most, eg., in a certain room, touching pets, eating certain foods?

There is an A&E paedatric nurse who posts on here, can't remember her name. Perhaps she can offer you advice.

Best wishes to both of you.

[Fuschia]

Yes, that's Buggie (we saw her on oneof our prev trips, think that was Twin I's pneumonia!)

I am not impressed with the GP, I had to make a HUGE fuss even to get her seen, the Gp just sort of shrugged. And if she can be very low in O2 without it being apparent, then the GP can't rellay tell anyway.

She hasn't been dx with asthma (if she gets seen in a month and is clear of viral infections they will have more of an idea I think)

It could be a one virus after another .. but has been more than a month now. MrF has bad asthma (as do most of his siblings and their children)

I think I've decided to take her this evening as soon as MrF is back from the school run. It's busy there prob after school, though, but hopefully we will be home for bedtime!!!

I just don't want it hanging over me, with all the other worries.

[new mother]

I agree - A and E

[Fuschia]

She is bad at night, though TBH last few days she is coughing most of the time. We do have a cat, and probably quite a lot of dust in the bedroom, i wa splanning to hoover the bed etc this weekend.

[buggie]

Hey Fuschia, (managed to find this thread between lil un's feeds!)

If I was there I'd have no probs with you bring her back in (esp if within a wk of being admitted they'd prob give paeds a shout straight off).

Bit confused how she's got a viral infection but been given antibiotics (the treatment for a bacterial infection) but that's by the by. If she completed the course of them and still has symptoms then that would suggest it is a viral infection.

Annoyingly viral infections can hang around a little while, and even if she was showing signs of improving, the night would be rough.

Think the fact she's coughing all the time and off food (?drinking ok/more than normal) are reason enough to get her checked. In A&E as well as having her prev notes to hand, they'll also be able to do full obs/check O2 level on her. Can understand why you'd want to wait until a "quiet" time, if asked directly I'd say don't "plan" ED attendances head straight in, but suppose hanging on will also give you an extra night to observe/see if there's improvement. Any deterioration/increased concern and head straight in there.

Best of luck with No 4 as well! x

[Fuschia]

Buggie, when we left a and e the first time, they said her chest was crackling at that point (wasn't on admission and chest xray wasn't too suspicious) so a bacterial infection could set in, hence the amocycillin.

Second time round they didn't hear crackling, xrayed her again and noted the previous areaes on the xray had improved if anything, but wheeze was bad, so they treated the wheezing/low oxygen levels (or at least that''s what I think they said!!)

I don't think she's had a bacterial infection, hasn't had a high temp at any point.

I am going to take her in as soon as MrF gets back.It will be busier than early in the morning (I realised on a previous trip with Twin I that 7.30-8am is a really nice quiet time!) but actually, I am quite worried about her. Midwife wondered if she might be anaemic, she has been looking quite blue, even the creche commented.

Just wish me luck we are not there all night, again. I can't stand it third time in a month.

[Fuschia]

PS I was hoping you'd pop up with advice, buggie, so thanks.

It's hard to know when you are over-reacting, usually I am quite laud back about childhood illness but a blue light ambulance dash is enough to make anyone a bit jumpy.

[alieh]

I would take her to A&E too. I have asthma, and TBH things can escalate quite quickly in children (don't want to scare you) and it really is worth erring on the side of caution. I remember the terror of having trouble breathing when I was small, and it really is important that they get her airways as open as possible.

Have they offered oral steroids? My asthma is very under control with inhalers (preventer and reliever) normally but when I've had any kind of cold (viral or bacterial) my breathing becomes out of control very quickly. Sometimes the only thing that fixes it is oral steroids (sometimes antibiotics will be enough, dep on whether it's an infection obviously). Not sure if they offer these for children, but if she has been having breathing problems this long I do think they need to consider ramping up from the inhalers if possible. But I'm not a doctor, so obviously they're the experts.

As if you don't have enough to worry about right now, but minimising possible allergens might make a huge difference. Even if you just focus on a major clean up of her bedroom. Take out as many soft furnishings (rugs, soft toys, etc.) as possible, major hoover of every nook and cranny including mattress, wash all bedding including pillows and duvets at as high heat as possible to kill dust mites, and keep the door closed to keep the cat out if you don't already do this. This makes a huge difference to my breathing when I'm having trouble.

A warm mist humidifier also really helps me at night, as does propping up with obscene amounts of pillows until I'm almost sitting upright (very difficult to convince a toddler to do this I know).

[Fuschia]

She had 3 days of prednisolone each time we left Kings.. and now has a brown reliever inhaler as well as the blue one

[vinceayre]

Fuschia,

I had asthma as a child and still do to a very minor extent. Once I left home it virtually disappeared and this was due to two reasons. We had a cat (fluffy!!) i loved her but she without doubt caused me to have asthma far worse than i should have. I bought a flat when i left home to find under the dirty carpets it had wood flooring, it made a huge difference to me and even now 24 years later I still have no carpets or pets with fur or feathers and im fine. How do i know this because my mother still has cats and whenever i visit i leave with eyes streaming and throat itching.

People will tell you otherwise regards the pet but you do really need to get rid of it to give your child a chance at not having asthma all the through her child hood. If you can do wood floors you will find that it makes a massive difference to the house dust mites as they love carpets.

I used to spend the summers in Spain as a child and had zero asthma there, my parents said it was the "sea air" but it was in fact no fluffy and no carpets. Sorry to be the bearer of bad news.

[sillywoman]

Fuschia, I don't mean to scaremonger but like Buggie said I really would take her back to Paeds ED to be checked over, make sure they check for rare & unusual things too such as pneumonia & rheumatic fever/ inflammation. I'm not a big worrier at all (contrary to what this post would suggest) & it is my proud boast to have only visited ED once in 15 years with any of my 4, but with the symptoms you record, over the period of time you say, I would be getting that babe checked out. I'd probably go to my GP, but he's great & I trust him, You don't so I'd say straight to the ED with you.

Poor, poor you. You'll be glad to see the back of 2010 I'd think?

[EDmummy]

Been thinking of you and Twin II, Fuschia. How did you get on?

[intexasatthe moment]

Poor Fuschia ,how awful .Hope little one is improving .

With Forset Hill Rd ,you have to be careful which GP you see .... some are less helpful/thorough than others .

[Fuschia]

I took her along, typically she perked up somewhat when we arrived and led me a merry dance dashing about. They called down a paediatrics doctor who checked her records and explained properly what I missed when the asthma nurse visited her on the ward while only MrF was there. (MrF now says they gave him an appt date but he didn't write it down as he thought a letter woud come...!!!!)

The dr said no appt date is showing but gave me contact details to ring on monday and chas eit up, said she HAD had a bacterial infection when she went in my ambulance the first time, and this can take quite a few weeks to resolve properly. Brown inhaler won't hav ekicked in yet..

So it's just waiting a bit longer really.

I feel like I have done my best to avoid another emergency dash, anyway.

[buggie]

Sounds like the Dr was able to clarify/reassure which is good. Typical that the change of scene lead to her perking up... is amazing how often it happens (amount of babies who had given their parents merry hell at home and would then beam at me in triage!).

Don't be afraid to use the blue inhaler whenever she is wheezy/chesty - am sure they've advised 4 puffs up to 4 times a day for next couple of days. Fingers crossed she's over the hump of it and going to improve - just in time for you to concentrate on No 4!!

[Fuschia]

buggie Wrote:

-------------------------------------------------------

>

> Don't be afraid to use the blue inhaler whenever

> she is wheezy/chesty - am sure they've advised 4

> puffs up to 4 times a day for next couple of days.

First time we were in that was advice, after last week's admission they said up to 8, as often as needed

[buggie]

up to 8 puffs is fine too - but would say if consistently needing to use 8 puffs (esp after a further 24/36hrs) have a low threshold for getting her reviewed again x

[Fuschia]

buggie Wrote:

-------------------------------------------------------

> up to 8 puffs is fine too - but would say if

> consistently needing to use 8 puffs (esp after a

> further 24/36hrs) have a low threshold for getting

> her reviewed again x

Yes, that's why i took her as she has needed 4-8 puffs every 1-2 hours, since she left hospital last Friday. Hopefully as the brown inhaler kicks in that will reduce.The dr also said some coughing (as opposed to wheezing) is Ok as she has stuff still to bring up since the original infection.

She coughs so much at night it's difficult to know what to do, I have her propped up... the coughing wakes her (and me!) up but the blue inhaler makes her hyper!!

[ClareC]

Was she given antibiotics and steroids? I always found the combination of antibiotics, and steroids (decreasing dose, v high at first, reducing each day) over about a 5 day period always sorted me out. It also helps to be propped as upright as possible when trying to sleep.

Hope she makes some good progress soon

X

[Fuschia]

She had antibiotics the first time, steroids for 3 days both times...

[ClareC]

3 days seems quite a short period. I used to have 6 tablets on day 1, 5 on day 2, 4 on 3 etc but then I was older, around 11, plus it was a few years ago now.

Not sure what the current thinking is, ive not needed steroids\antibiotic combination for around 5 years now.

I think it has already been said, but does make a massive difference, definitely minimise soft furnishings as much as possible. Carpets and curtains really do harbour dust etc which makes things worse.

Also, once she is better would be worthwhile having her tested for allergies, my asthma was definitely triggered by allergies, once I knew what they were (I had a fair idea on some (cats) but others were a surprise (tree pollen), it did become much easier to manage.

Funnily enough the only times I have needed the steroid/ antibiotic combo as an adult has been allergy triggered.

[Fuschia]

MrF is allergic to most of those things...

[Sanne Panne]

I'm so sorry you're having such a tough year. Just wanted to wish you lots of strength and good outcomes for the next few weeks xxx