what next?

hi,

my son is asthmatic and has been classed as isnce the age of 18months (now 4 and half). anyway he's getting worse over the years.

he started off on just ventolin (blue), this worked for a while. then he got put onto becotide (brown) as well as blue. again the 2 worked for a while, then he had loads of attacks and was given a course of pred. sorted things for a while. he then had more pred (1 lot a month) for a few months. at 2 and half he was given singulair pead tablets to take at night. again worked for 6months. then at 3 we had to call ambulance 4 times in 1 month and he was nebulised and taken to hospital. the docs changed his brown for flixotide (orange - not licensed for under 4's). he was on this until 2weeks ago when he got a chest infection and they have changed him to seretide (purple).

so he takes, blue inhaler 4x a day through spacer, purple 2x a day through spacer and singulair pead tablets at night.

what are they likely to put him on next time he gets worse?

(i also have asthma and have been on purple and blue inhalers for the past 6years. they work fine and mine is controlled. hence why i am asking what the next step up is if its needed as i have no expirience. the asthma nurse said she will discuss it IF he needs to go up again but i would like to know so i can research it!).

[yaf_user681_15459]

Im not sure if I can really offer any advice as Im kind of in the same boat. My daughter is on exactly the same meds as your son. She has Ventolin, Seretide and montelukast daily and is on pred about once a month to control flare ups and chest infections. (She's 15 months and was diagnosed at 6 months)

I too am confused what the next step is but I guess Im trying not to think that far ahead as this whole Asthma thing is too scary for words.

Like you, my husband has Asthma> he has pred about once a month through the winter along with his Seretide and Ventolin.

Im sorry I have no advice, just wanted to let you know you arent alone. Its a scary thing and its great we have this site for support. You can PM me anytime.

Take care and I so hope your son stays controlled and doesnt need to go onto the next stage of treatment, what ever that is.

Emily.

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The next step I would think is a referal to a respiratory specialist. I have been in a long and hard battle to get my son who will be 8 in 6 days refered. He was diagnosed at 18 months and at present is on 400mg Ventolin as required and at least 10 mins before any physical activity and before he can even get out of bed, 200mg becotide twice a day and 50mg serevent twice a day. They have refused to but him on seretide with it being a combined inhaler as they are always changing his treatment. His asthma is all-over-the-place at poresent to the point where we have know informed school that until further notice he IS NOT allowed to do any phyical activities in school and the only exercise he has is the walk to and from school everyday which is a mile and half there and back. He has anti-0bios and steriods everymonth for a week at time as well and I believe by the end of this week he will be starting his next course. We alwasy see a massive imporovement in his asthma for 2 weeks following the week of anti-bios and steriods but we never see a who month with-out needing these extra meds.

Good lucka nd I hope you childrens asthma starts to get back under control and stay controlled for a long time.

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I wouldn't assume that it'll get worse, it may have simply been that the correct dose and combination hadn't been found, but the next step would be either increase the ICS, add pred permanently, but could try changing singulair for theophylline, but cross that bridge if it ever arises, and don't forget diagnosing and controlling asthma in under 5's difficult due to lack of feedback from them.

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what next

for us the what next was alternate day pred and then alternate day azithromycin (an antibiotic) that has sort of settled things down and Alfie no longer has the alternate day pred but is still on his azithro. He also has a daily calcium tablet because of the high dose steroids he's on weaken his bones.

I think you should ask his respiratory consultant. Ours has been fantastic! Alfie is having a fine cut scan in the spring to try and identify what exactly is going on with his lungs.

Margot x.

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hi,

thanks everyone for your replies. someone said it may not get worse, the only reason i think it will is because of how it has got wose since he was really small.

since making my original post he has had another dose of pred (ends tomorrow) and we have spent most of this week up during the night with him coughing/wheezing and having to take more of his inhalers. the pred doesnt seem to have worked this time. i have rung the docs and i cant get in to see the asthma nurse until tues as she is on holiday! docs have told me to ring ambulance if i need to. due to this it was put on his file by the doc not asthma nurse - ""diagnosed asthmatic"" and the date.

i've even put damp towel on radiator and steamed up the bathroom in order to get moisture into his lungs and its not helped.

the school have said that he is struggling during and after PE and playtimes he cant run about as much as others and have arranged an app with school nurse to review what we can do etc. they have a spacer and blue inhaler at school and have give it twice daily as is.