Overall I don't want to dwell on some of the more serious attacks that A has had. We're keen to improve things for her and not limit her by harking back to 'what if's'. However if you're reading this blog because you are experiencing some of the same things, I thought some background into our experiences would be useful, starting with what actually has happened up to now.
When she was roughly 18 months old (she's 3 now) A had a number of colds leading to nasty chest infections, or at least that's what the doctors thought at the time. She had antibiotics 4 times in 6 weeks and as she came down with another nasty cold I clearly remember thinking that something had to be wrong. As that cold developed she seemed pretty poorly again, but come Saturday morning she seemed so much better that we decided to go ahead with our plans to go to a wedding and have my parents over to babysit. During the wedding reception we had a couple of calls to say that she was coughing a lot and then that she sounded a little wheezy on her chest. At that point we went home and followed the doctors advice to give her a couple of puffs of the blue inhaler he'd given us the week before and the wheezing seemed to settle and she fell asleep. A short time later, all hell broke loose. Suddenly she was screaming and literally hurling herself around her cot. Her breathing sounded terrible and she was inconsolable. At that point we rushed her into A&E.
I remember turning to look at her in the back of the car (knowing what we know now of course we should have called an ambulance). I remember thinking that she looked grey. At the hospital they took her blood/oxygen levels (saturation's) which we later found out were dangerously low. A doctor arrived immediately and from his demeanor it was clear something pretty bad was unfolding. He told us they'd be keeping her in, gave her a nebuliser and oxygen (and various other drugs) and said they'd see how she goes on those. Things settled for a very short time. She was still grey, still floppy and her laboured breathing was clearly visible as the skin sank in around her ribs, but her saturation's were improving and she seemed to be responding until suddenly, she wasn't. A paediatric doctor had arrived by then and I'll never forget her face as she told us that things had become more serious and that she was moving A to the High Dependency Unit (HDU). The only question I wanted to ask was the one question I didn't want to know the answer to, so I never did ask 'will she die?'
In the HDU she was given intravenous steroids and Salbutamol, back to back nebulizers and continuous oxygen. Thankfully she began responding fairly quickly and didn't need to be ventilated. We sat by her bedside the rest of the night, all the following day and by that evening felt confident enough in her progress to sleep while she slept. The next morning she was by far the chirpiest child in the HDU. Amazing for us, but very sobering as we suddenly had the emotional capacity to take in the nightmares playing out for the other parents around us whose children were not sitting up demanding toys and chomping down toast.
Since this first attack A has been hospitalized around 5 times, generally entailing at least one overnight stay but thankfully we have not seen the inside of the HDU again. Her asthma attacks always follow a respiratory virus and between June 2011 and February 2012 she had upwards of 10 three-day courses of Prednisilone (20mg daily) which is a scary steroid for one so young to bring her attacks under control. Since February 2012 we have mainly been able to control her attacks with inhalers alone, however this last month we've seen another flare up and just this last weekend a nasty attack with much involvement from the local GP's surgery, a course of Prednisolone and the familiar heightened state of concern. Unfortunately our hopes that things may have settled down in terms of the severity of her attacks seems to have been a little premature.
Currently A takes a combination of medications for her asthma. Daily she has 2 puffs morning and evening of the brown Clenil (steroid) inhaler. This is increased to 4 puffs twice a day when she is starting symptoms of a cold along with the blue Salbutamol inhaler as and when needed. When particularly bad she has up to 10 puffs of the blue inhaler every four hours (but to be honest often more regularly than that) and if she can't last 4 hours between inhalers without symptoms she starts on 20mg of the soluble steroids (Prednisolone) for 3 to 5 days. In addition to all of the above she takes Montelukast granules every day which act to block certain receptors in the airways which as I understand it are those that go a little crazy in the build up of an asthma attack. If I'm completely honest I can't be sure that any of the daily preventative medications do very much, but we continue with them religiously to ensure that we're doing the very best we can to keep things under control.
I remember turning to look at her in the back of the car (knowing what we know now of course we should have called an ambulance). I remember thinking that she looked grey. At the hospital they took her blood/oxygen levels (saturation's) which we later found out were dangerously low. A doctor arrived immediately and from his demeanor it was clear something pretty bad was unfolding. He told us they'd be keeping her in, gave her a nebuliser and oxygen (and various other drugs) and said they'd see how she goes on those. Things settled for a very short time. She was still grey, still floppy and her laboured breathing was clearly visible as the skin sank in around her ribs, but her saturation's were improving and she seemed to be responding until suddenly, she wasn't. A paediatric doctor had arrived by then and I'll never forget her face as she told us that things had become more serious and that she was moving A to the High Dependency Unit (HDU). The only question I wanted to ask was the one question I didn't want to know the answer to, so I never did ask 'will she die?'
In the HDU she was given intravenous steroids and Salbutamol, back to back nebulizers and continuous oxygen. Thankfully she began responding fairly quickly and didn't need to be ventilated. We sat by her bedside the rest of the night, all the following day and by that evening felt confident enough in her progress to sleep while she slept. The next morning she was by far the chirpiest child in the HDU. Amazing for us, but very sobering as we suddenly had the emotional capacity to take in the nightmares playing out for the other parents around us whose children were not sitting up demanding toys and chomping down toast.
Since this first attack A has been hospitalized around 5 times, generally entailing at least one overnight stay but thankfully we have not seen the inside of the HDU again. Her asthma attacks always follow a respiratory virus and between June 2011 and February 2012 she had upwards of 10 three-day courses of Prednisilone (20mg daily) which is a scary steroid for one so young to bring her attacks under control. Since February 2012 we have mainly been able to control her attacks with inhalers alone, however this last month we've seen another flare up and just this last weekend a nasty attack with much involvement from the local GP's surgery, a course of Prednisolone and the familiar heightened state of concern. Unfortunately our hopes that things may have settled down in terms of the severity of her attacks seems to have been a little premature.
Currently A takes a combination of medications for her asthma. Daily she has 2 puffs morning and evening of the brown Clenil (steroid) inhaler. This is increased to 4 puffs twice a day when she is starting symptoms of a cold along with the blue Salbutamol inhaler as and when needed. When particularly bad she has up to 10 puffs of the blue inhaler every four hours (but to be honest often more regularly than that) and if she can't last 4 hours between inhalers without symptoms she starts on 20mg of the soluble steroids (Prednisolone) for 3 to 5 days. In addition to all of the above she takes Montelukast granules every day which act to block certain receptors in the airways which as I understand it are those that go a little crazy in the build up of an asthma attack. If I'm completely honest I can't be sure that any of the daily preventative medications do very much, but we continue with them religiously to ensure that we're doing the very best we can to keep things under control.
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