asthma newbie-ish

[JJ]

My youngest has just had his first asthma attack and I have a few questions. But first...

he's on 20 mg prednisolone for the next 3 days, salbutamol 4 puffs 4x/day and the brown inhaler (forget the name and am too lazy to go look) 4 puffs 2x / day as well as reg doses of Piriton. His brother has food allergies and we've run the gamut of reactions for him, which is why asthma-boy isn't in hospital now (I know his doctor well and we've been through a lot together). But eldest son's reactions are/were (hope the latter) usually allergic; his asthma is mild (except the once when a dog shook by him after getting wet.....).

Now for the questions:

• he has a spacer for the puffer - can I put 4 puffs in at once or do I need to do them one at a time?
• in winter we use a humidifier for colds, etc with Olbas oil or similar - would this help/harm now?
• if he gets really bad and can't breathe, will an epipen help (we have masses here) or not? (note: the one time a doctor called me just to yell at me was the dog incident above where I didn't give my other son the epipen)
• any fave hospitals with paed A&Es in London? my docs recommendation is Queen Charlotte's, but would like anyone else's experiences.

Thanks in advance. I'm not looking for official recommendations and 'best practice' - have looked at all that and know it wouldn't work for our situation sometimes (speaking about eldest, now). There's such a variety of reactions and ways to deal with them! Would just really appreciate hearing anything you do with yours in my situation.

bump and also...

I'm keeping my son off of school (nursery) while he's on the oral steroids as we've had really awful illnesses when my eldest was on them for allergic reactions. (When he's sick he has more reactions, so it can be a very vicious cycle.)

What do you do? I'll still keep him off - his nursery is great and will be ok with whatever - but would like to hear opinions, esp about next year.

Hi JJ, I'm speaking from my own experience here, was diagnosed age 7.

spacer - 1 puff at a time, time consuming I know, but thats how it has to be done.

not sure about the humidifier, it depends onwhat sets him off, but of course you won't know that yet. Things like Olbas always help me to keep things a little clearer. I would think it would be ok, but obviously keep a close eye.

can't help with the other 2 q's sorry, what is an epipen?

the doses of salbutamol & becotide sound very high to me. Is this temporary until prednisolone course finished? My doses only go up this high when asthma is bad, and mine is quite severe. The norm is 2puffs. I would def check this. If this is the right dosage, see if you can get the stronger inhalers to take it down to 2puffs instead of 4. The reason for this is that if it does get bad, on 2puffs you can double up for a few days, but you can't on 4 puffs.

HTH

Thanks GarfieldsGirl. The doses are very high until he's a bit better and then will go lower - we're supposed to lower his salbutamol when he gets a bit better over the next couple of days then his doctor and I will discuss the becotide on Monday (knowing her it will be one puff/day as maintenence and hopefully salbutamol as and when). He's quite severe atm and I think if I had gone to a different doctor we'd be in hospital (not complaining - quite the opposite).

Thanks so much for the one puff at a time info - I want this to work and really appreciate the advice. I'll try the Olbas when he's mildly under the weather rather than now. Tis good to know it's not a cure-all.

Epipens are single shots of epinephrine (adrenaline) used for allergic reactions. They're magic for my eldest when he has a reaction, but am not sure what they do against 'normal' asthma.

Thanks again - can't tell you how much I appreciate it!

no don't try the epipen - it's only for allergic reactions and if your son isn't suffering one, I can't see how it would help? in fact, it may harm him (doesn't it make your heart beat very fast if you are not suffering a reaction?). I'm not medical though so perhaps ask your doc.

We have only seen paeds at Chelsea and Westminster and Kingston and we were impressed with both places.

actually just found something on the web that says it can help with asthma (what do I know!!) but I certainly wouldn't use it without speaking to doctors to check that you could/should use it in a severe asthma attack!

Hi JJ,My ds has asthma and has been on oral prednisolone quite a few times,the doses you mention sound similar to my ds's when he is going through an acute phase,except his steroid(brown) inhaler is 2puffs twice a day.
My ds has an epipen for food allergies ,I have never been told to use it other than for a reaction to food,which for him is nuts and eggs.I have once been unsure if he's having an asthma attack or an allergic reaction .That episode we rushed him to a&e and he didn't need it,he didn't have any other food symptoms like rash .I don't think the epipen will help an asthma attack in an emergency but I could be wrong,I'd check with the asthma nurse .
I haven't used a humidifier but I occassionaly use olbas oil when he's stuffed up with no harm.

I don't live in London so can't help there.

Thanks for the advice! Foxinsocks, am not worried about contraindications with the epipen at all (there are none with my youngest), just wondered if they'd have an effect with him. And I'll talk to the doctor about it, promise. Defending myself a bit - subcutaneous epinephrine in the er is very painful and stressful; we've had this before with my eldest - should've used the epipen!

ggirl, thanks for the info on doses. It really helps to know what other people are prescribed.