To Pred or not to Pred?

Hey everyone, I'm looking for some opinions about prednisolone please?

My 4 year old daughter is on flixotide 50 x 4 puffs morning & night. She has been really well since a couple of months and so upon advice of our doctor, I reduced her about a week ago to 3 puffs morning & night. She's having quite a rough time of it now and I put her back up to 4 puffs 2 days ago. I'm unsure if this flare up is due to the reduced flixotide or just coincidence as she has a sore throat - she's very hoarse - not sure if it has been cough induced or a virus.

Sunday night she had 2 attacks during the night, the second attack took 1.5hours and 10 puffs of blue inhaler to regain control. Last night she had 2 attacks in the night but less severe. The most blue puffs she has ever needed to regain control has been around 6, so given how bad it got, I phoned our doctor yesterday morning (morning after the first rough night), to let him know and to check with him that he was happy for me to continue her treatment or should I get her checked. He said he was happy but if she required 10 puffs again last night I was to contact NHS24. He also offered a prescription of Prednisolone. I declined and asked to wait to see how last night went and decide today. Since last night was better, it hadn't crossed my mind. However, she has coughed a fair bit today and has already had an attack, right at bedtime, 7:30pm. She needed 4 puffs blue.

My query is, would tmor be too late for Pred? Are we over the peak of this current bout? How do you know when it's time to try pred for you/your child's treatment? She has had pred about 2 to 3 times in the 2 years she's suffered with her asthma, but the doctor has always advised it to be used, not ""offered"", if that makes sense? I'm not sure if I should phone tmor or not.

21 Replies

  • Darn, I just read about pred on the webmd site and I wish I'd accepted them yesterday now. To be honest, I didn't really know what it was used for (yes, I know it's for asthmatics, but I didn't know what it actually does). :(

  • I was going to say it sounds like a course of pred may be worthwhile.

    Perhaps see how she goes overnight but it is difficult to tell if you are over the worst of it I never find it easy to tell with Thomas. It's strange your doctor offered it, I am usually told Thomas needs it? Doesn't make it easy for you surely a doctor should be making that decision for you?

    Jenny x

  • We're having to go to out of hours as she's had another attack. I tend to put of phoning NHS24 as they always take her temp and send us home, but this time I phoned as soon as the attack began, I got no questions other than the emergency ones, got put right through to a nurse and have an app at 10.

  • We've been and home again. She got a dose of Pred there & then and has a 3 day course to take. He was a much nicer, and far more patient doctor than any I've seen at OOH before. His first sentence was ""this isn't an asthma attack, just to reassure you"". I asked him to describe the symptoms of an attack, he said ""high pitched cough, persistent cough which may make her gag, rapid heart rate, her chest would be more (i can't recall his words but he meant in & out more forceful & rapid)"".

    I said, uh yeah, these were the symptoms she was having which made me phone NHS24! He still maintained it wasn't asthma. *shakes head*

    He said she wont have another attack tonight after having the dose of pred, but I'm not hopeful, I think she will, time will tell

  • Sorry to hear your little girl has had another flare up after being well for a while.

    The OHH Dr. seemed a little strange-did he say what it was then if is wasn't asthma? Why did he proceed to prescribe her pred and a 3 day course-a typical course of action for a child with a asthma flare/moderate attack then?

    Hope the pred has kicked in now and your little girl is free from attacks again-there is nothing worse-you just want to breathe for them don't you.

    Take care x

  • Honestly, every single time we have had to bring her to OOH the first thing they say is its not asthma, without fail. I know my child, I know what is her asthma flare ups. I wish they'd take notice of me.

    I had to take her to OOH again last night, the doc we saw did nothing but make me feel like crap. One comment was ""I see you have been to OOH for the same reason numerous times in the past, you know there's nothing we can do. This isn't an asthma attack"".i.e. Stop bothering us. I asked him to describe the symptoms of an attack so I would know for future, I haven't seen anyone have an attack, I don't know what its like. He reeled off symptoms, I said well that is exactly what she was like when i phoned Nhs24 an hour ago. its taken you an hour to give me this appointment, and then had us wait in waiting room for 20 mins. By now she's coming through the ""attack"".

    I'm so fed up of going to OOH for help and being told its not asthma or her chest is clear so go home, or she'll be fine the rest of the night now so see your own doc tmor, then a couple hrs later she's having another attack.

  • Is it worth getting your GP (or whoever diagnosed your daughters asthma) to write you a letter explaining your daughters condition? Is she old enough to do peak flows yet? That might be a useful tool in explaining whats going on (doctors like numbers).

    I assume you have an action plan for what you can deal with at home and when you have to get help - it might make things easier for you from an OOH point of view if you are just following orders!

    If she is still having attacks and needing OOH whilst on pred that is deffo summit you need to talk about with your GP! Its quite unusual (although this board is full of unusual asthmatics - i still get attacks on pred) and might be a sign that preventor treatments might need stepping up!

    Did you ask what he thought was going on if not an asthma attack? If your child is struggling to breathe then he must have some suggestions, surely?

    Anyways - hopefully you'll get to sound it out with your GP and sort things out to give you a bit of a plan! (or did you manage to get an appt today?)

    Hope you have a less disturbed night tonight!!

  • Could you start filming the attacks? That way you can show them what she was like when you contacted them.

    I got this idea because my dog used to have seizures from low thyroxine, but of course the trip to the vets always brought enough excitement to stimulate her thyroid, so the seizure would stop as soon as we got there. So we started filming them at home before jumping in the car with her - worked perfectly.

    I can't imagine how frustrating this is when it's your child and not your dog!

    Personally I've now got an instant-record button on the front of my phone and on the dock on my laptop, so that I can grab footage of my own worst attacks - haven't quite managed to remember to do it yet, but at some point I'm sure I will!

  • One of my friends is a nurse and yesterday she suggested filming on my mobile, it really hadn't occurred to me! Completely forgot last night, tho last nights was mucus related rather than wheeze.

    I have no Acton plan, I don't know when is the point of what would be classed as ""ok, she needs medical help"", I have never been""taught""how to deal with this, her Daddy & I just muckle through these attacks as best as we can. All we got was here's the blue inhaler. Then she got put on flixotide, ""here's a preventer, step it up when she's struggling, step it down when she's well"". After speaking to the helpline here I realised the step up/step down was gaining control/losing control constantly. It was MY request/decision to keep her on an steady & higher dose of preventer which has def worked. But still we don't know fully how to deal with the attacks.

    When the OOH say its not asthma, they just say its a virus. I can understand to a point, they see her when she's ok, whereas an hour before, she was absolutely not ok. Can I ask her doc for an action plan?

    I'm so relieved these bouts are more infrequent now, I feel so helpless. OOH makes us feel so rubbish that we put off calling, or don't call.

  • PS she's 4, her doctor has said she'd be too young for peak flow yet. Could I request a peak flow meter to bring home and practice with her so I can teach her how to do it? We won't know I'd she can unless we try

  • You should have an asthma management plan if she is on both a steroid and reliever inhaler. This will give you guidance on when to step up treatment yourself, and how - and when to get medical help.

  • Thank you, I'm away to read xx

  • I'm getting so anxious, my little girl woke up full of the cold this morning, it's the cold that sets her asthma off and after such a rough run last week, I'm a little scared of what lies ahead of us over the next few nights.

    I know there's nothing her own doc can do but I want to phone for reassurance, or some ""do this if this happens, if that doesn't work do that or phone NHS24"". After the (non)treatment we got last week from OOHs, I don't feel we can phone for help. :(

  • I know what you mean Thomas isn't well at the moment and although I got the pred yesterday I'm holding out to see if he can do without it. Im still in two minds whether to just start it or not. We have increased his seretide to two puffs twice a day and hoping for the best. I just feel happier that I've got it for over the weekend incase I need it as OOH and walk in always so crap!

    Could you not see if your GP will give you a course of pred to keep incase?


  • She had pred last week - 4 doses, one at OOHs on tues night then a dose per day on wed thurs fri.

    I feel like I am proving the OOH doc right in his implying I am a frantic mummy. ... cos I phoned requested a callback from our doc. The receptionist said she thinks he's finished for the day but someone will phone. Praying its not the doc who is useless, why am I being made to feel bad for seeking advice and support :(

  • Sometimes it just happens like that, Thomas has had 4 x 5 day courses during a bad month.

    Hopefully someone will be able to call to reassure you.

  • Doc phoned and said we have strong grounds for complaint against that doc from last wed night. He's also strongly advised another course of pred (3 to 5 dsys depending how she is over wkend ) to try to prevent another relapse like last weeks. He's such a great doc, said not to be put off calling nhs24 if we need to or to pick her up n take her to a&e. Feel relieved!!!

  • Thanks Jenny, sometimes just being told ""you're doing the right things"" is all I need. Xx

  • I still find it hard trying to work out what to do. As soon as Thomas gets a slight cough or cold I am terrified. He can deteriorate so quickly it's hard not to panic.

    I am glad you have finally got some decent advice.

  • Might be cheesy but i've got Kirsty to make a wee card to say thank you so I can give it to the doc when I go to collect her prescription. Just acknowledgement for his support. Our country is quick to complain about the bad but doesn't compliment the good nearly enough!

  • Friday night was fabulous, she slept right through with no issues, making me think it was over.... last night was horrendous :(

    I hate asthma :( It's a cruel cruel illness. Poor kid is exhausted (as are mummy & daddy)

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