Reducing Ventolin after a cold

My 3 year old twins both have asthma and we have been told when they have coughs / colds to use 4 hourly ventolin, 4 puffs. This seems to work really well for them, and has so far resulted in reduced chest infections and better control of their asthma. The problem is i'm not entirely sure when to reduce the ventolin. I don't want to keep them on longer than necessary, but also notice that as soon as I start to reduce, the cough that is associated with the cold starts to increase. I'm pretty sure its not the asthma cough as the sound is different, so am not sure if it is just that the ventolin also improves the viral cough too.

They are both nearing the end of their colds, no more runny noses etc and both have a slight cough, and I mean coughing only a few times each day and not at night. Is it best to wait til the cold / cough etc has gone completely before reducing to say 2 puffs 4 hourly or could we do it near the end of the cold, and is it usual to see a slight increase in the viral cough when reducing the inhaler, even though chests are clear?

We are under the hospital and a very good asthma nurse, plus the gp but this is the question I always forget to ask, and we are now in the situation again.

Thanks

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Hi Maria

I'm glad that your twins are getting better. I have trouble coping with 1 three year old so take my hat off to anyone who can cope with 2!!!

As i'm not medically trained i can't advise you on how to treat your children - but can tell you what we do with out little man (he's 3 1/2)

Anyway to the asthma. When Ollie has a cold/cough we've been advised by consultant to up his salbutamol (i think it's the same stuff) to 4/5 puffs am/pm and if that doesn't work to give it 4 hourly up to 10 puffs (we start at 4 puffs and increase if it isn't working). We tend to keep ollie on it longer than may be necessary - but we've found that it's kept us out of hospital this year and more importantly significantly reduced the number of prednisolone courses he's had to have.

We try to lower it as his cough/cold starts to improve - lowering the number of puffs we give each time - but it's not an exact science - more trial and error. Also every child is different.

I don't know if it's usual to see a slight increase in the viral cough when reducing the inhaler - i know with the cough that ollie's had for the last 2/3 weeks has come - got worse - got a bit better - got worse again etc etc. So we've kept him on 2 x 4 daily salbutamol - giving additional puffs when he's been outside to play or rushing around. As his cough/cold isn't really getting any better and has probably got worse since yesterday we're off to see GP Thurs to check there's no infection.

I'd ring either your own asthma nurse or the one on this site to ask their advice - i've spoken to the ones on this site and they are really good - but if you have a good one at your clinic then try them. I know i always forget to ask questions when at DOC's and always think of them when i've left!!!

Sorry not to be of any real help - I hope that your twins continue to get better. I know it's horrible to have to keep giving them medicine but if it keeps them well and off of oral courses of steroids then for us it's the lesser of two evils!!! But i have to say it must be tough trying to give puffs to two 3 year olds in the middle of the night!!!

Take care

Claire

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Hi Claire

Thanks for your reply. I managed to speak to our asthma nurse yesterday who is very helpful. She has reassured me to keep doing as we are doing. Oliver has been at 2 puffs 4 hourly for a couple of days and harry has gone down to the same today. Oliver has a check up at the gp tomorrow anyway so hoping all is ok.

It is hard work with 2 of them, even worse when they have been in hospital as one is left at home and they miss eachother!

I seem to always think the inhalers should be an exact science, when really its just a bit of trial and error, its nice to have someone else say the same.

The asthma nurse also said that the colds this year are really bad and taking ages to go, which seems the same for my children and possibly for your Ollie too. I hope he's a bit better today.

Take care

Maria x

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Hi Maria

I'm glad you spoke to your Asthma nurse. I'm glad that Harry is a bit better today and continues to get better. I know it's good to know that others are in the same boat (i hope that doesn't read badly!!!). I've found it a great help just to know that others are feeling the same.

I can only imagine how hard it is to try to deal with 1 in hospital and 1 at home.

Have to agree about colds this year Ollie has had cough/cold since about Xmas - he's now got Chicken Pox (EEK!!!) so we're in Quarantine which is miserable!!!

Off to GP tomorrow for checkup .

Take care and I hope that Harry continues to get better.

Claire

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Hi Maria Hope both your boys are on the mend now I find with Scott(7) that we start on 4puffs every 4 hours when a cold/virus is on the way( you can tell with time what the signs are) then when his cough/wheeze are getting better just gradually give less puffs less often until you are off it altogether Take care!!