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Respiratory infections triggering uncontrollable asthma

Looking for people with similar symptoms and how they control their asthma.

My 7 year old daughter has asthma only when triggered by a respiratory infection. This last time is was actually a sinus infection. She's had this since she was little, maybe around 2 yrs of age or less. However, only recently have we had trouble controlling it. Previously we were able to control it with combivent nebs, twice daily and albuterol nebs in between. This routine just seemed to make things worse this past episode, on Nov. 2nd and again last week. 

She ended up in the hospital on oxygen in November. What they did worked then, but last week, not really. Last week she was still at a 88-89% O2 sat on oxygen and she stayed that way for most of a day. I'm not an expert, but that doesn't seem acceptable. I live in rural Ecuador and there are no pulmonologists here, though we plan on trying to find one in the closest big city, Quito, 4 hours away over the Andes. Not ideal, but we hope to have a better plan in place for next time. The docs at the hospital didn't know what to do besides cortisone, oxygen and albuterol inhalers. Sigh. I hope the doc we find in Quito has a better idea.

The reason I'm writing is because, even if we find a pulmonologist, I'm not sure I'll trust what they recommend. So I'd like to know what you all do!

If there are others out there that have the same sort of trigger, would you write me with what your successful regime/plan is? Just so I can compare it to what is suggested.

Thanks so much,

Michelle 

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Comments 6

  • K8sMom2002

    Hi, Michelle — I hear you on your worry about your daughter!

    Upper respiratory infections — either viral or bacterial — are big triggers for both me and my DD. At one point when she was 18 months, she spent six weeks straight on powerful antibiotics. 

    I do encourage you to seek out a pulmonologist that you trust. What we have found with specialists (and ours is three hours away, though no Andes Mountains between!) is that a good plan can help in a variety of situations.

    • a good asthma action plan that is written down with a number to call for an emergencies can help a local doctor or hospital staff better treat your daughter.
    • a good asthma action plan can help keep her from getting so terribly sick to begin with — catching things when they're small helps!
    • a "sick plan" has been a life saver for us. We both now have "sick plans" when we realize we're coming down with an upper respiratory infection. For me, that includes antibiotics right away, since I am prone to secondary pneumonia, and it also includes steps like using our inhaler more often and sooner, even if we don't think we "need" it. 
    • an allergist or pulmonologist can help figure out if there are any other steps to be taken:
      • avoiding environmental triggers that can cause a sinus infection
      • getting flu and pneumonia shots to help prevent infections to begin with
      • tweaking medications, including long acting controllers, to make sure that in between infections, her asthma is well under control so that a respiratory infection doesn't immediately knock her down.

    Hugs … I know this is stressful for you, because I have walked in your shoes. 

  • Shea

    Id talk to a doctor about a steroid to settle the inflammation that often irritates asthma when one gets a respiratory infection– I usually need an antibiotic (I prefer azithromax), an oral prednisone taper, along with an inhaled steroid for nebulizer and/or handheld inhaler. I use budesonide (an inhaled steroid for the inflammation) in my nebulizer 2-3 times a day, along with albuterol (which helps open my airways) and ipatriprium-bromide(also helps ooen my airways) nebulized, and then I also carry flovent, albuterol, and combivent inhalers with me just in case I need them when Im away from my nebulizer because for me the medications work better nebulized).

    During respiratory infections I usually do an oral prednisone burst of 60mg for 3 days, then 50mg 3 days, 40 for 3days.. And continuing lowering by 10mg every 3 days until you wean off… But I am an adult, so a child would probably start lower). My primary care doctor doesnt mind prescribing prednisone tapers, but a pulmonologist, immunologist, or rheumatologist might be needed for inhaled steroids but some primary doctors will prescribe them, along with a referral, to hold you over until your appointment. Good luck!

  • Jen

    Hi Michelle,

    Welcome to AAFA's support forums.  You have some good questions.  Do you think you'd be comfortable asking the doctor to fill out an ?  You could ask them to include any changes or additions they might make when she's sick.

  • MariesMom

    Hi there,

    Thanks to all three of you for the helpful replies. Cynthia and Jen, An action plan sounds like something we need for sure. Jen,  I've ordered the action plan, you sent the link for, sounds like a great idea! Shea, a phone number for a pulmonologist that the emergency room doctor is a great idea and something I didn't think of. Thanks! Plus, and the doctors around here are much more willing to hand out their phone numbers, so that will probably work even better here than in the US. I was also thinking that some kind of steroid treatment was indicated, because I was reading that respiratory infections trigger asthma through the inflammation they cause. It's good to hear that confirmed. And Cynthia, we know when these things are approaching, we can definitely start inhalers before we feel like she "needs" them. Sounds like a good idea as well. 

     

    And thanks to all for the support, this has been stressful, because our old system stopped working and what they tried here didn't work! Wow.  

  • K8sMom2002

    I'm so glad we could help! If you have access to a printer, you can print a free downloadable asthma action plan right away with Jen's link above. The link to print it will be in your receipt that you get in the email.