Wheezy - would you go back to the brown inhaler?

[Grammaticus]

DS1 is ten and was given a brown preventer inhaler when he was five, following a night time attack when he was very short of breath. He has had a very low daily dose of it since then and been monitored by the asthma nurse at our GP practice. He has needed his blue inhaler only on a handful of occasions each year. He has never had another attack of the first sort.

We have never managed to get him off the brown inhaler because each time we have tried he has developed a persistent "her-hum" sort of cough and we have put the dose back up.

He also suffers from hayfever, as do I.

A month ago we took him off the brown inhaler. His peak flow was 200 - 220 when he was on it, and has remained at that level since we stopped.

He now has a cold, a mild but frequent cough and a wheeze (which is unusual for him). His peak flow is 210. He has used the blue inhaler but is still wheezy, though coughing less.

What would you guys do?? Do I restart the brown inhaler or hold out and hope that the cold will pass and he will remain inhaler-free?

restart the brown one if this is what he needs now. You can reduce it once he's feeling better.

I think it takes a few days to build up on his system though - and a few days should see the end of the cold, shouldn't it?

He's still got the cold, still coughing (now frequently) but his peak flow is still ok. And I'm still not sure what to do!

I would keep going with it. Both DSs are quite wheezy at moment - poss something in the air at this time of year, so we are stepping up the (in our case) orange and purple inhalers.

I feel fine about using them fairly constantly.

I would put him back on the preventer and go and speak to your asthma nurse or GP for advice.

Yes, go back on brown inhaler. IME, the times I feel worst about my own asthma are when I think, "Oh I wish I'd upped the dose a few days ago."

I am having a rubbish asthmatic time atm owing to a cold that won't go away - don't let it get away from you; get control with brown inhaler.

Why did you take him off his preventer? Was that on medical advice?

IME the preventer is the most important one to keep on - so that you don't get to the stage of needing the blue one.

You need to talk this through with the doctor or nurse who is managing his asthma.

FWIW I always upped the dose of the preventer whenever my ds had a cold - if I didn't, he would always get wheezy.

It was on advice, yes. As long as the peak flow remained steady the nurse was ok with us taking him off it.

The brown preventer always meant that there was no need for the blue reliever, and no symptoms - to the extent that I wondered whether he needed the preventer, IYSWIM. So after 5 years I took him off it!

Today he still has the cough, but no wheeze. Peak flow still ok, as I said above. I guess I'm just not sure what are the symptoms that point to a preventer inhaler and what is a cold that will pass. Non-asthmatics get coughs and wheezes, after all.

I would restart the brown if you are concerned at all

Excuse me, Grammaticus, may I hijack this group of asthma-knowlegeable MNers for a moment?

DD is 2.5. She is often snotty and has had coughs in the past which I (and GP) have decreed to be of the snot-down-the-throat variety. However, she has now developed a cough which gets worse when she gets wound up, and at night.

When she was lying on top of me coughing the other night at 2am I heard a distinct wheeze. I fetched ventolin (mine) and inhaler mask/chamber thing (prescribed but never used for DS when he had a chest infection) and dosed her up - 30 seconds later she was asleep and didn't stir or cough for the rest of the night.

Now, I am going to take her to the GP, I promise, but in your collective opinion does this mean she is definitely asthmatic? I am, DH is not, DS is not, but I was not diagnosed until I was 13 so have no memories/experience of childhood asthma.... and if DD is, is there any alternative to pinning her down and holding the mask on her ?

serves me right for hijacking

At 2 1/2 it's hard to diagnose asthma, cos kids can't do a peak flow. and some younger kids get wheezy with colds and grow out of it, which shouldn't be classed as asthma.

There's not much alternative to the inhaler and mask, a liquid salbutamol exists, but it's not recommended these days. try to make it fun/part of bedtime routine, and the mask doesn't have to be pushed hard onto her face, just next to it.

Does anyone smoke in your family? even if you smoke outside, not near your kids and not in the house, it can still make any wheeze worse....

HTH, cass.

If he has a cold he needs 4 hourly salbutamol, and may well need the brown one too, but check with the asthma nurse first.

It may be that he needs an asthma review, as things do change over time.

Thanks, Cass - I will take her to the GP, even though the cough and wheeze seem to be receding for the moment. Apparently DH managed to get her to volunteer to use the mask yesterday morning...

No, no smokers in immediate or extended family or friends, so it is not that.

If it was really distressing my two when they were little I'd wait til they were asleep before giving them their inhalers.

I know that feeling Jajas - before I got preventers with counters on, I would only know that it had in fact run out 3 days later when I started wheezing!

snap - except last time I hit panic stations I discovered a forgotten (and in date) Seretide inhaler in the medicine cabinet

Hope you get yours - it's miserable otherwise.

DD knows how many doses she gets on her inhaler so she makes a note on her mobile (complete with an alarm) to let her know 10 days before she's due to run out. Would that help?

If you've got a Lloyds chemist near you haven't they got a scheme to help with repeat prescriptions now? maybe that would help. I know my DH is always forgetting to re-order his statins then expecting muggins here me to sort it out for him.

Could I please do a tiny asthma-specialist hijack too?

DS2 has just been prescribed a brown inhaler as well as blue. We're trialling it at the mo: GP suggested (because I was concerned about whether he really needed it or not - he's 4.5) that we try three weeks on, three weeks off, twice and record the differences.

So far it is inconclusive: he appeared just more generally 'well' in the first bit of the brown inhaler, with still lots of coughing. Had a bad cold in the middle of this three weeks. Needed LOTS of blue inhaler also.

Stopped brown. No cough. Cold ended. Ran around outside, bedroom window open: no night cough later. But (to me) seemed a bit more 'tired' and under the weather in the evenings and looking more pasty and bog-eyed.

Then last night (after some running around in the evening outside and window open) really bad coughing attack, needing LOTS of salbutamol.

I'm just VERY confused.

Anyhow, what I'd really like to know is whether kids are supposed to have an asthma nurse/assessment/follow-up etc when they are diagnosed?

My GP is as helpful as he can be but when I mention some proper support he just shrugs and we're feeling we have no-one to talk to about managing things properly.

Any suggestions?

Almost every surgery has an asthma nurse who you should be seeing about your ds.Ask the re ceptionist for an appointment docs are rather useless
Asthma can't be officially diagnosed at young age but if severe enough concerns then they norm prescribe mild inhaler to help untill they can tell or child grows out of it.I had to talk my doc into letting us see asthma nurse when my son was under 2 as I knew he had all the signs and he was not going to suffer 8 yrs of cough medicines as I did.He's been on an inhaler ever since
Find it unusual that a nurse reccomended/agreed to a child coming off preventer as the reason that the child will not need reliever is that preventor is working.I know it's worrying putting steroids into children on a regular basis but it is honestly for the best.