Support for Viral-Induced Asthma/RAD

[smokeylo]

Hi moms,

My daughter, 3 years, has been diagnosed with viral-induced asthma and I'm looking for other mothers/parents to talk with about it. It's been a problem since she was 13 months old, but we didn't get a diagnosis/treatment plan until this winter. What was once an occasional/alarming flare up has become a persistent problem. She's had 6 VIA exacerbations in the last 4 months, all requiring steroid treatment. While the inhaler occasionally helps, we almost always have to resort to using the orapred. And that takes what feels like forever to work: she is coughing constantly, with no break, after a dose of orapred and several inhaler puffs. I feel so stressed about this: she has trouble sleeping, and the docs -- even the asthma docs!! -- seem to think it's no big deal. I hate it!! I am searching for other people in a similar situation.

[Peony]

At her age, why don't they have her on nebs when it is acting up? I'd seek another opinion, a pediatric pulmonologist if you can get into one. You obviously know it as well, but that many incidents in such a short time, means it is not controlled.

DD2 has viral induced asthma, she had struggled with RAD since she was a baby, she was 1 when she was first put on an inhaler. No symptoms other when she was ill which then meant she got sick very easily and very quickly. We did the same thing you are doing, winter after winter, it got to point where pneumonia was occurring several times a year, she was always ill, always coughing, and the coughs would linger and linger. We've had a standing order for codeine cough syrup for years now.  Her regular docs weren't concerned, "eh, it will get better when she gets older". This fall, I had enough, she was 4 by then and I wasn't about to go through another winter with multiple ER trips. By then she was on nebs and two different inhalers. Went to the specialists who couldn't believe how poorly her asthma was controlled and was started an aggressive treatment plan. Switched neb meds, we do those at the first sign of any illness, switched inhaler meds and instead of a pedi spacer went to a inspirease bag. And I finally agreed to give Singular a try. I wasn't thrilled about it but thought we could do a trial and things couldn't get worse then they had been. I have a entirely different child today. We've gone though some nasty bugs this winter, and NOTHING from her all winter, no coughing, no ER. DS got croup, she barely got a cold, last summer she ended in the hospital on a beach vacation from croup. DS and I again got this nasty, nasty respiratory infection that knocked both of us out for two weeks even after having to get antibiotics, she never got it. This child previously was nicknamed the walking petri dish because she got every germ known to man, if a disease came through the state, she got it, and got it severely. I can't sing from the mountain tops loud enough about just how much her asthma actually being controlled has improved her life and therefore the entire family. 

Certainly keep trying docs until you find one that takes you seriously. 

[smokeylo]

We are seeing a ped asthma specialist, supposedly one of the best in the country, but they are insistent that this many exacerbations is normal and there's nothing we can do to prevent them. A friend of mine with an older son with VIA has mentioned both the nebulizer and singulair. What are the relative benefits of a nebulizer vs an inhaler? DD is only just now becoming compliant with her "special nose medicine" so I'm a little nervous about going to the nebulizer, but it seems like that's a very common way to manage asthma in small children and the inhaler does not help when she's having an exacerbation due to illness (will often help if her allergies act up or it's environmental, though). And I'd definitely be interested in singulair perhaps next winter, especially if it reduced how often she ended up on the steroid. At least we haven't had to go to the ER for asthma this winter, nevertheless, I don't feel like things have improved much beyond that (we just have the meds on hand now).

[Peony]

With younger children and especially during viral induced incidents, a neb allows for more accurate and complete administration of the meds. Honestly, I can not believe they have not had her on nebs especially since you are using the inhaler multiple times during an illness induced event. I know families that have portable neb machines and use those instead of rescue inhalers even on the go. It is more time intensive, it can take 15 minutes or so twice a day. We only do them when she is ill, but they work so much better then an inhaler. It doesn't require precise administration, which in a child say under 5 is really hard to do with an inhaler.