For those w/allergies and asthma

Posted on: Wed, 01/10/2007 - 3:47am
krc's picture
Joined: 01/16/2007 - 09:00

Do you see an allergist AND a pulmonologist or only your allergist?

We have seeing both and it is such a hassle! Especially since her asthma and allergies are so related.

I called the allergist office and they said they could see/treat for both. (Funny they never mentioned this before?!)

My only concern is that her pulmonologist is only 15miles away and affiliated w/ a closer childrens hosp and her allergist is @45 miles away and affiliated w/ further childrens hosp, KWIM?

I really enjoy her allergist but we actually have more issues concerning treatment with her asthma. I don't really enjoy her pulmonologist. I only like the location and closer hospital.

What do/or would you do?

Posted on: Wed, 01/10/2007 - 4:06am
lilpig99's picture
Joined: 12/22/2005 - 09:00

DD has asthma and allergies and we see only her allergist. Her allergist is board certified in pediatric and adult allergy and clinical immunology. She is very aggressive in terms of dealing with DD's asthma.
You could always try seeing the allergist for both...and then switch back if it doesn't work out or becomes too complicated. I guess it all depends on who you think clinically [i]treats[/i] the asthma condition the best.
Good luck to you!

Posted on: Wed, 01/10/2007 - 4:26am
Corvallis Mom's picture
Joined: 05/22/2001 - 09:00

I would decide whether (maybe with the help of the two physicians) you feel that the asthma is best managed as a [i]chronic LUNG condition[/i] or as a [i] manifestation of ATOPY.[/i] KWIM? If it seems to be an intermittent thing that is mostly exacerbated by encounters with allergens, then I lean toward the allergist. OTOH, if it is something which is apparently non-atopically triggered, then I'd stick with the pulmonologist.
Many allergists are also subspecialists in asthma or even pediatric asthma. Ours is-- it's one of his two subspecialties. I would also agree that he's extremely aggressive in his management style.

Posted on: Wed, 01/10/2007 - 4:41am
bethc's picture
Joined: 04/18/2005 - 09:00

My DD's specialty clinic is for allergies and asthma, so her allergist handles both. We'd been going to our regular family practice clinic about her persistent cough last year, and it was just because she had an allergy follow-up visit that the allergist got involved. It was a good thing; he was very thorough about the dianostic process, which did lead to an asthma diagnosis eventually. It seems to make sense for us to see one Dr. for both.

Posted on: Wed, 01/10/2007 - 2:01pm
krc's picture
Joined: 01/16/2007 - 09:00

Thank you so much for your replies!
We had an appt w/ her pulmonologist today. She is 10 and was dx'd w/ asthma at @18 mos.(right about the same time as PA) We actually started to see the pulmonologist BEFORE an allergist due to the fact that our pediatrician also specializes in allergies (and she wouldn't even refer to allergist until I really pushed and that was only 2 years ago--over 6 yrs after being dx'd w/ PA). The pulmonologist does not do allergy testing or immunotherapy.
She has grown so much over the last year and her asthma is the worst it has been since age 4. She had multiple hospitalizations including those in ICU before Singulair. Singulair has been wonderful for us!
Lately she has been triggered so easily and we have been using her Albuterol way too much so I knew she needed an increase in her control meds. We've also missed 10 or more days of school due to it.
She was on Singulair 5mg, Flovent 44mcg 2 puffs twice a day and Albuterol/Zopenex as needed.
Her breathing tests were not good today. They said her large airways are at 80% which is good for her but her small airways were at 47%, not good. (These are the numbers she gave me, I hope I am stating it correctly)
The horrible thing is she didn't feel bad. She has gotten used to this being normal for her.
So they switched her to Singulair 10mg, Flovent 220, and gave us 5 days of prednisone. We are to go back in 4 weeks and go from there. I hate her having to take inhaled steroids everyday for so long but apparently it is better than the alternatives.
I was pleased w/ her appt today but feel there could be better care if we saw one doctor for BOTH.
But like others stated, I have no idea how the allergist would handle her asthma since she has never treated for it. This is something I will be discussing w/ the allergist at our next visit. I do know now that she specializes in asthma also so....
Sorry this is so long! If you are still reading, thank you for your time.
I would love to get this under control and hopefully switch to just her allergist. I'm happy to find out others do this also.

Posted on: Wed, 01/10/2007 - 10:59pm
notnutty's picture
Joined: 03/15/2004 - 09:00

krc: We also only see an allergist, he specializes in both asthma and allergies and my son's asthma only shows itself when he has a cold or when he has been exposed to an allergen. This makes the management of his astma/allergies easier because we only have to worry about one doctor and that doctor knows what is going on with both issues.
Hope the increase in Singulair helps. We increased my son's Clairtin a few months ago and he is doing so much better. Sometimes just changing the meds a little helps a lot.
Hope you DD is feeling better soon.

Posted on: Wed, 01/10/2007 - 11:25pm
mistey's picture
Joined: 01/18/2004 - 09:00

My 5-year-old son is now on Flovent 220 2-3 times per day (depending on if he is sick or not). He's been on that high of a dose since he was 3. I don't like it either, but it has been the only thing that has kept him out of the hospital.

Posted on: Thu, 01/11/2007 - 2:41am
luvmyboys's picture
Joined: 05/25/2006 - 09:00

We just see an allergist.
Did you mean you hate having her on oral steroids? or inhaled? We were recommended inhaled steroids when ds turned 4 and we turned them down BUT that was because he was under 5 and didn't really meet the criteria they are supposed to use which is needing oral steroids 3+ times in a given year. In other words one round of oral steroids is considered worse for their bodies than 4 months of inaled steroids because inhaled primarily go straight to the lungs where they're needed. Oral steroids impact all their organs since they are not 'targetted'. I did not want ds on inhaled steroids but would do it in a heartbeat if he was requiring prednisone a few times a year.
We chose Intal instead (a non-steroid, inhaled alternative that has been around forever) and ds has had NO prednisone or ER trips in 2.5 years now. We use claritin and singulair in addition.

Posted on: Thu, 01/11/2007 - 3:12am
krc's picture
Joined: 01/16/2007 - 09:00

luvmyboys- no, I did mean I hate having her on inhaled steroids everyday. She is ten and has been using them almost daily since she was 4. Possible long term side effects do bother me although I realize they are better than the alternatives of not using.
I do understand what you are saying, I dislike having to use the oral steroids too often also and hopefully increasing her dosage of Flovent will help prevent us from having to use Prednisone so often.
Once we get her asthma controlled again, I am going to schedule the appt w/ her allergist for BOTH. I see that it has worked for many and I think will help with better management of BOTH her asthma and allergies.
Again, Thank you for your responses [img][/img]

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