Alternative dx for asthma for temporary wheeziness?

[Annie N]

Two of my children were dxed by a nurse practicioner with asthma just because they had one episode with minor wheeziness. Even my older son, who has had wheeziness with colds for many years, was not dxed with asthma by the doctor.

 

None of the children has ever had a bad episode with asthma (the doctor said if my son's ever got worse than what it is that he would up the dx to asthma).

 

So what I am wondering is if there is something else that could have caused that one-time wheeziness in my children, because the NP wants to treat them aggressively, but the meds actually don't make any difference in them, except for that one time when they were actually sick. The med she wanted them to be taking all the time turns out now to occasionally cause psychosis in children (!!!!!!!!!!!!!!!!) so I am very glad I took them off it.

 

I would take them to our old doctor, but he moved :(

 

Thanks vor any help anyone may be able to give :)

[Jennifer in MI]

I don't know. I'm sorry.

 

I do have to ask which asthma meds sometimes cause phychosis in a child? My youngest boy was on asthma meds for a couple years when he was little. They probably saved his life a couple times, so I'm grateful for them. But, I'd like to know if I should be on the lookout for weird complications!!

[Annie N]

OK, in response to the request for the name of the med, I found out that I apparently saw something that looked more official than it actually was, and that altho there are anecdotal reports, one might say that the benefits outweigh the dangers, as long as one pays some sort of attention.

 

Sorry about that, all. I will have to remember this and never take the word of one official-looking document on the web again!!! (I am very embarrassed)

[sdWTMer]

When my kiddos need the temporary asthma meds, I give it to them because if they can't breathe well they're not going to be able to get better. I could be wrong though.

[LizzyBee]

Two of my children were dxed by a nurse practicioner with asthma just because they had one episode with minor wheeziness. Even my older son, who has had wheeziness with colds for many years, was not dxed with asthma by the doctor.

 

My kids' pediatrician in Baltimore told us that a patient has to have wheezing 3 times before being officially diagnosed with asthma. My oldest dd was diagnosed. My middle dd used to wheeze when she was sick, and I know it happened far more than 3 times. But she was never diagnosed with asthma - she just wheezed when sick, and no other diagnosis was necessary.

 

I would be concerned about having an improper diagnosis on your child's records. Since asthma is a chronic disease, it could affect your child's ability to obtain health or life insurance in the future. Does your NP work under the supervision of a doctor? If so, I'd make an appt to meet with the doctor about this.

 

In regards to meds, I am in favor of treating asthma and temporary wheezing aggressively. I lost a sister at age 49 to allergies and asthma. She was sickly from the time she was an infant, and had permanent lung damage by the time she was an adult. I am thankful that we have better drugs for asthma today. Keep in mind that wheezing often cannot be heard without a stethoscope, and inflammation lasts longer than the wheezing; therefore, treatment needs to continue long enough to get rid of the inflammation, not just the wheezing.

 

But if you mean that the NP wants to medicate your children on a long term basis, no, I would not be in favor of that unless they are having repeated episodes of asthma or wheezing. JMO, not to be taken as medical advice. :001_smile:

[LisaKinVA]

My pediatrician has never suggested asthma with my kids. Although, I did have to take my then 4yo to the ER due to Croup (*really, really bad wheezing), the ER docs said they would "not diagnose asthma based on a single case" (I was like, where did THAT come from? My kid has a bad case of croup!).

 

But no, a single case of wheezing is not usually cause for long-term treatment (treat the symptoms, and when they are gone, they are gone).

 

I think I'd be looking for a 2nd opinion (at minimum) if someone suggested asthma after just one experience (heck, I can work up a good wheezing episode after dusting the basement... I'm supposed to wear a dust mask, but then, I do have sensitive lungs... comes from a lot of history with pneumonia and bronchitis as an infant).

[Carol in Cal.]

This often enables you to prevent asthsma attacks.

 

That means giving sudafed when they are congested, and also using Naselcrom during allergy season. These are low side effect treatments.

 

You need to have a rescue inhaler (albuterol) available if their asthsma kicks up, and be ready to rush them to the doc if necessary. Learn the symptoms of a serious attack, and make sure that you take them seriously. Kids and adults do die from this--their air passages can close up and they can suffocate. But, in my experience with myself and my DD, I could manage to prevent asthsma from taking hold very consistently over the years, once I started using these other proactive approaches. I wanted to avoid steroids and have managed to do so.

[Annie N]

Well, I finally actually talked with the NP. Boy, is my face red!!!!

 

Apparently wheezing and asthma are the same "number" so any wheezing is considered asthma, but unless they have repeated problems with it, it's not considered a problematic sort of asthma. I don't exactly got it, but to me it's like using the same word for two different things, so I'll just go along with that. But it's not like when I was young and if you had asthma, you were Stuck for Life—now they assume most cases (considering how they are doing this sort of dual dx) will be grown out of.

 

I had the same concerns about insurance and things like military, where having been dxed will cause problems, but apparently that's only a problem if you have wheezing as an older teen or adult, not for children.

 

So, I've had to totally eat crow on this one... but this is one of those weeks which is to teach me humility, kwim?

 

Anyway, thanks everyone, for all your help :) I have a much better understanding of the whole thing now.

[Mrs Mungo]

My youngest is the one with lung problems in the family. If I had known then what I know now I would have encouraged them to treat him more aggressively *and* insisted upon seeing a pulminologist much sooner. He now has permanent scarring in his lungs and will *never* have full lung function due to his asthma *not* being properly treated when he was younger.

[Annie N]

Mrs Mungo,

I am sorry that happened to you. Do you mind if I ask how bad your son's asthma was? (Maybe I should do more about this!)

[Mrs Mungo]

Mrs Mungo,

I am sorry that happened to you. Do you mind if I ask how bad your son's asthma was? (Maybe I should do more about this!)

 

He was hospitalized when he was 4 with bronchiolitis. That's when it really started. I took him in several times and the doctors blew me off saying it was just an upper respiratory infection. It wasn't until it went on for almost a year and I threw a total hissy fit to get referred to another doctor that he started getting treated. So, he never had classic "asthma attacks" and wasn't even wheezing *most* of the time when I took him in. The problem was his asthma was *too bad* for him to wheeze. His main symptom was coughing, especially at night.

[Annie N]

Oh, that sounds awful! Thanks so much for letting me know.

 

My children have all been coughing a lot because there was a fire near us, and it took a while to put it out. We got a fair amount of exposure to smoke :( so I just put it down to that, but I think I am now glad that it's time to take them in anyway... I appreciate your telling me about what happened with your son, thanks.

[Mrs Mungo]

Oh, that sounds awful! Thanks so much for letting me know.

 

My children have all been coughing a lot because there was a fire near us, and it took a while to put it out. We got a fair amount of exposure to smoke :( so I just put it down to that, but I think I am now glad that it's time to take them in anyway... I appreciate your telling me about what happened with your son, thanks.

 

I'm honestly not trying to scare you or anything but I think these problems are ignored far too often. It's better to investigate it enough to rule it out or diagnose it, one way or the other. I just wish I had known *then* to insist on seeing a pulminologist, kwim? And generally, my son is fine, he runs and plays but he will always be on medication and he will never be able to join the military or anything like that.

[Annie N]

I'm honestly not trying to scare you or anything but I think these problems are ignored far too often. It's better to investigate it enough to rule it out or diagnose it, one way or the other. I just wish I had known *then* to insist on seeing a pulminologist, kwim? And generally, my son is fine, he runs and plays but he will always be on medication and he will never be able to join the military or anything like that.

 

It's better to investigate it enough to rule it out or diagnose it, one way or the other.—Yes, that's kind of what I need to get a handle on. I'm just planning to take them in more often until we all learn enough about it to judge on our own how they're doing. Right now, I feel like I thought they had colds that kind of wiped them out, but now I'm thinking that they could have at least been helped to feel more comfortable if they were indeed having more trouble as a result of the cold than I thought. (Gee I hope that made some sort of sense!) If they have an idea of how they feel and how the meds help them, and I do too, then we can react better to whatever is going on.

 

Thanks very to you, and also to all the others, who helped me understand all this better.