You would think it’s a pretty straight forward question but there seems to be some debate about this. I saw a little boy who has been on albuterol on and off for almost 4 years (most of this life). Mom tells me she thinks he has asthma but the various doctors he has seen can’t agree on this. He reportedly has a “weak immune system” according to mom and gets sick all the time. Even if it’s just windy outside, he’ll get sick and then within a week or two will starting wheezing and coughing at night. He does get better using the albuterol but she wants to know if vitamins will help his immune system.
So is it asthma or just his “weak immune system”, she asks? Given his history, I would guess that he does have asthma. Doctors sometime refer to this as Reactive Airway Disease, when the patient is very young and only starting to present with asthma-like symptoms. What else is going on? He probably has some allergies, which most asthmatic children also have. And when the allergies hit, his asthma gets exacerbated. This is probably what mom thought was his “weak immune system” at work. Obviously, we want to minimize how often he gets his asthma attacks. I suggested we get this boy tested to identify what he is allergic to.
Now, if you or your child has asthma, you should have regular follow up with your doctor. The frequency depends on the severity of your asthma. Here’s what you should cover during your visit:
- Tell the doctor if there have been any changes to your asthma symptoms, i.e. increase need for albuterol.
- If you are getting sick more frequently with coughs, colds, etc., ask the doctor if those can be a result of your asthma getting worse. Ask your doctor if you should get allergy tested.
- Talk to your doctor about the risks of over using antibiotics. Many patients with asthma mistakenly believe that they need a course of antibiotics every time they get an upper respiratory infection.
- Make sure you get all your relevant medications refilled during your visit. This will save you time later, having to call the office or pharmacy back and forth…. you know how that goes.
- There are clear guidelines for when the doctor will add a daily asthma medication or when he thinks you can come off certain medications. Ask your doctor if you have any concerns about specific medications or how to use it.
- You and your doctor should have a plan on what you can do when you have an exacerbation of your asthma and what symptoms will necessitate a visit to urgent care or the emergency room.
- And remember you should ask for your flu shot during the flu season.
And of course, don’t forget about making that next follow up appointment.