parents of asthmatics a question

[NHdisneylover]

Hi,
My son has what has been quite mild asthma. He has to use his inhaler a few times a day for about a week 2-3 time a year. Two years ago the inhaler did not work enough and he had to have a breathing treatment in the ER and was given a liquid steriod to take for a week in addiotn to using his inhalor.

Yesterday his inhaler did not work well enough either and he had to have a breahting treatment in the ER again and then go to his doctor today. His breathing is still pretty bad and she has upped his inhaler dosage andprescribed a steriod. I just got home with the steriod from the pharmacy and is an inhaler (I was expecting pills, somehting got lost in translation). It IS what the perscription says so I am sure the fault is my beginer's German.
The doctor's office is closed now so I cannot just call her with my question.

My question is:
DS uses a Vortex Chamber with his regular inhaler. In your experience should he also be using that to take the inhaled steriods?

 

[DisneyKT]

My DD also has mild asthma. This year she also needed a steroid to help her out. We used one spacer of both medicines with no problem. Our doc said it was ok as long as we clean properly. Hope this help.

 

[luvmy3]

My one ds uses pulmicort all year and it is not designed to use with a holding chamber. My younger ds was prescribed flovent for the winter months, the ped said that she felt because of his age and inexperience with an inhaled medication that it was better for him to use the flovent (comes in an inhaler) with a chamber instead of pulmicort. She said that when its a beginner they tend to do more swallowing of the medication instead of inhaling it and the chamber is just a way to make sure that it gets inhaled.
I don't think your ds needs to use the chamber since he has experience with an inhaler, but it is okay for him to do it if you wanted to.

 

[Tinijocaro]

From what I understand-if using albuterol, it is always better to use it in nebulizer form rather than inhaler form. They have changed the meds and delivery system in the inhalers and many people feel they are not nearly as effective as using a nebulizer.

Is a vortex inhaler also called a spacer? They do recommend using that if that's the case.

Do you have a nebulizer?

 

[luvmy3]

From what I understand-if using albuterol, it is always better to use it in nebulizer form rather than inhaler form. They have changed the meds and delivery system in the inhalers and many people feel they are not nearly as effective as using a nebulizer.

Is a vortex inhaler also called a spacer? They do recommend using that if that's the case.

Do you have a nebulizer?

An inhaled steroid is not the same medication, it isn't albuterol. The OP is referring to an inhaled steriod that would be taken daily, it is not a fast acting medication used to stop an attack. You are correct that since mandatory change in the delivery system, the albuterol inhalers seem to be less effective, I have noticed that in my ds and there have been many complaints online about it.
Yes, the vortex chamber is a spacer, just the brand name.

 

[Tinijocaro]

An inhaled steroid is not the same medication, it isn't albuterol. The OP is referring to an inhaled steriod that would be taken daily, it is not a fast acting medication used to stop an attack. You are correct that since mandatory change in the delivery system, the albuterol inhalers seem to be less effective, I have noticed that in my ds and there have been many complaints online about it.
Yes, the vortex chamber is a spacer, just the brand name.

I know, I went off on a tangent. Pulmicort and the like are preventatives-I have two asthmatics here. Has the delivery method for a pulmicort inhaler changed too? Would that also render the steroid to be less effective too? I have a dd (who has severe asthma) always use the neb each day- for pulmicort and then albuterol as needed, yes it's a hassle but I don't want any more week long stays in the ICU.

 

[shelbys mommy]

My son is asthmatic, all we have ever used is a nebulizer.

 

[luvmy3]

I know, I went off on a tangent. Pulmicort and the like are preventatives-I have two asthmatics here. Has the delivery method for a pulmicort inhaler changed too? Would that also render the steroid to be less effective too? I have a dd (who has severe asthma) always use the neb each day- for pulmicort and then albuterol as needed, yes it's a hassle but I don't want any more week long stays in the ICU.

I honestly didn't think of that since my asthmatic ds uses Pulmicort Flexhaler so its not like a typical inhaler. In fact until my other ds was prescribed his flovent just this past winter I didn't even know that steroids came in inhaler form. We have used the pulmicort respules for the neb but that was when my ds was very young.
As far as the albuterol, our doc told us that if we are home and can use the nebulizer to do that over the inhaler. She never said anything about it when she prescribed my ds's flovent so I'm not sure.

 

[Tinijocaro]

Since I didn't know what a pulmicort flexhaler was, I googled it only to find it is the same one both my kids have. I use it for my older son who only has mild asthma but not for dd8. Be sure your ds rinses his mouth out each time he uses the flexhaler.

 

[james'mommy]

Both my DH and DS are asthmatic. DS takes singular daily. When he gets sick we usually have to neb. He ends up on steriods once a year. We also have tons of rescue inhalers laying around. (Last month I counted 10 around the house.) We don't use a chamber because it isn't covered by insurance. We usually just give him 2 hits on the inhaler and he ends up with enough in his system.

 

[luvmy3]

Since I didn't know what a pulmicort flexhaler was, I googled it only to find it is the same one both my kids have. I use it for my older son who only has mild asthma but not for dd8. Be sure your ds rinses his mouth out each time he uses the flexhaler.

Yes, he's become a pro, unfortunately. We tried to take him off for the summer months, but he just couldn't handle it. Hopefully someday.

 

[NHdisneylover]

Thank you all You are all posting in my native language and i still feel a little lost with all of the terms flying in these posts

Rio (he just turned 11 if that means anything) is taking two hits at a time 6 times a day right now of albuterol. It IS what we used to have in the USA (so far as I understand the name is a little different but the doctor here told me last year it is what the USA used to use, the "better" stuff). Apparently it is still allowed here

He has never had a nebulizer. The doctors in the USA did not seem to think he needed it as he was sick so rarely and he is very calm when he gets sick. I get the impression that he is very likely to get one here in the next few weeks as they work out what to do with him after this latest attack.

Yes, what he uses with the albuterol is also called a spacer. Sorry for the confusion. He has never had an inahled steriod before. What he has for that is called an Easyhaler (name brand) and I have no idea what the USequivelant might be. I had him use it without the spacer for tonight and I will call first thing when the office opens in the morning to find out what to do after this.

It was odd in the ER yesterday. He does not sound wheezy or look really distressed when he has trouble so they did not seem overly rushed until they listend to him (even though we were telling them his peak flow was down to about 30% which scared the beejeebies out of me--he was going downhill so fast as we drove). THEN they were fast getting the inahler things attached to the med output in the wall, they handed it to him and started to walk off to discusswith another doctor if they wanted to admit him and out him on IV steriods. We had to stop them to ask them how to use it. Apparently DS was so calm they figured he had been in for tons of breathing treatments (he has had one other but they put some sort of mask thing on him and it was 2 years ago). It scares me alittle to send him to school tomorrow since he does not LOOK that sick or complain when it gets bad. I have told him about a dozen times today to not hesitate to call or tell his teachers he needs me if he feels a little of and to take his peak flow between every couple of classes. He is still only at about 170 and normal for him is 270-290.

 

[luvmy3]

Thank you all You are all posting in my native language and i still feel a little lost with all of the terms flying in these posts

Rio (he just turned 11 if that means anything) is taking two hits at a time 6 times a day right now of albuterol. It IS what we used to have in the USA (so far as I understand the name is a little different but the doctor here told me last year it is what the USA used to use, the "better" stuff). Apparently it is still allowed here

He has never had a nebulizer. The doctors in the USA did not seem to think he needed it as he was sick so rarely and he is very calm when he gets sick. I get the impression that he is very likely to get one here in the next few weeks as they work out what to do with him after this latest attack.

Yes, what he uses with the albuterol is also called a spacer. Sorry for the confusion. He has never had an inahled steriod before. What he has for that is called an Easyhaler (name brand) and I have no idea what the USequivelant might be. I had him use it without the spacer for tonight and I will call first thing when the office opens in the morning to find out what to do after this.

It was odd in the ER yesterday. He does not sound wheezy or look really distressed when he has trouble so they did not seem overly rushed until they listend to him (even though we were telling them his peak flow was down to about 30% which scared the beejeebies out of me--he was going downhill so fast as we drove). THEN they were fast getting the inahler things attached to the med output in the wall, they handed it to him and started to walk off to discusswith another doctor if they wanted to admit him and out him on IV steriods. We had to stop them to ask them how to use it. Apparently DS was so calm they figured he had been in for tons of breathing treatments (he has had one other but they put some sort of mask thing on him and it was 2 years ago). It scares me alittle to send him to school tomorrow since he does not LOOK that sick or complain when it gets bad. I have told him about a dozen times today to not hesitate to call or tell his teachers he needs me if he feels a little of and to take his peak flow between every couple of classes. He is still only at about 170 and normal for him is 270-290.

They did not prescribe a liquid steroid (prednisone), only the inhaled. From what you say happened I am totally shocked if thats the case. I also would just keep him home tomorrow, I have kept my ds home the next few days for less severe attacks becuase I can keep my eye on him much better than a handful of teacher can. Hope he is back to himself soon

 

[NHdisneylover]

They did not prescribe a liquid steroid (prednisone), only the inhaled. From what you say happened I am totally shocked if thats the case. I also would just keep him home tomorrow, I have kept my ds home the next few days for less severe attacks becuase I can keep my eye on him much better than a handful of teacher can. Hope he is back to himself soon

Thanksfor that post I am really wanting to keep him home--but Isecond guess myself; he neesd to not get too far behind in learning German and he is one who really has to WORK at school so I was thinking I should send him. Hearing another mom say it would not be out of line to keep him home makes me feel better about making that decision.

Both at the ER and the Dr.'soffice it was said that they would normally put hiom on something else (IV steriods in the ER and maybe the luquidsteriods you are talking about in the office) BUT that he seemed okay even though his numbers were really low so they felt it was better to wait and see. That honestly bothers me some. He happens to be really calm about stuff and have a high threshhold for pain. He did not cry or fuss when he broke his arm--but they still cast it ya know? DH is out of town and Iam going to have him sleep in my room tonight so Ican easily check on how he is breathing and it is easy for him to get me if he needs me (he has only EVER said he needed to go to the doctor 3 times in his life and all 3 times he really was very ill; once was yesterday).
I really, really appreciate the support

 

[Goofycampers]

I am really surprised your pediatrician didnl't write a script for a nebulizer so you can use it at home as needed. As a R.N. and a mother of a asthmatic, your son doesn't sound like a controlled asthmatic at all. If you have had to make an er visit, he should definitely be on something more effective. Asthma is too serious of an illness not to have everything in place when he has a flare up.

 

[NHdisneylover]

I am really surprised your pediatrician didnl't write a script for a nebulizer so you can use it at home as needed. As a R.N. and a mother of a asthmatic, your son doesn't sound like a controlled asthmatic at all. If you have had to make an er visit, he should definitely be on something more effective. Asthma is too serious of an illness not to have everything in place when he has a flare up.

Thanks. She does want me back next week and hopefully they will do more then. She did ask today if he had a nebulizer and why not. The answer to why is just that no one ever gave him one. I think sometimes things are just treated differently here in Germany than in the US also. This is only the second ER visit ever (once was in the US two years ago and then they told me if he had to make another one they would look at getting him a nebulizer, but not after one since he only needs the inhaler a few times a year at most). He had a bout in October also that did not land him in the ER but we did have to go to the doctor and she had him go from 2 puffs four times a day to 3 puffs 6 times a day to get it under control then. So that with this new episode has me really concerned. I am sure it is nothing compared to what many other parents deal with for their kds, but it is more than I am used to and I feel helpless without understanding what mroe can be done or when to ask for what. It is so hard to talk to him and hear him stop to breath every couple of words and not really have any way of helping. Okay, I am rambling now--sorry.