A-Z

Clare

Age at interview: 44
Brief Outline: El is Clare’s oldest child and was diagnosed with asthma when she was aged four. El also has hay fever and eczema and Clare believes that all these conditions are interlinked. Her first flu episode was the worse as she developed a chest infection and required antibiotics. Clare manages the episodes through close monitoring of the symptoms, giving over the counter medication and getting advice from the GP and nurses at her surgery, if necessary.
Background: Clare is married with four children ranging in age from 5 to 11 years old. She works part-time as a nurse. Ethnic background: White British.

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Clare explains that El’s diagnosis was slow to come, as asthma can be difficult to diagnose in young children. At age four El was diagnosed with asthma but given the preventor inhaler only to use twice a day. These days she uses the preventor and the Salbutamol as and when she needs it. 

The first time El became ill with flu she was very poorly, staying in bed for about a week and with all the flu symptoms in a very severe form, such as very high temperature, lethargy, very wheezy, not eating or drinking. Initially, Clare thought it was a bad case of cold but as her symptoms didn’t lessen, she took El to the GP and she was diagnosed with a secondary infection; chest infection. She was prescribed antibiotics and within a few days her symptoms improved and she went back to be her bouncy self. 

After her first episode of flu and her asthma diagnosis, El has been vaccinated against the flu every year. She has had other episodes, but those have been less severe than the first one. But in general, and in comparison to other children, Clare explains that El’s symptoms last longer and that it takes her longer to make a full recovery. Clare manages the flu episodes through close monitoring of the symptoms, giving over the counter medication and making sure she is hydrated. If necessary, she would seek advice from her health surgery including her GP and asthma nurse. El knows how to manage her asthma and when to increase her medication.

Clare thinks highly of her GP practice and she knows they don’t like to give out antibiotics unnecessarily. In her experience, her daughter has been well assessed and examined and health professional are very good at communicating with parents and going through the options and explaining their reasons for not prescribing. Clare trusts their clinical decision and she knows that if they prescribed antibiotics is because they are warranted. Clare does not like to give her children antibiotics except, when they need them like when they have a bacterial infection.

On two occasions Clare got a prescription for antibiotics from her GP as a precaution but was told to monitor the symptoms first, and if there was not improvement to use them. She agrees with this approach because it put parents on a decision making role regarding their child’s treatment.
 

After having flu-like illness, El developed a chest infection and was susceptible to chest infections for a long time afterwards.

After having flu-like illness, El developed a chest infection and was susceptible to chest infections for a long time afterwards.

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Has she ever had complications due to a flu-like illness?

We said she had a secondary chest infection that, that first time and I think that’s maybe how the diagnosis. It was around the sort of, were all around about that time, you know, when they said that they thought because obviously she was given some antibiotics then but she had been quite unwell with the flu initially and then obviously it wasn’t shifting. I did take her to the GP and that’s when he said, “Oh she had a chest infection which was probably because she’d had the flu. 

Is your child sort of susceptible to flu-related complications would you say or no?

Yeah [cough] yeah I mean like we had a chest infections and feeling very tired for quite a long time afterwards and weak and. Yeah

Ok

Run down.
 

El has asthma and she was very tired and weak for a long time after having flu-like illness.

El has asthma and she was very tired and weak for a long time after having flu-like illness.

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So on a typical kind of flu episode how long does it take for her to get sort of better, up and running again,

In comparison with other children that don’t have it she does take a lot longer and she seems to be, she seems to be a little lot, much worse affected as well, you know. She seems to take longer to recover and be worse and then have periods of time when she might be ok and appear to bounce back and they’ll sort of, like a typical flu up and down, a bit up and down where she’ll be quite flat for a lot of the time. Yeah.

So roughly one week, two weeks?

I’d say at least two weeks really because I think unwell for a week, a full week but then afterwards really under the weather still. You know, very, very low on energy, still coughing a lot, struggling with appetite, you know, that sort of thing. Just taking a long time to bounce back really. 
 

Clare likes the way her GP practice operates and appreciates their focus on preventative care.

Clare likes the way her GP practice operates and appreciates their focus on preventative care.

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But I mean I’m in a good GP practice where there’s a team, a lot of teamwork going on. You know, you can see that if you phone them up somebody will phone you back. They start advertising the flu (jab) clinics which are open, drop in clinics, you know, quite early on regularly in the summer time they will start advertising them and if you can fit into one of those you just phone up and they will make sure that you get booked in and if you haven’t booked on they will be contacting you to say, “Please can you book your child on for this. They need the flu (jab).” And so I think that is quite good because obviously they are doing everything they can to make sure that any vulnerable patient in the practice is, you know, is immunised as much as they can do that. Yeah and then we have an open surgery as well. So you can make appointments with individual GPs but every day there is also a walk-in surgery. So if you wake up in the morning and you need to go you can just go and you sit and wait and it might be two hours but you know you are going to be seen that morning. I just think it is very, very good actually I do. And you don’t go unless it is urgent because you might have to wait for two hours so, you know, if you are going it’s because you need to go and I think it does work quite well.
 

Once or twice Clare has been given a prescription by her GP for her daughter to use if her symptoms did not improve.

Once or twice Clare has been given a prescription by her GP for her daughter to use if her symptoms did not improve.

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Has she ever had complications due to a flu-like illness?

We said she had a secondary chest infection that, that first time and I think that’s maybe how the diagnosis. It was around the sort of, were all around about that time, you know, when they said that they thought because obviously she was given some antibiotics then but she had been quite unwell with the flu initially and then obviously it wasn’t shifting. I did take her to the GP and that’s when he said, “Oh she had a chest infection which was probably because she’d had the flu. 

So the decision to give antibiotics again was made by the doctor?

[Uh huh] Yeah.

Did the doctor discuss it with you or?

Yeah they were very good, GP practice yeah and they don’t like to give out antibiotics to be fair. They are very good at looking at a child properly and going through the options and explaining their reasons, you know, for not prescribing. So I do have a lot of trust in them if they are giving them out then it’s warranted yeah.

So when you take your daughter to the doctors because she’s with flu they check her?

Yeah they get, they do check her peak flow and, you know, check everything else as well. You know, listen to her chest and yeah.

Have there been occasions when you have been given a prescription and just to see?

It depends on, yes they have done that once or twice yeah.

And have you used that prescription?

I haven’t actually but I think it is quite a good idea actually because it sort of puts the owness onto the parents doesn’t it? And as long as they explain the rational for it and when to give it, it could work quite well actually, yeah.
 

Clare thinks it’s very valuable to hear other parent’s experiences on forums but it’s important to remember their experiences are anecdotal and may not be based on research evidence.

Clare thinks it’s very valuable to hear other parent’s experiences on forums but it’s important to remember their experiences are anecdotal and may not be based on research evidence.

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Has any, well I know you are a health professional yourself so have you looked for information about flu or a flu-like illness somewhere?

Yeah, yeah. I mean there is plenty of information out there I mean like all the NHS news traces and all that type of stuff, yeah. And obviously even in the GPs surgery you have like the screen and they will, you know, put up like health promotion literature up there and give out stuff yeah. 

But have you visited any forums or websites that provide more information?

Just sort of parents boards, I mean they are anecdotal stuff aren’t they but yeah I do like to look at those sometimes, yeah [laugh].

Ok. 

I think that’s the way it’s going though. People do get a lot of information off the internet and obviously the difficulty is it’s completely unregulated a lot of it isn’t it. So it’s making sure you look in the right places really isn’t it and…

Ok like the right places like?

You’re not…

Like official websites?

Yeah and parenting boards are fine as long as you recognise that they are people’s opinions and that, you know, they’re not necessarily medical backgrounds and stuff but that doesn’t mean it isn’t, it isn’t right, you know, because it works for one person. You might think yeah that’s a really good idea. I might try that but it’s just remembering that any advice that people are giving is just their own experience really isn’t it, you know? But I think they are very valuable actually.
 

El has the flu vaccine each year. She still gets flu-like illness occasionally but she has not been as poorly as before she had the vaccine.

El has the flu vaccine each year. She still gets flu-like illness occasionally but she has not been as poorly as before she had the vaccine.

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No obviously in the winter when the first time she got flu when she wasn’t immunised she was really, really poorly, really poorly. I mean like she did not get out of bed for like a week. And she was so unwell and she’s quite a lively child and full of beans and I’ve never seen her.

Do you know how old was she then?

That was the first time. She was about 5, yeah, yeah.

And you said that she wasn’t given the flu vaccination before?

I can’t remember when she started getting it. I don’t think she did get it the first time cos I think the diagnosis was slow to come.

And obviously I do get her immunised every year so we’ve never had as bad a situation as that first one I would say. But she has, she has had it again since even though she’s been immunised although I think that does offer some protection it’s not, you know, obvious a 100% is it fool proof.
 

Clare works part time as a nurse. She takes annual leave, unpaid leave or carer’s leave when El is ill and off school, but it is difficult to manage.

Clare works part time as a nurse. She takes annual leave, unpaid leave or carer’s leave when El is ill and off school, but it is difficult to manage.

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Do you have to take time off work sometimes?

Yeah, yeah, yeah.

Ok. And does it have any impact? I mean you taking time off work?

Well it does. Me and my husband try and share it between us. Well, I don’t work fulltime which does help but yes it is difficult because you don’t want to send them back to school when they’re not well but, you know.

Well obviously you can take carer’s leave if it’s like very unplanned but obviously if it’s going on for like a week then you would have to either take annual leave or unpaid leave yeah.
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