So many questions

[jemsister]

I hope I am posting in the right place. I'm in the process of figuring out if my almost 7 year old son has asthma. My MIL has it, and she thinks that my son has it. His symptoms are coughing and being out of breath, but he does not get an audible wheeze. His cough is worse when he's running around too much and getting rowdy, and also worse at night.

I also think it might be partially allergy driven. We thoroughly cleaned out his room, vacuumed everything, new sheets and washed blankets, etc., and for a few nights his cough was better, but last night his cough was back. Also, we visited some friends who have several dogs and at least one cat (maybe more? Lots of animals, anyway), and he could not sit in their house without one coughing fit after another. I made him go play outside and he did much better there, with no coughing, but as soon as he would come back in his cough would come back.

The cough is really deep and hoarse sounding, and usually dry. Sometimes he sounds gaspy when he coughs, and usually when he coughs he has to stop what he's doing and rest because one fit will just kill his energy. He's mentioned that talking makes him tired. When he described the cough to me, his own words were that the cough is blocking his breathing.

So anyway, he gets this cough off and on, and has for months. He's also become more prone to illness. He's been sick 9 times since last December, and he never used to get sick.

The bout he's been dealing with lately has lasted two weeks so far. It gets better, then worse, then better, then worse... it mostly has stayed the same for the last two weeks. This round started after I took him on a hike. The cough started that night.

So anyway, I don't know if he has asthma, he has not actually been diagnosed, but I took him to the urgent care clinic today and told them everything I mentioned above, and I said that I was concerned that it could be asthma. They prescribed albuterol, but didn't actually diagnose him. They said if it's asthma, then the inhaler will help, and that if it's not asthma it won't help. Is this true? Could the inhaler help if it's not asthma? Is this how asthma is usually diagnosed? He has an appointment with a new pediatrician on the 5th of September, so I'm hoping to get more answers then.

Anyway, he used the inhaler today and his cough went away at first, but then came back after an hour or so. But this time it was a productive cough. His cough has been much better overall though, and when he does cough, it seems mostly to be that he's coughing to cough something up, not just the dry cough that it usually is. And tonight, after using the inhaler at bedtime, he has not coughed once.

Anxious to see how tomorrow goes. I am worried that the inhaler won't help, and part of me is worried that it will and what the implications of that are. =/

So my question now is, if it is asthma, does that sound normal to use the inhaler and have the cough go away for a little while, but then the cough comes back? The instructions are to use it every 4 to 6 hours if needed, but do the effects of the inhaler actually last 4 to 6 hours?

[Dr. Richard M. Williams]

So many questions,
With regards to the diagnosis of asthma, your son is certainly old enough to be tested using a spirometer. This is a simple device that a child your son's age is capable of using. It is likely to be performed if indeed your son's physician does suspect asthma. As far as albuterol "working if its asthma"- other types of lung conditions also respond to this drug. It is also very common to test the individual with a spirometer with and without albuterol before the test. How much his test results improve after the albuterol can be used as a positive for asthma.

We often think of asthma as a problem with wheezing, shortness of breath ,etc. Coughing alone is not that uncommon. That you son appears to respond around animals, or when he is excited or exercising is also not that uncommon.

To determine whether he will need what is called "controller" therapy must be determined by his physician. This is often associated with the number of "attacks" during a week , does it occur at night and disturb his sleep, etc.
Repeated attacks of coughing may indicate to his physician that it may persistent asthma but I would wait and see what the tests show.
'Your question on whether the albuterol lasts 4-6 hours cannot be answered with 100% certainty. Very often, the use of a "rescue" inhaler once is sufficient. If , however, he is continually exposed to whatever is causing the attack, repeated use may be required and the effects may not last 4-6 hours. The only way to know is to try it.

I hope I answered some of your concerns.

[evelynanacion]

Dr. Richard M. Williams, million thanks. I didn't knew about the device spirometer and it's usefulness in testing Asthma in younger patients. Even answered my many questions in your post? I want to ask that if Asthma is fully curable?
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