Asthma moms

[hillview]

SIGH. DS1 woke up with a cough today. He coughs every few minutes -- dry hacking cough. He is on flovent 44 2x a day and albuterol as needed (I gave it to him this morning). I called the pedi and they made an appointment for 3:15 today (so glad they have weekend hours). What is likely to happen? Will they increase his steroid? We are using a spacer with a face mask for the meds.

TIA
/hillary

[egoldber]

My allergist would typically have us do the albuterol every 4 hours for 2-3 days and then if the cough had still not subsided, then he would likely go up to the next higher dose Flovent or add a different, second med.

[bubbaray]

I have limited experience with Flovent in particular (DD#1 did not react well to it). However, our protocol for colds or coughs for DD#1's severe asthma and my own asthma is to add 1 to 2 doses a day of steroid and ventolin/albuteral up to every 4 hours. If more albuterol is needed, we go to the ER.

For example, DD#1 was on Pulmicort 200 1 puff 2x/d. When she has a cold or cough, we up it to 1 puff 3 or 4 x/d. With the Pulmicort 200, usually 3 puffs a day was sufficient. With Pulmicort 100, sometimes 4 puffs a day wasn't enough during a cold. She is now on Symbicort 100, but hasn't had a cold since changing (touch wood).

What is your protocol for colds?

ETA: cross-posted with Beth. Our protocol is to increase the steroid right away and also start albuterol if needed. For DD#1, increasing the steroid seems to help more than the albuterol, which never seems to last the 4 hrs. I won't dose her more than every 4hrs unless she's in the ER, BTDT, not fun.

[hillview]

What is your protocol for colds?

Clearly I need to go to an asthma doc not my pedi. We don't have one :(

[bubbaray]

Knowing what to do for an asthmatic during a cold is really key to managing the condition. DD#1 has had many ER visits, always during either colds or allergy season. Now that I know better how to manage the condition with our meds at home, we are doing much better (ie., not needing the ER).

If your DS worsens before you can get to the dr, I would strongly encourage you to head to the ER. Don't screw around with dr's offices, walk-in clinics, etc.

Did your dr give you a protocol for when to head to the ER?

[bubbaray]

Ours is not this exact one, but you get the idea:

http://www.alaw.org/pdfs/asthma_management_plans/alaw_english.pdf

Note that your DS is in the yellow zone now (coughing). You need to watch and make sure he d/n get to the red zone. For us, that means difficulty breathing (tracheal tuck, rib retractions), rapid breathing (breathing significantly faster and more shallow than normal) and, as she has gotten older, she vocalizes that she can't breathe. If DD#1 says she can't breathe, I administer meds asap and pretty much get ready to either call 911 (haven't needed to do that) or take her to the ER (on many occasions).

[hillview]

Ours is not this exact one, but you get the idea:

http://www.alaw.org/pdfs/asthma_management_plans/alaw_english.pdf

Note that your DS is in the yellow zone now (coughing). You need to watch and make sure he d/n get to the red zone. For us, that means difficulty breathing (tracheal tuck, rib retractions), rapid breathing (breathing significantly faster and more shallow than normal) and, as she has gotten older, she vocalizes that she can't breathe. If DD#1 says she can't breathe, I administer meds asap and pretty much get ready to either call 911 (haven't needed to do that) or take her to the ER (on many occasions).

Thanks yes. We've been to the ER 2x in the last few months due to asthma. So far no retractions or difficulty breathing (that is when we head to the ER). Do allergens impact asthma?

thanks!
/hillary

[egoldber]

The other reason to build a relationship with an asthma doc is they will get to know your kid. I think bubbaray's DD tends to go from yellow to red abruptly. My older DD will hang out in that yellow zone for a long time, so the doc does not feel the need to push quite so hard so fast.

I can also just call and they will give me a protocol over the phone, but if things have been lingering, then they will certainly want to see her.

ETA: Many times asthma is allergy induced. My DD's asthma is allergy induced asthma.

[bubbaray]

The other reason to build a relationship with an asthma doc is they will get to know your kid. I think bubbaray's DD tends to go from yellow to red abruptly. My older DD will hang out in that yellow zone for a long time, so the doc does not feel the need to push quite so hard so fast.

I can also just call and they will give me a protocol over the phone, but if things have been lingering, then they will certainly want to see her.

ETA: Many times asthma is allergy induced. My DD's asthma is allergy induced asthma.


ITA with Beth. Establishing a relationship with the asthma doc is key.

Yes, my DD#1 goes from yellow to red quickly if we don't get right on it once she's in the yellow zone. Her asthma triggers are either colds/viruses OR seasonal allergies (pollen, grasses, etc).

[Kindra178]

Knowing what to do for an asthmatic during a cold is really key to managing the condition. DD#1 has had many ER visits, always during either colds or allergy season. Now that I know better how to manage the condition with our meds at home, we are doing much better (ie., not needing the ER).

If your DS worsens before you can get to the dr, I would strongly encourage you to head to the ER. Don't screw around with dr's offices, walk-in clinics, etc.

Did your dr give you a protocol for when to head to the ER?

It's all about management. We do Flovent 2 puffs once a day for maintenance, but then move up to 2 puffs twice for colds. We do Xopenex inhaler with spacer or nebulizer (which all the docs we go to say work better notwithstanding various studies that seem to establish otherwise).

Do you have a nebulizer for albuterol? That might work better. Good luck!