I'm confused-allergies, asthma, albuturol, etc

[twins r fun]

Can someone shed some light on this for me. I called my pediatrician today, but unless I'm actually in the office and can keep asking her the same question in different ways, I just seem to get even more confused by her and I don't get any indepth explanations! Not a good trait in patient/doctor relationship, but she's great in many other ways!

Caleb has been getting these coughing attacks for the last few days. They are pretty severe and he ends up wheezing. He doesn't have any cold symptoms-just the cough. He's also been wheezing when he's had a bad cold. In the past, we've treated it with albuturol through a nebulizer and last time a steroid and it gets better with the meds and goes away when the cold is gone. But like I said, this time there is no cold. So today the doctor told me to give him albuterol and said there's something going around or it could be allergies.

But I don't understand this! Is it asthma? Is it allergies? Should he be seen by the ped? Should he be seen by a respiratory specialist? Will it go away? What does albuterol do? Do I still give him cough medicine? Why is the ped just treating it without finding out more info or coming up with a plan? I have done a internet search on asthma and allergies in a toddler, but am not getting any consistent information. What do you guys know about this?

I should also add that Caleb was on a ventilator at birth and has some lung damage. He came home on oxygen and was seing a pulmonologist until last summer. She discharged him from her care because he was doing fine. But maybe I should call her or get my doctor to refer me back there.

Thanks,
Nicole

Nicole

[C99]

I'd get a referral to a pulm. specialist or allergist if you can. The symptoms and treatment you descibe sounds like asthma, which can be exacerbated by a cold or triggered by allergies -- in fact, I can't understand why they'd treat Caleb with albuterol if it wasn't asthma-related. Of course, this is my experience in dealing with this myself -- I don't have any young child experience w/ asthma.

hth

[sweetbasil]

Nicole,
So sorry Caleb is going through this- and you, too! Albuterol is considered an asthma intervention, as it is a bronchodilator- reduces inflamation of the bronchiols to make breathing easier. A friend of mine who is a ped. said that giving our son his albuterol inhaler was just as efficient as using Xopenex in the nebulizer- it's quicker, cheaper, just as long lasting.

My understanding, from DS's ped, is that he has asthma (as do I, and several family members before me), but it can be triggered by allergies- which is why it isn't always a cold that causes his symptoms appear.

Especially given Caleb's breathing problems at birth, you might feel more comfortable either making an appointment to see the ped or going to a respiratory specialist. To this point, we've just stuck with our ped and haven't seen a respiratory specialist, because the ped has done a great job of tackling Kellen's breathing problems...but that's completely a personal thing. But if seeing a doctor is going to make you feel more secure/give you greater understanding of the situation (it would for me!), then I say go for it.

Take care, and please let me know if I can help at all :)

[atlbaby]

Hi Nicole,

I'm so sorry Caleb is so uncomfortable! Most of my allergy experience lies in the food department, but I have asthma as well (though not a "bad case", and it got better as I grew up--but why couldn't the food allergies do this??:( )

Anyhow, in my experience colds can exacerbate asthma symptoms, as well as changes in temperature--and we are definitely getting temperature fluctuations with 35 degrees today and 65 degrees for tomorrow! Since you've seen a pulnonologist before, and because Caleb has some lung damage I would definitely give her a call again--especially since you aren't getting a good explanation and plan from your ped. I started seeing an allegist at about age 2, so if the pulmonologist or your ped can recommend you to one that sounds like a good idea to me.

My experience with our ped (since I am very worried about Arielle developing food allergies) is that they don't get terribly worked up with allergy symptoms--they seem to enjoy saying "there's something going around"! (DH has confirmed it's not just ours!:) ) So I may also take her to a pediatric allergist to have her assessed too. Did you like the pulmonologist you took Caleb too before?

I hope I've been some help--and that Caleb feels better soon!

--Rachel
Mom to Arielle Jill, 10/30/01
#2:) EDD 10/24/03

[twins r fun]

Thanks all! I have a call into the pulmonologist and am waiting for her to call back. Caleb is a mess and the albuturol doesn't seem to last as long as it is supposed to (he starts wheezing again before he's technically due for the next dose). Hopefully the pulm. will call soon-don't really want to go into the weekend without any advice.

Julie, I'm going to email you, if I can find your address (I think I have it) since you've done this before!

Nicole