We moved to the UK from America last year and my 8 year old just had his first asthma review here. He has viral induced asthma and was diagnosed when he was 3, so dealing with this is not new for us. I was stunned to have the nurse tell me that our approach to his care was wrong. He has always taken his maintenance meds only upon the first sign of cold/flu symptoms and then his rescue inhaler (or nebulizer meds) as needed. I have been told by his prior doctor that the big goal with medicating children with asthma is to medicate them enough so that they do not need to go on oral steroids, but not to overdo it as the more they can remain healthy without any medicine, the better. The theory being that the long term affects of oral steroids on children is concerning at best. We've done well with that approach and once we were past the initial first season, we've almost not needed to resort to oral steroids at all. Now our new carer is telling me that I'm using his rescue inhaler too much (basically anything more than 3 times in a week) and that such overuse can lead to COPD in his later years of life. Her approach would be to prescribe the oral meds much after a week of symptoms. (She also wants him on maintenance meds 365 days a year.) WHAT?! If this wasn't so completely opposite from our prior advise it wouldn't be so concerning. And I don't mean to be elitist, but his carer in the States was not only a doctor, but also a specialist in allergy and asthma care. Has anyone ever heard about this COPD link? I haven't been able to find anything online in my initial searches. I hate to completely ignore this woman, but I'm just not convinced she's right. On the other hand, I certainly don't want to be doing something that will affect my son's later years.
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