Not at all-- feel free to quote the entire post there!! (or this one, for that matter) I meant to post about it there yesterday, but got side-tracked before I could find it again.
My daughter's asthma has shifted slightly (worsened, actually, at least in frequency) in the past year or so. We were aware that this could happen during adolescence, though obviously we aren't pleased about it. She probably uses rescue meds 2-6 times a month even without illness or allergy being in the picture.
We are much better about checking peak flows as a result. That's helpful in some respects, since we know what a 10% or 20% decrease in peak flows looks like, and she knows very well what it feels like.
We also are quite aggressive about pre-medicating in any situation where an impairment is likely-- before exercise, before general anesthesia, etc.
So we have a sort of decision tree-- but not an "action plan" so to speak. Not the way that we do with food allergy.
But I have lot clearer picture of when to transition from the one to the other now, and so I'm happy about that.
Basically, the decision tree re: breathing problems of any kind is:
Possible allergen exposure?
Y/likely? try ONE administration of albuterol-- and if it helps, observe, if not, proceed to allergy action plan-- aggressively. Use Epi.
N/unlikely? try up to TWO administrations of albuterol (5-10 min apart), if impairment isn't significantly better, proceed to allergy action plan and watch carefully. If impairment worsens, use EPI.
Other factors which change things slightly include:
a) ease of access to EMS (the more difficult, the more aggressive we'll want to be)
b) overall 'atopic' context-- that is, how reactive has she been recently, how much allergen load currently, etc.