I saw your question posted on 18th may 2012 just now. Though it is late, it may be useful to others.
You have raised 3 questions and they are very important.
treatment as climbing up a staircase by a one and a half to 2 year old child. It will usually climb one step at a time. it will stabilise itself for a while and then climb the next one. Similarly there are 5 steps in asthma treatment. Like the child we can climb only one step at a time.
This has 2 advantages.
1. Side effects of the drugs are greatly reduced
2. We are giving the childs own natural immunity and other supporting body systems to overcome the illness.
What are the 5 steps
1. We give nebuliser or inhalers ( usually albuterol(salbutamol
) or terbutaline
) as and when the child develops symptoms
2. to add corticosteroids
as inhaler (flixotide
in your case ) or nasal steroid inhalers
3. To add daily oral tablets like singulair
4. To raise the above drugs doses
5. To think of giving low dose steroids or other immuno suppressants
When to raise the level?
If there are
a. 2 attacks of wheeze in 30 days
b. 3 attacks in six months
c. 4 attacks in a year
Ofcourse, this criteria can be changed by your doctor, who knows the best for your child
How do we asses the response?
He should NOT have
1. Night cough
2. Night wheeze
3. Day time wheeze
4. Activity ( playing or shouting ) should not produce wheeze or cough
5. Nose symptoms ( nose leak, itch, block, sneeze)
How long it will take to stop medicines?
Atleast 6 months of the steroid and then gradually taper and stop.
In India, several people have become frustrated with allopathic medicine
and migrated to other streams of cure.( including pediatricians themselves )
In my 27 years of experience, many have returned to allopathy or atleast stopped the alternative system medicine