Friday, October 21, 2005

Reactive Airway vs. Asthma

Those of you who've been reading this blog for any length of time know that I think the diagnosis of "Reactive Airways Disease" is a load of bologna with a capital "BS."

Well, on the asthma parents list, the topic came up, so I thought I'd delve into a bit in the place where I can be as opinionated as I like. (So glad blogs were invented!) Here's my little rant, followed by some legit info:

The way I see it, it's either asthma, or it's not. Nothing pissed me off more than the doctor at some practice or other who once corrected me when I referred to little B as being asthmatic. "He has Reactive Airways," she said. No, you stupid cow. He has asthma. Any kid who's on Flovent 220 and Singulair year-round, has been on Orapred more than half a dozen times before his third birthday, sees a Pediatric Pulmonologist on a regular basis, and has spent more time in the ER than both his parents put together deserves to be properly diagnosed. Don't use your stupid, namby-pamby, politically and legally safe terms to describe MY kid's asthma.

And while you're at it, give us parents some credit. We're very much in control of our son's health, and I think we know what we're dealing with.

Okay. Off the soapbox..

Here's the stuff I found about "Reactive Airway Dysfunction" (or "Disease," depending on your source):

From eMedicine:

Background: Not all children who wheeze have asthma. Most children younger than
3 years who wheeze are not predisposed to asthma. Only 30% of infants who wheeze go on to develop asthma. Reactive airway disease has a large differential diagnosis and must not be confused with asthma.

Clinical factors suggestive of childhood asthma include recurrent wheezing, symptomatic improvement with a bronchodilator, recurrent cough, exclusion of alternative diagnoses, and suggestive peak flow findings...
(Hmm...How are they getting peak flow readings from kids under the age of 3??)

Here's an interesting paper on RAD and Irritant-induced asthma (IIA) by Thomas H. Milby, MD. Just one interesting snippet:

Once symptoms do become clinically apparent, both RADS and IIA behave clinically
like non-allergic asthma, which, of course is what they are.


Interestingly, this paper mentions nothing about RAD as a "pre-asthma."The author describes it more as a reaction of the respiratory system to an external substance, like a toxic gas or something. And the difference between RADS and IIA is the period of time before the reaction occurs. To me, this sounds like the most appropriate definition of the term "Reactive Airway." Read the article. See what you think. (This article also backs up the definition.)

Hmmm. Hold the phone. These are describing "Reactive Airway Dysfunction Syndrome." Is that different than "Reactive Airway Disease?" Must research. Must learn.


Ugh...I've spent over an hour looking for definitions for both, and I haven't found a THING. I suspect they are different. I'll keep looking and post more tomorrow.


Anonymous said...
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stephanie g said...

I am so interested in your findings, my daughter was just diagnosed with 'reactive airway' and I am freaking out, most of what I read talks about it being caused by chemicals in the home, since neither of us have asthma.

Eric said...

Doctors need to learn to trust parents more. They think we are all morons b/c we don't have a PhD. I have a 14 month old who only gets wheezy with severe colds. We recently had a big one pass through our home which sent us to the hospital for a week. The doctors suddenly say it is asthma and call DSS saying we neglect her b/c she lives on a farm. Correction we live in a barn according to the report. Now we have to get rid of all our animals (the ones with fur anyways) and the stuffed ones too b/c they say it is asthma. How is this possibly asthma when she only gets sick??? I Don't know but i am raging and apologize for ranting on your blog but I needed this.

Anonymous said...

Eric: My daughter was the same way. She had horrid attacks with onset at day two of any respiratory clockwork. This passed into history around the age of 11 or 12, but we had some amazing experiences with Drs along the way.

Shadae Yancey said...

my son (5years)was diagnosed with RAD at 15mos. His episodes began at 8mos. The two weeks ago while suffering with the flu, the doctors changed is diagnoses to asthma. I have read statics and the growing number of asthmatic children in the U.S. is horrendous. What is causing this?(
Other reports I have read state that chemicals (sulfur) being released in the air are causing so many adults/children to have respiratory problems. Each year billions more are diagnosed.

What are we to do?