I recently took Marino to the pulminologist to get a plan for this cold/flu season. We generally start a proactive prevention plan in September to get ahead of any viruses, since Marino's asthma only becomes problematic with illness (there are other times he is coughing/wheezing, but it doesn't slow him down).
Now that he is a little older, the doctor wanted to make some changes. The end goal is to have him not need oral steroids to control his asthma, even with an illness. Last year, he needed oral steroids 6 + times to get his breathing under control, and the pulminologist is not satisfied with that. So, instead of using a nebulizer to deliver asthma medication, we're now using an inhaler with a spacer. The spacer has a small mask, similar to the nebulizer mask, but without the ventilation holes. We spray one puff of the medicine (albuterol) into the spacer, and we need Marino to breathe in 6 times, let him take a break and repeat. We currently do this twice a day, unless he's sick, at which point we up it to 4 puffs 3 times a day and add in the breathing treatments via the nebulizer. Here is Marino and my mom using the spacer.
In case anyone is curious, our insurance covered the cost of the spacer/mask, but they run around $30 - significantly cheaper than a nebulizer.
We've also moved on to the chewable form of Singulair. Marino loves these and always asks for a second. This is also a lot easier to manage than the Singulair granules.
It remains to be seen if the changes will make a difference. He currently has his first cold/cough of the season and it hasn't gotten any worse since we stepped up the number of treatments. I have to say, the spacer is about a million times easier to use, quicker and doesn't require electricity, so we can use it anywhere.