13yo new asthma diagnosis, inhaled corticosteroid?

[LNC]

She has seen a pulmonologist for allergy shots and mild asthma symptoms during pollen season.

 

She started couch 25k last summer after quitting 7 years of ballet (bc of poor turnout for pointe). She couldn't progress bc of chest tightness and being crazy out of breath. She broke out in hives after a run a couple weeks ago.

 

The dr. did a lung function test oday and said she should have Flovent daily in addition to Xopenex as needed. I'm concerned about side effects! He said it isn't like the oral or iv steroids I have taken, bc it is only absorbed by the lungs - like hydrocortisone cream is absorbed by the skin only. I'm a little skeptical. I would hate to have her deal with long term issues with weight and bone loss like I have.... What would you do?

[Joker]

My asthmatic doesn't do well unless she's on the same kind of regimen. She does Flonase daily, as well as Zyrtec. She has the inhaler to use whenever she needs it. She hasn't had any side effects as of yet.

 

Younger dd had asthma for years (she seems to have grown out of it) and was on the same kind of meds and had no side effects.

 

If the need it, they need it.

[Mrs Mungo]

My son has been on some form of inhaled corticosteroid since he was 4 and now he is 11. He doesn't seem to have any side effects. Now, when he gets sick and has to take oral steroids? He is angry, hungry, etc. It's clear that his daily inhaler does not have the same side effects.

 

Here is an article discussing possible side effects, but the major ones are rare in kids:

http://allergies.about.com/od/medicationinformation/a/inhaledsteroids.htm

[Pippen]

Side effects from inhaled steriods are often minimal, especially when compared to not being able to breathe and/or exercise.

 

It's counter-intuitive to those of us who use medications cautiously, but when it comes to asthma, medicating preventatively and medicating early usually results in using less medication in the long run. I let it go once when I was pregnant and the lungs were so inflammed it took several years to totally settle down again.

[Ellesmere]

Consider the risks and the benefits.

 

I agree with the advice you have gotten so far. If you have a pharmacist in your area that you can chat with, it might help, too. Having gone through that sort of asthma treatment, I'd not hesitate to do some sort of treatment for my kids like you describe. It would depend on the MD, though. My former PCP just had a standard way to treat anyone with asthma and I do much better with my allergist. I trust our current one to either refer us out or give us something beyond a canned response.

[Dana]

My son's on daily Flovent and has been for years. He does Xopanex through a nebulizer when needed since albuterol makes him mean. When we tried stopping the Flovent, he needed albuterol (inhaler). Staying on a maintenance dose of the Flovent keeps him off the xopanex or albuterol and also off the prednisone.

 

Keep the asthma maintained.

My husband went through a ton of problems due to his lack of medication for his asthma growing up. His asthma would get out of control and he'd end up in the ER and then on a ton of much stronger steroids.

 

If there are triggers to the asthma, figuring those out can be very helpful.

My husband is highly allergic to cats. We had a cat. After our cat died and more of the dander got out of the house, dh's asthma improved enough to where he doesn't always carry his albuterol. He used to have to take it at least a couple of times a day.

 

Good luck.

[Mrs Mungo]

Also, remember, uncontrolled asthma leads to permanent lung damage. That is the risk of not doing it.

[Pippen]

Also, remember, uncontrolled asthma leads to permanent lung damage. That is the risk of not doing it.

 

Yes! That's why I've adopted the "Drug Early, Drug Often" approach. :coolgleamA:

[Ottakee]

Like other said, the inhaled steroids are such a tiny targeted dose compared to the IV or oral steroids that are needed if the asthma gets out of control.

 

If her asthma is affecting her so that she couldn't do ballet, etc. then I would certainly use the meds.

 

Like one ER doc told us, if you can't breathe, then NOTHING else matters.

[Chris in VA]

Also, remember, uncontrolled asthma leads to permanent lung damage. That is the risk of not doing it.

 

It's also bad for brain development. The parts of the brain that are developing in the teens include the areas that control impulsivity and decision making. You want those to get all the oxygen they need!

 

Plus, unmanaged asthma can go downhill very, very quickly.

 

I say this as a mom whose son was on inhaled steroids for several years.

[LNC]

Thanks everyone. I do understand what you are saying. She has chest tightness with running, gets out of breath unusually, and did not do well on her breath testing. But, she doesn't wheeze. I have older sons with severe medical issues, so I'm hesitant to go down this road with her for something that "seems" so minor. She does need to be able to work out, so we will give it a try.

[Pippen]

My two kids with exercise-induced rarely present with wheezing. It's usually coughing and a tight chest feeling.

[Chris in VA]

Yep--mine didn't wheeze, just coughed. Once it was so bad his pulse ox was very low--ER low. I didn't know how serious it was.

My point was that chronically under-oxygenating your brain is NOT good for you. (I don't even know if that's a word, but ykwim.)

 

Is she monitoring peak flows? We found that to be important in managing asthma.

[Joker]

When mine wheeze, it scares me because it means they are very, very sick. They only wheeze when it has becomes serious. I felt the same way when mine were diagnosed because I thought they were supposed to wheeze, but letting it get that far was so dangerous.

[G5052]

You want to minimize inflamation in the lungs. When that isn't handled, you get scarring and of course that leads to horrible complications.

 

If you want to find what that is like, talk to a respiratory therapist. They deal with that all of the time, and it isn't pretty. Many of the older people that you see carrying oxygen around and gasping in doctor's offices are people who didn't benefit from the inhaled steriods that we have now.

[Ellesmere]

Thanks everyone. I do understand what you are saying. She has chest tightness with running, gets out of breath unusually, and did not do well on her breath testing. But, she doesn't wheeze. I have older sons with severe medical issues, so I'm hesitant to go down this road with her for something that "seems" so minor. She does need to be able to work out, so we will give it a try.

 

I'm glad you will.

 

Mine wasn't under control or properly treated until my 20's and I still resent being told it was no big deal from the time I first noticed symptoms and all the way through high school. But our PCP didn't take it seriously. After a couple years, I finally got a rescue inhaler, but nothing else in the way of help (advice, peak flow monitoring instruction, etc). We got no further help until my late teens, and later an allergist set me on the right track in my 20's.

 

I understand it seems minor next to other things and you probably don't need one more chronic condition to deal with. But asthma tends not to be minor to the person who has it, so hopefully the treatment works out for her. Good luck with everything.

[Unicorn.]

Give her the steroid. It will help heal her lungs, and it isn't' minor. I'm saying this as someone whose ds did have side effects from the inhaled steroid including anger and weight gain, round face, etc. My ds took his for a year, and his lungs were finally able to heal enough that he hasn't had any kind of problems or interventions in 7 years. Even when he got the flu 2 yrs ago. If I had to do it over I would.

[Dana]

My two kids with exercise-induced rarely present with wheezing. It's usually coughing and a tight chest feeling.

 

Our allergist called it "silent asthma".

 

My husband has the wheeze. Our son doesn't.

[Desert Rat]

My asthmatic doesn't do well unless she's on the same kind of regimen. She does Flonase daily, as well as Zyrtec. She has the inhaler to use whenever she needs it. She hasn't had any side effects as of yet.

 

Younger dd had asthma for years (she seems to have grown out of it) and was on the same kind of meds and had no side effects.

 

If the need it, they need it.

 

I agree. My 9yo asthmatic take Zyrtec and Singulair daily. For awhile he was on Advair, a coritcosteriod. It worked wonders for him and we could get him to a point where he is maintaining. Now we use albuterol for asthma attacks (We love xopenex but it's not on our prescription plan). And we use Pulmocort, an inhaled steriod, for serious bouts of asthma usually related to illness.

 

If they need it, they need it. Remember that pharm companies have to list every. single. reaction. I try to keep that in mind when looking at the warnings.