Thursday, June 24, 2004

A thought on pediatricians --

Anyone who knows me personally has heard me say this:

There have been days when I've taken Bryn to his regular pediatrician, she's listened to his chest and back and told me he sounds fine.

The same afternoon, I'll take the boy to his pulmonologist, she'll listen to him, and she'll tell me that he's *not* moving air well, and put him on either Duoneb or Orapred.

She tells me that there are subtleties to pediatric asthma that you have to really be trained to here. I've heard this from respiratory therapists in the Peds ER, too.

So, while I love, love, love our pediatrician, when it comes to Bryn's breathing, I always call the pulmonologist first.

After reading the "Camp Super Lungs" article, I wonder how many people just trust their pediatricians and *never* see a pulmonologist. Case in point: the kids photographed for the article, a brother and sister, are, well, pretty darned overweight. While I know this can happen when you spend a lot of time on steroids, obesity is probably a little bit of a hindrance when you're already having a hard time breathing. I imagine there are plenty of parents out there who are scared to let their kids run around if they're asthmatic -- but you should probably find out if that's one of your kid's triggers before condemning them to life as a couch potato. (I'm NOT saying that's the case with the kids in the photo.)

Another example -- we have friends whose pediatrician put their kid on Flovent, but only when he's having an attack. Now, I could be wrong, but I'm pretty sure inhaled corticosteroids are intended for LONG term use. I mean, do they even work in the short term? Our doc recently said something along the lines of, "a year of Flovent is like 5 days of Orapred." So I can't see that short-term use of Flovent does much good.

...So my thought to all the pediatricians out there: If you think a young patient of yours has asthma, PLEASE -- send them to a pulmonologist! I'm sure most insurance companies would cover a few visits.

No comments: