Any asthma "experts" about?

[JillCrewesmum]

Dd2 suffered quite badly with asthma about 5 years ago. Over the years it's been very well controlled and negligible. In the last week its got worse. She's using her blue inhaler roughly four times a day. I'm going to ring the GP in the morning - she's well and happy - would you say a brown inhaler is what she needs?

All children with asthma should be on an Inhaled Corticosteroid (ICS). Like the brown inhaler.
If blue inhaler is being used more than 3 times a week then asthma is poorly controlled, needs review and additional/change in inhalers.
What are her triggers? Allergies, illness, exercise? Do you have a peak flow meter and if so do you use it?

If she has been well controlled for years, has she got a virus/chest infection?
How old is she?

Not an expert, but I spent 8 weeks working with a respiratory lead nurse recently and we did a lot of asthma management.

No we don't. We'd almost forgotten about it tbh it's been so long since she's needed it, we've just made sure we always have a couple of up to date blue inhalers. She seems to have dropped off the asthma review system as well. More than three times a week? I'm worried now.

Go and see your doctor. I’m not an expert but I do have asthma and use a brown inhaler twice a day. Unless I have a cold / chest infection then I don’t have to use my blue one at all.

She's 15. She doesn't feel ill at all, no chest infection. No allergies as far as I know, although we are very rural and often have lots of crops nearby. We have maize right next to the house and it's very high - can you be triggered by maize??!

She needs an asthma review, your GP practice should have someone who can do it.
Make an appointment asap.

We have a dedicated Asthma nurse at our doctors, they are the best to see as they are kept up to date with the latest medication.
See if your practice has one!

She should still be on your surgery's QOF register and should be called for an annual review. Obviously this hasn't happened, so ask about it when you go. ICS is recommended for all children with asthma regardless of symptoms as it prevents long term damage from inflammation in the lungs. Dosage can be stepped up and down depending on symptoms and eg if suffering hayfever then up it at that time of year or when likely to get winter colds etc.
Your surgery's asthma nurse should be able to sort it all out for you and provide a written asthma management plan.

For reference the emergency asthma attack protocol is 10 puffs of blue inhaler, then if attack doesn't subside call 999 and after 10 minutes you may take another 10 puffs. Obviously stop of improved. Can cause lightheadedness short term but better to be able to breathe.
Unlikely she will have an actual attack, but this is the advice you will be given during annual reviews.

May be dust from the maize, everyone has different triggers. Dr/nurse will be able to talk you through it all. Best of luck.

Thanks so much, great advice. I've given her a piroton incase it's an allergy

Good idea. Though it may be the irritation of dust particles rather than an allergy, but worth a try as it's often hard to pinpoint a trigger.

I am just 40 and have had asthma since I was 7. I have always had a preventer (I now have two) but I have used my blue inhaler daily, if not multiple times daily. Some days are worse than others.

I find my peak flow a better guide - for me, anything under 550 is cause for concern, I usually need steroids at about 520/530. My normal peak flow is about 600-620.

Do you have a peak flow meter? Have you ever used it for readings?

If she's using her blue four times a day, then she does need to see someone tomorrow. If you can't get her in with the asthma nurse or a GP at your surgery, then you might need to see if you can get her an appointment with OOH or a walk in centre.

Not an asthma expert but long time asthmatic. The quick changes in weather could be causing a flare up, I've always had an exacerbation when the weather changes and this week I've had to go to docs for steroids. Feel fine otherwise it's just a tightness in my chest.

Good thinking on the piraton incase it is an allergy.

Definitely need a GP/asthma nurse and review.

It's always handy to know your/your child's normal peak flow when well so it can be done and you can see how much it has gone down by.

Good shout on the weather idea, gilmoregal I’m off to the GP for steroids tomorrow, hadn’t thought that the weather might be the issue.

DS2 has been coughing a lot more in the last few days. I think the weather is a factor as he's a lot less well generally in autumn and winter.

If she is having to use her blue inhaler that much then her asthma is not under control. See the GP asap and I would also ask for a referral to the hospital. I would also discuss using a different inhaler such as Seretide or Symbicort that includes both a steroid (preventative) and reliever and which you use everyday. This works much better and gives better cotrol of the asthma for most people but GP's aren't keen on prescribing them as they are more expensive than the brown and blue inhaler combo.

How did you get on OP.

She has a brown preventer, a peak flow (hers wasn't great) and a prescription for prednisone in case things get really bad. She's still wheezy but much better than she was.

Glad that your DD's been seen & has a preventer inhaler plus emergency steroids in case she needs them.

Very much recommend that you make use of the resources provided by Asthma UK - they've a nurse-staffed helpline (they have a WhatsApp version now too, apparently...) & produce a range of written resources that you (& your DD) might find useful.

It's really important that your DD has a written asthma management plan to follow; & it should be reviewed & updated by the person responsible for overseeing her asthma care (for most people this is their practice nurse) on an annual basis. Obviously plans should also be reviewed & if necessary updated if there are any acute issues! My asthma is hospital-managed, but I still have an annual review at the practice to ensure that they are clear on what my current treatment plan is & so that they can get their funding for ticking that box.

As you'll see ifwhen you check out the Asthma UK site, it's very common for children with asthma to experience an increase in symptoms at this time of year. It's also known that hormones can impact on asthma control for some women, so it might be your DD's hit a point in puberty where that's become an issue.

I hope that your DD feels better soon: grumpy lungs are a miserable thing to be trying to negotiate with; & if you're exhausting yourself just breathing, it's tricky to cope with things like school...