Wheezing Child: Checkups Matter
It is easy as a pediatrician to share instructions with parents, to give them the medical information pertinent to taking care of their children. It comes second nature to those of us in practice long enough. We train for this, we go through rigorous hours as residents in the hospital. We sit for long stretches in the library pouring over text books and doing exam bank questions in preparation to give our patient families the absolute best clinical information. I know that I've done this effectively over the years.
However, I did not really know the feelings of fear, of anxiety, and terror until I had to take care of my own child as he struggled with wheezing. An evening like any other I drove through Atlanta traffic to pick my son up from daycare. As we drove home, I noticed he indeed was coughing a lot as his daycare director described. My mind was preoccupied with fighting though the bumper to bumper traffic and running a list in my mind of dinner preparations. He continued to cough and cough. We finally arrived at our house after about 30 minutes and pulled into the garage. I went to get him out of his car seat where he had been sitting more quietly than usual. I then finally noticed how rapidly his stomach was moving. I quickly ran into the living room and took his shirt off, to notice that indeed he had retractions and continued to cough.
He's wheezing I thought, the words hit me like a ton of bricks.
I had seen this many times before and knew what to do, but here it was happening to my own little one. I will admit, I panicked. For what felt like 5 minutes I just froze, held him close, and panicked. I know it was not actually that long before my brain registered the respiratory distress and I began to act. We had a nebulizer machine in our home and albuterol. I ran to get those items reassuring my little one he would be ok. I placed the mask on him as the mist disseminated from the machine with the familiar hum going. In that moment I sent up a prayer of protection for my child. I called my husband and a friend who was also a pediatrician. The breathing treatment made a difference as I had seen many times before. We continued a few more treatments that night and went in to his doctor in the morning.
I'll never forget that feeling though. Moments like these remind me that my patients and their families are not just data. They are not a collection of symptoms and signs with treatment plans. The experience of illness is emotional. What helps us all is recognition of illness and having a plan. It provides some level of control in a situation that may seem out of our hands, even for someone with experience.
As we continue through what many of us in healthcare call respiratory season, cold and flu viruses increase the potential for kids who have reactive airway or asthma to have flares. A very important part of management is knowing when to use medications, and how to use them correctly. I have found in my experience as a physician parents don't always understand the difference between a rescue medication (albuterol) vs a daily medication. Additionally the technique of using an inhaler with spacer isn't alway done correctly. I encourage parents to talk with their child's physician about wheezing/asthma several times a year and review techniques.
1. Find the triggers, talk with your child’s doctor about allergies, seasonal changes, foods that aggrevate the wheezing.
2. Understand the signs, learn when things are escalating.
3. Use medication correctly, follow instructions on how to use your child's rescue medication (albuterol) and daily asthma medications.
These three factors are commonly described in the American Academy of Pediatrics literature. The more parents understand the process, the better outcomes children will have managing asthma and wheezing.
-Be Blessed, The Mommy Doc
