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Our imminent attack strategy

I had the pleasure of being interviewed by two lovely researchers the other week from the Health Experiences Research Group (HERG) at the University of Oxford. They are behind the Youth health talk and Health talk online websites which allow you to share the experiences of thousands of people through audio, video or written accounts of health related conditions and illnesses. Very worthwhile and well worth a look.

As part of the interview they were interested in the things that we do when we feel A is at risk of an asthma attack, and, as we found ourselves in that position again last week I thought it might be useful to share those things, things that I realise we do quite automatically now, but which we've learned to do over time. It's very specific to A and her asthma triggers of course, but I thought it might illustrate how over a period of time you get quite used to the routine of what to do and when and although you never lose that feeling of worry and panic when caring for a child with respiratory difficulties, you do get past the debilitating feelings of 'not again?', 'why us?' and move onto a more controlled approach using the experience you've (unfortunately) gained. Small comfort I know if you are at the start of this journey, but some of the below may be at least a little beneficial.

As soon as A gets the first sign of a cold or runny nose we immediately up the dose of the Clenil (brown) inhaler from 2 to 4 puffs morning and night. This is agreed with our GP and is intended to provide a larger hit of preventer medication when most needed. We also keep an eye on her Personal Asthma Action Plan and of course check that we have enough inhalers, Prednisilone and  Montelukast stashed in the cupboard. This is the 'medical' approach that we take and I guess will be different from child to child.

Although we have no evidence or reason to believe that dust is a contributing factor to A's asthma, we always make sure that we give her room and the rest of the house a thorough vacuum and change of bedclothes when she's at risk of an attack, even if they've only recently been changed. This is really just in case dust further irritates her and worsens an attack. We have also found decongestants such as Olbas quite useful for her overnight and the thing we find particularly beneficial is to either put a steaming bowl of water in her room overnight (regularly replenished and well out of reach) and/or putting a big load of bedclothes in the wash and hanging them on banisters and radiators to keep moisture in the air. This last tip really helps with her coughing and has on occasion stopped it completely.

If things do worsen, we check her saturations regularly and monitor her breathing rate throughout the night while giving the blue inhaler 4 hourly or less if necessary (we set an alarm), at this point (at night), one of us will sleep in her room on the sofa bed to keep an eye on her and an ear out for her breathing. If her saturations go below 94 at night or during the day and she is displaying asthma symptoms (coughing, wheezing, breathing fast etc) with little effect from the blue inhaler, we give her 20mg of Prednisolone. If things don't improve fairly quickly, within a few hours, we seek some kind of medical attention either at our local GP's, the 111 service or if necessary A&E.

Thankfully this time either the above strategy was not necessary, or did its magic. But if you do find yourself wanting to formalise such a plan, at least for the medical side of things, I cannot recommend the Personal Asthma Action Plan from Asthma UK enough, about which I shall write another post shortly.

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