Asthma without wheezing?

[KatyMac]

I've always understood DD had a sort of viral asthma; un-noticeable until she has a virus then WHAM it hits

But she has been ill for about 3 weeks, cold, chest infection, maybe a chill & all throughshe has been taking her blue inhaler 8-10 times a day.

3 times now a GP has listened to her chest & her asthma is fine...so what is going on?

I'm not sure, but I have had asthma for 20+ years and have hardly ever had a wheeze that a dr can hear.

Checking peak flow can be more useful for some people. I find when mine is bad I cough a lot in the morning and a night too.

Taking a ventolin 8-10 times a day indicates her asthma is out of control and it sounds like she's in need of a preventer of some sort or even oral steroids to try and get it back under control.

I would take her back to the gp.

She doubled her preventer when the cold started (about 5th Nov)
She saw the locum GP today

I am a bit confused

Her peak flow is about 230 - which is a think fairly low (but she doesn't take it regularly any more)

Gosh I am so far from being an expert.

What did the gp say?

It does sound low.

She's fine

No temperature (her bedding/PJs are sodden), no wheeze, no sound of a chest infection - she is visible exhausted & she suggested bed rest for a few days & see what happens no explanation for the low peak flow or the excessive use of ventolin

I don't wheeze, just feel beathless (like running up the stairs, gadping). only for a full blown atack do I wheeze.

peakflow sounds very low which is worrying but not surprising as she has a cold.
does she take a preventer (steroid) inhaler at all? if not she needs one.

I spent an entire summer on steroids for my asthma, but no wheezing.

Yes she is on becotide (2x250 twice a day, normally 2x125 twice a day but doubled when the cold started) & singulair

Just realised I put this in adult as she is 17.....maybe I should have stuck it in kids still - I don't know, is she grown up or not?

If her chest is clear, and there is no evidence of a bacterial chest infection then she may not need steroids or antibiotics.

The advice nowadays is to keep the inhaled steroid dose constant (no benefit from doubling) and use ventolin as much and as often as needed - it may be that she needs up to 10 puffs every 4 hours whilst she has a viral infection, ideally through a large volume spacer such as a Volumatic.

Viruses can linger and you can often move seamlessly from one to another! It is rough and she must feel pooped, hopefully it will be over soon.

If she is wheezy, coughing up mucky stuff, feverish or not getting relief from her ventolin or the relief isn't lasting more than a few hours then certainly go back for a review.

I wonder if she is sweating more at night?

Well she certainly can't manage 30+ hours of dance a week

The GP suggested bed rest & monitor; I'm glad I have her home from college I can feed her properly & watch how she does

I think she got a bit better went back to college too soon & got worse straight away and was off again

Ds just coughs doesn't wheeze. Asthma nurse said if we are using blue inhaler more than 3 x a week then the preventative one needs to be increased. When the brown one is at the correct dose then ds hardly uses the blue one.

OK so should she use say 4 or 6 puffs from now on & see how long it's lasting & increase/decrease as necessary?

Dame that is true for day to day asthma management. It's slightly different when there's a viral or bacterial exacerbation.

Katy you say she's on Becotide 125 normally - do you mean Seretide? Beclametasone doesn't come in a 125 dose. Yes I would suggest she tried upping her ventolin to say 4 or 6 puffs through a spacer and see how she goes.

I might (that could be DH or my Dad to be honest I get them all mixed up) Dark Brown?

No, DH is QVar & my Dad hasn't had one since he had the lung cancer I don't think

Becotide is dark brown in the 100 dose; it doesn't really matter I was just thinking if it's Seretide 125 (which is purple) you shouldn't double it!

I hope she's better soon

Nope she is purple - Seretide she has been on 125, 250, 375 & 500 variously over the last few years

The hospital changed her dose everytime they saw her for ages - now she has a 125 & a 250 and she is to swop between them as she needs to

Oh I can't keep up with it but I know the latest as it was in the letter they signed her off with (can't see paed asthma peeps any more)

Walked downstairs to check 2 different purple inhalers

DS rarely wheezes despite being classed as a brittle asthmatic.