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Question About Asthma Diagnosis

Dear Dr. Kagen,

Recently I took my son to a new doctor. He has had a deep cough for over 10 days. No fever, no nasal congestion...just this cough. At first he would only cough in the morning and a little at night. Then, the last two days, it became obviously worse. A nurse at the head start center where I work heard him and got me an appointment that day with a doctor. She listened to my son and heard a wheeze. It was the first time I had heard my son wheeze. She prescribed an asthma inhaler with a mask and set up an appointment for me to come back in 5 days.

Co-workers have been telling me how they have had experiences with their children being "mis-diagnosed" with asthma. I know that the asthma medication is a steroid and I am concerned that the doctor might have been a little hasty. Do you have any advice?

Thank you,
Sarah F.

Dear Sarah,

Thanks for asking about the onset of wheezing in a child after what appears to have been a viral like illness.

The most likely explanation for your child's symptoms would be a viral infection which may have triggered the symptoms of wheezing.

Asthma is just a word which means ticklish lungs. Many things may cause wheezing including allergic reactions which we doctors call asthma when they occur in the lungs.

Give your doctor and your child a "tincture of time" to observe what happens next. Youth is on your son's side. If symptoms of cough and wheezing continue even though appropriate medications have been used, then it may be time to see an Allergy and Asthma Specialist. Ask your doctor about the medicines she prescribed knowing that low doses of inhaled steroids are very safe even for longer periods of use in children.

The amount of medication needed to control each asthma patient is unique to each patient. Medication requirements depend upon how much mucus and inflammation there is within the lungs. The more mucus a patient makes, the more inhaled medications are required to control both the excessive inflammatory reaction and the thick, sticky allergy mucus.

I hope this brief information is helpful to you. Be sure to look at the other areas of Allernet.com for more info on allergy and asthma. [All About Allergy and Any Questions?] Let me know how things are going in several weeks.

Good luck.

Steve Kagen, M.D.
Allernet.com