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My son has been diagnosed with cough-variant asthma (a rarer form with no wheezing - just coughing) and has just been prescribed inhalers for symptomatic use. My question to others experiencing this is... have you found environmental modifications that truly made a difference (carpet removal, whole house HEPA filtration, etc.)?? I am not fond of him using inhaled steroids (only 4 1/2) and would like to make the most difference possible environmentally.

Thanks!
 

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Hi,

Does your son allergic to any thing? Usually,
asthma is caused by the allergy. Have you take
your son to the specialist to check what is the
cause of it?
 

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My daughter (now almost 19 y.o.) was diagnosed at 18 mos. I could practically write a book. As previously mentioned, get him to an allergist for a good allergy test. Not sure if he is too young for desentizing shots or not...but they'll know. If they DO an allergy test, make sure they get a deep epidermal test. My daughter's first test didn't produce any sig. results because Children's Hospital didn't do a deep enough epidermal test on the first try. This was a huge problem because for YEARS we had no idea that she had REAL allergies until we did another test when she was about 10. Meanwhile, she spent needless years of suffering.

Much of the problem is probably dust. I covered the pillows, mattress/box spring in zip up plastic liners which can be purchased on line or at Linen's N Things. Later found it a Godsend for spills! Animal dander can be a problem and there used to be a product called AllerPet (vet) but not sure about it's effectiveness.

Anything that holds dust like carpeting can be a problem. I modified her bedroom area since that's where she spends most of her time. I didn't go crazy with the rest of the house though. I never removed the carpeting in her room.

We installed an electronic air filter, but not sure it wasn't a needless expense. Main place to control the environment is where he sleeps. You might find one of those Sharper image Ionic Breeze's helpful, but check out their AUCTION at SharperImage.com before buying RETAIL. I have a bunch of those units around the house, but again, I'm not sure they'd really help an allergy suffer or not. But, they DO clean the air and nobody's sneezing. :)

There are also other drugs avail like Singulair, but he may be a little too young for those. Kids immune systems generally begin to mature around 5 and they're a little better equipped to fight off infection at that time. They also start school, which can bombard them with colds which can easily turn asthma into pneumonia. Zithromax is a super antibiotic for certain types of pneumonia/chest infections. Teaching him NOT to put his hands anywhere near his face/mouth is best tho.

I'd go for the test and follow up with the shots ASAP. That's the best and most effective way to handle it. Medicating is treating symptoms and not the problem. Plus, he'll want to spend the night at friend's houses, sports, etc. and you'll constantly be concerned about his environment so best to get aggressive NOW.

You can PM me if you have any add'l questions, etc.
 

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DMor said:
My daughter (now almost 19 y.o.) was diagnosed at 18 mos. I could practically write a book. As previously mentioned, get him to an allergist for a good allergy test. Not sure if he is too young for desentizing shots or not...but they'll know. If they DO an allergy test, make sure they get a deep epidermal test. My daughter's first test didn't produce any sig. results because Children's Hospital didn't do a deep enough epidermal test on the first try. This was a huge problem because for YEARS we had no idea that she had REAL allergies until we did another test when she was about 10. Meanwhile, she spent needless years of suffering.
Dmor, good to hear from you again. Lots of good info here. My son has allergies and may have or be developing Asthma. There is certainly a correlation. He was tested for allergies even before he was 18 mo. old but it was just a skin scratch to confirm our strong suspicions of the allergy (which it did). I would also recommend seeing an allergist. They will probably do the scratch test first. If it doesn't turn anything up you may want to follow with the test that Dmor mentions.
 

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I'm very sorry to say that according to a Consumer Reports test, the Sharper image Ionic Breeze air cleaners are relatively ineffective. The problem is that it simply can't force enough air into the cleaning area to be effective (which is why it's silent, there's no fan slamming a large volume of air through a filter or an electrostatic precipitator).

The room unit they top-rated was the Friedrich C-90A, an electrostatic precipitator unit that is quite expensive, but does not require expensive HEPA filter replacements (it must be cleaned regularly, like in a dishwasher). It was effective even on lower fan speed settings (quieter ones). Thing looks like a big kitty litter box, unfortunately.

The next top-rated one is the Whirlpool Whispure APS450, which I have. Frankly, I don't know how much difference it's making, but it "seems good."
 

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While we're at it...

Kid illnesses are the toughest because they can rarely speak for themselves. Meanwhile docs sometimes miss important EARLY symptoms and illness can overtake their small systems pretty quickly. You almost ALWAYS know your kid better than anyone else, so don't hesitate to request med procedures like Xrays.

In my daughter's case, I could usually tell the diff between viral and bacterial pneumonia by the fever's she'd run, and other symptoms, etc. There were numerous times I'd suspect pneumonia and the doc, upon 'first listen', would decide it was something else and NOT X-ray her. On those occasions, I would always comply but politely request that the doc sign something stating that the Patient's mother requested, but was denied an X-ray. They're hesitant to sign anything...so you'll GET the X-ray. ;) I cannot think of ONE X-ray I'd requested that didn't confirm pneumonia. She had a habit of contracting it in the UPPER LUNG area...where it's harder to diagnose and easily missed, but just as deadly.

Anyway...don't take "no" for an answer if your instincts tell you otherwise. We had numerous 'close calls' that might have had a different outcome if we weren't a little medically aggressive. A good friend of ours lost their boy at 5 when a simple cold turn into bacterial pneumonia and caused organ failure. He left school early on a Friday and was GONE on Sunday. Our kids were the same age and suffered similar symptoms when they were ill. So...HEADS UP!
 

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wmquan said:
I'm very sorry to say that according to a Consumer Reports test, the Sharper image Ionic Breeze air cleaners are relatively ineffective. The problem is that it simply can't force enough air into the cleaning area to be effective (which is why it's silent, there's no fan slamming a large volume of air through a filter or an electrostatic precipitator).

The room unit they top-rated was the Friedrich C-90A, an electrostatic precipitator unit that is quite expensive, but does not require expensive HEPA filter replacements (it must be cleaned regularly, like in a dishwasher). It was effective even on lower fan speed settings (quieter ones). Thing looks like a big kitty litter box, unfortunately.

The next top-rated one is the Whirlpool Whispure APS450, which I have. Frankly, I don't know how much difference it's making, but it "seems good."
I think I have about 6 of those Sharper Image cleaners, including a couple of Quadras. I agree they don't seem to move much air. The ARE dirt grabbers tho! They seem to work best in our smaller 11x12 bedrooms, but for any larger room, I've got two running. They DO make racket if they get fuzz or something trapped in there. They start humming like crazy and its a pain to get them to 'silence' in spite of regular cleaning. So...depending on time frame, some remain OFF til I have time to fiddle with them. :)

On another note...one of mine started smoking and was unrelated to cleaning it. It literally melted the plastic piece near the bottom. So, if I hadn't been home...one wonders? Of course, just try to return it...or get a credit, etc. duh...

Sniff...sniff...is someone cooking plastic upstairs again? :)
 

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Discussion Starter #9
Thanks everyone...

I knew I could count on this forum for some suggestions! Keep them coming!

I have already encased his mattress and pillows in that allergy proof bedding (and our bed, for that matter, as he spends time in our bed, too:rolleyes: ;) ). I was wondering about the removal of our carpet (only in two rooms - our bedroom and family room) as to whether or not it would make a significant difference. It really seems like a heavy duty air cleaner/purifier would have to help - and I appreciate the postings on the models.

I really think you guys are on to something about the allergy testing. However, someone suggested to me that allergy testing is pretty rough for a little one. However, it seems like the easiest way to tackle this (environmentally or otherwise) is to know what his triggers are - specifically.

I am really concerned about giving him inhaled steroids to control the bronchial inflammation. The possibility of stunting growth (even a little) scares me!

DMor or anyone - would you recommend an allergy specialist or a pediatric pulmonologist? I would think the pulmonologist would order allergy testing (?). We are only an hour from Duke, and I am considering taking him there.

Thank you guys again!:) We have a great bunch of people on this forum!!:D :D
 

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Re: Thanks everyone...

'X MOM said:

I really think you guys are on to something about the allergy testing. However, someone suggested to me that allergy testing is pretty rough for a little one. However, it seems like the easiest way to tackle this (environmentally or otherwise) is to know what his triggers are - specifically.
I agree. It is best to use the tests to confirm your suspicions to a specific irritant. My allegerist does not recommend general testing. To the extent that you can zero in on any possible sources, this will really help. The scratch test does cause them to cry usually but if it confirms an allergy it is well worth the temporary discomfort (easy for me to say, right?). I would certainly recommend talking to an allergist even if you don't do any testing - they may give you a better idea what to look for, etc. I hope that helps a bit.
 

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I was diagnosed with asthma when I was two and had severe problems until I reached my teens. My dad also suffers from asthma, and still has problems. We also both have the typical allergies (pollen, dust, animal dander, etc).

In my experience, there were two things that would bring on an attack. Exercising without pretreating myself with an inhaler, and some kind of allergic reaction. As far as keeping allergies in check, getting rid of carpets, keeping the house dust free as much as possible, and avoiding animals, or being VERY careful to wash my hands and never touch my face after petting a dog or cat, are all pretty important. I don't think we ever used air cleaners that much. I suppose it can't hurt, but its not a solution alone.

I think your best defense (where 'your' includes your son) is knowing what causes an attack. While you may never know exactly why an asthma attack is coming on, knowing what to look out for, and how to recognize the signs before the attack is severe, is often the best you can do.

My son is two, and at this point I think its more a matter of when than if he develops asthma, or at least allergies.
 

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Wow - sounds like you guys have this topic pretty well-covered.

XMom:
I also second allergy testing (probably because I am an allergist :) ). As far as I know, Duke is a good facility and has a good reputation. I do know some allergists on the East Coast if you need other referrals, and a good friend of mine is in Knoxville (which doesn't sound that close...)

The controversy over inhaled steroids is an interesting one; several studies have appeared to show that kids on normal doses of inhaled steroids do not have any difference in height vs. kids off of inhaled steroids over a 5 year period. This was done with Pulmicort (=Budesonide). The important thing is that if asthma (= reactive airways disease) is not controlled during childhood, there is evidence that lung function may be compromised in the future (i.e. as an adult or older child).
However, the good news is that there are other options for treatment. What you REALLY want to avoid is too much oral steroids.

As far as air purifiers/cleaners, true HEPA filters have been shown to be effective as stand-alone cleaners and in vacuums in reducing airborne irritants including pollens and animal dander. Indoor humidity <50% is recommended if you are dust mite or mold allergic; covers are also important (which you've already done).

Check out www.aaaai.org and www.acaai.org as they have some parent information there.

Hope this helps!

P.S. Make sure that when you see an allergist, they have gone through allergy fellowship training, which is an additional 2-3 years after completing a residency in internal medicine or pediatrics.
 

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From a Pediatric Physician Assistant...

The latest studies I have read regarding inhaled steroids and growth show that children who have poorly controlled asthma face a greater degree of growth delay than do their counterpart siblings who use inhaled steroids. These studies, and countless data in support of INHALED steroids impress me enough to use inhaled steroids in my patients.

IMO, one of the great innovations in asthma medicine is Advair, which is a combination of an inhaled steroid, fluticasone (Flovent) and a long-acting bronchodilator, salmeterol (Serevent). These are combined into an easy-to-use dry powder inhaler.

Hope this helps allay any fears...
Sincerely,
cbarry
 

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I agree completely re: inhaled steroids :) However, not everyone needs them, so it's good to have other options as always.

Advair is a great choice, but it's technically indicated for adults and kids > 12 years old (not that we haven't used it in younger kids because it's components ARE approved for kids 4 years and older). The only limitation is ability to use the diskus device.

Just to make sure, have kids measured regularly with a stadiometer and this will help keep a close eye on growth in case there are any concerns.

Hope this helps, X Mom!
 
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