Hello, Thank yo u for asking at HCM. I went through your daughter s history and would like to know more about her as follows: a. What was the first age when she had breathing difficulty? b. How frequent are her breathing difficulty/wheezing symptoms? c. How she responds to drugs or nebulization? d. What are her nose symptoms - running nose, sneezing, nose congestion, etc? e. Does she frequently vomit/nauseate? f. Has she had any skin allergies - atopic dermatitis or hives? g. How has been her weight? Does she gain weight normally or not gaining weight? h. Does she have frequent diarrhoea, constipation or other stomach related complaints? i. Does she have any one in family with allergies? Is she exposed to passive smoking or other smokes/fumes routinely inside home? Above details would help me to understand your granddaughter s health in a better way and therefore to make more specific suggestions for her. At present, from your provided details, I would like to make suggestions for her as follows: 1. If she requires frequent oral steroids, I would suggest her regular inhaled corticosteroids (via metered dose inhaler with spacer with face mask) which reduce frequency of episodes. 2. If she has nose symptoms, I would also add antihistamine like levocetirizine & montelukast in her regular treatment. 3. I would suggest her allergy testing for common inhaled and food allergens. 4. If she has other symptoms like weight loss, stomach symptoms, etc, I would think of other diagnosis and would suggest additional investigations accordingly like testing for cystic fibrosis, GERD, etc. Hope above suggestions will be helpful to her. Should you have any further query, please feel free to ask at HCM. Wish your granddaughter the best of the health ahead. Thank you & Regards, Dr Parin N Parmar