Some questions

Hi My son is 2yrs 4mths and has had asthma since 11 months old. To start with it was a 'viral wheeze' and it wasn't too bad. He then got pneumonia last may and things pretty much went on from there. I have a few questions that I am hoping someone will help with.

1) he was on preventer becotide 50mcg 2 puffs am and pm then in feb it was increased to 100mcg 2 puffs am and pm which the leaflet states as the max dose for a child. Today however the doctor has increased it to 4 puffs am and pm while he is unwell, is this too much? does anyone else have more then the leaflet states?

This leads to my next question

2) Isaac is currently unwell with a chest infection, he seems to get one every 3 or 4 weeks, the doctor said it is quite common for children with asthma to be prone to chest infections and I have no answers as to why. In the last year he has had antibiotics 14 times which I feel is an awful lot. Is it as common as I have been made to believe or should I request further investigation as to why they happen so often?

I will add that he had no follow up x-ray after the pneumonia to check his lungs had recovered so should I demand one now?

3)Do any of your children suffer anger? I know he is at the terrible 2 stage, but after a course of pred he is awful and he was getting bad again when his becotide was increased to the 100mcg 2puffs so I am worried that if it is contributing he will become unbearable once the 4 puffs set in.

4) I feel that we have been told (not in so many words but) 'your son has asthma, here's some inhalers, get on with it' and have been offered no support or advice as to what to do.

After taking him to the doctors today the doc wasn't at all concerned that 6 puffs of ventolin is only lasting 1 hour! I was under the impression that if 10 puffs didn't last 4 hours then he should be seen at the children's center for nebs. This has happened in the past and the doctors at the hospital said just that, but you can't just turn up you have to have a referral note from your GP.

I'm sorry this is all over the place, but I am sick with worry about the night I have ahead and have already decided that if he gets any worse we are just going to go to A&E instead of GP.

Any advice or info would be greatly appreciated.

Many thanks in advance

Sarah

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Hi i know how you feel my son went through the same pattan. I think you need 2 push 2 see a consultant.as i was told only thay can go outside guide lines. If u are unhappy with your gp ring nhs dirct or try 2 get in contact with your asthma nuse at your gp,she may be able To give advise. Pm me anxtime

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Thanks for your reply. I am going to push for some more answers.

We don't have an asthma nurse. There is one at the surgery but she won't see Isaac because he is young and when I did make an appointment to speak to her she said that I have to see the doctor instead and passed me on.

At what age do you see the asthma nurse?

Sarah

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Hi Sarah

I hope that Issac is ok.

My son has recently been diagnosed with brittle asthma he's 2 and 9 months but was initially a 'viral wheeze'.

We see the asthma nurse at our surgery (although i didn't find her that helpful) we had to ask for the appt and were told that we would only see her once a year (really helpful). We see our GP (try to see same one) who is good. Although seeing the nurse means that Ollie is on her list for extra vacinations.

Ollie does get quite agressive after being on pred - just had a course after being in hosp last week and he's being really foul with me and his dad. He's currently on 4 puffs of 50mg becotide and i haven't noticed that it's worse but only been on that dose for 5 days and only just come off pred.

He's usually on 2 puffs of becotide am & pm and montelukast (singulair) everyday and salbutamol and pred as needed.

He used to get lots of chest infections and was constantly on antibiotics but he doesn't seem to now.

After 5 trips to hospital ranging from 1 to 6 nights we were referred to consultant - although i don't think she's a specialist so about to lobby for a referral to a different one. I would ask to be referred to get it all checked out and to get some answers to your questions.

We weren't given any support initially - i've downloaded/ordered leaflets off this site which are really good - also downloaded the Asthma Action Plan - which is really good as it ensures that the DR's and us are all clear on the steps that need to be taken when ollie's ill. I've found this especially useful when seeing different GP's. Also phoned Asthma Nurse on this site she was really really good - made me feel more confident about taking things up with GP and/or Hosp.

Ah GP's and their varying advice (don't get me started) We were told by one that we should lower Ollie's salbutamol as it was making him 'hyperactive' - after he'd bounced off the gp's office walls. Even though he was only lasting about 2 hours and was on Pred!!!! We ignored him and ended up in hosp next day for 6 nights. I now don't see that GP and would rather go to A&E than see him.

I know how you feel - the constant worry - dreading night - all i can say is if in doubt go to A&E - they're not the nicest places to spend an evening but at least Issac will get treatment more quickly than via a GP. We waited 3 and half hours for an out of hours GP to visit last week only to be sent straight to hospital at 2am!!! Never again in future i'm going straight there.

I hope the above has helped - I hope that Issac is a bit better. Take Care

Claire

xx

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hi Sarah

sorry you have been going through so much with your son. My son turned 3 in February and has been battling asthma since last summer. He is taking becotide, 2 puffs morning and night and ventolin as and when needed. He also takes singulair (montelukast) which has been the thing to make the MOST difference. After listening to my son cough night after night for WEEKS on end he was finally put on Singulair and that has really helped keep things under control. Prior to this he had many admissions and about 5 courses of preds.

My son had pneumonia in January and was automatically scheduled for another x-ray a few weeks later so I certainly would ask about another x-ray just to make sure his lungs are looking clear. I know it can take months for it to completely clear.

I know different areas do things differently but I have found I have had to research and push for a lot... being on this site has given me a huge boost. We do see an asthma nurse, it used to be every 2 weeks, and then once a month and now whenever I want to. We've also seen a consultant and will go back in 4 months to see him again.

Everyone has a different protocol but with my son it was decided that if after just 5 minutes his attack isn't under control (with giving ventolin every minute) then we call 999. At other times when his asthma just isn't 'under control' or he has a bit of a cough then we give him his ventolin as needed but if I was needing to give it a lot more than our agreed amount then I would also call the docs or go to A & E (or out of hours) on the weekend. When they are so young they deteriorate so quickly.

Hope you manage to get the help you need. Sorry you are having such a rough time... go with your instincts and push for help and answers.

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Hi thank you for your replies.

Isaac seems to be getting over the chest infection now so that is good. We have an appointment next week to see the GP and I am doing to ask for Isaac to be seen by someone else mostly for my own peace of mind.

His ventolin use has now gone down to 4 puffs 4 hourly so I am much happier and he is coughing less. It's just a question of how long before the next infection?

Sarah xx

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Question 1 - I'm on well above the dose of pretty much all my medications. for example my steroid levels, I have 40mg of oral pred daily, 2mg of nebulized flixotide twice a day, two puffs of flicasone 500 twice a day and seretide 250 2 puffs twice a day! heck I recon I take more steroids than Arnie at his peak. My ventoline is the same the recommended daily dose for nebs is 4 - 5mg a day I'm on 8. I have to agree with the prof though that it's better to rattle than to stop breathing. It's not ideal to need more than the recomended does, it's a sign your treatments are generally not working, there are times when it can be appropriate. think about the recommendation on ventolin inhalers, max does is something like 2 puff every 4 hours, but we know it's safe to take up to 10 one after the other when your having an attack. If your Dr thinks it's for the best, as a short term measure, and it's helping don't worry too much.

Question 2 - the main downside to asthma is the susceptibility to chest infections. it's part of the territory unfortunately. I've had pneumonia twice and it knocks the stuffing out of you for quite a while, if you would feel more comfortable then do ask for a follow up x ray, but assuming he is being seen by Dr's about his asthma it is likely they would pick up any further complications during routine follow up appointments.

Question 4 - if in doubt phone NHS direct, they can refer you to the center, or if you or they are concerned they will get an ambulance for you. they take asthma seriously and can be really good at giving advice while you are waiting.

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Thanks for your input Charlottesmummy.

Just thought I'd add when Isaac had pneumonia we were sent home from hospital after a night on oxygen and lots of nebs because Isaac was bouncing off the ward walls. They missed the fact that he had pneumonia and treated him for his asthma instead! 36 hrs later we were back and this time they x-rayed and found pneumonia on his left lung alot and the start on his right so any longer and it would of been double pneumonia.

The same Doctors saw him and couldn't believe how 'well' he seemed. He wasn't at all well as he was sat on my knee usually he would be trying to empty the cupboards or climbing the walls. I explained this to them and they listened 2nd time. Within 24hrs of IV he was wall bouncing again! one nurse said he seems to be defying medical text book.

Sarah

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Sorry to hear your son Izaac is experiencing constant chest infections. When my eldest son was small he was also very prone to chest infections so I can understand a little how stressed you must be feeling.

In 2005 I was plagued with chest infections all year and at the end of the year I came down with a very painful kidney infection. I have always taken a small dose of vitamin C which I thought helped fight infections, but after that year I bumped it up quite a bit and never neglected to take it every night.

Since then I have had no chest infections and no kidney infections.

Hope your son will soon be a lot better.

Good luck,

Serendipity.