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Asthma

Child with Pneumonia and Asthma

02/04/2011

Question:

My six year old son developed wheezing and "feeling bad" in one day and was taken to the hospital because he was steadily getting worse after leaving the doctor`s office that same day. The doctor had verified that he had LLL pneumonia and already knew he had asthma but didn`t check his O2 levels while at the office. I didn`t feel good about my visit and went to the hospital shortly after. His O2 levels were at 70% at that time and he had also been vomiting which the physician had been aware. He spent 6 nights in the hospital and came off the oxygen on day 5 of his stay. His oxygen levels took a while to get back up. The physician said his pneumonia was atypical. He is currently on prednisone, albuterol, and Omnicef. 

I almost lost my child and this scares me as he has not had anything like this happen before. In the past he only takes albuterol and pulmicort when he begins having symptoms such as a runny nose, and Allegra twice a day. He has remained healthy most of the time getting a cold maybe once a year. I am scared to death. I am wondering if its time to see a pediatric asthma specialist? I have never witnessed my child in such a weakened state and I feel frightened all the time now when the weather is cold, when he`s at school, etc. I am a basket case. I need to feel some peace of mind and to do the best thing for him. Any advice?

Answer:

Asthma exacerbations can come on fast and furious, particularly if they have been triggered by respiratory infection. It is a frightening experience to go through. I am glad your son has recovered. 

It may be very helpful for you to see an asthma specialist. In these situations, a general overhaul of a patient's overall asthma control is needed, including a discussion of whether chronic daily controller medications (therapy to prevent attacks from starting in the first place, and keep those that still "break through" milder) would be helpful. This evaluation should include an attempt at lung function testing. Also, an "Asthma Action Plan" - that is, what symptoms and signs to look for, when to start albuterol, when to contact a physician, when oral (not inhaled - they don't work very well once a child is already sick) steroids should be started, when to call 911 - needs to be made. This plan should incorporate the symptoms and signs your son had leading into this recent severe illness, so the next time they occur everyone knows to act fast - and check his oxygen level. You should have albuterol available for his use at school, and share his "action plan" with his teacher and school nurse. 

I think once you have this discussion and plan in place, you will feel much more "in control" of this situation, and the sensation of being constantly frightened for him will improve a lot.  

Best wishes.

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Response by:

Elizabeth D Allen, MD Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University