Written by Joanna Betancourt MD., FAAP
And even with all the knowledge obtained during medical school and pediatrics practice, it was hard to accept.
As an infant, and exclusively breastfed, our daughter developed cow's milk protein allergies that manifested as bloody stools and a severe rash at only 6 weeks of age.
After a very tough time, she improved, but the rash was ongoing in the flexor areas of her arms and legs, particularly worse during her second spring. Her rash was ECZEMA, or ATOPIC DERMATITIS. By 17 months of age, we started noticing occasional swelling around the eyes, so I took her to an allergy specialist.
Our daughter underwent blood and skin allergy testing and was also diagnosed with mild egg allergies. By age two, she got a cold and had some wheezing associated with it. It was winter and I knew many viruses that cause common colds, can make little kids wheeze.
So I treated her with Albuterol nebs for 1-2 days. I thought that she probably would not wheeze ever again. However, every spring and fall, she had mild wheezing episodes. We never needed to take her to the ER or admit her to the hospital. Everytime, she was fine after 3-4 days with the use of Albuterol. Her eczema was off and on and she was frequently stuffy and with dark circles under her eyes.
By age 4, I had to admit it, SHE HAD ASTHMA! Our daughter went through what is known as the ALLERGIC MARCH: starting with food allergies, advancing to eczema and allergic rhinitis and finally presenting as recurrent wheezing or ASTHMA.
We were "lucky" though; her asthma was mild.
Until last year, when she developed about 3-4 "not as mild" asthma attacks. We had to add an oral steroids on 2 occasions. Last summer, she got a cough that lasted about 2 months despite several treatments that included anti-allergic meds, nasal sprays and antibiotics and again, she improved.
One evening in October of 2010, Alex complained of chest pain. She didn't have a cough or labored breathing. Of course I auscultated her and she was clear. I gave her an albuterol neb this time and a steam inhalation.
She felt better...however, was not as playful.
I slept with her that night. Two hours after her neb, I felt her breathing deep and different. When I turned on the light, she was working hard to breath, her ribs were noticeable with the pulling of her abdominal and chest muscles to reach air, her lips were ashy and she was breathing heavily and faster. No cough, believe it or not. I followed the asthma action plan that was pre-established for her. She improved, but this was a very close call.
It was so obvious then that her asthma was slowly getting out of control! I just was thankful I decided to keep a close eye on her that night, because I would of not been able to hear her from my room.
Alex was immediately started on a preventive medication: an inhaled steroid she uses twice everyday religiously, before brushing her teeth. Since then, she has not had another asthma exacerbation.
She, of course, still gets colds and coughs, but recovers easily after 1-2 days. She has not missed a day of school since we started her "controller" medicine and I feel so much more confident she will be alright.
Asthma, No Small Condition.
Asthma is one of the nation’s most common and costly chronic conditions, affecting over 38 million Americans at some point in their lives. An estimated 8.6 million adults and 4.1 million children had an asthma attack in the past twelve months (2008 NHIS). The cost of asthma is estimated to be over $30 billion a year. Asthma can also be life threatening; more than 3,600 people die from asthma each year.
That is, about 9 people every day. Although much has been learned in recent years about asthma management and control, the information still needs to be put into sound public health practice. Managing asthma requires a long-term, comprehensive approach, including:
- Patient education
- Behavior changes
- Asthma trigger avoidance
- Pharmacological therapy, and
- Frequent medical follow-up.
In most cases, what causes an individual to develop asthma is unknown. The occurrence of asthma attacks, however, has been linked to:
- Respiratory infections
- Exposure to environmental factors such as allergens, tobacco smoke, and indoor and outdoor air pollution
A number of epidemiologic studies have reported associations between air pollution exposures and asthma. The association between ambient air particulate matter concentrations and asthma, including increased hospital admissions, is well documented.
An estimated 9.6 million children (13.1 percent) under the age of 18 and 24.4 million adults 18 and older (10.9 percent) had been diagnosed with asthma during their lifetimes.7,9 Current asthma prevalence is higher among children ages 17 years and younger (9.1 percent) than adults (7.3 percent).11 In 2007, asthma accounted for 3,447 deaths. In the United States, that’s more than 9 people every day. Unfortunately, one of our patients was part of these statistics in 2010.
Most children with asthma miss a significant number of school days due to asthma flares up during winter and spring. Parents also miss work days because they need to take care of their sick child, not to mention the burden of needed ER visits, hospitalizations , doctor's office visits, and long, sleepless, anxious nights.
Salud Pediatrics Asthma Clinic
In our effort to provide the best preventive health care, we would like to invite you and your child to participate in our Asthma Clinics on Thursday October 13 and Thursday October 20.
The purpose of these clinics is to prepare you and your child for the upcoming season by classifying his/her asthma and establishing an action plan so that the frequency and severity of asthma flare ups decrease.
During the Asthma Clinic we will provide:
- Identification of asthma triggers for your child.
- Classification of his/her current asthma. Even if your child has been well, asthma can strike anytime.... You need to be prepared!
- Establishment of a customized Asthma Action Plan that would empower you, the school staff or other care providers to take control of his/her asthma symptoms and act on time to avoid potential life threatening complications.
- Introduce the use of a Peak Flow Meter so that you can objectively assess how your child is doing and how severe his/her symptoms are.
- Hands on training on the use of asthma medications, spacers, and nebulizer.
- Give needed prescriptions and pertinent refills.
- Flu vaccination and allergy testing for identification and control of triggers, if indicated.
Your participation in our clinic will be billed to your insurance company as a typical office visit.
Call us at (847)854-9402 to set an appointment on either of the 2 dates available.
Please bring with you all your child's asthma and allergy medications (inhalers, neb solutions, syrups, tablets, nasal sprays) and any aerochamber or spacer you have.
We would like to partner with you so your child enjoys a healthy season.
Thank you for trusting the care of your children to us!