Over-diagnosed Asthma?!

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Jezsmo
New Member


Date Joined Nov 2010
Total Posts : 1
   Posted 11/11/2010 6:04 PM (GMT -7)   
Hi everyone, I am new here and have a question that I hope some of you can help me with.

My 4 year old daughter has been diagnosed with Asthma as of yesterday. This is not a big surprise to me, but based on the circumstances I truly was not prepared for the level of seriousness that the Asthma/Allergy doctor has put on it and I can't relate to it based on what I have seen as her symptoms. However, I also am aware that I know little about Asthma so that is why I am here. :) I should preface this by saying that she HAS had eczema almost her entire life - since she was an infant.

In September of '09, my daughter woke up and was clearly having trouble breathing. It was very alarming to me and of course I took her to the doctor, who tried to treat her with breathing treatments but after being unsuccessful we were sent to the ER where she remained for about 8 hours receiving breathing treatments and steroids. No mention of Asthma - I asked but was told it was more like a reactive airway because she could not be diagnosed with Asthma on the first incident.

13 months go by and all is well. She did have a few colds that winter and such but no problems whatsoever. All appears normal. In October (last month) it happened again. Off to the ER she went and she ended up getting admitted because they could not stabilize her oxygen level. She was released the next day. But this time we left with an "Action Plan".

I *think* there might have been the start of an incident about 3 weeks later. It seemed like it but I don't really know enough to be sure. But I did treat her and she was okay so I either did a great job or there was never one in the first place.

I took her to her reg. pediatrician and he did a blood test for allergies. It came back with her having many environmental allergies. It also came back that she was allergic to cats and dogs. And we have a cat (and yes, the cat is leaving.:) Because of the high number of allergies, our pediatrician referred us to an Allergy/Asthma specialist.

Yesterday, I took her to this new doctor. I think I expected that he would diagnose her with Asthma but I was fairly certain that it would classified more as "intermittent" and we would be advised to treat as it comes up. But, it didn't play out that way.

This doctor said that my daughter has chronic asthma - that her lungs are likely always inflamed at some level. He put her on a steroid inhaler 2 puffs - 2x per day - every day. He also put her on zyrtec, prescribed prednisone to keep in the house "just in case", prescribed a rescue inhaler and prescribed some skin creams.

Of course I asked a ton of questions about this because it's a bit shocking to me see this requires daily treatment when she has only experienced breathing issues on two (maybe 3) occasions over a 13 month time period.

The doctor explained that this combination of eczema, asthma, and allergies is why he believes she has chronic asthma and that it is following the typical path and that because of this she is not likely to grow out of it. He definitely said that her asthma will get worse instead of better.

Okay. Fair enough. Perhaps that is true and if it is, I am all over it. But, I can't seem to wrap my brain around it. I can't shake the feeling that the diagnosis and subsequent treatment plan doesn't fit the reality. I am well aware though, that my daughter being only 4 could have other symptoms of tightness in her chest and such that she can't tell us about because (according the doctor) it's always been there and feels normal to her. To me though, all was well until one day everything went crazy with her breathing and she was treated. And then it happened a year later and yes, that concerned me that perhaps it is more than what it was ... but chronic asthma...? steroid inhaler 2x daily?

I am (obviously) going to follow her tx plan to the letter because I can't second guess it with my own level of knowledge. But, I am wondering if I should get a 2nd opinion or does this sound pretty typical to all of you?

Thanks for all your help!

percycat
Veteran Member


Date Joined Jul 2005
Total Posts : 1952
   Posted 11/12/2010 1:51 PM (GMT -7)   
Hi, and welcome!

It sounds like you have been a little thrown off-balance by the doctors' reactions. I don't have asthm, but I do have some asthma-like symptoms when exposed to my bad allergic triggers; that's my diagnosis after 2 pulmonary funciton tests and a methacholine challenge. Nevertheless, I also have a rescue inhaler, and I take Singulair every day. One allergist prescribed a combination inhaler for daily use (I think it was Symbicort?), as an experiment, but I currently take a different inhaled medication daily (Intal) prescribed by my new allergist. My point is that even without a diagnosis of any kind of true asthma, I've been prescribed several of the usual asthma medications. All supposedly have a safe track record, although I don't know much about the combination inhaler, since I didn't actually take it. I do feel a bit better - I think due to the Singulair and Intal. And I loved how steroid shots or inhaled steroids made my lungs feel open and comfortable, but I had side effects from the inhaled and so didn't continue them (and shots are not for long-term use in a case like mine).

So that's just to give you one example of somebody with a pretty weak set of symptoms, but heavier set of medications.

I hope some of the others will be along soon to share their ideas.

percycat

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 11/12/2010 4:52 PM (GMT -7)   
I was told I had chronic asthma due to several environmental allergies. I'm on Advair 250/50 2 times a day as a maintenance medicine. I have a rescue inhaler for emergencies. Also have a nebulizer to use for extreme emergencies. I also take Zyrtec every day and patenase nasal spray twice a day.

Has the doctor discussed doing a breathing test on your daughter? My lung doctor insists on one every year.

One way to listen for breathing problems with your daughter is after she has been playing hard placed your ear against her back and listen to her breathe. If you hear any rattling fluid like sound that is probably an asthma attack for her. Sometimes you can place your hand on her chest right at her breast bone and feel a vibration. When she talks you may hear any kind of gravel in her voice like she needs to clear her throat. Also watch for a mouth breathing.

Until she can tell you when she's having trouble breathing these are good ways to listen out for asthma attack with her.

Good luck and keep us posted on how she's doing.
Joy

SmurfyShadow
Veteran Member


Date Joined Dec 2008
Total Posts : 2386
   Posted 11/14/2010 4:54 PM (GMT -7)   
I have chronic asthma hon. And the steriod inhaler is her medication to prevent attacks. The doctor you saw, was it a pulmonologist? Because that is a doctor whom specializes in asthma, if it wasn't take her to her primary and get a refferal to a pediatric pulmonologist. It is easier, as she is a child to give her an inhaler to do every day than to get her to take a few pills. In fact, I personally prefer the steriod inhalers, over the advair and pills because I am constantly on the go between my chemotherapy and caring for my grandmother with alheimers. So I use the inhaler every day, as I can do no matter where I am at over a few seconds. It does sound like your daughter has environmental asthma. There are different types of asthma. I have both sports and environmental asthma. Sports induced asthma is having asthma attacks while like running, swimming, you know exercise. I did notice however, when she does have attacks, it is severe attacks. I am not sure if they told you this, but during an asthma attack your airway becomes restricted. Due to this, if not treated right away during an attack and respond to treatment, you can actually cause brain damage due to lack of oxygen. This usually presents in a worsening attack to the point where one loses conciousness. That is why it is actually really important to keep asthma well controlled. I suspect they just dont want your daughter to get so severe to where they can't control it. I've unfortunally had those severe asthma attacks where I've lost conciousness. Last time I did that, I was walking into the ER and someone in scrubs asked me if they could help me, I handed them my inhaler, so they knew it was either COPD or Asthma (same treatment for both) and proceeded to lose conciousness right after I handed the guy my inhaler. I was told that day, if I had came in 30 minutes later, I would of died and there was nothing they could of done about it. That is the next city bus for me. Since then, I've started doing as they told me to do, and did my steriod inhaler daily, still do. I have not had an attack like that in two years now. I've had smaller ones, where my rescue inhaler was needed. Please dont hesitate to ask as many questions as you want hon. Moderators, this is based on personal experience not my medical training.
Don't Care Bout Nuffin No More, Guess I shouldnt even be in this world

madabs
Regular Member


Date Joined May 2008
Total Posts : 387
   Posted 11/15/2010 2:01 PM (GMT -7)   
My 10 year old has had asthma since he was born and there were times awhen I felt ALOT like you, that his doctors were over-reacting.

I would want to take him off his medications. I would think he was doing great. No coughing or wheezing. Then I would take him in to doctors for something unrelated and find out that he was wheezing, I just couldn't hear it. My son's and maybe your child's asthma doesn't always come on like an emergency where it is obvious, but it comes on with milder symptoms where the distress is much harder to recognize. The could be having a little attack when they wake in the morning and we may not see it. And because it is mild, it resolves on its own or they can just function at the lower level. So there could be three big events a year we see and that scare us half to death and then a bunch of little events that we don't even recognize.

My son's got worse as he got older and of course, he got better at recognizing the symptoms so that the was able to tell whenever he needed his "puffer". Even now, just recently during a check up, I told the doctor that his asthma was better than its been in years. The doc then adminstered a computer assisted test of my son's lung capacity and he did poorly and we had to up his meds so it is still hard to figure it all out.

I don't know if any of that fits your situation, but thought I'd throw it out there.

My son has an "action plan" too....every six months.
UC diagnosed 10/05
Currently In Remission after a nearly 4 year flare.
My colitis burned out as inexplicably as it orginally
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