Question:
My 1 1/2 years old daughter has been diagnosed with asthma. It seems, quite literally,
that she is sick ten months out of the year. She constantly has some type of
cough, whether it be a dry, hoarse cough, or a phlegmy cough. Oftentimes it's
accompanied by a runny, gooey nose. When I hold her I can literally feel the
vibrations of the mucus in her back and chest. I'm constantly listening to her
lungs with a stethoscope to listen for wheezing. Her pediatrician and
allergist have her on Albuterol with Intal, along with 4 puffs of Flovent
daily, and currently she's also on Prednisolone and a prescription cough syrup.
So...tell me this.... Can someone explain to me the connection between the
mucus, runny nose and asthma? Her pediatrician calls her an "Allergy girl" and
that when she gets a mild cold or something, she gets a "respiratory allergy"
reaction to it and that's why it flares up the way it does and lasts so darn
long. I've also heard her condition called "reactive airways disease" by an ER
doctor. Also, I'm wondering, if she should get a severe wheezing attack (which
she hasn't so far) to the point where she's having trouble breathing...is the
Albuterol the fix for that? (before taking her to the ER that is.) She has
never had an "attack" before, but when I asked her allergist/asthma dr. about
it, he didn't provide me with any good information and/or medication
Answer:
It is typical that you were not given enough info from the docs. I do alot
of 'asthma teaching on our pediatric unit, and feel that if the docs gave
better info, then these kids would probably not be admitted to us. Reactive airway disease is another term for 'baby' asthma. it means that
the child has 50-50 chance of developing 'asthma'(in my opinion, its asthma
any way you look at it)
Your daughters 'asthma' is probably allergy related, the only problem is,
finding out what she is allergic to. it can be environmental (dust mites,
pollens, etc), animals (do you have animals?) or food. im wondering if
maybe there is a food allergy of some type since you said that she is sick
10 months out of the year.
other triggers could be smoke (does anyone smoke in the house? ask them to
do it outside!), exercise can induce an attack, cold (breathing it in),
humidity makes it difficult to breath.
This is what happens during an attack(simplified): the allergens enters her
body, histimine is released and a whole mirad of symptoms happen; runny
nose, cough, wheezing, irritability, shortness of breath, and 'bronchospasm'
which is tightening of the airways.
the wheezing is caused from the tightening of the airways (this makes a
whistling sound as air enters and leaves the lungs). along with that, the
allergic response also causes swelling and mucous production in the airways
(and nose), in the bodys attempt to get rid of the allergen. thats why she
sounds so cruddy, mucous.
did the give you a nebulizer(a compressor type machine)?
albuterol is the drug that helps to open the air passages to help her breath
better. yes, this is the one to use when she is having an attack. if you
find yourself giving it to her more than prescribed or if she needs it
before the next doseis due, then take her to the ED. this should not be
given at home more often than every 4 hours. the side effects of this
medication is irritability and jitteryness (along with other side effects).
intal is a medication to help prevent the airways from reacting to what
ever she is allergic to, thereby preventing an attack. this is a
preventative medication.
Flovent is a fairly new medication, it helps prevent inflammation of the
airways. this is also a preventative medication. did you get a aerochamber
to use with this medication? alway have her rinse her mouth (i have no idea
how to do that in a 1 1/2 year old!)after this medication to prevent an
oral fungal infection.
Prednisone is a steroid that will decrease the inflammation in her lungs.
usually taken short term during acute attacks.
if you have animals, keep them out of her room (better yet, find new homes).
try to keep her hydrated during attacks, offer her drinks often, and if she
refuses, try freezepops or popsicles. if she gets dehydrated, it causes the
mucous to become dry and tacky along with her mucous membranes. this will
prevent the mucous from becoming stagnent in the airways, therby preventing
an infection. the first thing we do when a child is admitted onto our unit
is to put an IV in to hydrate the child.
Another important note: if at any time you dont understand, or feel
overwhelmed, or are aprehensive about how your daughter feels, call your
doc, day or night. thats what they are there for. trust your instincts.
and one more thing, asthma has an uncanny way of being worse at night.
