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Dr. A. Clark
Dr. A. Clark, Pediatrician
Category: Pediatrics
Satisfied Customers: 4437
Experience:  33 years of experience as a general pediatrician in private practice and in pediatric urgent care.
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6year old son. dx with asthma. inhaler am and pm. pft 50%.

Resolved Question:

6year old son. dx with asthma. inhaler am and pm. pft 50%. He had test when has cold. around cows, chickens, cats, dogs when at dads. seems to always come home sick. He does have some wheezes currently. inhaler in am and pm seems excessive to me at this point?? no further tests were ran. I have a dog and although he does cough some (especially at night) he runs and plays around allot. adenoids removed about a year ago. ear tubes at same time. Am I being overly dramatic thinking that inhaler am and pm seems excessive at this point?
Submitted: 11 months ago.
Category: Pediatrics
Expert:  Dr. A. Clark replied 11 months ago.

Dr. A. Clark :

I'm happy that you have asked me to assist you with your child and hope that you can benefit from my many years of helping parents like you.

Dr. A. Clark :

Hi. Can you tell me which inhaler medication he is using?

Customer:

actually no i can't. his father has him this week and called when he was out of the house. he didn't recall what it was. i am wondering if it is excessive to start a child on inhaler so soon. am and pm?

Customer:

he does have a history of having bronchitis about 2 times a year.

Dr. A. Clark :

There are two types of inhalers and so it depends on which one it is. Do you not have him with you now to look at the lane?

Customer:

no. his dad has him. he had just went to dr. 2 days ago.

Customer:

shared parenting.

Dr. A. Clark :

One type is called a rescue inhaler and contains albuterol or a similar medication and the other type is known as a controller medication and is a form of a steroid. Twice a day every day with albuterol to control his symptoms means he is not being adequately treated and needs to be on a steroid inhaler too. Some kids are on just the steroid inhaler to keep from wheezing since it is more of a preventative medication.

Dr. A. Clark :

He is not too young as we used both medication even in infants and toddlers.

Dr. A. Clark :

It really depends on an accurate diagnosis of the underlying cause of his cough/wheezing, etc.

Dr. A. Clark :

What did you mean by "pft 50%"?

Customer:

his father told me that he is on inhaler am and pm and that he is also on a rescue inhaler that the physician said he probably won't need. for a 6 year old i am wondering if correct dx was made? he was not taken to pediatrician. pft...pulmonary function test.

Customer:

it should read 80%.

Customer:

but he had test when he was sick anyways. which i believe could influence the results.

Dr. A. Clark :

If his pft was diminished then he likely does have asthma. The issue then is if he is having to rely on his rescue inhaler too much (daily!) to stop his cough then he needs to be reevaluated.

Customer:

well, i get him back today for the week. i am a nurse and will certainly be keeping a close watch on him. so if he is using his rescue inhaler at least one time a day he should be re-evaluated. i am forgetting every bit of my nursing skills at this point.

Customer:

i guess i was wondering if excessvie. i know that long term steroid use is not a good thing. i want my son to be active. i don't want his asthma to influence his level of activity.

Dr. A. Clark :

Yes, the goal of successful asthma management is very infrequent use of a rescue inhaler by proper management with a steroid inhaler, occasional oral steroids for flare ups, and other medications as well. Long term use of inhaled steroids is NOT dangerous and causes no side effects as has been demonstrated by many studies over the years.

Dr. A. Clark :

Here is a good resource for parents about asthma management for children:

Customer:

he doesn't always have a cough either. it seems like it happens when he is at his fathers. he comes back to me usually with a cough. i was almost hoping it was allergies to animals. thank you very much.

Dr. A. Clark :

I suspect there are asthma/allergy triggers at his dad's but it may also be that he is not diligent about using his medication there.

Customer:

Thank you so much. I will read this. I would guess you are correct about diligence.

Customer:

so to re-cap....the scheduled inhalers (whatever they may be) should control his symptoms. If he starts using the rescue inhaler at least 1x day then he probably needs re-evaluated. Steroid inhalers are very helpful in asthma treatment and I have nothing to worry about?

Customer:

He may have to use inhalers for the rest of his life? and it will not affect his ability to play sports?

Dr. A. Clark :

Right and you will see more specific guidelines in the linked article. Every child should have an "asthma plan" that gives parents exact measures to follow for flare ups. This requires a peak flow meter at home to have him blow into to measure his lung capacity and thus establish his unique zones: green, yellow and red and what to do at each stage.

Dr. A. Clark :

Here is the most commonly used form:

Dr. A. Clark :

His doctor needs to fill this out and most school systems require on on file with the nurse in case of a flare up at school, as well as a rescue inhaler on him at all times.

Customer:

Yes, I have read this. Printed the plan. I have read allot about asthma in children over past couple of days. thank you. Like i said at the beginning my concern was that this was excessive at such an early stage.

Customer:

he runs, jumps, plays. I want that to remain the same. I want his life to remain the same.

Customer:

Thank You.

Dr. A. Clark :

I agree and with appropriate management there is nothing he should not be able to do.

Customer:

Thank You So Much!!

Customer:

I will read the articles now. You have been very helpful. Its funny that when it comes to my family I cannot recall any of my nursing skills and rely upon asking lots of questions. Thank You.

Dr. A. Clark :

You are quite welcome.

Dr. A. Clark :




Please let me know if you have any further questions and if not I hope you will take advantage of the opportunity to rate my advice when you exit chat. Please feel free to ask for me by name the next time you have a question about your children.




Dr. A. Clark, Pediatrician
Category: Pediatrics
Satisfied Customers: 4437
Experience: 33 years of experience as a general pediatrician in private practice and in pediatric urgent care.
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