Asthma Worsening - what do I do?

[sbgrace]

I'm going to try to hit the high points:
My son is three.
Environmental Allergies started last summer.

Last winter began allergy attacks and we began a nebulizer as needed (at night only when he had a cold)

This spring developed chronic hives. We did skin prick allergy testing (positive to tons of environmentals and 6 foods out of 12 foods tested). Removed the foods and started zyrtec for the hives. The hives continue anytime we get rid of zyrtec.

Problem:
In the past month he has been having severe allergy symptoms (nasal and sinus mostly) which surprises me given the zyrtec.
Most concerning we had to start using the nebulizer nearly every day twice a day.
In the last week we've had to use it 3 to 4 times a day. I'm scared now to take him anywhere because he has attacks in the car and the nebulizer isn't portable.

Why is this happening? I don't know what to do. I really don't want steroids (right? I don't want him to die either). Anything natural I can do or medical suggestions? We don't have a family history of allergies and I feel lost on where to go from here.

[meowee]

My daughter has severe, life threatening asthma. She is prescribed daily Singulaire and Pulmicort as preventative meds. This worked very well and we were able to wean her off of it except for when she is sick (her asthma is virus induced).

What med is he on now?

If you could stabilize him with the daily preventatives you might be able to gradually wean him off. The "emergency" meds have more side effects than the preventatives, as far as I understand it.

[mclisa]

[QUOTE=sbgrace;8556594]In the last week we've had to use it 3 to 4 times a day. I'm scared now to take him anywhere because he has attacks in the car and the nebulizer isn't portable.

QUOTE]

He needs to be seen by his doctor now. He needs more than the nebulizer at this point.
Yes, he may need steroids to get this under control but then you'll be able to concentrate on his prevention.

My daughter is on singulair and flovent. Since starting that combo, no need for steroids or nebs (or er visits.)

[USAmma]

I have asthma and so does one of my daughters. I have always been told that if I have to use the "rescue" inhaler more than twice a week then my asthma is not being controlled well and we need to increase other meds. My daughter is doing very well on Singulair daily and Flovent 2x a day during certain times of year. I take Singulair during allergy season and Flovent rarely (about 2 months out of the year). It makes a huge difference for us both. I hate to push meds for everyone, but asthma is not something to mess around with, it really isn't. It can be scary when it's not being controlled.

[jocelyndale]

Asthma is very serious and needs to be controlled. While there are non-pharmaceutical ways of dealing with triggers/inflammation, the fact remains that your child may still need medication.

If environmental allergens are a trigger, try to make your home--and especially the bedroom--as safe as possible. This may mean doing away with window treatments and carpeting. You may need to invest money in mattress/pillow encasings and ventilation improvements. Frequent washing/dusting (wet dusting) is a must. You may need to keep pets out . . . you might need to start freezing beloved unwashable stuffed animals to keep the dust mite population low. Humidifiers often help asthma, but they sometimes increase mite and mold populations. It's all a delicate balance.

Good luck.

[sbgrace]

Thank you all for your thoughts. I've just really been lost in all of this and it helps to get perspective of those of you with experience. Thank you!

Do I see his pediatrician or the allergist who did the skin prick testing?
Now that I think about it his pediatrician prescribed singulair with the nebulizer. Then this spring the allergist said forget the singulair because it isn't helpful and put him on just zyrtec. I'll add back the singulair and make an appt (with which one?)

His bedroom is as allergy proof as I can make it--all bedding washed weekly on hot (including his stuffed dog which otherwise remains in the bed). Mattress has dust mite casing. Wood floors. Hepa filter on central air conditioner. I'll wet mop more frequently in there though.

Flovent--maybe that is where we need to go. I take it it is a steroid? Does it affect growth or anything? Not that we have a choice--if it is steroids or breath I'll pick breath.

He did test faint positive to cat and I kept the cats. They don't go in his room but perhaps they need to go anyway.

[USAmma]

I would see a pulmonologist for the asthma management, and keep seeing the allergist for the allergies. Even though they are related symptoms, the pulmo will really help with the asthma more than the allergist in most cases. My dd sees both types of doctors.

Good about his room being allergy proofed! That's a great start.

From what I understand Flovent does not affect growth the way oral steriods do. You might ask the doctor about it just to make sure. I consider the benefits greater than the risks.

[bdavis337]

If you're just using a nebulizer with Albuterol or other rescue meds, he's not getting the inflamation in his lungs reduced, and you're not going to see any improvement. Get him to a dr asap for some a more effective med (I JUST went through this a few weeks ago with my toddler and had lots of great responses, here's the thread:

asthma thread

[candletime]

my 3.5 y/o has severe allergic asthma, we control it with Provex, a natural anti immflamatory and antihistamine. it works awesome. i don't have much time rightnow, but if you would like more info email/pm or post here and i'll try to get back later. melalecua makes it, if you are interested.

blessings!

[jocelyndale]

The fel d 1 protein (allergenic protein found in the sebum and saliva of cats) is very sticky. It takes a long time to denature and it gets tracked everywhere. Office buildings often show up positive for it because of cat-owning workers!

Anyhow, could you introduce a nighttime shower? You may need to blow dry his hair, but a nightly washing would help prevent his taking any extra pollen or dander/proteins to bed with him. A fresh pillowcase each night might also help. If you have a family bed, it might need to be a family ritual. My allergies and asthma are MUCH less bothersome when both my husband and I take nighttime showers. If I don't, I'm miserable the next day. If he doesn't, I'm just slightly miserable. If we both do it, I'm golden.

You can buy filtrete material to put over vents. If you have ductwork, this might be a good idea in his room.

[Ok]

Another vote for see a dr, preferably a pediatric pulmonologist. Untreated or undertreated asthma can cause permanent airway re-modeling over enough time. Like diabetes and other chronic diseases, you should try to keep the upper hand and avoid spikes. We were also given the mantra of "more than 2x wk for albuterol means asthma isn't under control."

There are 2 parts to asthma: inflammation and mucous prouction. Either alone can be a problem, together they create the situation where the person can get the mucous out b/c of the inflammation.

Zyrtec didn't work for my kids. Singulair worked for one child, but not another. It could be you just need a better (or at least different) allergy med.

Oldest ds had the actual asthma and once he was on a mild daily preventative (study medicine, don't know name... but was being compared w/ flovent, which he took after the 2yr study was over)... anyway, he used to get sick a lot, catch everything, etc. Once we finally got the coughing under control, the daily meds kept him healthy and well.

I agree w/ the nightly bath, esp after being outside. We also bought some HEPA air filters, and though I've heard that studies indicated they didn't make a difference-- as much dust as they picked up in my house I think it did help.

We took all the carpet out of ds' room. Put his bed in dust-proof casing. Anything that could create/hold dust was kept elsewhere (including toys/books). I will say that we eventually moved (for job reasons) and he has been much more stable at our current house, which makes me wonder if the old house was part of the problem...

Caffeine is a natural brochiodialator that will help open him up, and even more so if it's warm tea (warm helps too!).

It stinks to deal with it. ((hugs)) Hope you find the right answers for your ds.

[tooticky]

Pulmicort question

DD is only 5 months but has been quite wheezy for about 2 months now.

She's been taking Pulmicort twice a day for the past 10 days, along with Salbutamol about 2 or three times a day.

While her symptoms have gotten a bit better, she's still really congested and moderately wheezy.

I think she is more in the Reactive Airway Disease category at this point than asthma, but I'm concerned that after 10 days of treatment she is still wheezing and congested. I was expecting more of a recovery.

Her doctor is not in the office until Tuesday, so I'm just looking for feedback here on what others have experienced with Pulmicort. I would much rather she didn't have to take this steroid, but of course want her to be able to breathe easily.

More background info: I've been on a TED for about 6 weeks - no gluten, dairy, soy, eggs, etc.

Any feedback would be most appreciated!

Thanks,
Erin.

[Ok]

Originally Posted by tooticky

DD is only 5 months but has been quite wheezy for about 2 months now.

She's been taking Pulmicort twice a day for the past 10 days, along with Salbutamol about 2 or three times a day.

While her symptoms have gotten a bit better, she's still really congested and moderately wheezy.

I think she is more in the Reactive Airway Disease category at this point than asthma, but I'm concerned that after 10 days of treatment she is still wheezing and congested. I was expecting more of a recovery.

Her doctor is not in the office until Tuesday, so I'm just looking for feedback here on what others have experienced with Pulmicort. I would much rather she didn't have to take this steroid, but of course want her to be able to breathe easily.

More background info: I've been on a TED for about 6 weeks - no gluten, dairy, soy, eggs, etc.

Any feedback would be most appreciated!

Thanks,
Erin.

5mo is still so little. ((hugs)) Pulmicort takes at least 2-3 wks to reach therapeutic levels so it won't be working it's full magic yet. It still helps with the inflammation as the body is getting used to it.

The salbutamol just keeps airways open and doesn't solve the underlying reasons for inflammation and mucous production.

When dd was 3yo and got pneumonia, she did pulmicort for 2mo to help her heal. Ds2 did pulmicort as well for a short burst of time.

Do you know why your dd is wheezy? In ds2's case, it was silent reflux and he's reflux all the way into his nasal cavities and aspirate some into his lungs. His body just created gobs of mucous trying to salve the irritation from the reflux. He was finally dx'd at 5mo and went on zantac and improved a lot-- although still had trouble until around his 2nd bday. He'd been treated for allergies and infections and yadda yadda... finally we saw a pediatric pulmonologist who "straightened it all out." O yes, with ds2 and reflux, the asthma meds didn't really work. Benadryl actually helped some b/c it dried mucous, although his problem wasn't allergies so it didn't solve the problem. O yeah, w/ his reflux he was a reverse-cycle (nighttime) nurser and preferred nursing on one side (so that his stomach was always lower) which was with his left side down (I think... sorry, years ago).

At 5mo RAD v asthma is probably not a productive debate.

What does your dr think is at the root of this? You seem to be working on the allergy theory, but if you eliminated all that 6 wks ago and she's still having trouble, that makes me wonder if you have still not found the right culprit.

Best wishes.

[tooticky]

Her doctor thinks that her wheezing is from an early (1 week old) infection with RSV, and that her airways are still healing. She has had a chest x-ray that looked normal.

She was prescribed Pulmicort 2x/day for 10 days and now I am supposed to give it to her only once a day for the next couple of days, then every other day for a couple of days.

I'm wondering why she prescribed it for such a short amount of time? Maybe I should keep giving it twice a day until we can see her again.

I did the TED to see if it helped wheezing and congestion but also to see if it helped her gassiness and stomach pains. Seems to have fixed the latter but not the former.

I am worrying about poor dd having permanent lung damage from all of this, or having asthma... I wish she hadn't gotten sick so young... Poor winter babies :

[glorified_rice]

I'm sure this is a no-brainer, but I just want to make sure the op has taken all chemicals out of the house (cleaning, solvents,air fresheners, detergents, etc...). Even things as innocuous as toothpaste and shampoo have triggered asthma attacks for me. Also, look at cured meat consumption. I get an almost instant asthma attack after eating traditionally cured bacon. I hope your son is feeling better soon. Asthma can be such a scary thing to deal with.
http://www.feingold.org/PF/asthma.html

[mclisa]

Originally Posted by sbgrace

Do I see his pediatrician or the allergist who did the skin prick testing?

I would see whoever can get you into an appt now. If you didn't go this week, I would take him into an acute care type place this weekend to see if he needs to get a burst of steroids.

We see a pulmonlogist.

[bdavis337]

Originally Posted by tooticky

Her doctor thinks that her wheezing is from an early (1 week old) infection with RSV, and that her airways are still healing. She has had a chest x-ray that looked normal.

She was prescribed Pulmicort 2x/day for 10 days and now I am supposed to give it to her only once a day for the next couple of days, then every other day for a couple of days.

I'm wondering why she prescribed it for such a short amount of time? Maybe I should keep giving it twice a day until we can see her again.

I did the TED to see if it helped wheezing and congestion but also to see if it helped her gassiness and stomach pains. Seems to have fixed the latter but not the former.

I am worrying about poor dd having permanent lung damage from all of this, or having asthma... I wish she hadn't gotten sick so young... Poor winter babies :

We used our Pulmicort for 2 weeks, and are now down to every other day, and then we're done at the end of next week, unless and until he gets another bad respiratory illness and then we'll use it at the very first sound of a wheeze. Asthma isn't always chronic, and in some children it only appears when allergies or a respiratory illness strikes hard. If that's the case, there's no need to medicate when the symptoms don't present, esp. if they don't present without certain outside parameters. So if my son only needs treatments during allergy attacks and bad colds, that's all we'll do.

You will be able to tell if the weaning off isn't working. If she starts wheezing, coughing and acting tight again, you'll know quickly!