My allergy/asthma kid was diagnosed with asthma around age 2. It was cough variant initially and now is the wheezing sort. He does Singulair and Zyrtect for the allergies and that does control it pretty well for him. He does use albuterol before going outside when he's in his outdoor allergy season. We shower when we come in too which is a pain. I use HEPA units in the main play room/living space and his bedroom. For him controlling allergies is key to controlling his asthma.
But I really identify with the struggle you wrote with my other child. He started with asthma like you're describing after an episode of pneumonia this fall. His asthma has been harder to control. It's triggered by even the mildest virus. There may be an allergy component, which is a surprise to me given we've never felt he was an allergy child. He seems to possibly be reacting to my parent's house--we recently moved and are spending more time there. I don't see allergy symptoms but we do see asthma flairs. I have him on Zyrtec now to try to control that part of it.
He has had a couple of rounds of oral steroids. We were told one day of those is equal to a year of inhaled, maintenance steroids. So I've decided that, if we find ourselves there again, we will go the inhaled route. So far I've managed to control the asthma better and avoid the need but I'll go there if that changes.
Things I'm doing that are helping:
Pycnogenol at the doses described in this study daily. It has been key in reducing his asthma flairs and severity. Missing even a dose sets us back though so it looks like it's going to be a continual need. http://www.ncbi.nlm.nih.gov/pubmed/12639402
I had found pediatric studies with it as well but, for some reason, I'm not finding them to link when I search. This article refers to one and quotes findings. http://www.nutraingredients.com/Research/Pycnogenol-may-help-children-manage-asthma
I am using Tumeric (just one tsp a day) too. I don't seem to need this one unless we're triggered. But it does help in those situations and helps a lot. Actually, we're using it daily now as a cold virus flair snuck up on me and we had a rough time period and I don't want to repeat that.
I am doing albuterol when I first see a virus rearing to try to stop the cascade. The most I've needed it is every 4 hours for about 24 hours and that is a vast improvement from where we were--every 3-4 hours around the clock for months. Most viruses he hasn't even needed that much.
You are going to need to address controlling the allergies component. I'd start with zyrtec if you're comfortable. If she doesn't tolerate that or it doesn't help enough move to another. Singulair may help with that component of her asthma. It really helps my asthma/allergy son. The other child reacting poorly to it (emotionally) but those symptoms left when we took him off. I don't regret trying it and it does help his twin with no side effects.
Right now your daughter, like my son was, is not well controlled. The key is using albuterol more than one 24 hour day in a flair (or needing that more often than once a week or two weeks for actual asthma symptoms if I recall). If she doesn't respond quickly to additional measures you might take I'd consider going back on the inhaled steroid. You want to avoid needing those oral steroids!
It is ok, and a good idea, to give it before you expect symptoms as a preventative--so before going outside, exercising, at the onset of a virus, etc.--her known triggers. Preventative is ok. It's the responsive, pulling her out of symptoms and needing to do that every 3-4 hours too often, that is indicating the lack of control.
I feel for you. I was just dying with that round the clock albuterol. It's stressful. My son has autism, ADHD, and a metabolic condition. That didn't make the asthma issue any less stressful. It was horrible! It still is when he has a flair. But I feel better about it now. I hope the same for you.Edited by sbgrace - 4/1/13 at 6:59pm