Can someone fill me in on the 'brown inhaler' thing please?

[WilfSell]

DS been checked out for lots of things. Including night cough. Has been vv unwell lately and doctors don't really know what's wrong (except of course implying we have AnxiousParentItisWithTooMuchGooglingTime ) Anyhow, blood tests came back all normal.

So what they think is lots and lots of viruses but perhaps with underlying asthma.

He has had a night cough since a baby. But so did his older brother who completely grew out of it (no evidence of cough for years now)

So today they send us home from hosp with blue and brown inhaler, tell us to try both for two weeks and see if he is better.

I am still in denial perhaps. I don't want him to have asthma. I still believe he will grow out of it.

so would be grateful to hear from MN asthma experts about pros and cons of the steroid treatment, whether I should think about other things, whether there is recent research I could read etc..

Thanks.

He may well grow out of it - but letting him have the brown inhaler in the meantime will help him feel better now

There is a type of breathing which can help - I don't know the name - but someone will pop in with it fairly soon (they normally do)

When DD takes her higher dose inhaler she gets better quicker & gets ill less often than when she takes her lower dose (hers are purple tho')

Thanks katymac.

I'm also a bit confused about the advice they gave. The Dr said do it for two weeks and see. The children's nurse said it wouldn't have any effect unless given consistently for 6 weeks. I'm a bit befuddled by this. Any ideas?

Isthe brown one called becotide or something similar?
It's the preventative steroid one iirc
It can work within 4 days but its accrued and repeated use increases its effectiveness..
Now my asthma dates back 25 years but...

The blue inhaler will show short term affects (effects?)

The brow longer term ones

But I think & I could be wrong if the blue doesn't help at all, the brown isn't likely to do much better

So if you have a bit of improvement short term - the chances are that you will have more improvement longer term

If that makes sense?

The blue should make things a bit more comfy & the brown make it a bit better

Don't be surprised if the brown one gets replaced with a different colour one (between my day, DH & DD I have seen nearly every colour of inhaler - actually no yellow ones)

DD went on to a tablet recently which made things much better

Has the asthma nurse discussed Peak Flows or is your DS too young?

Blue inhaler is "reliever", relieves symptoms such as wheeze, breathlessness, cough, kicks in quickly and wears off quickly, so usual advice is to use as required.

Brown inhaler is inhaled steroid, this reduces airway inflammation and does not give instant results, takes about 2 weeks to start working and several weeks for full effect.

Both probably worth a trial. Do not worry about steroid side effects as inhaled steroid in doses as prescribed (typically 2puffs 2x/day) do not affect the rest of the body. Are you using any kind of spacer ie Volumatic or Aerochamber - big plastic things to make it easier for children to use inhalers properly? How old is DS?

if you have the 50mcg light brown coloured inhaler, then it is a tiny tiny dose, and one or two puffs are just enough to strengthen and improve your lo's sticky lungs, and it is very easy to reduce and remove later on. Yes he is quite likely to grow out of it, most do, but imho the inhalers are fine and they really do stop the poor little things coughing all night and therefore feeling permanently tired.
Sorry if that isn't what you wanted to hear... I have to say that 5 yrs ago with a wheezing baby i stood exactly where you do, but now - and with two asthmatic dc along the way, I understand how they work and know that i have one "winter wheezer" and the other who is worse in summer because of her allergies; I also know that at 3yrs and 5yrs we manage the symptoms etc with the inhalers when they are needed and reduce them - usually getting off them completely in their "good season".
Your child should have regular reviews at the hospital with the paediatrician - my dc do; you really need to understand that inhalers aren't a one way street.
HTH.

The brown inhaler will help any inflammation of the lungs (ie. the cause of the asthma) - so if the asthma is at steady state, then you wouldn't see an effect until using it for a while (hence what the nurse said) - its a longer term preventive measure. However if he's had lots of infection lately, then he's in an inflammed state rather than a steady state, so you should see an effect after a day or two.

The blue one will give immediate relief but effect will only last 4-6 hours.

Gosh, that's all really helpful: thanks. I am thinking ohmigod we're on some kind of slippery slope here. So good to hear things can change.

BTW he's had the blue inhaler for years. He's 4 now. But because he has never officially been diagnosed with asthma, we have never had any detailed advice about it.

So we blithely carried on giving one or two puffs of salbutamol at a time. Was utterly shocked today then to see the nurse giving 10 puffs! No wonder, perhaps, that we perceived it as making no difference... Who do we discuss the idea of 'regular reviews' with? The GP? Or a specialist asthma clinic? The Paeds told us to make an appt with GP for 2 weeks hence to review the Beconwhatever inhaler...

He does have a spacer and is very good at using it.

the steroid dose of the brown inhaler is very localized, affects lungs only, so not like taking oral steroids. Glad he has a spacer. I had asthma as a child and milder as an adult - one thing that really h elps is a dehumidifier - one with an air purifier - i think really worth investing in one in this country. Other things are dustmite proof bedding covers and no carpets [not always practical obviously]
Hope you get to the bottom of it.

Ah. He already has lino with roads printed on it. Some carpets elsewhere though.

We do have lots of damp (metal single glazed windows) and sometimes mould. Perhaps it is time to tackle this (we only moved here last year - he coughed before though).

i would say that could be a key exacerbating ingredient. Look into an air purifier/de-humidifier if you can.

I will look into it: thanks, I really appreciate the advice. Doubtless I will be stalking you for more

Tackling the damp/mould will make a massive difference

Also the 10 puff of blue was because of a bad attack/crisis - it isn't a 'normal' or 'routine' dose, so carry on with your one or two puffs unless told otherwise

[preens self at having acquired personal stalker]

Some great advice on here - I felt same as you when DS first got his inhalers - horrified that he had asthma, and more horrified I didn't know he did despite months of night coughing.

I just wanted to add that my DS has asthma that is brought on by colds and viruses. We manage with 2 puffs twice a day on the brown inhaler only, then when he has a cold he will always need the blue inhaler a few times (always seems to go to his lungs). As soon as he is better blue inhaler not necessary. I just wanted to add this because getting rid of carpets or mould and having dehumidifiers is of no help to this type of asthma apparently. Don't go spending money on anything until you know what the triggers are...

is that what the paed told you ksld? That getting rid of mould/damp air would not affect your ds at all? Even if your ds's asthma is triggered by viruses i am extremely surprised by that - mould and damp air is bad for anybody's lungs [though pervasive in the UK, not trying to make you feel bad Wilf]

I have two DCs with asthma, both of them had it chronically as small children. They are classed as 'brittle' asthmatics which means they can go from very well to very ill in a very short space of time. DS has also had two bouts of silent asthma where his lungs just shut down and there was no wheeze, no cough nothing excpet his skin being grey and him being limp. Both children became swimmiers as their lovely consultant advised us that it would help them to learn to breathe fully (most of us only use one third of our lung capacity, for asthmatics it's important to use all of the lungs).

They've had long spells of very high dose inhaled and oral steroids with many hospital stays.

Over the years we found the best way to manage their conditions was to be religious about their meds regimes. Ds now never needs a preventer inhaler and only uses his reliever about once or twice a month. DD had a really good spell for a few years where she was able to manage her asthma with just a blue inhaler but last year it came back. She's now on Symbicort and a tablet called Singulair (Montelukast) and her condition is back under control.

Asthma has never held them back. DD is our County record holder for 400m, 800m and 1500m freestyle. She has also competed at National level in triathlon.

I woudl encourage you to use the steroid inhaler. DD has restricted growth due to her poorly controlled asthma. I know she would also adavcate the use of the inhaler.

10 puffs of a blue inhaler won't do any damage to a child, they can take a whole tube and the only side effect is likely to be an increased heart rate. The reason they tell you no more than 2x2 puffs in any 4 hour period is because IF you go on to need nebulzing the nebulizer will be less effective the more blue inhaler you've taken. Needing to take more and more blue inhaler is an indicator that he would need to be seen by a doctor.