Identifying and managing pediatric asthma

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Egon is a cute dog, but a dog nonetheless. Also, we might have taken the whole "roomies" thing too far. Nah. It was awesome.

When my son, EK, was four, two friends and their pup moved in with us. We had a whole Brady Bunch kind of thing going on which amounted to a A LOT of free babysitting. We also noticed EK developing a persistent cough that was most noticeable at night.

Given my mastery of denial, I chalked up his constant snot factory of a nose and general upper-respiratory issues to cooties from daycare. Twice he had croup and required steroids to get his system under control. His doctor was hesitant to label it as asthma because it was 2014 and labels were passé. Plus, kids grow out of croup, right?

However, one night the steam-shower-thing and the sit outside in the cool-air-thing did nothing for the litlte guy. Next stop, Lurie Children's ER.

After a few hours, we were finally ushered behind the fancy frosted door. The docs checked our guy’s oxygen’s levels, gave him some steroids and told us to sit tight. Soon we were discharged and headed for home. However, when we exited the highway to make our way to our digs, EK awoke gasping for air.

My husband ran every red light as we raced to the nearest hospital. EK was panicking as he sort of choked out, “I can’t breathe”.  As we pulled up to the ER’s sliding doors, I jumped out of the car, skipped the waiting room line and registration area  and pushed the double ER bays in like I was cameo'ing in Grey’s goddamn Anatomy.

A nurse quickly transferred EK from my arms into his and started his breathing treatment. A gold-chain, hairy-chested doctor popped in, started a cool mist inhalation thing and prescribed additional steroids. A few hours later I was jostled awake by my four-year-old as he ripped off his monitors and said he was going home. I shrugged my shoulders, thanked the staff and followed the kid out.

I guess it was time for a trip to the allergist where we we found out he is allergic to dogs (one in the house), cats (two in the house), dust mites and maple trees. Whoops.

The doc explained asthma to me in simple terms: When any of the above triggers, or an infection like croup, are introduced to our guy’s respiratory system, his airways become inflamed, swollen, mucous-filled and sensitive. In children, asthma often manifests itself through, you guessed it, frequent and persistent coughing. JACKPOT.

Environmental factors aside, our lifestyle was affecting our kid’s health in a major way. What do we do with our friends and their dog? Our cats? Our house? And how do we explain asthma to our kid?

HOUSEHOLD MAINTENANCE

First, we purchased multiple air purifiers and run them around the clock.

Second, we purchased all new pillows and covered them with special allergy cases. We change the family’s linens weekly and wash dirty sheets and pillows (wash the pillows!) in HOT water. It may be overkill, but we've noticed a huge difference in his nightly sleeping patterns.

Our friends with the dog soon (willingly) moved out, we constantly ensure EK’s door closed to prevent the cats from spreading their nasty dander and continue to disappoint our allergist with the fact that yes, they are still alive. We’re not winning, but EK can breathe.

MEDICATIONS

eevbhfcvtrd1pdlfdmeulm-l0t7btb7ykdw3nv5urds_size_mode_2_size_1600x1200_c4320e58-3f3e-491b-8a03-c1bbca7326f6_1024x1024At the conclusion of our first visit with the allergist, EK was prescribed Cingular (chewable 4 mg tablet) and an Albuterol inhaler. The Cingular is a maintenance prescription while the inhaler is used on an “as-needed basis” (i.e., if he cannot stop coughing). He also takes Zyrtec to keep things at bay.It a lot, I know, but the alternative is way worse. We also have an emergency dose of steroids in case we are traveling or he wakes in the middle of the night with a full-on attack.

The creation and implementation of a maintenance plan is crucial to avoiding flare-ups. Pediatric allergists are well-versed in all available options and used to coordinating to care to keep your kid on the playground and out of the ER. We’ve gone from daily puffs of the Albuterol to once every few months.

Our travel bag always includes chewable Zyrtec (liquid is always in 4 ml or larger bottles), Benadryl and his inhaler. We also keep bottles of each medicine at the homes of folks who have pets and frequently play hosts to our little family.

We also take clean pillowcases (and pillows if we are traveling locally) whenever we travel and might even discreetly wash the pillows if we have a tough night.

It may sound like a pain in the ass, but it really is manageable and we haven’t had a hospital visit due to asthma-related issues in three years!

I also realize we are very lucky: While EK’s asthma is mild-to-moderate, it’s far less scary that the thousands of families who deal with allergies and asthma on a daily basis.

EXPLAINING ASTHMA TO KIDS

magazine-sized-single-page-templateOur Chicago-based pediatric allergist, Alex Thomas, helped explain asthma to EK using his colorful and informative comic book (including an action plan) titled, “Iggy and the Inahlers”.  Through Thomas’ comic, EK learned about his triggers, how to properly use his inhaler and recognize signs of an asthma attack – at age 4. Plus, trading cards !?!? Seriously, if you have a child with asthma, Dr. Thomas’ Iggy collection is worth checking out and is available in both English and Spanish. Check out the website for educational videos, free downloads, clinic resources and more!

Child and adolescent asthma isn’t fun, but most cases are manageable if you identify your child’s triggers, partner with an allergist in creating a maintenance plan and educate yourself and your child on the proper dosage and usage of maintenance medications.

p.s. I told my kid he’s allergic to smoke because…I can.

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    Annie Swingen

    Chicago-based hyperbole enthusiast. Mom to a kid and sometimes my mom. Overboard (1987) obsessed weirdo. I like the funnies in life.

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