Reversibility and more

[HaydiesMum]

Hi again,

My son had an outpatient appointment today and wondering if any of you can shed light on something. He had his lung function test and they re-did the reversibility test (he hasn't done one of those for a while just the normal lung function test).

His initial lung function was 76% and went up to 81% after 5 puffs of Ventolin which I think she said was around 7% increase. He's obviously on all of his meds (seretide, ciclesonide and montelukast) and had had some Ventolin earlier in the morning so assuming that doesn't then mean the asthma diagnosis he has had for years is now questionable as not close to the 15% reversibility? I did ask her what difference the reversibility results would make to the plan, sh told me a higher reversibility would indicate he either wasn't taking his meds properly or with some people that a higher dose may help but that his results indicated he was taking his preventors as they are prescribed. Now I'm home I'm wondering what the lower reversibility indicates, following her explanation would imply increasing his meds won't help but where does that leave us??

We didn't get to see his consultant which was a shame, the asthma nurse is amazing but has now gone away to talk to his consultant and work out a plan. She agreed 3 courses of oral steroids in 4.5 months wasn't great and as he has now been symptomatic since October (other than a week or two after each course of steroids), waking several times a week due to his symptoms and needing his Ventolin upon waking pretty much every day as well as during the day around two days out of three she agrees its time to try something different . . . she didn't volunteer what . . . fingers crossed I'll hear from her or the consultant in the next few days.

[Superzob]

I would have thought that the Seretide would produce a permanent improvement in lung function (because it is long-acting), so the amount of reversibility from short-acting Ventolin would be reduced. That seems a good thing to me and, in the absence of any medical advice to the contrary, I would stick to the current asthma plan.

[HaydiesMum in reply to Superzob]

Thank you, they did the reversibility because he's been badly controlled, had a call late yesterday to say plan is to increase ciclesonide and see if that helps but another appointment in 2 months. Fingers crossed increasing helps.

[Statch]

Can only go from my last reversability test was asked to go without meds for 24 hours prior which are montelukast,uniphyline,carbosytine,respimat and relvar. Want told the initial result but was told 41% improvement and put forward for biological therapy so maybe that is the next step for your son.

Anyway hoping you get some clarity soon

[HaydiesMum in reply to Statch]

Thanks Statch. Hes never been told to stop meds before an appointment/lung function test. Guess it takes some of them quite a while to leave the system but imagine even 24 hours shows more accurately how the lungs work without meds?

Increasing his ciclesonide for now and going back in 2 months, fingers crossed.

Hope you dont gave ling ti wait for the biologicals and that they work well for you.