Allergies/Asthma questions?? (Updated Post 38)

[LuvOrlando]

A couple of things, first I totally hear you about the medicine. I have 2 Asthmatic kids and the medications ARE scary, but so is an Asthma attack and if all you've seen of one is the cough then I understand your skepticism. However, Asthma is one of those things that can become life threatening is a matter of minutes. My DD11 is the healthier child of my 2 who NEVER has audible symptoms. Inspite of my DS's more obvious distress DD is the one that it took the Dr to listen with a Stethoscope to hear an attack and she is also the one during the H1N1 scare that nearly died from Pneumonia and a blood infection.

With regard to the Asthma care, treatment and medications there are a few things you should know.
#1, you need a peakflow, this can tell you if your child's lung volume is shrinking. It can be unreliable but can also be a help once you know what is or isn't normal for your child.

#2, there are a few different categories of medicines. Albuterol is an inhaled medicine that is called a rescue because it shrinks the lung inflammation immediately. An Asthmatic should never ever ever be away from Albuterol and an Asthmatic should never ever be sent to the nurse or left alone in any way if he/she is in distress. Albuterol can be taken from a hand held inhaler or a nebulizer. Last year they changed the propellant formula in the hand held inhalers which made them pitifully poor at delivering the medicine during an attack. The medical community keeps trying to say it is the same, but it isn't, ask people who struggle with the disease and they will tell you. The inhaler is ok if you have no other choice, but a poor second choice to be honest. Then there are maintainence meds which work on preventing the inflamation in the first place. These need to be taken all the time and are often delivered with inhalers. These will not help during an attack and will sometimes even make one worse so you need to know which is which. Then there are the allergy medicines, and Singular sort of bridges between Asthma maintinence and allergy maintainence.

#3, there is a big difference between being allergic to something and flaring up due to an inhaled irritant. A person not allergic to a particular pollen can have an Asthma attack from it just because the actual particles get in there and irritate the airways. This happens with smoke, with dust from wind, with chalk, with perfume and all sorts of other stuff so sometimes it's not what is in the air, its the fact anything is in the air so windows should not be left open ect.

#4, there is a enormous difference between an Allergist and a Pulmonary Dr. I went to see Allergists for years before switching to a Pulmonary Dr and the difference has been important. Allergists are not the same and personally, I don't like them for Asthma because they only see one thing.

#5, consider the Immunocap allergy test. Both my kids had the skin tests say they were allergic to tons but the Immunocap was more precise and only came back with 1 thing for my DS12 and zero for my DD11. This was a pretty substantial change because prior to this I was being told I needed to get rid of my pets, needed wood floors due to Dust Mite allergy- which i did in addition to replacing ALL the carpet in my home... lots of $ for allergies may have been wrong due to human error for the tests. I think there is a big risk of cross contamination in the skin test that doesn't happen with the blood kind.

Pm if you have questions and I'll try to get you more info .

 

[gina2000]

It's interesting to see how different doctors use the meds. My son has very mild asthma. He does use an inhaler 1x/day and albuterol whenever needed but definitely before he swims or does any sort of strenuous exercise. Albuterol is used as a preventative as well as a rescue inhaler. That is per both a pediatrician and a pediatric pulmonologist.

 

[JessicaR]

Albuterol is not a steroid. Albuterol is a short acting beta-agonist that works as a bronchodilator. Used as quick relief or rescue medication.

OP - Many people have sports induced asthma and take a puff or two prior to playing. This is not abnormal and not an issue as far as using the medication daily. The problem with daily use stems from those that are using their inhaler all day long to breath. That's a definite case of needing additional prophylactic asthma meds such as inhaled steroids and or Singulair type meds.

I'm glad you are getting a second opinion. Write down the questions you want answered. Its helpful when you are with the doctor and forget what you want addressed.

 

[LuvOrlando]

Albuterol is not a steroid. Albuterol is a short acting beta-agonist that works as a bronchodilator. Used as quick relief or rescue medication.

OP - Many people have sports induced asthma and take a puff or two prior to playing. This is not abnormal and not an issue as far as using the medication daily. The problem with daily use stems from those that are using their inhaler all day long to breath. That's a definite case of needing additional prophylactic asthma meds such as inhaled steroids and or Singulair type meds.

I'm glad you are getting a second opinion. Write down the questions you want answered. Its helpful when you are with the doctor and forget what you want addressed.

You are right, it is not a steroid. That's what happens when I click and paste and do not re-read before I run to the bus-stop to get my DD. i will go back and change it, please do so in your quote so no-one is misinformed.

 

[LuvOrlando]

It's interesting to see how different doctors use the meds. My son has very mild asthma. He does use an inhaler 1x/day and albuterol whenever needed but definitely before he swims or does any sort of strenuous exercise. Albuterol is used as a preventative as well as a rescue inhaler. That is per both a pediatrician and a pediatric pulmonologist.

We also do the Albuterol via a nebulizer prior to activity in addition to daily maintainence medicines. The big difference is that the Albuterol is short acting and won't help at all outside the window of effectivness which runs 4-6 hours. My daughters Flovent and DS's Advair or Pulmicort, on the other hand, work long term at suppressing inflamation.

For some people with only exercise induced Asthma the Albuterol alone might be fine. Just keep an eye out for any escalations or changes over time and get re-evaluated every so often.

Every kid is different but if a Dr is looking at Singulair he/she is probably looking at something bigger than exercise induced alone. Because Singulair is taken every day the Dr must suspect triggers that occur regularly.

 

[Aneille]

Every kid is different but if a Dr is looking at Singulair he/she is probably looking at something bigger than exercise induced alone. Because Singulair is taken every day the Dr must suspect triggers that occur regularly.

This is the part of the equation I was not able to get from my dd's dr. I asked about the severity of the asthma and he got somewhat defensive and I never got an answer and told me he knew his diagnosis was correct. I guess we will see when she goes for a second opinion.

As far as the triggers what makes me suspect is during the winter we do not have any cough that I am aware of. And she never quits in her sports during te winter as far as I can tell. She doesn't cough while in the home either. I only noticed this because she plays Spring Soccer. She's coughs in the early fall too but later in the fall she plays all out and no problem. I actually have asked my daughter if she really needs to cough and can't breathe or is it a way to just take a breather from being winded. (she has some friends with asthma and maybe she's seen them cough and need to take a break.) And she now uses that to get out of a few extra laps etc. I am adding this so you can understand how little she is coughing.

I realise dust mites are in your home year round. And we have a dog so that is year round. I am not sure if that is the single reason he gave her singulair or what. He never told me the severity of the reaction to the mites etc either. He did a test under the skin for the mites, dog and cat.

I know you can have allergies without it triggering asthma and you can have asthma without allergies. Its a tangled mess.

Something just doesn't seem right to me though in how she was diagnosed. He didn't seem to listen to what I have noticed during the last year. Or he could be right on the money but since he didn't explain himself, it leaves doubt in my mind.

 

[LuvOrlando]

This is the part of the equation I was not able to get from my dd's dr. I asked about the severity of the asthma and he got somewhat defensive and I never got an answer and told me he knew his diagnosis was correct. I guess we will see when she goes for a second opinion.

As far as the triggers what makes me suspect is during the winter we do not have any cough that I am aware of. And she never quits in her sports during te winter as far as I can tell. She doesn't cough while in the home either. I only noticed this because she plays Spring Soccer. She's coughs in the early fall too but later in the fall she plays all out and no problem. I actually have asked my daughter if she really needs to cough and can't breathe or is it a way to just take a breather from being winded. (she has some friends with asthma and maybe she's seen them cough and need to take a break.) And she now uses that to get out of a few extra laps etc. I am adding this so you can understand how little she is coughing.

I realise dust mites are in your home year round. And we have a dog so that is year round. I am not sure if that is the single reason he gave her singulair or what. He never told me the severity of the reaction to the mites etc either. He did a test under the skin for the mites, dog and cat.

I know you can have allergies without it triggering asthma and you can have asthma without allergies. Its a tangled mess.

Something just doesn't seem right to me though in how she was diagnosed. He didn't seem to listen to what I have noticed during the last year. Or he could be right on the money but since he didn't explain himself, it leaves doubt in my mind.

First, it is obvious no parent wants to hear their child has Asthma. Take that little truth, acknowledge it, and then try really hard to see past it. The most important thing to remember is that if an Asthmatic isn't medicated properly each time they flare up their lungs scar a little, bit by bit until they lose capacity permanently. The name of the game is preventing permanent damage and the steroids help do this. My kids both have Asthma and their lungs are still at 110% capacity because of the daily preventative meds, the albuterol doesn't prevent scarring from what I understand.

The 2 times of year you are noticing are the times of year when mold tends to be pretty big. My DS used to play soccer and was having such a hard time, before these new medicines, that he actually had to change sports because his endurance became such a problem. Now, with the right treatment he is doing really well in Lacrosse and his endurance is up. I am hopeful he will be ok through Football season too. There is nothing worse than the look on an Asthmtics face when his/her lungs just give up and someone says, "Oh, you are just out of shape" It's pretty awful. The way you can tell is if the kid has good days and bad days. A non Asthmatic kid doesn't usually have bad days. They don't cough when they run. Also, watch her run with her peers. If everyone else can keep the pace, especially with suicides, and yours can't there may be trouble especially if the Dr suspects Asthma.

I don't think your DDis copying other kids. No kid WANTS to show a weakness or be different. My DS's Asthma only shows itself in a cough. Apparently this is common in children. They cough because the inflammation makes them feel like something is in their throats which can be cleared... but it can't. Also, Asthmatics have more mucus in their airways.

Check out this website www.aanma.org/

Because my DS only shows coughing as a symptom I have to instruct everyone around him that if he is coughing and does not have a fever to indicate he is sick his cough MUST be treated like as Asthma attack, because it is.

I hope your Dr helps you guys sort it out. I tnd to think second opinions are good with this sort of thing. No way you'll get 1 Ped & 2 specialists all being wrong

 

[Christine]

First, it is obvious no parent wants to hear their child has Asthma. Take that little truth, acknowledge it, and then try really hard to see past it. The most important thing to remember is that if an Asthmatic isn't medicated properly each time they flare up their lungs scar a little, bit by bit until they lose capacity permanently. The name of the game is preventing permanent damage and the steroids help do this. My kids both have Asthma and their lungs are still at 110% capacity because of the daily preventative meds, the albuterol doesn't prevent scarring from what I understand.

This paragraph is a GEM!!!

It was very hard for me to come to terms with my son's asthma. I tried very hard for a long time to deny it almost. Or think that the doctor's were overdiagnosing (when, in fact, his ped underdiagnosed him for YEARS!!). It wasn't that I was concerned with him having something, but he'd already had so many things by then (eczema, food allergies) that the asthma thing just about did me in. Add to the fact that NO ONE in my immediate or extended family had ever had asthma, and I was scared and overwhelmed.

The best thing I ever did was get to a pediatric pulmonologist (after several peds and two allergists). That's were I felt more at ease and I trusted the doctors completely.

 

[Sparx]

This is the part of the equation I was not able to get from my dd's dr. I asked about the severity of the asthma and he got somewhat defensive and I never got an answer and told me he knew his diagnosis was correct. I guess we will see when she goes for a second opinion.

As far as the triggers what makes me suspect is during the winter we do not have any cough that I am aware of. And she never quits in her sports during te winter as far as I can tell. She doesn't cough while in the home either. I only noticed this because she plays Spring Soccer. She's coughs in the early fall too but later in the fall she plays all out and no problem. I actually have asked my daughter if she really needs to cough and can't breathe or is it a way to just take a breather from being winded. (she has some friends with asthma and maybe she's seen them cough and need to take a break.) And she now uses that to get out of a few extra laps etc. I am adding this so you can understand how little she is coughing.

I realise dust mites are in your home year round. And we have a dog so that is year round. I am not sure if that is the single reason he gave her singulair or what. He never told me the severity of the reaction to the mites etc either. He did a test under the skin for the mites, dog and cat.

I know you can have allergies without it triggering asthma and you can have asthma without allergies. Its a tangled mess.

Something just doesn't seem right to me though in how she was diagnosed. He didn't seem to listen to what I have noticed during the last year. Or he could be right on the money but since he didn't explain himself, it leaves doubt in my mind.

I have very bad allergies and I think I may have asthma. I would cough and sneeze year round. I take Singulair and I noticed a 100% difference. Do you think its possible that she actually has strong seasonal allergies instead of asthma?

 

[Aneille]

She was tested for mold and was negative. I suspected mold myself (or another seasonal type allergy) but according to the doctor she didn't show a response. She only showed a response to dust mite/cat and dog dander and a slight response to cockroach.

And the thing is my kid does keep up. She runs harder and longer than most of her peers but I think that is partly due to her age. Not many 8 year old girls give even close to 100% in sports yet. So even if she gives 80% she is outrunning most of them.

And my kid must be weird because she was thrilled with getting an inhaler. She isn't being seen as different or weird because some of the 'cool' kids have them too. She was really bummed I wouldn't let her bring it to school today. I really don't get that!

I am not in denial at all. I brought her to her pediatrician because I suspected exercise induced asthma and perhaps a seasonal allergy. I want her to be healthy and enjoy the activities she loves. I also want to make sure she is not being overmedicated for her condition. Since I am not clear on her condition, I am not medicating her. When its clear to me, then she will be medicated.

I will update when I get to talk to a different doctor (who is comming highly recommeded even from someone on the DIS!) Hopefully I can get a cancellation so I can get in sooner.

Thanks again for all the information. I really am listening to it all. I am glad to hear that kids are doing well with their treatment and the treatment is allowing them to play the sports they wish and feel well too.

 

[disfan07]

I have extremely severe asthma. My pulmonologist said that the results of the methocholine challenge were something that he would see more in someone with COPD or who smokes rather than an 18 year old.

I am on....highest dose symbicort (2 puffs 2x day), pulmoicort nebs 2 x day zyrtec 10 mg 2 x day, singulair 1x day, plus taking my xoponex everyday before going to the gym. My 02 sats stay around 94% as my normal because of my asthma (I'm routinely between 90 and 94% throughout the day). But i dont present with normal asthma symptoms....it took 2 1/2 years to diagnose my asthma.

For me, we've essentially run out of options. We thought it was allergic asthma but they tested me for that and it is not allergy induced.

I average about 2-3 hospital stays (between 5 and 7 days each) per year for asthma. Plus 4 or 5 doses of prednisone a year.

If she really has asthma you need to treat it now. Do not put it off. It is not something to mess with.

 

[Evi]

if your daughters allergy tests showed a sever or even moderate allergy that is significant enough to trigger her asthma I would consider allergy shots. If it is an option. though it would require her to go every week for the first year it is well worth it if it reduces what triggers her asthma.

 

[need2cruise]

A couple of things, first I totally hear you about the medicine. I have 2 Asthmatic kids and the medications ARE scary, but so is an Asthma attack and if all you've seen of one is the cough then I understand your skepticism. However, Asthma is one of those things that can become life threatening is a matter of minutes. My DD11 is the healthier child of my 2 who NEVER has audible symptoms. Inspite of my DS's more obvious distress DD is the one that it took the Dr to listen with a Stethoscope to hear an attack and she is also the one during the H1N1 scare that nearly died from Pneumonia and a blood infection.

With regard to the Asthma care, treatment and medications there are a few things you should know.
#1, you need a peakflow, this can tell you if your child's lung volume is shrinking. It can be unreliable but can also be a help once you know what is or isn't normal for your child.

#2, there are a few different categories of medicines. Albuterol is an inhaled medicine that is called a rescue because it shrinks the lung inflammation immediately. An Asthmatic should never ever ever be away from Albuterol and an Asthmatic should never ever be sent to the nurse or left alone in any way if he/she is in distress. Albuterol can be taken from a hand held inhaler or a nebulizer. Last year they changed the propellant formula in the hand held inhalers which made them pitifully poor at delivering the medicine during an attack. The medical community keeps trying to say it is the same, but it isn't, ask people who struggle with the disease and they will tell you. The inhaler is ok if you have no other choice, but a poor second choice to be honest. Then there are maintainence meds which work on preventing the inflamation in the first place. These need to be taken all the time and are often delivered with inhalers. These will not help during an attack and will sometimes even make one worse so you need to know which is which. Then there are the allergy medicines, and Singular sort of bridges between Asthma maintinence and allergy maintainence.

#3, there is a big difference between being allergic to something and flaring up due to an inhaled irritant. A person not allergic to a particular pollen can have an Asthma attack from it just because the actual particles get in there and irritate the airways. This happens with smoke, with dust from wind, with chalk, with perfume and all sorts of other stuff so sometimes it's not what is in the air, its the fact anything is in the air so windows should not be left open ect.

#4, there is a enormous difference between an Allergist and a Pulmonary Dr. I went to see Allergists for years before switching to a Pulmonary Dr and the difference has been important. Allergists are not the same and personally, I don't like them for Asthma because they only see one thing.

#5, consider the Immunocap allergy test. Both my kids had the skin tests say they were allergic to tons but the Immunocap was more precise and only came back with 1 thing for my DS12 and zero for my DD11. This was a pretty substantial change because prior to this I was being told I needed to get rid of my pets, needed wood floors due to Dust Mite allergy- which i did in addition to replacing ALL the carpet in my home... lots of $ for allergies may have been wrong due to human error for the tests. I think there is a big risk of cross contamination in the skin test that doesn't happen with the blood kind.

Pm if you have questions and I'll try to get you more info .

Thank you for this info!! I was recently diagnosed with asthma and this info has really helped me with questions I had about it and the types of medications I am on.

 

[laurie31]

double post

 

[laurie31]

I read your OP yesterday, and didn't even know what to say, but now that I have read your updates I understand. I am horrified that you and your DD weren't given asthma education. As many have said, this is gold standard treatment for asthma, and Singulair has been used in kids for years and years and it's an awesome thing for most of them.

Did anyone show your DD how to use the inhaler and spacer? How about a peak flow meter? Someone needs to demonsrate it to her, and then watch her do it to make sure she's doing it right. She should keep a peak flow log for awhile, so you can get an idea of what's normal for her, what's her personal best, and where her danger zone lies.

Peak flow meters have movable green, yellow, and red indicators that you can set yourself, once you know where your child's zones are. You should also have an action plan for each zone. For example: Green is 80-100% (everything is fine), yellow is 60-80% (use your rescue inhaler, an adult should watch closely) red is below 60% (use rescue inhaler and call 911). The action plan should include what to do next if the inhaler doesn't help if the child is in the yellow.

I hope the new doctor does a better job of explaining things to you and that you get some solid asthma education. It should take 30-60 minutes, just for the education part, not the doctor visit/exam/testing part.

Here's some links about peak flow meters. I consider them a very important tool in helping a child manage their asthma, almost as important as the medications. Knowledge is power, after all.

http://www.nationaljewish.org/healt...le-management/tools/peak-flow-zone-chart.aspx



http://kidshealth.org/parent/medical/asthma/peak_flow_meter.html

 

[vettechick99]

Ok, this is a totally serious question, will the dog dander spray work on a DOG that has allergies? Our dog has the worst allergies in the house. She is just miserable. We give her benedryl, fish oil, use a steroid spray as needed for the itching, bath her with medicated shampoo and conditioner and she STILL has bad symptoms.

I have no idea, golfgal. DD is only allergic to cat dander so we have the one for cats. I'll look on the container when I get home today and give you some more information on it. We have a Basset though and she had terrible allergies too. She's on prednisone which helps greatly, but doesn't solve the problem.

 

[Aneille]

Laurie- They did not give us a peak flow meter, or show her how to take the inhaler. It is just one of the many reasons that I am questioning if she really has asthma or is very mild.

I didn't get a cancellation today for the place of my choosing but I will call again tomorrow. I've heard really good things about the 2 doctors I am trying to get an appointment with so I am sure it will be a better experience. They work at the same allergy center together with another doctor.

Otherwise we have an appointment for next month. The earliest they could see us.

The first doctor is seeing us back in one month but obviously I will be cancelling the appointment.

 

[Aneille]

Update:

I saw the new allergist/asthma specialist this afternoon. He came highly reccomended.

His diagnosis was very very mild exercise induced asthma. Those were his exact words. Her only required medication is ProAir.

She passed her breathing tests at the office.

I have been allowing my DD to use her inhaler but I have not treated her allergies and it has been working very well. He told me to keep doing what I am doing. She is to use her Pro-Air 15 minutes before her exericise. He gave me a spacer for the inhaler, and showed my daughter how to use it.

She does not need to use it for hockey as she is symptomless in the winter. She can choose to use it during softball if she starts to have symptoms. Right now softball is not strenous enough to trigger any asthma symptoms.

She is to use it for soccer as this is the only sport we notice the cough.

He told me as she gets more competitive and older things may change. But if she were to quit sports right now, she would not need the inhaler unless she got sick.

He told me that if she gets allergy symptoms to give her Claritan but I do not need to treat her everyday for allergies.

I am glad I got the second opinion. I am very comfortable with this treatment and he explained things to me and he will see her in the fall to see how she is doing. He said after that he likes to see athletes every 6 months to make sure the treatment is still working well.

 

[cepmom]

Aneille~
I'm so glad you were happy with this new specialist! Is it the same one I told you about?

 

[Aneille]

Cepmom -

Yes it is the same doctor you told me about. They had a cancellation today and I was able to take it.

I am so glad we went.

You were the 3rd person that recommended that center to me and the 2nd person to recommend that particular doctor. They were so nice and I did not seem rushed. And he was very open and told me he would answer any questions I had. I also liked that he asked a lot of questions of me and of my DD.

Thanks again!