I very clearly remember the day it started. It was one of those chilly autumnal mornings and we were all piling into the car to head off for lunch with friends. As my husband carried our two year old son out of out of the house, he remarked, "I didn't know he had a cough". "He doesn't!" I replied. But sure enough, as I listened, he was coughing. Actually, he was coughing a lot. He had eaten his breakfast just before coming out and maybe he had eaten too fast, I reasoned. My husband also seemed to have a bit of a cough that day so I didn't think much more about it.
After that, it was just small things that didn't quite add up. If our son had an ice-cream or giggled a lot when we tickled him, the cough would be back. At night time too, especially when it was chilly, he would cough. Sometimes quite a bit. But again, this wasn't every night and settled quite quickly. My husband too often had a cough at similar times so I sometimes thought they both had a cold. Otherwise, our son was just as a little boy his age should be: into everything with endless energy and full of toddler gorgeousness.
Then when he was four, out of the blue, he had a severe allergic reaction to a brazil nut. As I sat up through the night anxiously monitoring him as he slept, it began to dawn on me. That cough, which came at seemingly random times of day and night, could it be asthma? Somewhere, in the back of my mind, I began to piece it together. Allergies and asthma often go hand in hand, don't they? On our return from holiday, I made an appointment to see our doctor.
Listening to the symptoms I described, our GP was helpful and prescribed us a brown inhaler known as a 'preventor' to try. Although he showed me how to use it, the demonstration was crammed into the end of a short appointment. There was no further follow-up for some time. Since then, the care was not regular enough to really get a clear picture of whether the inhaler was helping or indeed whether we were even using it properly. The following winter, my father in law, a retired GP, came to stay and heard our son coughing. He told me to get him quick smart to the doctor and get a blue inhaler - also known as a 'reliever'.
Looking back, I feel really bad that I didn't spot the signs earlier. Why hadn't I put the pieces together? I suppose to me, as with many other people, asthmatics have a wheeze and our son certainly had never had that. My experiences have really made me wonder, how many people have never had their children's symptoms diagnosed or are needlessly mismanaging their children's asthma or indeed their own, through lack of regular check-ups and specialist care?
According to Asthma UK, we have one one of the highest rates of asthma in Europe but it is estimated that seven out of ten people with asthma do not receive care that meets even the most basic clinical standards. Tragically, every day in the UK, three people die of asthma, yet two thirds of asthma deaths are considered preventable with good, basic care.
An asthma nurse recently told me that September is a peak time for emergency hospital admittance for children who have asthma. One of the reasons she suggested was because people mistakenly stop using their brown (preventer) inhalers over the summer. I wonder too, whether all schools have the necessary expertise to spot and accurately manage asthma once term starts.
We really need a co-ordinated strategy to address this common condition. All parents should be advised of the common symptoms and all adults acting in loco-parentis should know how to best care for children who have asthma. Adults too need to be aware of the symptoms and be proactive about asking for specialist medical advice if it isn't offered as a matter of course.
There are many things I now know to do which minimise the chance of our son even needing his blue inhaler. Small things that make a big difference to him: closing the windows in his bedroom during the day in Summer to reduce the chance of pollen aggravating his breathing at night; ensuring he has his flu vaccinations in winter and consistently and carefully helping him to use his brown inhaler correctly. Importantly, I also make sure that I book in regular appointments with the asthma nurse.
For us now, thankfully, our son's asthma is mostly under control and barely affects him unless he gets a cold or bug. The care we have received lately has been of the very best quality too - a recent home visit from a specialist asthma nurse answered all our questions, reviewed how our son uses his inhalers and she was full of top advice. But this was arranged at my persistence and the recommendation of friends rather than offered as a matter of course.
We have also found out that my husband has asthma. Suffice to say, we now have quite a collection of inhalers in our house but at least we now know how to properly use them.
For further advice, back to school tips and information on asthma visit: https://www.asthma.org.uk/or call the Asthma UK Helpline on 0300 222 5800 to speak to an expert asthma nurse.