increasing meds in an 11yr olds

Not quite sure wether i need re-assurance or whatever but i need some input from others please.

My daughter Chloe is 11, for the last 4 years she has happily being plodding along with the pulmicort and ventolin when needed as well as hayfever meds from march- sept.

Early last yr things went downhill and the pulmicort was increased and serevent added. Yet again things have deteriorated and she is now taking 400mcg becotide twice a day as well as the serevent and has just been prescribed her second lot of pred in 6 weeks after only havnmg it once in the last 5 yrs. Her peak flows range from 130-320(the latter being above norm for her height/age) I am allowed to decrease her meds i fi feel she is stable and i do this as needed.

Chloe doesnt have attacks but is very much cough variant and also doesnt wheeze, we know she is nut, dust fur and pollen allergic and so treated as such.

I am very much aware that in asthma terms Chloe is not severe but nweverthe less im worried about the way things are going.

What concerns me is the increase in meds without an obvious trigger are the GPs being over cautious as they know me very well ( brittle asthmatic for 10 yrs) . The Dr seems happy to up the meds without looking into the cause of her downward slip which i find very frustrating.

What do you guys think?

Thanks for letting me vent as well?

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Hi Hopalongkp Sorry to hear Chloe has gone downhill after so many years being stable After reading some recent messages I wonder if the woersening of her asthma could be to do with hormones ! Being 11 she will just be coming up to periods etc and there are one or two threads on here that are to do with asthma starting or getting worse suddenly at this time in a young girls life Hope things improve for you both soon!

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Jass

Thanks for your reply. The thought has crossed my mind but im unsure as Chloe is very small for her age and as such has no outward signs of puberty yet despite her age. She is under the Paeds because of her growth (or lack of!!) and they seem to think that she maybe on the verge of puberty and hopefully she will grow once it starts.

but despite that i think that i might keep a record of flare ups to see if it does go in any cycle- anything to find a trigger .

THanks again

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Hi Hopalong, sorry to hear Chloe is having a bit of a rough time at the mo.

I have 3 kids, 2 asthmatic and one pretty much ok so far (touch wood.)

My daughter who is now 14 had no real probs until she was 7 then had a bad winter with a number of viral infections and ended up on 5 courses of pred that year and Becotide with ventolin as needed. It pretty much settled down by the time she was 9 and she stopped needing Becotide and occasionally used her ventolin. Since she reached puberty it has all gone abit mad again. She is not often bad enough to require pred but is constantly coughing, getting out of breath running for busses and hogging the ventolin. She refuses to take flixotide says it doesn't help and makes her worse. Tried pulmicort and had same respose. So in my book decreased asthma control and a hormonal 14 year old don't go to well together!! Constant battle of wills and I only occasionally win. She refuses to accept her coughing is asthma related despite an increase from 250 to 350 in peak flow after ventolin.

On the other hand, my son who is 12 (and may be coming up to puberty, hard to tell if moustache is puberty or steroids!! ) has had a lousy winter with reduced peak flows, almost constant pred and numerous admissions. I have asked why it has gone haywire and was told it was probably and blip and asthma can change all the time. Not really reassuring. I read that boys tend to get a bit better during puberty, if so would it please hurry up!

What I am trying to say is one kid had a hormonal problem and the other just had a terrible winter. There have been a multitude of nasty bugs this year with lots of people suffering for weeks with colds and viruses. Hopefully Chloes decline is short lived and her control improves with the weather. You know her asthma best and know when to increase and decrease meds. If you are unable to decrease steroids or she continues to need courses of pred then I would question whats going on. Does she see a peads cons? If so hold out till next appointment and talk with them about your concerns.

I seem to have babbled alot and apologise if I have not helped.

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Hops - just to echo what the others have said, really, plus to add - I've tried to figure out what happened to get me from an occasionally-never-ventolin user to Step 4, and I've never hit upon the right reason. ""Asthma can change all the time"" is certainly true, for reasons that are probably far beyond me as a humble GP. Hold tight, hopefully things will stabilise out - they usually do.

Cathy

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Thanks again for your replies guys.

I suppose im finding Chloes downhill trend more worrying in that when i went from being a moderate asthamtic to a brittle i knew the cause as such( multiple PEs caused alot of dmage amongst other things) but as such there is not an obvious cause but i am tracking monthly cycle stuff now!!

On the the plsu side after 2 doses of pred her pfs have already picked up and she not coughing as much.

She is under a paeds cons mainly due to lack of growth over the last 4 yrs though she is now taking an interest in her asthma too but we arent due to see her til next Jan but GP has said if this continues he will get her seen earlier.

hugs to all