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Toddlers: 12 - 24 Months
Asthma?
DD is wheezing both inspiratory and expiratory today and has been on/off for the week. She had wheezing in previous colds and my Dr. is not being very proactive about it. I had asthma when I was a kid, and this time of year was the worst. I called the office and they are going to fit her in this morning. I am worried that they're going to continue to be very casual over this. I am at home with her, I hear her wheeze...
If so, I am going to immediately have her records transferred to another office. I am wondering if your kids have asthma and what you do for it? Albuterol nebs? Do you check pulse oximetry at home? Did you get allergy testing (ugh)?
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Re: Asthma?
it is common for LOs to wheeze at this age because their bronchi are so small so it is hard to diagnose asthma at this age especially since they cant do a lung function test...however if LO is wheezing they can treat it and you should advocate for your LO
ask you ped to check for retractions (if it is asthma they will retract during breathing)
DS is 9 and has brittle asthma and it is the rarest/deadliest form. I have a nebulizer at home, i check his pulse ox (both can be bought at any home medical supply store) and he is on allergy shots.
They will not do allergy shots this early...
that being said your ped can prescribe albuterol for a nebulizer or xopenex inhaler (if you get an inhaler...get a spacer)
if you are concerned about asthma I would go see an asthma/allergy dr....peds are great but when it is asthma or could be...a specialist is what you need
It took them FOREVER to dx my son with Asthma. He would wheeze, choke, so bad that he would turn blue. It took taking him in 6+ times in a month time span for them to dx him with Asthma. Typically they dx Asthma until after 2, but they will dx reactive respiratory. Basically reactive respiratory means that your child wheezes (has trouble breathing) in reaction to anything (virus, allergen, etc.).
We now do pulmacort (a steroid) on the neb 1 x daily and bump it up to 2x daily whenever he is sick or exposed to a trigger. We have used albuterol on the neb, but due to the side effects switched to Xopenex neb treatments. I send him to school with an inhaler of xopenex and spacer.
GL! From my understanding most pedi are very hesistant to give the dx of asthma. You could at least asked to be referred to an asthma specialist for evaluation.
Like a pp mentioned, most doctors are hesitant about "officially" diagnosing asthma at this age because they are unable to do the tests they normally do to confirm it. My son has been tentatively diagnosed with asthma. It only appears when he has a cold, but has put him in the children's hospital twice and the ER three times in six months.
Right now, we're giving preventative medication a whirl?he has the inhalant Flovent twice a day administered with a spacer. He's also had a few rounds of prednisone and we have a nebulizer with albuterol for the times we need it. We've only been on the Flovent for less than two weeks, so I can't tell you if it's helped yet or not. Singular was another medication mentioned, but we haven't tried that as of yet.
You're doing the right thing by switching doctors. We've been fortunate enough to have a regular pediatrician who takes our concerns seriously and is very knowledgeable about childhood asthma. We have an appointment next week with a pediatric pulmonary specialist at the children's hospital to see what the best plan for him will be.
They are kind of hesitant to diagnose young children with asthma because sometimes it goes away. People used to call it childhood Asthma but our Dr. told us that does not exist because if you have asthma then you have it for life. What they not consider it is reactive airwat disease and it typically goes away within a few years. My little guy has been struggling with this pretty badly for the past year. This time of year is definitely the worst time for is and he had a bad episode last week. The good news is that most kids do outgrow it. We use a nebulizer and a baby inhaler both of which are very difficult to use with a toddler because you have to hold them down. I keep asking my Dr about allergies and he says it may be the trigger but he has yet to let us test him for allergies. When my LO is exposed to a virus he usually has an episode.
My Dr. takes wheezing very seriously which I appreciate. So you may want to look into talking to another Dr. When we have an episode it usually lasts anywhere from a week to a month. I hope that helps a little if you have any more questions feel free to PM me. Good luck with LO hope she feels better soon!
i would recommend seeing an allergist/asthma specialist. we are going through this with DD and her allergist is infinitely more knowledgable than her pedi. we are also going to switch pedis, but i love her allergist. this way, you will be able ti avoid potential triggers.
edit to say that we are doing allergy testing next week and her allergist showed me what they use and did it to my arm. LO will probably be upset but it seems to be a quick process. it barely hurt.
Thanks for all of your great advice. I just got back from her appointment, where we saw a new PA for the first time. This PA took us very seriously and listened very intently. By the time we got to the appointment, DD's wheezes had stopped. I had worried that this would occur, which is why I hadn't taken her to the doc all week. The wheezes just come and go, and are seemingly worse in the AM and the middle of the night. At first, the PA said, "a lot of parents think they hear wheezes, but it is just mucous in the upper airway"... and I told her that I worked as a RN in an adult ICU for 7 years. I normally never pull that card, but I wanted to be taken seriously. (I also told her that I have absolutely no experience with pediatrics). So, she offered to send us home with a script for an albuterol neb and told me that it is extremely difficult to dx babies with asthma/allergies and suggested seeing a specialist. I hate albuterol's side effects. I would hate to have to put DD on it... but I would if she was wheezing terribly. I am going to hold onto this script for awhile and try to decide if this is serious enough to warrant an appointment to the allergy/asthma specialist. If her wheezes resolve without intervention, I may just keep an eye on her for awhile, and continue to assess the severity of her situation. I will pick up a pulse-ox, however, as her SPO2 was 94%. I would have liked to see it a bit higher than that, and I wonder what her SPO2 is when she is actually wheezy.
Also, DH is calling to have someone come and clean out our ducts this week, which may be helpful.
Thanks, again, for answering my questions. Even though I have experience with critically ill adults, I always doubt myself when it comes to DD!