Monday, March 12, 2007

When to switch to a Peds Pulmonologist and other questions answered!

Got a great comment today with a lot of good questions...some of which I can actually answer!

I'd love to ask you some questions since I feel like I'm kind of a
beginner in this whole at what point do I take him to a
pulmonologist vs. the regular ped? When and how does he get officially diagnosed
with asthma? What about allergy testing--when is it recommended? I never feel
confident in deciding whether or not to do you decide? Stuff like

So here's answer #1 -- Take your child to the pulmonologist as soon as you suspect your child is asthmatic. Assuming you have insurance coverage and a pediatic pulmo nearby, GO. Many pediatricians -- even the fantastic ones -- miss the subtleties of peds. asthma. Go to a PP or an Asthma/Allergy specialist as soon as you every think you should.

Answer #2 -- Children often keep the "Reactive Airways" diagnosis until age 5. Asthma is a type of RAD, but doctors seem to be skittish about making the hard diagnosis. I'm not sure why. My PP diagnosed B with asthma at age 2, but other specialists still insist on referring to his condition as "Reactive Airways," even when I correct them. I mean, JEEZ, I think my pediatric pulmonologist may have been qualified to make the diagnosis.

Answer #3 -- With the allergy testing...our PP sent all three of my kids out for blood panels at their first appointments with her. Now that B is 5, he's going to an allergist for more in-depth testing. So it may be another "age 5" thing.

Answer #4 -- As far as nebbing, always call your doctor first...but we prefer to err on the side of caution. When in doubt, neb. At first sign of a cold, neb. Think you hear a wheeze? NEB.

See a pattern?

Bottom line...get a pediatric pulmonologist on your team. It all falls into place from there.

Hope this helps, Miss D!

1 comment:

Depressionista said...

This does help, very much! I have been debating about going to the pulmonologist...I think part of the reason is that I don't want to admit it's a real problem. Isn't that terrible? So far, his symptoms have been pretty mild and controllable, but I want to feel more in control of it, and I know that you are right, a pediatric pulmonologist can help me out with that.

We have good insurance, but unfortunately the only PPs in my area are affiliated with a hospital I don't trust and will not take my child to. So that brings me to another often would you say, on average, does each child see the PP? Does the PP do initial tests and check-ups and lay out a plan that you can then follow up with your ped, or do you have to see the PP for all asthma-related stuff? I'm thinking about trying to go somewhere a little further away if we wouldn't have to be visiting the PP every other week or anything.

I really like your site...thank you so much for answering my questions and being such a great resource!