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Allergy doc wins again
Dec. 31st, 2010 09:42 amSo we took Charlie to my/his allergist/asthma specialist, and she listened to his lungs and switched up the plan a bit. She said not to give him the singulair or the pulmacort right now, because those are to prevent a problem and right now he's already having a problem. She said to keep him on the antibiotic, give him more frequent breathing treatments (nebulized xopanex), and start prednisone right away. In a week we're going back and at that point she'll evaluate him for asthma, but she said there's no point in trying to diagnose it when he's in the middle of a respiratory infection.
If she does diagnose asthma, she said she'll probably put him on once-a-day pulmacort for 6 weeks or so, and then take him off it again, which will get him through the winter. She said parents prefer to start with singulair because it's a chewable tablet whereas pulmacort is nebulized, but singulair only prevents one type of asthma whereas pulmacort prevents all types. So she always starts with pulmacort and only adds singulair if the asthma isn't controlled with just pulmacort. It is SO WEIRD to have a doctor explain the whole rationale for prescribing stuff, seriously. Also with the prednisone she said there are two types, liquid and a quick-dissolve tablet. The tablet is more expensive but the liquid can cause an upset stomach, so which would we prefer her to prescribe? OUR CHOICE.
At the same time she's not touchy feely at all, and she was like, "here, he should take this first prednisone tablet immediately, oh, you're nervous about giving him prednisone because of a possible rebound eczema flareup when he finishes taking it? Well, if he doesn't take it he's going to end up in the hospital, so how about you give him this right now. You have cream for the eczema, right? so shut up, mom." Not in those exact words, of course, but that was the basic idea.
So we have a followup with her in a week, and a followup with the regular pediatrician in a week, and that gives us time to find a nice way to tell the regular pediatrician "uh, we only sort of did what you said and we mostly totally went to another doctor, but we still love you, sorry!"
If she does diagnose asthma, she said she'll probably put him on once-a-day pulmacort for 6 weeks or so, and then take him off it again, which will get him through the winter. She said parents prefer to start with singulair because it's a chewable tablet whereas pulmacort is nebulized, but singulair only prevents one type of asthma whereas pulmacort prevents all types. So she always starts with pulmacort and only adds singulair if the asthma isn't controlled with just pulmacort. It is SO WEIRD to have a doctor explain the whole rationale for prescribing stuff, seriously. Also with the prednisone she said there are two types, liquid and a quick-dissolve tablet. The tablet is more expensive but the liquid can cause an upset stomach, so which would we prefer her to prescribe? OUR CHOICE.
At the same time she's not touchy feely at all, and she was like, "here, he should take this first prednisone tablet immediately, oh, you're nervous about giving him prednisone because of a possible rebound eczema flareup when he finishes taking it? Well, if he doesn't take it he's going to end up in the hospital, so how about you give him this right now. You have cream for the eczema, right? so shut up, mom." Not in those exact words, of course, but that was the basic idea.
So we have a followup with her in a week, and a followup with the regular pediatrician in a week, and that gives us time to find a nice way to tell the regular pediatrician "uh, we only sort of did what you said and we mostly totally went to another doctor, but we still love you, sorry!"
