How do I know when/if to give DD her inhaler?

[ChristusG]

At DD5's yearly check up back in March, I asked her doctor about the fact that DD seems to cough a lot. She'll run around and then begin to cough. She'll get to laughing a lot and then cough. She's have a crying meltdown and then cough. The doctor said it was a slight form of asthma and gave us an inhaler and a spacer. She's usually a very good doctor, but she explained nothing about it nor told us how/when to use it. Since then, there's been several instances where I've wondered if I should have given it to DD.

 

When DD got to laughing and playing rough at my parents house, she began to cough. Every time she'd laugh, it would be followed by a cough. And twice now when DD has gotten very upset and had a meltdown, it would end up being cry, cough, cry, cough, cry, cough (the second instance of this just occured tonight, which prompted this post).

 

Each time, I've gotten DD to sit down and rest for a few minutes. After the laughing, excitement, or crying subsided, the coughing would significantly ease up. She never seemed to be distressed or concerned about being unable to take a full breath or anything like that. Should I be giving her the inhaler in these circumstances? I know that the inhalers themselves can have side effects (jittery, rapid heartbeat, etc), so I don't want to give it if it's not needed, of course. How do you determine when to give your child their inhaler? We've never used it. Nor has she been "officially" diagnosed with asthma.....just what the doctor mentioned at her appointment.

[sewingmama]

Honestly if it subsides quickly I wouldn't give it to her.

 

I have asthma -I know when to use it because the coughing turns into breathlessness and my chest constricts. In turn it becomes very difficult to get your breath. The coughing worsens till it feels like you are choking to death.

 

If I only cough lightly and the other symptoms don't happen I don't take my inhaler.

 

However - always make sure you have the inhaler on you even if she usually rights herself. Asthma can suddenly turn bad in an instant and it's better to be safe then sorry.

 

My DD has the same symptoms as your DD - meltdowns and laughing etc bring on huge coughing fits. I have thought she might develop asthma later on but I have never given her the inhaler for it.

 

Just get your DD to sit quietly and breathe deeply for a few minutes before giving it to her. You'll be able to tell if she needs it -she won't be able to get her air in and she will become distressed.

[sbgrace]

It does sound like an asthmatic cough and I would give the inhaler in that circumstance. My son asks for his inhaler when he's needing it but he's been dealing with it longer so knows what it feels like when the asthma is acting up. If you treat her when she's coughing she'll get a better sense of when she needs it.

 

My other son is poorly controlled right now due to a virus. I'm giving his preventatively. I'm taking it you're not seeing the cough that frequently, right? Just occasionally when she runs or gets upset?

[sparrow]

At DD5's yearly check up back in March, I asked her doctor about the fact that DD seems to cough a lot. She'll run around and then begin to cough. She'll get to laughing a lot and then cough. She's have a crying meltdown and then cough. The doctor said it was a slight form of asthma and gave us an inhaler and a spacer. She's usually a very good doctor, but she explained nothing about it nor told us how/when to use it. Since then, there's been several instances where I've wondered if I should have given it to DD.

 

When DD got to laughing and playing rough at my parents house, she began to cough. Every time she'd laugh, it would be followed by a cough. And twice now when DD has gotten very upset and had a meltdown, it would end up being cry, cough, cry, cough, cry, cough (the second instance of this just occured tonight, which prompted this post).

 

Each time, I've gotten DD to sit down and rest for a few minutes. After the laughing, excitement, or crying subsided, the coughing would significantly ease up. She never seemed to be distressed or concerned about being unable to take a full breath or anything like that. Should I be giving her the inhaler in these circumstances? I know that the inhalers themselves can have side effects (jittery, rapid heartbeat, etc), so I don't want to give it if it's not needed, of course. How do you determine when to give your child their inhaler? We've never used it. Nor has she been "officially" diagnosed with asthma.....just what the doctor mentioned at her appointment.

 

Yes, in the bolded circumstance, I would probably give the inhaler. Our dd's cough starts sounding a little phlegm-y and that's when we know she *definitely* needs a puff.

 

My dd has exercise-induced asthma, which is what it sounds like your dd has. My dh has asthma, so I had some help understanding when she needed the inhaler and when to ride it out. After years of dealing with it, dd can now monitor her own symptoms and know when she needs it. We do a pre-activity puff before soccer, too. Soccer also really helps with her endurance. She has much more endurance, and needs her inhaler much less, at the end of the soccer season.

 

I like this website's clear information about EIA: http://kidshealth.org/parent/medical/asthma/exercise_asthma.html#

[ElaineJ]

Can your doctor give you a peak flow meter so that you can get a more objective measure of how well she is breathing? Many years ago when our doctor wanted to put my asthmatic son on Singulair I was resistant as I didn't want him taking medication daily if he didn't really have to. She had me use the peak flow meter several times a day for a week or so without the medication and then take the same measurements for a period of time after starting the medication. the difference was dramatic enough to convince me to stick with the medicine. Prior to that "experiment", I hadn't thought he was realy having much issue with his breathing. All this to say, if you got used to using the peak flow meter it would give you a better idea of where she is at and when she really needs the inhaler. (My son is now 12, by the way, and can tell for himself when the inhaler is needed.)

Elaine

[Pippen]

I agree about exercise-induced likely being part of this. I would have her use the inhaler BEFORE any running around.

 

It was hard for me to break the mentality of don't medicate until a symptom is bad but with asthma you actually will use less medication if you medicate preventatively.

[Ellesmere]

Can your doctor give you a peak flow meter so that you can get a more objective measure of how well she is breathing? Many years ago when our doctor wanted to put my asthmatic son on Singulair I was resistant as I didn't want him taking medication daily if he didn't really have to. She had me use the peak flow meter several times a day for a week or so without the medication and then take the same measurements for a period of time after starting the medication. the difference was dramatic enough to convince me to stick with the medicine. Prior to that "experiment", I hadn't thought he was realy having much issue with his breathing. All this to say, if you got used to using the peak flow meter it would give you a better idea of where she is at and when she really needs the inhaler. (My son is now 12, by the way, and can tell for himself when the inhaler is needed.)

Elaine

 

I agree about exercise-induced likely being part of this. I would have her use the inhaler BEFORE any running around.

 

It was hard for me to break the mentality of don't medicate until a symptom is bad but with asthma you actually will use less medication if you medicate preventatively.

 

 

Strongly agreeing that objective measurement with a peak flow meter and prevention are key.

 

Even as an adult, objective measurement is more reliable than what I would self-report for my own symptoms.

 

I went years undiagnosed as a child and it was such a struggle. My otherwise-fine PCP just didn't seem to understand and my parents got no help trying to figure out things. It is worth digging for answers on this.

[FO4UR]

I'd ask for a referral to a pulmonary ped. The coughing might only be the tip of an iceberg...or you might find that is not the case at all. Either way, better safe than sorry.

 

My 9yo has severe asthma, and even when he does not have any *visible* symptoms (coughing/wheezing), his breathing is pretty terrible without the daily maintenance meds. I found a pulm. ped here and thought to myself that it's too bad that ds was not symptomatic around the time of that first visit (b/c I wanted the Dr to see what ds really struggles with!), and it surprised me greatly to see the results of the testing they did on him!

 

The scary thing with small children is that *not being able to breathe* becomes a normal feeling for them. They may not know what it feels like to have a good, healthy breath...and so don't ever tell mom that they are having trouble. After several months on his new meds, my ds can finally tell a difference in his breathing before we see coughing/wheezing/hunching over to catch a breath.

 

 

I would give the inhaler when you see the coughing. Asthma is generally a downward spiral. The quicker you treat the first symptoms, the better.