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Asthma: “We’d rather have a cough syrup”

A child comes into the practice with a persistent cough. The mother discontinued the prescribed medication on her own initiative after a few days. The following conversation drives me almost insane.

Once upon a time in my practice – a mother, her sick daughter and I. Just a little info: The situation took place before Corona. Now the two are again present in my practice because the daughter’s symptoms do not want to subside.

When moms know better…

Mother: “She’s still coughing.” She talks about her thirteen-year-old daughter sitting next to her.

Me: “Did she continue to inhale?” The daughter has asthmatic problems, has a BMI of 32 kg/m2, and I put her on an inhaled corticoid three weeks ago.

Mom: “Well, we left that out. She’s still coughing.”

Me: “Yes, but the lungs were free afterwards. And now you were allowed to inhale continuously so that it doesn’t get worse again.”

Mom: “Mmmm. Didn’t do anything. She’s still coughing.”

Me: “These continuous inhalations take a little time. Nothing can be done in less than two months. You should have kept inhaling. Now start all over again.”

Mother: “It didn’t help.”

Daughter: “It didn’t help, I’m still coughing.”

Me: “Okay. Suggestion (like three weeks ago, by the way): You inhale again regularly with your discus, at least until the end of October – and then we’ll meet again here.”

Daughter: “I always have to breathe heavily when I’m climbing stairs or when I’m running.”

Me: “Yes.” (see BMI)

Mother: “And the cough?”

Me: “The Lufu was really good with the short-acting drug. And now your daughter can simply inhale with her discus permanently, so that it stays that way.”

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Mother: “But what am I supposed to do with a drug that doesn’t help? I’d rather put it down.”

Me: “To be clear again: I recommend you to use the drug permanently, but you just stop using it after a few days? Then it cannot be successful either!”

Mother: “So it’s our fault now?”

Me: “Yes! It’s not about guilt. It’s about giving the drug a chance.”

Mother and daughter in chorus: “So we have to carry on like this now?”

Me: “Yes.”

Mother: “Maybe you’d rather write down a cough syrup?”

And the moral of the story: Aaaarrggh!!!

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Image source: Dhruv Mehra, Unsplash

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