when to step down meds again

How long do you/your child stay on increased dose of inhalers once a flare up is back under control, before stepping back down to normal dose?

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Hi Fiona,

I think this is different for each individual, and ideally should form part of the agreed asthma management plan (the one which uses the traffic light system from Asthma UK seems to be the most common).

I never increase my inhalers - Im already on two different steroid inhalers all the time, so go straight to oral prednisone, which unfortunately I've been on since August 1st..

Lynda

[Thomass_mum]

Thomas's medication is never increased when he is ill either. When he has nebulisers and steroids we stop his seretide and montelukast until he has finished his course of pred but always continue as normal with the Nedocromil and flixonase.

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The only thing that ever increases for us in ventolin. We then have to wean off it until he's off once he's getting better. He usually has oral pred if that isn't enough but he still has his other medications with that. Like lynda said it is very individual as everyone has different medications and copes differently.

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I wish I had more support from our doctors.

We (we= hubby, myself, daughter who is nearly 4) have no care plan, we have seen the asthma nurse at our practice once in the last 18-24 months, and only because I requested it, we never get asked to come in for any reviews (I am slightly asthmatic, but rarely need inhalers and I get offered review appointments regularly!!).

The way we have been advised to treat her is 1 puff of clenil 50 morning & night, and we can increase to 4 puffs morning & night if we feel she needs it. And to use the ventolin as & when required.

What I usually do is, since colds are her trigger, at the first sign of a runny nose I usually increase her to 2 puffs morning & night, and if the coughing starts (or when!) I put her up to 4 puffs morning & night immediately. I try to start the decrease back to 1 puff morning & night after a couple of days on even keel.

To be honest, I never know if I am doing the right thing since any time I have had to take her to out of hours when things are really bad, the first thing they say is ""it's not asthma"". I am contemplating going back to my doctor and challenging this and asking why she is on inhalers if I constantly get told she is not asthmatic.

[Thomass_mum]

Even though his consultant says he has asthma we always registrars at the hospital tell us its not asthma even though its all in his notes. You could try asking to be referred to a specialist respiratory and allergy consultant at the hospital perhaps if they will refer you you may get better support? Thomas doesn't have a care plan I asked his consultant about one to be given the GP during his last admission along with a course of emergency steroids for at home. They wouldn't agree to either, they want him to be taken to A&E for any flare ups of the asthma.

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You don't sound like you're well supported at all. Definitely see your gp and/or asthma nurse. You should really have a plan in place so you feel more confident at least of how to handle things. Don't be afraid to tell them how you feel. I've learnt you have to push to make sure they stay on top of things. Don't wait to be called, call them if you're worried. My GP is generally great and has said he doesn't mind me bringing him in at all and would rather he see him than have me sat at home worried.

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I appreciate your comments. How I wish I had thought to use google before now and could've found this site so long ago! I think I might book an appointment after new year. Even just for a check up. Every flare up is worse than the last.

Her's has the same pattern each time too: dry, whistly/high pitched cough as soon as she goes to bed, this usually goes - sleep for an hour or 2, coughing for an hour or 2 whilst having a few to a lot of doses of ventolin (last wk I swear she had about 15 doses the night she was horrendous), sleep an hour or 2, coughing/ventolin for an hour or 2, etc until morning. This lasts 2-4 nights then it becomes a lose cough which ventolin doesn't ease, the lose cough then disrupts sleep for a few nights.

Last winter the cycle went as above, She then had a week free before it started over again. Outside of colds she's absolutely fine

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i would just like to second all the other advice. defo get and appointment with gp and/or asthma nurse. tell them how you feel. that each attack is worse than the last as this is a sign of badly controlled asthma. and insist on an asthma plan with.marker symptoms and peak flow and step by step instructions for different treatments. also try ringing the asthma UK help line. they are always extremely friendly and helpful.

sorry things are so difficult for you all at the.moment. i do hope things improve soon. stay well

Rose

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Next time she's having a flare up, I'm going to record or film her on my mobile as any time I need to take her to doc she hardly coughs so it's difficult for them to know how she is at worst