Asthma or panic attack? Inhaler use

[NearlySchoolTimeAgain]

DS got prescribed a blue inhaler for cold weather sports induced asthma a couple of years ago.

Since moving his asthma worsened and he now has a steroid inhaler as well.

However we have periods where the steroid inhaler doesn’t work so well to control his blue inhaler use. Sometimes this correlates with an increase in local pollution. Sometimes for a few days after a missed dose. Then he uses the blue inhaler more.

He often feels breathless in the mornings walking downstairs and sometimes takes the blue inhaler then. A few minutes rest can sort that out as well.

My main concern is that he’s taking it sometimes when he feels breathless but I think that’s induced by stress / panic. For example he described a situation in school today which worried him so felt breathless and used his inhaler.

Is that OK? Could the blue inhaler be harmful if it’s a panic attack? I think the physiological response for a panic attack could still be the same as an asthma attack so it might help? I think we’re going to have to go back for a review if the mornings don’t improve as I don’t think he should feel so bad so regularly if the steroid inhaler is working?

This is all a bit complicated and I don’t think I’m dealing with it properly. 😨

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The blue inhaler won’t be harmful if it’s a panic attack. Though stress can be an asthma trigger for some people so it could be that a worrying situation is triggering his asthma.

You’re right to think he needs a review, if he’s using the blue inhaler a lot he may need a different dose of his preventer.

Have they given you a peak flow meter to use at home? Ask for one if you haven’t got one, it’ll help you keep an eye on things.

My son trundled along barely ever needing his inhaler and often forgot it when he went anywhere. He then had a period where his asthma was just awful which started about 2.5 years ago and he had several hospital attendances, ambulances called to school, the works. This coincided with him developing allergies and having anaphylactic reactions to something- we don’t know what. He was advised to up his steroid inhaler etc etc and started on montelukast which is supposed to help with the allergies.
He often had panic attacks too which would trigger asthma attacks. We put this down to the fear he got each time he started getting short of breath because his face would swell up each time he had an attack.
Touch wood, he has improved now and things are considerably more settled. Coincidentally, he has also grown over a foot in height and we wondered if the massive growth spurts were anything to do with it. The Drs thought it was perhaps a possibility but we will never know. He is over 6’ tall and very slight.

Thankyou for replying Gibble.

The paediatrician who prescribed the steroid inhaler said that his asthma was allergic asthma and that although we could have tests to diagnose what it was, it wouldn’t make any difference to the treatment. He mentioned montelukast last time we saw him as well. I’ll read up on what that is.

Coincidentally my DS is also growing very quickly at the moment - which has resulted in Osgood Schlatter disease and some back pain as he has scoliosis too. :(

Maybe the panic is triggering an asthma attack? I’m not sure how to tell the difference. They feel the same to him symptom wise but he estimates that 10% of his inhaler use comes after panicking.

His asthma attacks don’t look like I would expect them to. So at school he just withdraws and goes to the toilet without telling anyone. It scares me. :(

Is his scoliosis curve big? Scoliosis can affect asthma/lung function if it’s a severe curve.

I take montelukast daily for my asthma, have done since I was a kid (also have scoliosis) and it reduces the inflammation in the lungs and bronchial tubes so it becomes easier to breathe but it’s a gradual type of med.

Asthma.org do a good job of describing the difference between a panic attack and an asthma attack
Here’s the link: www.asthma.org.uk/advice/manage-your-asthma/emotional-support/anxiety/

I don’t know what big is TBH. It’s never been picked up before so I’m not sure if it’s the result of his quick growth. Or maybe a connective tissue problem (that was what the paed suggested as he’s got hyper mobility). Or maybe a really switched on paed who’s taking more time to look at him as a whole spotting something that’s been there a while?

I’ll read that link Thankyou :)

Both theories seem possible so it may be one or the other or both. 'Big' curves tend to be around 50 degrees ish or more but they're usually very obvious.

It sounds like you have a great paeds!

He is absolutely amazing. He’s picked up a couple of issues that haven’t ever been mentioned before (considering he’s got multiple health conditions so has been under various paed consultants since before birth!). We’re abroad and there seems to be more of an emphasis on holistic care here. Kids see a paediatrician rather than a GP until they’re 14.

I went through the two checklists with him and he feels he ticks all the boxes. Except peak flow as ours got lost in the move. I must get another one.