5 year old with asthma

[ButterflySkies]

Hello, first time posting in health and about this but after some advice on what I should be asking for from peads/GP.

My daughter has asthma, and over the last month has also had frank blood in her urine with pain and vomiting, followed by three UTIs each needing different abx to treat. She’s been referred for bloods and a scan for this, and we are sending another urine sample when she is off abx. Throat and ear infection needing abx, chest infection needing abx. She had a 5 day course of steroids around a month ago as her hayfever kicked in, and we stepped up her asthma plan. Poor love started steroids for wheeze last Friday which didnt work and she ended up on back to back nebulisers on Weds. She’s home and they’ve covered with abx just in case but it looks likely it’s just asthma/wheeze. She needed the nebuliser straight away so they didnt xray.

She may have just been unlucky this month but she takes montelukast, seretide (purple inhaler), two antihistamines and blue inhaler as needed. We are militant about inhaler technique and not missing dozes. Her school attendance is about 70% and ive had to collect an additional 22 times on top - id say around 15 are for wheeze (a handful of appointments and the other illnesses in there).

I think her triggers are well managed at home but I think the school environment is a trigger - she has hayfever, cant cope in humidity or damp weather, does occasionally wheeze with illness, and we suspect is allergic to dust/dustmites.

i just wondered if anyone had experience of similar and had any advice on what I can ask her consultant or GP for in terms of prevention. Her attack this week was silent, after 5 days of steroids, and severe despite the preventatives. She is nowhere near as bad as she was, but is continuing to slightly belly breathe and sound slightly breathless. Im planning on taking her back to the GP today - she’s not bad enough to need hospital but will of course go if they recommend. And they’re trying to find space with her consultant in the next two weeks.

thank you x

Firstly if she still sounds breathless and is belly breathing, doesn't that align with the NHS advice about when to go to A&E? (it says to call 999 if you: do not feel better after taking the maximum dose using an asthma reliever inhaler )

Thanks - i had her checked in CAU yesterday with the same symptoms as today who were very thorough said she is working hard but her chest isnt tight and her wheeze is slight. They won’t amend her current weaning salbutamol plan for her current level of exertion and she doesn’t need a nebuliser, and they have no space to admit for monitoring so the message from the hospital is return if she worsens. We live 5 mins away and i obviously wouldnt risk it if she was deteriorating. On Weds she was belly breathing at rest and couldnt speak, her breathing is way more relaxed at rest, this is with light activity. Im comfortable with how and when to get emergency care and will have her reviewed by the respiratory lead at the GP as soon as i can today, it’s long term how we prevent this happening is my question.
just for reassurance in the lead up to Weds on nebulisers id seen a dr/CAU daily with her and they said they were very comfortable we can spot her emergency signs