It can be very scary to deal with an asthmatic child (I have 2 -- but I think it's easier for me because I, too, am asthmatic -- so I know myself how it feels). You've received some good advice here but I thought I'd add my 2 cents worth.
When to use the albuterol:
- For right now, until she gets this under control (a few days to a week or so), use 2 puffs every 4 to 6 hours. It's best to space the 2 puffs out a bit: do one, wait five to ten minutes, do the second. This allows the first puff to open those airways a bit which makes that second one even more effective. Don't be afraid of albuterol inhalers. They're very safe. Still, like any prescription medication, use it with respect and follow directions.
- Going forward, you & your daughter will most likely find she needs the albuterol less. Still, when she needs it the dose is usually 2 puffs at a time (again, spaced 5 - 10 minutes apart). It's funny -- this is one medication that I've never seen the dosage change, regardless of the age or size of the patient. Kids, adults -- whomever -- it's still 2 puffs at 4 - 6 hour intervals as needed.
How to know when she needs it:
- My asthma attacks come on slowly -- even over the course of a few days -- so I'm sometimes not even aware at how I've been struggling in a low-grade kind of way. For me, some times it feels like I just can't get a deep breath. Sometimes there's a tightness or sense of pressure in my chest. Sometimes it's a recurrent cough. Some things you can watch for (in addition to the cough -- a good indicator): does she sigh a great deal? Take audible deep breaths more often than usual? Does she seem very tired, even though she's getting enough sleep? In addition, there's the wheezing or chest rawls that most people associate with asthma -- don't be fooled though; you can not be wheezing and still be in some distress. When my daughters were younger and would get colds, I'd put my ear right up to their chest & have them inhale. You can frequently hear some rumbling even without a stethoscope. One suggestion: if your daughter says she thinks she might need her inhaler, have her use it (as long as it's been at least 4 hrs since the last dose). Just because she's not coughing or you can't hear her wheeze doesn't mean she's not having trouble.
Possible triggers:
- Colds (well, duh!) and allergies seem kind of obvious but for me, a big trigger is rapid weather changes (weird, huh?). A doctor once explained that, for some, rapid changes in barometric pressure or unstable weather patterns can cause a problem. Some people have trick knees or other joints, I have trick lungs. I can usually tell when a storm is coming; spring & fall, being more of transition seasons in our area, are harder. Extremes of temperature OR humidity; very dry air is as much a killer as humid days. Stress can be an issue for others. Seasonal allergies are a biggie for one of my daughters. Neither my kids nor I have ever been to an allergist -- but I know a lot of what they're allergic too (fortunately, none of us seem to have the harder to figure out allergies; we're your run-of-the-mill hay fever, some animals, dust kind of crowd). Why deal with the cost & discomfort if you can watch & get a decent handle on things yourself? We find Claritin, Benadryl & Zyrtec as needed (no -- not all at once, silly!) help us manage the allergies.
If you're confused or trying to determine what's going on, keep a log/diary of what's going on & how she's doing. For me, it took a while before my asthma was really under control. Then, the symptoms became much fewer in frequency & in intensity. For one of my girls, once we managed it well & she grew up a bit, her symptoms pretty much stopped.
A couple of things:
- after using the inhalers, a little sip of water or something will help rinse out her mouth. They taste like hairspray (bad enough) and I've been told that some inhalers, if they park at the back of your throat, can cause an infection (I've never had a problem myself -- but why temp fate?).
- Take a look at whatever cold medications you might be giving her. Many caution against using them with asthmatic coughs.
- A cool mist humidifier on a low setting is helpful at my house this time of year. It just gets very cold & dry in the northeast. Dry, like humid, isn't fun.
- Exercise is good -- unless she's in the midst of an episode. For me (a way-too-out-of-shape middle aged mom), I make sure I use my albuterol before I do any unusually heavy-duty physical activity (right now, snow shoveling comes to mind) -- even if I feel fine & am not having any symptoms. I don't let my asthma stop me, but I'm also prudent and prepare myself well. Think of it the way you think of sunscreen; it's more effective when you put it on before intense sun exposure.
-- a final word (at last, you say! -- sorry, I get a little long winded): One of my girls had some respiratory issues for about a year and then nothing for the seven or eight years since. I wouldn't say she has asthma, but she did have some asthmatic response to a bad cold that turned into bronchitis. Once we got her stable and were vigilant for several months, she never again needed any inhaler meds. Not sure why it happened then, but it did and it hasn't since. I'd wait a bit & see how things go before I became convinced your girl has asthma. Hopefully, this will be as short-term for you and your daughter as it was for me and one of mine (not so the other. *sigh*).
Hope this helps. Good luck to you and to your daughter!
