Lyndsey

Age at interview: 35

Brief Outline:

Lyndsey has three children all of whom have been diagnosed with asthma. Her youngest son is most severely affected. To try and protect her children against the flu, her whole family gets the flu vaccine. Lyndsey tries to manage her son’s flu at home and as soon as there is a virus in the family she ups his medication.

Background:

Lyndsey is 35 and a fulltime mum to three children aged 8, 6 and 4. Ethnic background: White British.

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Lyndsey has three children, aged 4, 6 and 8and they have all been diagnosed with asthma. Her younger son, diagnosed at 2, is most severely affected. With three children, Lyndsey says winter seasons can be tricky as viruses and colds tend to go around the whole family with often at least one of them being ill. 

Her younger son’s asthma is easily triggered by colds and viruses. Lyndsey has learnt to manage his flu or flu-like illness mainly at home. As soon as there’s a virus at home, she ups to dosage of his asthma medication, which she has learnt to do with the support and advice from the asthma nurse. As he starts to get better she keeps to dosage higher for another couple of weeks to make sure he is fully recovered.  If he develops an incessant cough with the virus, she usually gets an antibiotic prescription from her GP. Lyndsey describes how important it is to build a good and trusting relationship with the doctor. In her experience, the chest auscultation can be an unreliable investigation and it’s important to take parental views and experience into account when diagnosing and treating children.

As Lyndsey is a fulltime mum she can keep her children at home until they are fully recovered and let them rest as much as possible. Her experience with the out of hours’ GP in their area has been positive and she has never needed to take her children to the A&E with flu or flu-like illness.

Lyndsey’ whole family gets the flu vaccine every year, including the parents who pay for the vaccination. Lyndsey has noticed that this has helped the family to be ill less frequently, even with the common cold. She believes that offering the flu vaccine to all primary ages children would be incredibly important as many of them might be undiagnosed asthmatics like her children. 

As time goes on, managing her children’s acute illness has gotten easier. Through trial and error she has learnt to know what works best for her children which is both down to experience but also because her children are able to communicate more as they are growing up.

Lyndey sits on her son’s bedroom floor watching him breathing when he has flu-like illness symptoms which are affecting his asthma.

Well, it’s the hours and hours and hours of it and when you’ve got a child, who is feverish and so probably not sleeping very well and coughing and struggling, when it comes to a point, I think I phoned the out-of-hours service about four or five am and said, “I’ve got to bring him in.” And they gave me a slot about half five, six o’clock or something. So it was sort of later on in the night that I knew I had to take him. So it’s just, it’s just, you just lie there listening to them don’t you and you keep popping in to make sure they’re alright and end up sitting on the floor of their bedroom just watching them [laughs].

So yeah, that was the most stressful I think because we were a bit worried about him, whereas in other situation, we were more worried about ourselves because we weren’t sleeping [laughs]. Whereas, yeah, but fevers and viruses do affect it hugely, don’t they, because they do, that’s what brings on, I mean a child can be completely fine and have no asthma symptoms during healthy episodes and then you have a virus in the house and suddenly, it becomes quite frightening. My asthma nurse at home, she always says, “Just be alert because it can come on very quickly.” That was one of the most helpful pieces of advice I was given, actually, with regards to my youngest child.

Lyndey has learnt from previous episodes of flu-like illness that when her son starts “incessant coughing” he needs to go to the GP to get antibiotics.

What about any other symptoms, fever or?

Oh yeah. He’d have a fever, yeah, yeah.

Would that, at what point would that start going up and?

I’m trying to think now. I think it varies from virus to virus doesn’t it. Sometimes it’s worse than others and it isn’t always that the worst fever means the worst wheezing. It isn’t always that. Sometimes the wheezing can be almost independent of a fever. But certainly they would be snotty. I guess it just depends on the cold doesn’t it.

Yeah.

It depends on how serious it is and whether it will end up with an ear, throat, chest infection or whatever. I do know, with my youngest, that when he does start the incessant coughing, as I defined it earlier, when he does start that with all the inhalers as well, that’s the point when he needs antibiotics.

Right.

And if I explain to a doctor, “He’s cough cough coughing.” They normally say, “Oh that doesn’t mean he needs antibiotics.” Because for most children it doesn’t but it does for him. If that’s the point at which, if you give him antibiotics, twenty four hours later he’ll be better and I know that and that’s fine with…

Okay.

…my GP.

Lyndey values the local out of hours GP service but since the doctors don’t know her she feels she has to push the ‘competent, capable mother card’ to ensure her son is prescribed antibiotics.

It depends on how serious it is and whether it will end up with an ear, throat, chest infection or whatever. I do know, with my youngest, that when he does start the incessant coughing, as I defined it earlier, when he does start that with all the inhalers as well, that’s the point when he needs antibiotics.

Right.

And if I explain to a doctor, “He’s cough, cough, coughing.” They normally say, “Oh that doesn’t mean he needs antibiotics.” Because for most children it doesn’t but it does for him. If that’s the point at which, if you give him antibiotics, twenty four hours later he’ll be better and I know that and that’s fine with.

Okay.

My GP but with the out-of-hours service you have to really push for that because they don’t know you. So you have to sort of push the competent, capable mother card and say that he really needs them. 

How do you decide who you’re going to see, whether it’s out-of-hours, A and E, your friend, GP friend, you know? I mean in the olden days they had NHS Direct, now they’ve got the new 111 service.

Yeah, I wouldn’t bother with that.

Why’s that?

Because I want to see someone. And I want a prescription. I wouldn’t take them if they don’t need one. Maybe once or twice I’ve been sent away without one and I’ve decided not to really push. I’ve never, when I’ve tried really hard to get one been refused but sometimes, when I talk to the GP, and listen to them and I haven’t been completely sure of the situation, I’ve gone away without one. But, usually, in that situation, I’ve been back within a day or two. So I was right really but I wasn’t completely, but, you know, you don’t want to give them drugs they don’t need. So I’m not, you know, I’m not a drug happy mum in that way because I don’t, you know, I do want to listen to the professionals but I will always try and go and see my GP or…

Yeah.

…I’d just go to the out-of-hours. They’re all right, the out-of-hours. They just don’t know me that’s all. That’s the only difference.

You sometimes have to wait for about forty five minutes if they’re very busy. And that’s not very nice because sometimes there’s children in the waiting room vomiting and I mean I really wouldn’t take a child with vomiting anywhere but you don’t know what situations they’re going through do you. No, it’s not great but it’s all right. You can, you can see somebody.

What about A and E? Is that ever a consideration?

I’ve only ever gone to A and E for an accident. I’ve never gone to A and E for a virus. Because we have all night out-of-hours care so I would prefer to go there. A and E, you can wait for four hours, you know.

Lyndey’s son, who has asthma, spent twelve hours on the children’s ward and after being assessed he came home with steroid and inhaler medication.

The out-of-hours GP, who’d I’d taken him to at the crack of dawn about six in the morning after a really bad night, he said, “I think it’s pneumonia. You’d better go to hospital and they’ll give you some antibiotics.” And this and that and we were there in hospital for the, for about twelve hours, which we were very lucky, we got to come home for bedtime actually, because then you could get some sleep because he was sick. He had a virus. They didn’t give him any antibiotics. They just gave him a high dose steroid and lots of inhaler and he got through it and so it clearly wasn’t, I think it must have been like a just a viral chest infection or something, I don’t really know, but it didn’t need antibiotics anyway. 

Lyndey’s children who all have asthma usually have a five day course of antibiotic treatment. They experienced no side effects apart from slight diarrhoea when they were babies.

Any side effects, any negative effects that they’ve had on antibiotics?

No, not really. When they were younger, it might make their nappies a bit more runny but it’s not it’s not that severe. Yeah, you’d barely notice it really.

Okay. So they’ve tolerated it well from that point of view.

Yeah, they’re, it’s quite a good refined drug isn’t it. I think. It’s only a five-day-dose as well, that they get routinely, yeah. 

Lyndey wasn’t told clearly enough to look for signs of influenza or flu-like illness in her asthmatic children. Later the information from the asthma nurse was very helpful.

So coming on to sort of information and what you have been told, so just firstly, I just want, you know, when they were diagnosed, early days, were you ever told that to look out for viruses, look out for these things that they might be of a concern for your children?

Not properly. No, that was something I had to figure out for myself. I think probably I was told but not clearly enough. So when you’re very uneducated about something, people think that one telling is enough but they actually need to spell it out very clearly. That’s been the case for me in all sorts of situations in life. It doesn’t go in very well into your mind to start with and, after a few months of it, you can sort of think, well, yeah, I should be managing this more preventatively, if I can. And they probably did tell me that but it never went in.

Yeah.

I’m sure they did but it might have been the GP that said it in a vague way and the asthma nurse has got a way of communicating with me that’s very direct and clear. And it may not have come from her. I, yeah, people always, they take annual leave at times when you need them and, you know, these things happen and you just muddle.

Yeah.

Muddle through really.

What about since, what, you know, you talked an awful lot about the asthma nurse. So is that your main source of advice and information and?

She is great and she’s the one that got me on the Asthma UK website. 

My asthma nurse at home, she always says, “Just be alert because it can come on very quickly.” That was one of the most helpful pieces of advice I was given, actually, with regards to my youngest child.

Lyndey says that looking after her three asthmatic children when they were ill with flu-like illness would be ‘extremely difficult’ if she was working.

Well, it’s the biggest ruiner of plans isn’t it, children’s illness and not serious, not life-threatening. Children’s illnesses are just ruin your plans all the time. I think, I don’t know how and I’ve said this regularly, I don’t know how, with three asthmatic children, I would manage a job at this stage in my life. I just, you know, the advantage of just one of us being in employment means that if he needs to sleep, he can go and sleep in another room and go to work and I’ll be up with the children. And then if I’m unwell, he can take that role but, at this stage, I think it would be extremely difficult and I would end up sending them to school when they shouldn’t be at school and now I can, I’ve got the freedom of keeping them off, which hopefully, prevents them going downhill with a particular virus and it takes the pressure off, certainly being at home.