Back on the meds?
D’s been off his asthma medications for a couple of months. He hasn’t had a real attack since the first one, in February 2005. Last winter, we treated every cough as if it might be asthma-related. He’s been totally symptom free since the spring, and his pediatrician agreed that we might as well see how he did without the steroids. There’s pretty good evidence that long-term use of inhaled steroids retards growth slightly, and lord knows that he could use the extra inches.
He’s got a cold, and a little bit of a cough. School’s about to start, and I’ve read the study showing the dramatic peak in attacks among school-age kids in September and October. The doctors quoted in that article argue forcefully that asthma should be treated as a chronic, not episodic disease. But a lot of kids also grow out of asthma. No one’s been able to give me an answer as to how to find out of he’s outgrown it other than keeping him off the meds and seeing what happens.
August 25th, 2006 at 12:35 am
We only took Wilder off steroids at the end of June, because he only went on them for the first time in March (after his hospitalization) and the allergists, in retrospect, thought it was clear he should have been on them for several springs prior. (Wilder had his first big non-pneumonia weezing attacks in June 2005. I’m not sure this story is making sense, and I’ve just gotten started.)
When Wilder went off the steroids, it was with the understanding that he would go back on them as soon as he needed to use any albuterol with any cold. We didn’t need to get the doctors’ sign-off on that, and our allergist advised us to err on the side of the steroids. Elba already has a runny nose this week, so I’m wondering now if I should refill the pulmicort prescription. (Wilder uses the 200mg turboinhaler, only once a day. We could boost to twice a day if things got very rough in the winter.)
Wilder hasn’t been diagnosed with asthma per se, though. They keep saying it’s more like Respiratory Distress Syndrome, because he hasn’t displayed wheezing with exercise. It’s just an illness-related problem. So far.
Our allergist and our pediatrician seem to discount the steroid-growth restriction connnection. They both say that inhaled steroids just don’t show that much effect, that it’s all caught up by adolescence anyway…the studies make my head ache, they’re that confusing.
After reading that article, I’m sure we’ll go on the steroids as soon as Wilder gets his first cold.
It’s a _little_ easier for me to say we’ll go back on the steroids because Wilder jumped from the 25th percentile in height to the 50th over the last year. A LOT of that growth happened between January and July, if our at-home against-the-growth-chart measurements are reasonably accurate. I think finally medicating Wilder’s wheezing/asthma/RDS/whatever allowed his body to take the energy it has been spending just breathing and re-direct it towards growth. Or at least, that makes sense to me, when I consider how much coughing he was doing at night until we started the steroids, and how now they think growth mostly happens during sleep. (Wilder grew 2.25 inches between January and July, and my informal sense of how his pants were fitting makes me think most of it was after his hospitalization in March.)
None of which is precisely relevant to your situation, but I guess I’d share all the data points for our decision. FWIW, my cousins both had asthma with nebulizer treatments every day for years, and they’re now both approaching 6′ tall (at ages 16 and 18) even though their parents are 5’8 and 5’6. And both outgrew their asthma, which I remember being dramatically bad — once one of them had to be medivac’d down from the lake because of an attack.
I know, anecdotes schmanecdotes.
Speaking of my cousins, Wilder had a small potty accident on my grandparents’ carpet while we were home in July. I apologized and my grandmother said, “oh, J (the older of the two cousins) used to throw up all over the place whenever he ate peanuts by accident.” The kid has peanut allergy and his grandparents weren’t taking any precautions against cross-contamination. ARGH. How my aunt managed not to kill them, I have NO idea.
[I hope no one in my family ever finds this comment!]
August 25th, 2006 at 8:09 am
There are lung function tests–my allergist used to do them for me when I saw one. BAsically a tube you breathe into as hard as you can and a machine measures your lung capacity from it. Do you have a doctor you can ask to see an allergist or asthma specialist to see if they can do that for you?
August 25th, 2006 at 10:37 pm
my advice is don’t ever take a child off preventive medicine for asthma, and the reason I say this is my mother-in-law died of asthma, her son’s asthma was very bad as a young boy, went away and then came bay violently as an adult, and my kids can never be off of their asthma medicine because every time they come off of it, eventually they have problems. I don’t mean to scare you, but more kids that die have minor asthma, because the theory is it is undertreated. and believe me, Wilder most likely has asthma. doctors take a long time in deciding if kids have asthma because they usually wait until there are more than 6 episodes to diagnose it. my oldest had been wheezing for months and we were told it was bronchiolitis and finally after I pointed out we had asthma in the family again and again, they said “oh she has asthma”. also, I had exercise induced asthma as a teenager and now it is actually asthma. hope this helps and good luck!
DragonLady
August 29th, 2006 at 11:10 am
It’s also ragweed season. And it’s really bad this year. http://www.washingtontimes.com/metro/20060815-103140-6215r.htm