To Inhale or not to Inhale...?

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CathyC - 30 Oct 2007 22:48 GMT

Hi, just wondered if anybody had any experience they could share with
me. My son (3 years) doesn't have asthma attacks but has medication
for tight chest, cough, and wheezing he gets as soon as he has any
virus/ cold etc. My doctor first told me to use a blue inhaler when
necessary and then further prescribed a brown inhaler for when he got
really bad, but later told me i should be using the brown one twice
every day. When I said he was normally healthy and fine he agreed it
was ok to only medicate when he had symptoms (only every couple of
months or less), but information i've read suggests this won't work
because its cumulative.

Other people have suggested that frequently using steriod medication
will make the asthma worse! (because of the body's dependency on the
steriod). I don't really want to be medicating my son daily with
steroids and now i feel paranoid about using the inhalers at all. I
can't work out whether the problem is getting worse and if so is this
because of a natural progression in the asthma, or because of the way
i'm mediacting it??

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miles - 31 Oct 2007 01:24 GMT

> Other people have suggested that frequently using steriod medication
> will make the asthma worse! (because of the body's dependency on the
[quoted text clipped - 3 lines]
> because of a natural progression in the asthma, or because of the way
> i'm mediacting it??

Not sure what blue or brown inhalers might be. There is not standard
color codes. Blue is possibly Ventolin (Albuterol) and the brown might
be QVair. Albuterol would generally be used as needed to rapidly
improve breathing and stop an acute attack. QVair would be used on a
daily basis and could reduce the need for Albuterol.

Normally a simple way to monitor improvement or worsening is to use a
peak flow meter. They are very inexpensive devices you blow through and
available for home use. But your son is only 3 so it can be difficult
to get accurate results from such a young child. Your Dr. may have
other alternatives.

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Ted Edwards - 31 Oct 2007 21:46 GMT

> Hi, just wondered if anybody had any experience they could share with
> me. My son (3 years) doesn't have asthma attacks but has medication
> for tight chest, cough, and wheezing he gets as soon as he has any
> virus/ cold etc. My doctor first told me to use a blue inhaler when
> necessary and then further prescribed a brown inhaler for when he got
> really bad,

The label on the inhalers should have the name of the drug on it. Type
the names (one at a time) into the search block on
http://www.dogpile.com/
You'll be able to find out just what they are.

> Other people have suggested that frequently using steriod medication
> will make the asthma worse!

Like the song says, "It ain't necessarily so!" Inhaled steroids should
not be stopped suddenly but _if_ they are the appropriate medication, it
is worth the trouble.

> (because of the body's dependency on the
> steriod). I don't really want to be medicating my son daily with
> steroids and now i feel paranoid about using the inhalers at all.

I have COPD and have been using Pulmicort for 12 years and have observed
no side effects. At one point my doctor and I agreed on a test to see
if it helped and how much. I tapered down to zero and stayed there for
a few weeks. It was quite clear from my plots of PEF that it was helping.

Ted

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00doc - 31 Oct 2007 23:36 GMT

> Hi, just wondered if anybody had any experience they could share with
> me. My son (3 years) doesn't have asthma attacks but has medication
[quoted text clipped - 6 lines]
> months or less), but information i've read suggests this won't work
> because its cumulative.

I think in your reading you may be confusing wheezing in a small chidren,
which usually not not the same as asthma, with asthma in older kids. In oldr
kids the lung damamge from chronic inflammation is cummulative and so you
would not want to just trreat them during flares. You want to prevent the
flares. Things are different in young children.

> Other people have suggested that frequently using steriod medication
> will make the asthma worse! (because of the body's dependency on the
> steriod).

The first thing you need to do is stop talking to those people about your
child's health. They may mean well but they don't know much about asthma
and, more importantly, they don't know when they don't know.

> I don't really want to be medicating my son daily with
> steroids and now i feel paranoid about using the inhalers at all. I
> can't work out whether the problem is getting worse and if so is this
> because of a natural progression in the asthma, or because of the way
> i'm mediacting it??

Most kids that young do not need preventative meds year round. Just giving
them meds for flares is fine as the chronic steroids have not been shown to
provide benefit. Whwn the kids get older then keeping them on steroids does
help prevent long term damage. Some 3 year olds do have severe and
persistent enough symptoms that we treat them like the older kids and keep
them on the inhaled steroids.

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