Any parents with asthma kids? Advice please?

[monkeyallen6]

Dd is 4. Earlier this year she had a nasty viral infection and cough which made her breathing laboured. I took her to a&e where she was given nebulisers. This cleared her chest quickly and we were given a blue inhaler to bring home which she hasn’t really needed since.

A few weeks ago she developed another cough. She wasn’t unwell with this one at all but the cough has now lingered beyond 3-4 weeks so I took her back to the GP who said her chest was clear but gave her a brown inhaler to have one puff per morning while the cough is still present. This doesn’t seem to have helped much but again, she is perfectly happy and well in herself. Just a chesty cough especially in the mornings.

Her dad has lifelong asthma and she is also prone to eczema and allergies like hay fever which I know all go hand in hand. If she does have asthma is there anything else I need to be doing? I am worried with winter bugs approaching as the doctor said she is likely to be more vulnerable to them. She also starts school this week and I’m wondering if I need to send her blue inhaler with her even though she very rarely needs it.

Any advice?

Hi op, my dc was diagnosed with asthma recently and had the same symptoms you have described.
If I’m completely honest, the blue inhaler doesn’t help a great deal. What I found with my dc is that I helped there and then but even a hour later they could feel like they needed it again.

Can you request a FeNO test at the doctors surgery? It’s so quick and your child will breath into a tube and it can measure the inflammation in your airways. Over a certain score and asthma is more likely.

Dc has since been on a combination inhaler daily which helps a lot. There are still odd occasions they need an extra puff but it is a preventer as well as a reliever.

Take brown inhaler everyday as instructed. Blue inhaler should go everywhere she goes. Did they give her a spacer to take it with?

Also definitely inform the school. I’d let her take the blue inhaler there if that’s all you have as it will help if needed.

Definitely make sure you have a spacer. My son has asthma, diagnosed after a life threatening attack. If she is coughing, we were told increase use of blue. We also have 2 brown in the morning and 2 at night, along with a antihistamine. Do you have a wheeze plan? The asthma nurse details should be on that.

She has a spacer yes. No plan and no formal diagnosis yet so I’m a bit clueless. She rarely needs the blue one but the brown one doesn’t seem to be doing much (it has only been 4 days of morning puffs though).

To add, when we left the hospital the advice they gave me was the administer two puffs of the blue inhaler every 10 minutes for up to an hour if her breathing ever got bad again. If it didn’t improve after the hour to take her to hospital. The brown one has been given more recently following the recent (but non serious) cough. She’s never needed more than two puffs at a time of the blue inhaler and even that has been rare.

The brown inhaler takes a while to build up, four days is nothing. I thought one puff twice daily was the minimum but perhaps for very young DC it is different.

There is a possibility that in the absence of a diagnosis DD is getting halfway measures, so I would push on that. She defo needs a rescue inhaler at school.

However there is a move towards combi inhalers (preventer and reliever) that @HappyLittleCrow mentioned. Our GP surgery is switching most patients over, our asthma nurse has had her own DC switched, etc. I love it. No spacer is needed: The powder collects in a little reservoir and you inhale it when you are ready. Much easier.

My new inhaler is red as I think most of the combination inhalers are.

Best wishes to DD.

DS is 5 and he used to suffer badly from wheezing whenever he had a virus (his 2 year old brother is even worse so I live in constant fear of germs and bugs…).

For DS5, the brown inhaler was a game changer in how it prevented these attacks, hence why I say he used to get them. He has one puff twice a day in the colder months and it made a huge difference for him so definitely keep that up as you go into winter (unfortunately DS2 hasn’t had the same response so that’s a whole other issue we’re dealing with). The current plan for us, under a consultant’s guidance, is to keep it going with the brown inhaler through winter and stop next summer altogether to see if he still needs it when he’s bigger.

In terms of the blue inhaler, when he started reception last year I had no intention of sending it to school as the episodes were only caused by respiratory viruses so I figured I would send it in when he had a cold. But as I mentioned it on the medical form, the school asked for one for him with instructions so for the whole year they kept the blue inhaler, a spacer and a set of instructions I had typed out in a small case.

Thank for this advice I will contact the school and make them aware and see what they advise. Like pp the blue one is only something she uses when she has wheezing usually brought on by a viral bug. But if it is safer for her to have it as a precaution I will of course send it in.

Im also concerned about the length of time this current cough is lingering. She is not unwell at all but the chesty cough has been present for almost 4 weeks on and off. Her chest is clear and so is her throat and ears. The GP tested her oxygen levels last Thursday and they were also good. Maybe this is just something she will struggle to shake off if she is indeed asthmatic.

Yes I also think that’s right re the one puff twice a day. Depends on the dosage but as DS5 got older and responded well to the brown, I asked the consultant if he can do just one puff in the morning and she said something about the life of the inhaler being only half a day so he needs a puff twice a day as otherwise it’s pointless.

But that’s assuming it’s the same drug - I’m talking about clenil modulite here.

I think the whole family of drugs work similarly. My red inhaler also requires one puff twice daily to maintain the preventative aspect.

As a lifelong sufferer of asthma- yes, blue inhaler should go to school. To save the faff of having to retrieve it constantly from the office - get another prescribed- also ask if they have emergency ones in the medical kit just in case. The brown one- takes a while to build up in the system but does work in reducing the amount of attacks. How the hospital told you to use the blue inhaler is how you should use it- I believe 11/12 puffs in quick succession is equivalent to a nebuliser. If she needs more than that, she needs to go to a&e. (There is argument (by my gp) that calling an ambulance and being treated in the home is also an option- so you’ll have to way up taking her yourself to a&e or calling ambulance and removing one from the streets, my doctor told me to call the ambulance, I’d rather go to hospital so I can be treated quickly and get out of everyone’s way - no one has given me a definitive answer as to which is most cost and time efficient due the nhs!)
Ask for allergy tests. Do you have a peak flow meter at home? Dr can prescribe your daughter one. Worth keeping a record of when she is ok and when she is bad so you can gauge what to do. Also, as a teen, I used to find I would forget my blue inhaler all the time, so came up with strategies to help ease my asthma attacks if I had one out and about (my asthma was not well managed!) - an ice cold still drink helps me, I met a lady on a train who found hot tea worked for her. Also breathing through a cold wet flannel also helps me. Sleeping in semi sitting position helps at night, not flat, v pillows great for this.

Google how to make a makeshift spacer out of a plastic bottle or paper/plastic cup, weirdly I have rarely used a spacer because they weren’t a thing eons ago. I have had to make myself a spacer once in my life for me, and once in my life for someone else. Having that knowledge will stop you being in a spin if you inadvertently forget to take it with you, because from what I’ve seen, they are cumbersome.

Ask for an asthma nurse appointment.

They’re the best people for coming up with plans.

Go back to your GP for a written personal asthma plan, that describes current treatment and the escalation plan.
read up on asthma and lung UK website.
get regular reviews with GP
current treatment not fully managing symptoms it sounds like (she coughs in the mornings) so treatment needs to be reviewed. Is she having water after brown inhaler to rinse the dry out of her throat and mouth ? Ensure bedroom is dust-free (no carpets curtains piles of soft toys) no damp/mould. do you have cats ? Cat dander common trigger. Ensure they’re never around smokers and smoke.
if GP in doubt they should refer to paeds.
school should have blue inhaler and spacer for emergency use
https://www.asthmaandlung.org.uk/support-parents-carers

As previous people said, the brown one has to be taken every day and builds up over time. It an take weeks for it to become effective so don't worry about it not making a difference yet.

I used to follow a similar pattern to your daughter - I'm fine until I get a cold and then it turns into a lingering cough. Taking the brown one stopped that. That's why you must persist with the brown inhaler as she will feel like she doesn't need it but then when she does, she won't have the inbuilt protection that the brown one gives her if she hasn't been taking it consistently.

I think what confuses me if that there is diagnosis yet. The GP said that they are reluctant to diagnose in young dc as lots of them show asthmatic type symptoms which they then grow out of. Given that dd dad has it I think it’s more likely that this could be ongoing with her so I guess all I can do is keep an eye on her and insist on an asthma plan should she have difficulties again. Prior to this virus earlier on in the year she’d never used an inhaler so it’s odd how severely it came on but thankfully we haven’t had anything quite so serious since then.