GP implying dd's 'asthma' is her being manipulative... anyone heard of this?

[bakedpotato]

dd had a nightcough as a baby which a paed diagnosed at around 1 year as 'baby asthma', a very loose term. since then we have been using the inhalers during the winter but dropping them in the summer, when the cough goes away. for the last 7 wks, after she caught a bad cold, we've been having terrible trouble at night. not all her coughs wake her up, but recently she has been waking most nights between 1-4, having a coughing fit and then crying for us. neither of the inhalers now seem to be having any effect.
gp last week sent her for x-ray, which doesn't seem to have shown up anything unusual, and put her on a 3-day course of a steriod called prednisolone which he said would have an instant effect on her airway, which he assumed was inflamed from weeks of coughing. it didn't work for the first 2 nights, but then we had 2 clear nights for the first time in ages.
just went to see another GP who said it may well not be asthma, because of prednisolone not working.
he implied that because x-ray is clear, ie it doesn't show any infection or anything, this whole thing may be an exercise in manipulation, a ploy to get attention. (i am pg and i know i give off anxious/desperate vibes because i am so keen to sort this out before the baby comes... i'm probably coming across to the gps as deeply neurotic.)
has anyone else heard of this? it seems a mad idea to me. dd is just 3, and has always been a fantastic sleeper, she has no fear of bed/bedtime, is usually happy to go to bed etc.
when she does cough and cry, we don't exactly rush in, and we never get her up/put on light, we just give her water/quiet reassurance, and leave almost immediately.
her cough sounds real enough to me it's a dry, tight cough, not a wheezy one, and she also coughs after exercise but of course the doc hasn't heard it.
am totally at a loss now how to respond to the next bad night.

[bakedpotato]

also, the cough went for good a while back

[Angeliz]

I think you'd know if she was doing it for attention and TBH it doesn't sound like it to me!

[Ameriscot2004]

Prednisilone takes a few days to take effect - as do all steroids.

It's a very powerful drug. I'm surprised that your GP gave it.

[tatt]

keep a voice recorder/ tape recorder by the bed and tape the coughs. very unlikely to be attention seeking but you could phone the nurses on the asthma helpline as they would give you courage to tell the gp off.

[bakedpotato]

Ameriscot, he wasn't eager to prescribe it, but he said it was the next logical step (the Nat Asthma Helpline had also advised this) and it was a very low dose. i'm curious though about what you say about it taking a while to work, as he was very specific, he said it would start to have a beneficial effect within 8 hours. but what happened was that the cough went temporarily just as the dose finished, which would tally with what you say.

i think the NAH is amazing. but GP was a bit dismissive. he said, 'well, they haven't seen her, have they?"

[bakedpotato]

oh whoops, in my 11.26 post i meant to say 'the COLD went for good'
doh

[misdee]

presnisolone doesnt have immediate effect really. it takes a day or 2 to start owrking properly. dd1 has been on this a few times for her eczema and asthma.

I have been told that my dd2 vomiting is attention seeking. yeah right whatever.

if your dd coughs after exercise and at night its likelt that it is asthma. its hard to dx in under fives tho dd1 has had a brown and blue inhalor since she was 2years old.

[misdee]

yes 8 hours to see some effect but not get rid of it totally. when dd1 had asthma atack she was put on 2 week course of it.

[luckymum]

bakedpotato - my ds was diagnosed with baby asthma. We have no history in our family and I was very dubious. He also had recurrent ENT infections. We were referred to ENT for removal of tonsils, adenoids and for grommets to be put in. Both the ENT surgeon and the anaethetist felt that he didn't have asthma at all, but that his night-time cough was related to catarrh (post nasal drip? I think they call it). It disappeared post surgery so I think they were right.

[JJ]

bp, my son had many short courses (5 days for him) of prednisolone when he was little (9 months to about 3 years old).

It always seemed to me that it took a day or two to hit the full effect, esp if his reaction was bad or had been going on for a while.

Just a word of caution: keep her away from sick people as she'll pick up anything that's going around until the course is finished. My son's allergies were exacerbated by sickness and we had about 5 months once with the reaction/prednisolone/sickness/reaction/and so on cycle.

[bundle]

knew this would be you, bp!
i'm talking to a cough specialist hopefully later today (there's a big british thoracic society meeting in london next week) so will try to remember to ask. from what i remember before he said gps were often too keen to diagnose asthma in children when it just wasn't there (though it is hard to diagnose apparently). dd1 used to vomit when she coughed a lot at night but she was much younger than your dd and i think it was something like post nasal drip exacerbated by I want my mummy tantrums..

[Nutcracker]

BP - If your Dd is doing that for attention then so is mine and has been for the past nearly 5 years.

What a ridiculous thing to say. I know kids can manipulate situations when they think it will get them some attention but in the middle of the night, i don't think so.

My Dd's asthma sounds extremely similar to your Dd's. Mine also started off as a permamnant night time cough as a baby and it took 14mths of hell before we finally got her diagnosed as asthmatic.

Like you dd, my dd rarely uses her inhaler in the spring or summer but in the winter she always needs it especially if she has had a cold.

We have found that mainly her reliver inhaler is pretty useless as if she is having a bad coughing fit (ie where she can't talk for coughing) then it just doesn't work.
If we make sure that she has her brown inhaler at least every night then 90% of the time her asthama is under control.
She has also had prednisolone which sometimes works but sometimes not.

I would carry on responding to your dd exactly the same as you are now, no fuss etc, i certainly cannot see how you are doing anything wrong.

Do you have an asthma clininc/nurse at your surgery ??? If you do i would go along and have a chat with them, they are usually very good and mine was quite gobsmacked by some of the stuff various doctors had told us.

HTH xxx

[Nutcracker]

Meant to say also that i agree with what others have said about prednisolone. It doesn't work straight away, it takes about 2 days to kick in.

[Tissy]

I was told by a consultant paediatrician that the prednisolone should take about 4 hours to work-but she did say that I should give prednisolone at the beginning of an attack, before it gets too bad (dd's asthmas seems to be a sort of "all or nothing phenomenon"- she's either fine with no wheeze at all, or very bad needing steroids and nebulisers- we don't get anything inbetween!)

[bakedpotato]

thanks for all of these responses. i just rang the NAH again. they echoed the consenus here, telling me that prednisolone can take a while to act. the fact that she had 2 clear nights on end of the course suggested to them that it had in fact worked.

they also told me that the new inhaler the GP just prescribed in experimental fashion (Serevent) is NOT advised in the under 4s. this is according to the British Thorassic Soc's asthma guidelines.

I'm angry now. i'm going to have to go back this afternoon and ask for a new prescription, for something called Singulair (anyone heard of it?) which the NAH says would be better for her age. I know i'll end up crying (with fury) over him. he made me feel such a fool, but actually he has been rather irresponsible.

[JJ]

bp, my son was on Singulair for a few years and it was a wonder drug for him. BUT it only works in about half the cases -- you'll know within a few days to a week if it does.

Good luck. We also had luck with a steam humidifier; he needed it in the winter to sleep peacefully, even with all the meds.

[bakedpotato]

just managed to speak to GP on phone (nearly fell of chair when they put me straight through).

he admitted he should have told me about severent not being officially recommended for the under 4s (he said despite this it's often prescribed to them) so we could have come to a joint decision on it. he was slightly less patronising in general and also acknowledged the prednisolane could have taken longer to work than he had originally suggested

next step is to find out how long it will take for a hospital appt to come through.

will try singulair next, JJ, and humidifier too if i can find it (it didn't seem to work when she was younger)

[bundle]

bakedpotato, if you can't find the humidifier sling a wet teatowel over the radiator in her bedroom and place some water near to it too to put some humidity into the air

[bundle]

(amazing when they put you through isn't it? i'm glad he was nicer to you)

[bakedpotato]

thanks, bundle

[brave]

[bakedpotato]

JJ, many thanks for suggesting the humidifier. i dug it out last night we used to use it when she had colds as a baby and it seems to have made quite a difference. she coughed sporadically throughout night, but was much quieter both at start and end of it, instead of having her normal paroxysms.
also, re the 'attention-seeking' theory, and nutcracker/misdee's reassurance: i'm now totally sure that this is not a possibility here. last night, 95pc of her coughing happened when she was asleep, and that's pretty standard, i now realise.