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» April 2011 Asthma Adviceline Case Study
April 2011 Asthma Adviceline Case Study
Robert has a six year old son, Mark, with asthma and allergic rhinitis. His has been very well controlled for the past 2 years and he managed to reduce his son's medications. However he became very unwell about 3 weeks ago and despite increasing his son's medication to what he was originally prescribed, he is still not better. He called the Asthma Adviceline for advice.
Robert's Story: I rang the Asthma Adviceline and explained the situation. The Asthma Nurse asked me what symptoms my son was experiencing. I explained to her he coughs a lot and gets very short of breath. He was waking up at night ,coughing and his nose was dripping constantly. He was using his blue reliever more often and was getting less relief from it. She said that it appeared that my son’s asthma was out of control. I told her how Mark never had an actual asthma attack but that when his asthma went out of control he becomes worn out and generally unwell. He can’t lie flat and his sleep is very interrupted. he has no appetite and becomes quite irritable. The Asthma Nurse said what I was describing was an acute exacerbation of asthma and said that I should bring my son to my GP as soon as possible and address a number of issues such as:
- That Mark is has been unwell for 3 weeks with shortness of breath, night time disturbance and wheezing.
- That I have been changing his medications (increasing and decreasing the doses depending on how well Mark has been) without a formal asthma management plan.
- That nasal treatment needs to be addressed either with a nasal spray or a tablet specific for rhinitis.
- That he needs to have his inhaler technique checked.
I used to use a peak flow meter and diary with Mark and the Asthma Nurse suggested that I go back to using the peak flow meter again as this will take the guesswork out of knowing how well my son is. She said she would send me a new diary. She also suggested that I replace the chamber device. My previous one was 2 years old and the nurse explained how this would not only improves the efficiency of the medication but reduces the side effects in the mouth. I had noticed that Mark has had dreadful thrush in his mouth since he stopped using the chamber.
The Asthma Nurse stressed the importance of complying with medication and recognising the signs and symptoms of deteriorating asthma and when to get help.
She also said that it is recommended a child with asthma when well controlled should have a routine asthma review every 6 months. Mark has not been seen by a doctor in 2 years. The Asthma Nurse advised me to make an appointment with my GP to review Mark’s asthma and that at this next visit I should ask about a personalised asthma plan for Mark, a review of medication both for his chest and nose and a further appointment to have him assessed again to see how well this plan is working.
I felt a lot better having spoken to the Asthma Nurse and realising that although I have been managing my son’s asthma quite well for a number of years, there are more structured ways of doing this and I have made an appointment to visit my GP with the intention of putting this plan in place.
