Question:
My son's asthma has gone from intermittent to moderate persistent in the last
year (after a move). I am currently looking into taking him to a specialist,
since his GP doesn't seem to be taking it seriously enough.
Can anybody make any suggestions as to the pros and cons of a pulmonoligist vs.
an allergy/asthma specialist? Some of his asthma is allergy related (grass,
alternaria) but most of it is just plain inexplicable.
Answer:
If you interviewed a pulmonologist and an allergist and they both seemed
equally qualified, I'd probably pick the pulmonologist, whose training would
cover more medical knowledge about breathing and the lungs. BUT it seems to me that a very important factor is experience. The doctor
who had the most experience with asthmatics would get my nod -- number of
patients treated, especially successfully treated.
My approach is this... it might be (better than an 80% chance) allergy
related. So see an allergist and have allergy testing done. The source
(trigger) might pop right out at you, saving your son a life's long
journey into posting to these websites.
OK, I kid... it xmas, darn it. But, it's true. Maybe it just the cat?!?
Get rid of it and he's fine. Not so simple in most cases, but you never
know. More likely he'll be allergic to things you've never heard of and
probably saw depicted in a b movie once.
OK, I kid, again. Anyways, the allergists eliminates the possibility
that allergens could be causing the problem. Important information to
know.... and yes, they can treat asthma.
I guess I'd go to the pulmonologist if it isn't allergy related,
oooooooorrrrrrrrrrrrr, the allergist isn't getting the asthma under
control, oooooooooooorrrrrrrrrrrrrrrrr, he's in sports and wants to
break all the records, ooooooooorrrrrrrrrrrrrrr, you just feel better
about it.
Look, while I've been somewhat candid in this post, it's easy...1)
Eliminate the allergy possibility 2) Go to the specilaist.
Your best bet would be to find a doctor who specalizes in asthma.
Normally this will be a pulmonoligist or an allergist, and some of
these doctors focus on asthma more than others. you pick
the doctor to follow his asthma. Have you had him tested for allergies or
is the grass allergy something you have just noticed? One of the major
concerns I had when we were looking for a doctor for my daughter was how
well they got along together. If the doctor paid attention to her. This
was important to me because as she gets older she will be taking care of
herself more and I will be stepping back. Right now she is 8 yr.. old.
During the appointment I stand back and let her answer the doctors
questions and encourage her to ask him questions. The doctor we see now
is a GP that is very interested in allergies and asthma. We are blessed.
You can choose either, but an allergist might be better suited. Many
family practicioners are also well suited to treating asthma, as is
mine. Allregy testing, however, as some recommend, is an art, not a science.
Scratch tests can give both positive and negative results, depending
on where on the body they are given.
The "allergy shots" that are recommended following the tests do not
always help. In some cases they do, some they don't.
One type of test, the "RAST" test, uses a blood sample and is tested
against likely allergens to see if antibodies (IgE antibodies) are
present when exposed to the suspected allergen. A questionairre will
be needed to be filled out to narrow down the possible allergens.
While this might seem more "scientific", I have had both done and both
gave, more or less, similar results.
In any case, treatment for asthma includes inhaled steroids if the
person needs to use their bronchodilator inhaler more than twice
weekly. Asthma is an inflammatory disease, and controlling the
inflammation is the key to real control.
Unfortunately, there are risks with all treatments, and you will need
to discuss these with the doctor. Both bronchodilators and inhaled
steroids have potential causes for concern, but they are better
alternatives to suffocating from an asthma attack. Personally, I think
I need to breathe now and would worry about the consequences later.
