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Children's health

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Asthma, steroids and severe nosebleeds in DS aged 11

5 replies

Middleoftheroad · 28/07/2017 11:17

Background:
DT1 is 11. He was diagnosed with asthma about 5 years ago. It comes on during a change in season (air humidity) and after a cold. If this happens I have always had to resort to steroids (Prednisolone) and inhalers.

He had always been 'wheezy' with a cold (his DT fine) as a younger child, but following a scary attack while we were on holiday a few years back, he attended an adthma clinic and was prescribed a brown and blue inhaler. Most of the time he is fine.

He has alwaya snored and had chronic nosebleeds. This is relevant.

He is tiny for his age (130cm and 4stoneish) compared with DT2, who's no giant, but has a good 10cm/stone on DT1.

We took all of his asthma, noesbleeds, v heavy snoring, to mean he has tiny airways and will grow out of it - trouble is he doesnt grow much.

This week both boys had a slight cold/cough. As usual, DT2 bounced back fine. DT1 developed a cough and had an asthma attack Tue.

Took him to GP to ask for Prednisolone. Previously the dissolvable tablets have been a golden bullet for us when colds have left him wheezy. we always kept a few back and have used them in desperate times as the only thing that works. Probably twice yearly.

The new doctor said they have stopped prescribing Prednisolone in the dissolvable tablets and that we can only get it in vials now. Doctor seemed a tad unsure and was looking up info on his computer.

We were prescribed 10 vials of it (5mg each). However pharmacist thought it was odd as he said they do prescribe the tablets still and also said 10 viles odd number. He ordered this new type in especially.

Anyway...DT1 had a couple of vials and perked up. Last night though he had the bloodiest longest nosebleed I've ever seen. It was quite disturbing and upsetting for him. This is a boy who is used to a couple of nosebleeds per week - sometimes quite heavy- but this was in a league of its own.

He's coughing and wheezing again today, but I'm scared this new type of Prednisolone is too powerful and worried of side effects. Not sure what to do.

OP posts:
DottyGiraffe · 28/07/2017 12:48

Can you see a different GP today? Or asthma nurse at the surgery? Might be worth it if they haven't worked as the tablets used to?

youlemming · 28/07/2017 15:10

Does the info with the steriods list nose bleeds as a side affect?
It does all sound a bit confusing and as above if you can get another appointment today it would be worth getting things checked out.

Has his nose been checked by ENT, if he has weak vessels that cause the bleeding is corterisation (?) something that can bee looked into.

I have asthma and have had inhalers since I was 4, I couldn't count the number of times I've ended up on steriods with it as a child but it has lessened as I've got older, and this weather at the moment is playing havoc with my chest, so i hope it all settles down for him soon.

Middleoftheroad · 28/07/2017 15:44

Thanks for the replies -sorry, been out and about but could not get appointment today.
The wheezing has eased a bit so am keeping close eye on him. Yes, nosebleeds are a side affect - it's just this last one required two adults to stem this time.

We are just moving surgeries funnily enough, so when we are seen at new surgery I will ask if he can see ENT specialist (we saw one years ago when his snoring was causing problems at night and I think that's where the narrlw airways came from).
Youlemming, sorry to hear your chest is playing up but glad your asthma has improved with age. I think there is sn assumption it's just exercise that can trigger asthma, so it's not everyday normally, but like you, changed in air, cold.

Re nosebleeds I would like him to have it corterised if posible. Even a simple plane journey is a nightmare for him or a simple knock to his nose. We don't buy expensive bedding!

OP posts:
IwillrunIwillfly · 29/07/2017 00:25

With regards the prednisaloneb that seems an odd dose. Were the 5 vials to be given all in one go? Normally it would be probably 30 to 40mg once a day for 3 days, so 10 vials of 5mg would be 50mg which is too much. Each of the soluble tablets is 5mg. Incase you struggle to get them again, the tablets they give to adults/kids who can swallow tablets (also 5mg per tablet) can be crushed and dissolved in a small amount of water.

If he's still wheezy are you multidosing him? (10 puffs of salbutamol using a spacer every 4 hours?) if you are and he's wheezy even with this you should get him seen again.

If youre finding youre having to use steriods multiple times a year, it doesnt sound like his asthma is totally under control akd he might need a different preventer etc. That combined with your concerns about him being small would make me think a referal to paediatrics might be useful.

nocoolnamesleft · 29/07/2017 22:40

Odd. If the soluble prednisolone tablets had a supply issue, I'd have expected a very urgent email from our chief pharmacist, as we use a lot of them. Not aware of any supply problems at all.

Sounds like ENT referral would be useful.

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