Childhood Diseases

Posted by: Mom of boys | 2009/03/18


3 Asthma questions

Dr my oldest son( 5 yr old) has multiple EA and some slight food allergies. He has been on all the chronic meds, Zyrtec, Nasonex and Singulair the last 2 years with success....The last month he has been struggling with excersize indused asthma...also coughing badly at night and plenty of mucus...His pead put him on Flixotide (2 puffs morning and night), after listening to his lungs and x-rays....He sometimes uses Ventolin when needed...He is much better now and can run without almost any coughing, he also comlpains less of tierdness....My first question:
-My pead don' t feel it' s needed to go to a pulmonologist...He feels that with the current meds my son is doing better and is functional. He said that we can lower the flixotide later to 1 puff and see how it goes. No one has ever done a lung function test on my son and dr feels that with all the clinical signs and examinations his treatment is optimal at this stage...Do you think that it would be of ANY extra value to see a pulmonologist?
My second question......
-He is still eating bread even though he tested very low on RAST (1.96) to wheat. He doesn' t show any signs of allergy after eating wheat...Will stopping him from eating it make any difference in his asthma?
My 3d question:
-My baby (15 months) has been admitted with lung infection last week(for 5 days) in hospital....He has been ill for 3 weeks, today with the follow up the pead says that his lungs is clean and sounds well. He said that in hospital he heard wheezing in his lungs and this can indicate asthma. He needs to use Zyrtec and Singulair chronic now and Pulmicort and combivent when needed. The ' sweat test'  was negative....His RAST for EA was 6. Dr has a feeling that he will develope more allergies as he gets older....What I want to know: Can a diagnosis of asthma be made only on a few examinations where wheezing was heard and is it really necessary to use this strong meds at this early age (This was his second admission for pneumonia in the last 6 months).

Expert's Reply



There would be no additional benefit for your son to be seen by a pulmonologist. He is too young to have his full lung functions tested, but he should blow on a peak flow meter when he is seen by his paediatrician.
He can continue to eat bread.
Your baby does seem to be allergic as well and it is likely that he is now showing the first signs of having asthma.
The usual advice is to start on Singulair Sprinkles now. He does not need to be on Zyrtec as well. He should use Combivent only when necessary for wheezing or if he coughs especially during the night or in the early morning.
Your paediatrician seems to be experienced in diagnosing and treating children with asthma.

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