Struggling with possible asthma diagnosis, advice needed.

[Labbiemum16]

Hoping the MN collective can help me out here, I am struggling to get to grips with inhalers, doses, frequency & managing asthma in my daughter.

Some history, DD is 10 yrs old, we have noticed in the last couple of years that every time she has a cold or virus she struggles to shake it off and coughs incessantly for up to 2 weeks after. When she was very small a similar thing happened and we were told possible "atopic" asthma and given a brown inhaler to use. Which we still have.

Time hop back to last week, having picked up a cold at a birthday party the previous weekend, she was full of cold, snot etc going into the week, blowing her nose all the time, then the cough appeared.

On Wednesday she had sports day, (nightmare as she struggles with sport) when she came home the coughing accelerated and became so bad we reached for the inhaler. This seemed to help, she went in to school on Thursday and had a dreadful day, she had a full blown coughing attack, where she described not being able to breath and tight chest. I kept her off on Friday, saw the doctor where she said it could well be asthma. We were given, a brown & blue inhaler and the flow meter to monitor her until our appointment on 8th July, where they would give us an idea if she has asthma or not. All going well or so I thought!

Weekend not too bad, getting into routine of flow meter and morning/evening doses, wasn't too sure how bad it needed to be before giving the blue one.

Monday she goes into school with her new blue inhaler, doesn't use it as she thought it wasn't too bad, comes out in the afternoon, looking like death, the coughing was horrendous, we gave her a dose, got home and she deteriorated, constant coughing, chest tight, until I phoned 111, they got duty doc to phone and we had to make a dash to hospital, she had 10 doses of ventolin trying to get on top of things. By the time we arrived at hospital things had calmed down and she was much improved. She had so much ventolin that she then went hyper and it took me hours to get her settled, she then went into a massive deep sleep and wet the bed (something she has never done even as a small child) she was so mortified by this, it seems so awful for her to go through this.

They gave us 3 days of steroid tablets to take and upped our daily brown dose to 3 morning, 3 evening. We have an appointment to see the chest/asthma doc at our surgery tomorrow, but the coughing is still constant, just finished the steroids, I have no doubt judging by her flow rate it has helped but can't help feeling we are getting little improvement.

My questions are: How often should we be using the blue inhaler/maximum doses per day? How bad does the coughing etc need to get before using it? How long do these steroids take to work? What other things, other than medication can help?

I feel really useless at present, we are in no mans land with a diagnosis, I haven't a clue what I am doing but trying to wing it so as not to alarm DD, the only relief she gets is being in the shower with the steam but once out it is back to coughing. Poor love is so tired and to top it off she has a loose tummy today, probably from all the meds and I am feeling desperate!!!!!

I know the doctor can answer these questions, but I will forget half that I want to ask, will feel pressed for time and come away feeling a total failure!

Thank you for taking time to read this, I am sorry I have rambled on but at a loss how to help her.

[DottyGiraffe]

I think I would give a puff or two of blue every four hours for now, to keep it regular, then reduce/do less often as she settles. You can't overdose on ventolin, but it increases heart rate/shakiness. But better to keep on top of things at the moment than let the coughing take over.

If she's coughing and can't stop, I'd give inhaler then repeat if no change after say 20mins. If still no change I'd give more but also seek further advice as it may not be enough.

Once brown kicks in, her need for the blue should lessen and episodes on top of normal days should too.

[Toocold]

Is there anything you can think of that has made her react so badly? I ask as my daughter has really bad hay fever and can become asthmatic from it, I think once you find the triggers it will help, although it can take a long time to realise what they are, I'm asthmatic and its damp for me, whether it's in a room, pool or just the weather. The brown inhaler taken properly will help her, I really feel it if I miss a couple of doses, but on the other hand managed a half marathon last year so it isn't all doom. I hope she feels better soon.

[Labbiemum16]

Thank you Dotty & Toocold, I will do that with the blue inhaler, we are see the doc tomorrow morning and may get a better idea then

The trigger always seems to be getting a cold, which leads to this uncontrollable coughing. She does get a bit of hay fever but it hasn't been too bad this year. Perhaps the combo of the cold/pollen and sports day was too much as it has definitely been worse since.

I do feel a bit like a passenger at present and would like to be more proactive rather than reacting.

[Emptynestx2]

Like others have said, at present she needs to stabilise and then you will work out the dosage together with the dr. Well controlled asthma shouldn't require the blue inhaler but at the moment it's not controlled. Steroid tablets should work within 24hrs and the brown inhaler will take a few days. Try not to panic, you did the right thing to react and get her to hospital but hopefully you won't have to keep doing it.

My asthma was bad,y controlled when I was young which was my own fault as I hated the preventers, if she doesn't get on with the inhalers there are other options, diskhalers for one which work better for me but are more expensive. Keep going back if you're not happy or worried. Good luck

[Pooka]

Ds's trigger was and is getting a cold. But pollen can also trigger. He has daily antihistamine in summer and it seems to have held things at bay (touch wood).

[TinklyLittleLaugh]

FWIW my DS was pretty much like you describe your DD when he was ten. He's 22 now and hasn't had any symptoms since he was about 17.

Long term we did things like remove all carpets from our house, replace our son's curtains with blinds, get rid of soft toys and unescessary dust catching clutter.

Interestingly our GP suggested cutting out dairy, but 12 years ago we thought that was pretty faddy. A couple of years ago our DS developed a very obvious lactose intolerence, and would run to the loo after a sip of milk. We wonder if it may have been a factor all along.

[Labbiemum16]

Thank you emptynest, hoping to get some more answers and help today. I am sorry you struggled when you were young.

Will post an update

[CPtart]

Make sure she's using a spacer with her inhalers, at school too.

[Emptynestx2]

Hope you get some answers. Once I got the right treatment I have been very well thank you.

[Emptynestx2]

How did you get on today?

[LaContessaDiPlump]

Your poor DD - her experience would be called an asthma exacerbation, and a pretty significant one since she required systemic steroids afterwards. Poor thing.

All I can suggest is that HCPs need to look at how she uses her brown inhaler (maintenance therapy); excessive use of the blue inhaler (i.e. reliever therapy) generally implies that the brown one is either not suitable for the asthma sufferer, or isn't being applied properly/regularly enough. HCPs will talk to her about proper inhaler use so you can ensure she's getting maximum benefit from her current therapy, but if her problems persist after that then a new therapeutic approach may be needed.

You may want to Google GINA (Global Institute for Asthma) as they make the most widely accepted guidelines for asthma management and have materials you can download. I work on this area in my day job so am very happy to answer any queries you may have about terminology.

I hope you got some useful answers today!