Guest guest Posted July 23, 2001 Report Share Posted July 23, 2001 , maybe you can help answer this one for me... We took Graham to a pulmonary specialist with the thought that he may have asthma (at least exercise induced). He doesn't normally have any problems but our physical therapist called our ped and said he felt Graham was wheezing and doing a lot of labored breathing during his sessions. So our ped sent us to the specialist. My problem...The specialist discussed Graham's immune deficiency, listened to his chest (which he said sounded fine) and then chose not to do a pulmonary function test, but to give him Albuterol and Intal 3 times a day all based on 1, his immune deficiency and 2 the fact that he was on Xopenex in April and May because of viral and bacterial infections that caused him to wheeze. Like I said, no tests were run except for a sweat test for cystic fibrosis which came back normal. He told us that it would be 3 hours before they could get us in to do the pulmonary function test and it really wasn't necessary. We still volunteered to wait...but he insisted it was important. So do I fill the prescriptions? Or do I wait and get a second opinion? The background info I gave the specialist was that Graham has Bruton's. He was hospitalized in May for viral and bacterial infections that caused the wheezing. He is on IVIG every 4 weeks. Only the physical therapist notices the wheezing and heavy breathing and I don't give him breathing treatments. I have allergy induced asthma that started 5 years ago but is under control as long as I take my allergy shots and I haven't used my inhaler in nearly 5 months & do not take any daily meds. I just feel like he decided that because Graham has the immune deficiency that he must have asthma. I wish I had spoke up while I was there but it took a little bit of time for all of it to sink in. My family and I are at odds on this one. They feel that the doctor knows best. And when I posed this question to them, they got angry... " If the doc said Graham had a mental handicap or a physical handicap based on our family history, wouldn't you want futher testing done to prove or disprove it? " Thanks for the input. Kim, mom to Linz 11 and Graham 6 mos (Brutons) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2001 Report Share Posted July 23, 2001 Kim - Did the pulmonologist say that he has asthma? Did his notes reflect that? He might be trying the bronchodialators as a way to diagnose the problem. If after taking these treatments on a schedule he does better in PT then he is considered responding to treatment and the treatment is one for asthma. Another thought is that these meds are also used for respiratory disease and infections. He might just be trying to pump up or help out the lungs to fully function from recent infections. Macey has more of a reactive airway than asthma. She has had a few true asthma attacks but most of her wheezing and problems with exercise happen when she's had recent bacterial or viral respiratory or sinus infections. Her airways tend to " react " to infection. Some doctors state that Reactive Airway Disease (RAD) and asthma are the same thing, some don't. Macey's doctors are of the opinion that when Macey's sinus and lung health is stable she doesn't wheeze. Rarely does she just start wheezing out of the blue like a true asthmatic tends (though not all the time) to do. If you want to seek a second opinion then you may try seeing an asthma and allergy specialist. Most allergist handle asthma patients. Pulmonary function tests (depending on how extensive) are difficult to do in a child much less a toddler. Macey started a simple spirometry test at 4 yrs old and still isn't ready to do a reliable complete set of PFT's. I know from working at the hospital that there is a way for the Respiratory Department to do PFT's on an infant or toddler but there is alot involved and usually this is reserved for extensive lung damage or history of respiratory distress. I'm sorry the appointment didn't go as well as you had hoped. Let us know what you decide to do. -- Ursula Holleman Macey's mom (6 yr. old with CVID, asthma, sinus disease, GERD, kidney reflux, Sensory Integration Disorder, Diabetes Insipidus) http://home.att.net/~maceyh/ http://groups.yahoo.com/group/PedPI D Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 24, 2001 Report Share Posted July 24, 2001 Kim, I don't know if I'd ask for a second opinion just yet. My daughter Autumn has severe asthma & we've never done pulmonary function tests. When she was 6 months old, we started intal 3 times daily also. It didn't really help her much, though. I kow for some people Intal works wonders, especially small children. Autumn's underlying problem has to do with infections, not just her allergies. If her asthma flares up, you can bet she's got an infection somewhere. I haven't really pushed for the pulmonary function tests either. She's so young that I'm not sure that the results would be very reliable. Couple that with the fact that she's been through so much testing already. I had to ask her to do more of them. The asthma may be exercise induced. If that's the case, the Intal should help. If not, you'll certainly have a baseline after a few months of use. Hope this helps! Ray, mother to Tabitha (age 5), Autumn, age 3 (IgG def., asthma, chronic sinusitis, and allergies), and Duncan Avery, 2 months _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp Quote Link to comment Share on other sites More sharing options...
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