I just need to rant about these doctors a minute

[emkana]

When ds was ill with bronchiolitis in hospital in Germany he was discharged with four different drugs, because he was still wheezy - a blue inhaler, a brown inhaler (steroids), Singulair powder (ever tried giving a powder that doesn't dissolve in water to a fully breastfed baby? Not fun!) and antibiotics. I dutifully gave him all this stuff but got more and more worried because they just didn't seem to help. So when back in the UK I took ds into hospital here to be assessed - consultant spoke to me and said there was evidence that the brown inhaler and the Singulair powder were ineffective when given to babies this small, so to stop using them and to increase the dose of the blue inhaler, and to finish the course of AB's. Still ds didn't improve much. Then I read on the internet that you really, really have to shake the blue inhaler for a good while before using it, and since I've done that ds seems to be getting better, fingers crossed.
So I ask myself: Why didn't the doctors in Germany know/tell me that these heavy-duty drugs might do sod all for ds? And why did nobody explain to me how to use the inhaler properly?

How on earth do you use an inhaler with a baby?

And if you're not "used" to an inhaler, you're meant to use it with a spacer, although, again, I don't know how you'd use them with a baby, either. Unless there's some sort of mask-style spacer?

What a nightmare, anyway. I'm glad to hear DS is getting better ...

We use this thing with a mask to go at one end. It works okay-ish, though I'm still not sure how much medicine ds is actually getting.

I have an appointment to see the consultant here on the 8th of September, I expect she'll tell me then what the radiologist in Bristol who she's sent the pictures to had to say, I'll wait and see what the result of that is before I send the pictures to the US.

Emkana, I'm asthmatic, and in my experience the doctors know squat about actually using the inhalers and couldn't tell you how to use them anyway. It's why I always recommend newly-diagnosed asthmatics book an appointment with the surgery's asthma nurse asap because they DO know how the inhalers work and are much better at the practical advice side of things.

I'll try and find out if our surgery has an asthma nurse.

Have you got any top tips for using inhalers? Because we're going away for a few days so I won't be able to see a nurse for at least a week.

You need to make sure that you have got the right mask for the spacer - the aerochamber is the one that is most commonly used in the UK. There are masks designed for infants (under 1) and children (1-5), the thinkgs to remember are - trying to keep a good seal between face and mask (easier said than done) and only putting 1 dose of medication into the spacer at a time. These are the instructions for the aerochamber

You can also have a look at Asthma UK which has lots of helpful advice on inhaler use. They also have a helpline number you can ring (although not sure what the hours are during bank holidays) which are manned by asthma nurses and are usually really really helpful.

I'll copy and paste the useful bit:

How do I use a spacer with my child?

When you first get the spacer, wash it in warm soapy water and leave to drip-dry.

1. Fit the mask on to the spacer if necessary.
2. Shake the inhaler well.
3. Fit the inhaler into the opening at the end of the spacer.
4. Place the mask over your chld's face so it seals around the nose and mouth.
5. Press the inhaler once and allow your child to take five slow breaths in and out of the spacer. This is called tidal breathing.
6. Remove the inhaler and shake again.

Repeat steps two to six for each dose of medicine. Your doctor or asthma nurse will tell you how many puffs are needed. Always check with them if you are not sure and ask them to write this down on a personal asthma action plan for your child.

Remember:

• Only put one puff of medicine into the spacer at a time. If you put in more than one puff, the droplets of spray stick together and coat the sides of the spacer so your child actually gets less medicine.
• Wash your spacer once a month - leave it to drip-dry as this helps to prevent the medication sticking to the sides.
• Spacers should be replaced at least every year, especially if you use them daily.

Using a spacer and mask with babies

If you are finding it difficult to use a spacer and mask when giving medicine to your baby, try the following.

• Cuddle your baby on your knee or cradle the baby in your arms. Gently tuck your baby's arms out of the way with one hand if she/he tries to knock the mask away.
• Be positive and smile. Your baby will know if you are anxious.
• Gently stroke your baby's cheek with the mask so that she/he gets used to the feel of it.
• Use it when your baby is asleep.
• Wipe your baby's face after using a preventer.