Dear Scratch or Sniff:
I’m wondering if kids can develop asthma long after the initial onset of allergies (environmental and/or food)? The last couple of times my son has been sick there has been a wheeze, though the doctors say his lungs sound “fine.” Recently he’s been struggling with his nose/throat/cough and now complains that his lungs hurt, both when he inhales and exhales. No fever. We have an appointment with our allergist, but it is still a couple of weeks off. I’m curious about your experiences with asthma and if this sounds suspicious.
It absolutely sounds to me like your son could be developing asthma. What you describe is pretty similar to what we experienced on our road to an asthma diagnosis which, incidentally, was a couple of years after my son’s allergies made themselves known. I’m glad you’re following up with your allergist to get to the bottom of this issue. (Sidenote: if this is a current concern, you may want to get in to your pediatrician for some help until you see your allergist.)
Before my son was diagnosed and subsequently placed on a daily controller med, any typical cold would stay in his lungs much longer than it would for those without asthma. Looking back, I can now say I saw early warning signs like clearing his throat repeatedly after being around cats (allergy trigger) for any length of time, or respiratory issues dragging on like with those minor head colds.
Here are some things that might help prepare you to discuss the possibility of asthma at your next appointment with your allergist who hopefully is a board certified asthma/allergy specialist:
The allergist likely will have your son do a lung function test to measure his small and large airways. The test – at least at our allergist’s office – will require him to breathe in and out of a tube connected to a computer. It is set up like a game, to help kids concentrate and work hard to accomplish their goal. Your allergist should then discuss the results of that test and explain to you what is currently happening in your son’s airways. The first time we did this, it was a huge “Aha!” moment for me to know what was going on inside my son’s body.
Talk to your allergist about owning a peak flow meter at home – he can write a prescription for one, or you can pick one up on Amazon (we have this one and love it) with your allergist’s recommendation on the range you need to monitor.
Having a peak flow meter will allow you to have an asthma action plan in place – again from your allergist. Much like a food allergy action plan, this is a doctor-directed document that will tell you exactly what to do in case your son’s peak flows are not within the recommended range. For instance, when my son’s peak flows are in the “green” range, we continue as normal on our controller medication. When they drop to the “yellow” range, we increase our controller med by a certain amount and add in rescue meds, followed by a call to the allergist. If they drop to “red” – which has not occurred since he’s been on a controller – then we know exactly what to do.
Monitoring peak flows a few times each week, and then adjusting our approach according to the plan, gives us a great amount of control over my son’s asthma.
I wish you well at your appointment. If you feel you don’t get the information you need, or if you want a second opinion, finding a good pulmonologist could also be a great option for you.