Difference between a pediatric pulmonologist and an allergist/asthma specialist? - Mothering Forums

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#1 of 6 Old 04-05-2013, 03:51 PM - Thread Starter
 
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My daughter is 5 and has moderate asthma going back about 3 years now that is treated with twice daily pulmacort and once daily singular.  She does occasionally have some breakthrough wheezing or whistling that we treat with albuterol, but for the most part it is well controlled.  Before the addition of the singular about a year or so ago, she was hospitalized every couple of months for extreme asthma flares for a few days at a time.  Throughout all this she was managed by our family doctor, and tended to by hospitalists while in the hospital.  She was sent for 2 different batteries of allergy tests, all of which were negative-so as far as we have been able to determine, it's not an allergy issue.  (Although recently it's been suggested by a friend that a gluten issue could be contributing to her asthma, but I haven't had time to really investigate that yet)

 

She has never been referred to or seen a pulmonologist, but the allergist she saw for the testing was an asthma specialist-although only potential allergens were addressed at the appointment, she didn't really delve into her asthma issues.  

 

My nephew had 2 asthmatic episodes which required an er visit, and on the second he was referred to a ped. pulmonologist.  My daughter has been hospitalized at least half a dozen times, if not more, and not including er visits and never was. When I mentioned a pulmonologist to our family doctor she said that the allergist we previously saw for the allergy testing is an allergy specialist and who she would recommend. 

 

So I suppose my question is this: Is there really a difference between an actual pediatric pulmonologist and an allergist who is also considered an "asthma specialist" that would make seeing a pulmonologist over the allergist worthwhile?


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#2 of 6 Old 04-05-2013, 05:25 PM
 
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Big big big difference. Pulmo is lungs only. An allergist (while typically well informed on asthma) is more about immune system and often an allergy/immunology perspective on things.

 

That said, our Ped is who does most of our asthma management. We see our allergist 2x year and have never seen a pulmo. 

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#3 of 6 Old 04-05-2013, 05:37 PM - Thread Starter
 
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Is your child's asthma allergy related? That's the part that I'm getting hung up on with kind of wanting to see a pulmonologist...that she doesn't have any known allergies.  And her first asthmatic episode was actually a case of pneumonia, which she had twice in a row.


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#4 of 6 Old 04-05-2013, 06:24 PM
 
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I'm surprised that with being hospitalized as much as she has been that a pulmo wasn't suggested.  I know you said the allergist didn't really touch on the asthma either :(  I would think that with the history and a lack of allergies that maybe if you find she isn't being well controlled with what she's on seeing a pulmo would be a good idea.  

 

As for my DS, I'm not really sure if the allergies/asthma are related other than having allergies increase your risk of asthma. He's got seasonal allergies but his asthma is really active from Oct.-May so who knows! lol

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#5 of 6 Old 04-07-2013, 01:20 PM - Thread Starter
 
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Yep, my daughter doesn't have any allergies at all...and some of her asthmatic episodes come out of nowhere, although occasionally she suddenly runs a fever with them. 

 

We have an appointment next week with a pulmo, so I think I'm just going to go ahead and take her and see what she says.  We're not required to have a referral, so I don't need our doctor to sign off on it, and if the pulmo says anything different that what we've been doing, then I'll just go back to our doc with the new info and say this is what we've been advised to do.


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#6 of 6 Old 04-07-2013, 09:03 PM
 
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Quote:
Originally Posted by thefreckledmama View Post

Yep, my daughter doesn't have any allergies at all...and some of her asthmatic episodes come out of nowhere, although occasionally she suddenly runs a fever with them. 

 

We have an appointment next week with a pulmo, so I think I'm just going to go ahead and take her and see what she says.  We're not required to have a referral, so I don't need our doctor to sign off on it, and if the pulmo says anything different that what we've been doing, then I'll just go back to our doc with the new info and say this is what we've been advised to do.

 

If you are basing her "not having allergies" on bloodwork, I wouldn't assume she doesn't have allergies.  Or rather, she may still have intolerances.  Especially if that bloodwork was done at the beginning of things--3 years ago.

 

Gluten and dairy (actually, anything--but these are the two major ones) are notorious for causing the underlying inflammation that can cause asthma.  It's worth investigating via elimination even if the test say it's not a problem.  I usually have my clients only ever remove one thing at a time, but in a case like this, I would remove gluten, dairy and soy for a month, see if there's improvement, and do a challenge of one of them at a time to see if there's a reaction.  Gluten and dairy are processed by the same enzyme in the body--so often, they coincide for reactions.  And dairy and soy proteins can look very similar to the body--so the overlap is that about 80-85% of people that react to one also react to the other.

 

Dairy leaves the system much quicker than gluten, however.  So if you were to break them up, you could militantly remove every trace of dairy and soy for about 2 weeks and then do a challenge to see if there's a reaction.

 

Gluten takes longer and often "misbehaves" on the way out (it aggravates things as it leaves the body) and can take several weeks before you see changes.  People say 6-12mo, but my young clients (children) are usually in the ballpark of 6-8 weeks.

 

Inasmuch as it can seem daunting, it's not that bad.  If you click my link in my sig, my website has a Free Resources section that walks you through how to tackle an allergenic or restrictive diet.


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