daughter of 6 coughing again but peak flow ok

[lcoram]

Can anyone please advise. My daughter has been well for the last 5 months. no coughing which is the longest time ever. we now have an asthma plan in place which is 2 puffs of the preventer (dark brown) twice a day. her peak flow is normal around 200 - 240 if this drops to 160 we are to give her 2 puffs of the blue inhaler 4 time a day. the weather has been unsettled and she now has a cold which has started the coughing again. her PF dropped a little but today back good. But she is coughing all night and all day today. its been 2 days taking the blue inhaler but no change. Can I increase the Brown inhaler I wonder. she is well in herself but this cough is starting to get worse. a visit to the docs if no change but wonder if anyone has some helpful advise.

[Minushabens]

I would expect that you'd be fine increasing the brown inhaler as this is common practice, but as with all such queries just give a quick call to the surgery (GP or nurse) to make sure they are OK with you doing it, based on the symptoms you are seeing. It's possible they might want to get her checked over or prescribe something different.

I hope she soon feels better.

[lcoram in reply to Minushabens]

Thank you. I have given her a double dose of the brown inhaler tonight and we have given the blue every 1 hour in the last 4 now, but this has not seemed to help. bless her. its taking us 6 years to finally get a plan in place and doctors to treat it as asthma all was going so well so far this year.

[green881 in reply to lcoram]

You should not give more than 2 puffs of the blue inhaler (Ventolin) in 4 hrs, you do need to call the surgery right now or after hours care if they don't answer.

The brown (I'm assuming it's Qvar) won't act right away it takes time to build up in the system. FYI Qvar comes in two sizes, Qvar 40 and Qvar 80, the max dose is 4 puffs of Qvar 80 a day if i remember correctly for adults but I don't know for children.

Neither the brown or blue will really help a persistent cough though, sorry. The cough may aggravate asthma, you have to treat them separately.

I was in your daughter's shoes in my youth so I know how it feels. It's tough on the parents but the kids seem to take it in stride somehow.

[lcoram in reply to green881]

thank you for your advise. after reading this I phoned the NHS direct who advised an out of hours emergency doc appointment. My daughter has a chest infection again and we were given antibiotics and steroids. took the first lot when we arrived home late and she slept much better. thank you

[green881 in reply to lcoram]

Good that worked out. The steroids are strong and sometimes they work very fast. You should visit your regular doc tomorrow and discuss the plan how long on steroids and whether to taper, and then what type of dose for the Qvar. She will need to stay on Qvar for a while until clear then taper gradually but hopefully she can get off the steroid pills quickly. It's probably a visit to the doc tomorrow then a visit or call every week for several weeks. Keep a diary of how much Ventolin she needs.

You're new to this so gradually you will learn the limits of all the meds. It may be daunting but good to hear you are on the right path.

[lcoram in reply to green881]

thanks again. we saw the doc again today and she will be on the steroids for 6 day total. hopefully we will get some sleep tonight. thank you for understanding that we are new to this and need as much advise and info as poss.

[green881 in reply to lcoram]

Sounds like you are on the mend - don't stop taking even if she is 100% you don't want it to flair back up. The doc should come up with a plan to taper and gradually reduce all the meds..