Asthma, Controlling Your (cont.)

MEMBER QUESTION:
Is Singulair a good asthma medication for a 6-year-old? Are there any side effects?

ENRIGHT:
Singulair works for about half of children and half of adults for asthma and for rhinitis. Whether or not it works for your child can only be determined by trying it. It can be prescribed all the way down to age 2.

MEMBER QUESTION:
I was wondering what your thoughts were on Xolair. My doctor seems reluctant for me to try it due to my tendencies toward reactions. Also I recently read that it my not be as effective as was first thought.

ENRIGHT:
Xolair is a very expensive medication that reduces blood levels of IgE. It is considered when asthma is allergic in origin with high blood levels of IgE and not controlled with chronic use of all other asthma medications, including prednisone. It's impossible to predict which patients will respond well to Xolair After the doctor approves it and the insurance company approves it, then it must be tried for several months to determine whether it works for you.

MEMBER QUESTION:
I think I may be seven weeks pregnant. My asthma has started deteriorating. Before the last few weeks, I had only used my inhaler three times in six months. What can I do? I am afraid of taking corticoids in case it harms the baby.

ENRIGHT:
Two very large studies of pregnant women have reported in the last two years that inhaled corticosteroids are safe for both the mother and fetus. Avoiding low oxygen levels due to an asthma attack is very important during pregnancy. Call your doctor to discuss these issues.

"All asthma people must avoid inhaling smoke, whether from cigarettes, fireplace, candles or incense."

MEMBER QUESTION:
I always have feelings that my left bronchial "tree" is more "wheezy" than the right as well as it always produces more sputum. After prednisone for seven days I almost stopped wheezing but I couldn't stop coughing. With cough-variant bronchial asthma, is there any different approach to treatment? Are there any efficient mucolytics available? Is it possible that I have bronchospasm more prominent on one side than on the other?

ENRIGHT:
Asthma may be distributed in patches throughout the lungs; however, the treatment remains the same. The presence of wheezing and the loudness of wheezing is a very poor guide to asthma control.

Cough-variant asthma is merely asthma where the predominant symptom is cough and not wheezing or chest tightness or shortness of breath. The treatment of cough-variant asthma is identical to the treatment of wheezing asthma.

MEMBER QUESTION:
What else can I do with my asthma when I already use Advair Diskus, Singulair, albuterol and theophylline? I still have symptoms and wheezes when something triggers me off which is most often at least once a day.

ENRIGHT:
You should become a sleuth to determine all of the triggers of your asthma symptoms and then take measures to minimize those asthma triggers. All asthma people must avoid inhaling smoke, whether from cigarettes, fireplace, candles or incense.

MEMBER QUESTION:
Is there any risk for a kid with asthma to have tonsillitis/adenoids surgery? My daughter is 3 years old. What is your opinion?

ENRIGHT:
Whenever surgery is planned, asthma should be well controlled. Be sure to work with his pediatrician and the anesthesiologist to minimize his risk of an asthma attack after the surgery.

MEMBER QUESTION:
My son was diagnosed as having asthma at age 2. For the most part, the first two years of his life he coughed at night. We were finally referred to an allergy and asthma specialist when he was 2 and they said he had asthma. He's now 3 and a half and we've been giving him nebulizer treatments of Pulmicort for 1.5 years every night before we put him to bed. Sometimes we add albuterol and Xopinex if his cough has flared up. Is it safe for him to be on Pulmicort for this long? And how much longer can or should he be on it? Even if we miss a day or two of treatments he coughs at night. He also takes Singulair and Zyrtec for his allergies. The high pollen counts now really seem to be triggering him to cough.

ENRIGHT:
Pulmicort is a very good inhaled corticosteroid which is effective at reducing airway inflammation to the lungs. Like most medications, it does have side effects and can at medium to high daily doses for more than a year result in a reduced growth rate in toddlers. Therefore, the risks associated with poorly controlled asthma need to be balanced against the risk of side effects from inhaled corticosteroids. The other medications that he is taking are very unlikely to cause long-term side effects.

MEMBER QUESTION:
It was determined that my daughter is allergic to dogs. Is there anything we can do to minimize her allergic reaction to dogs without getting rid of our dog?



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