Sending kids with active asthma flare to school

My son is 6 and in kindergarden. He has a history for environmental allergies and asthma. His asthma as been a non factor for about a year. However, over that last 4 weeks things have gotten much worse. About a month ago, he started having difficulty breathing following his gymnastic workouts. So I began making sure he had albutrol before his workout and that seemed to help.

Unfortunatly, several days ago he woke several times at night complaining he could not breath. The next morning we reported to his ped. and the doc said he was indeed tight and wheezy. We are treating the flare with decdron x5 days, doubling his simbicort for 2 weeks and treating active symptoms with albutrol prn every 3-4 hours. He is feeling fine except he isn't breathing well.

Problem #1 is the steriods make him a 40# manic monster, and I am concerned that in a school setting he may have an issue with behavior.

Problem #2 his attacks are really suttle until they are not and by the time he notices, he is in real trouble.

Problem #3 he has a prn order for albutrol for wheezing, but his main problem is more labored and shallow breathing not necessarly wheezing. I am concerned the nurse won't all me to schedule a treatment during the flare.

He is better today than he was on Friday but not well, and I would have expected more give the amout of drugs he is taking. Do I send him to school or do I need to keep him home until he is back to his baseline?? Again he is not sick or bothered by this at all, but it is clear there is an issue. What would you do. We see pulmonology on Tuesday.

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My grandson had similar problems with his asthma. We got him a rabbit air, air purifier for his bedroom. Basically making a safe room for him. He went from waking up almost every night to waking up once or twice a month. He seemed to do much better during the day with a good nights sleep and my daughter was able to cut back on some of his meds. The Rabbit Air purfiers are pricey but the other purfiers do not work at all compared to the Rabbit Air. I have attached their website for you. My grandson has had the Rabbit Air for 2 years now with fantastic results. The website is: www.rabbitair.com

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I have a now 9 yo who has had asthma since she was 18 months old. She has bad flares; even her sub acute flares, her small airways are at 18% of expected in performance. I completely get where you are coming from. One solution: I do not send her to school. Because of all the reasons you say, including the behavior issues on the prednisone. This is especially true when she was younger and unable to moderate her behavior in any meaningful way. Another: Send them, with a note to the nurse and teachers explaining prednisone, maybe w a link to web md or something re: side effect. Now, to the breathing breaks. You can go in to most schools and do a neb treatment yourself - ask. So, you can go in after three to four hours and give him some albuterol proactively during a flare. Tuesday, talk to you doctors about changing the order, maybe? We have for wheeze. We also have for tightness, before gym, playgound, cold weather, etc. Basically, we are transitioning to whenever my 9 YO needs it - she knows now. We are on better meds for us now: dulera. AVOID Singulair, if you can. It crossed the brain blood barrier and makes kids bat sh*& crazy. IT is a drug looking for a disease, according to my ENT, and I encourage anyone on to research it. NOT A FAN. GOOD LUCK.

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Hi! I pray your son is back under control. Does he see a pediatric pulmonologist? Since his symptoms get so severe, even if the pulmonologist is some distance away, he can work along with his regular doctor. Has his doctor written out an asthma care plan for the school to follow? It should detail everything. His nurse should have a list of everything he is on, so if they need to call EMT's they will have a list of all his meds; and the Individualized asthma care plan, which should also state the effects steroids and some of the inhalers, like albuterol or proventil, can have on him.

I was a Health Specialist (Nurse) for a preschool program throughout our county - 11 different buildings - 200 staff and 903 children. I had a health plan form that I sent home for every parent with a chld who had asthma, so they could have the doctor complete it. When the report came back, I met with the parent and teacher, and also the child. These were 3-5 year olds. Any of the staff that had responsibility for the chld was taught how to administer the inhaler with a spacer (MDI). This gave me a chance to make sure Mom was doing it right, that the teachers, bus drivers and whoever knew that they knew what they were doing. The plan and the meds were in the first aid kit, and went wherever the child was.

When we started using nebulizers - we had the child go to a school where there was a health tech - and they administered the treatment. I even had a Sesame Street Asthma Video for them to watch.

It was tough getting them to "buy" into this, but I told them it was my liscense and the child's life was on the line. I needed to know that they knew, and then they signed off on the training, and could contact me with questions. They all had to notify me immediately after administering the treatment. I'd check back. The parent was notified. The parent didn't have to come get their chld, unless they had another attack or the medication did not work. Then they would have to take them to the doctor or hospital, and yes, I had a form for that as well.

I'm retired now, and have been a life-long asthmatic. There wasn't any medication back then, so I got pneumonia a lot. I will check, or you can check on the asthma journal sites, especially the pediatric ones. Use your own common sense and gut feeling about sending him to school. I wouldn't keep him home because of his behaviour. Teachers should be informed, and should have a plan of what to do. It might be good to have a team meeting.

Because of HIPPA rules (the Privacy Act) they will not tell but drivers or bus aides anything, but there is no law about you telling them yourself. Bus drivers also got a copy of emergency forms, so the children could be treated immediately if they got hurt or sick on the bus.

You might receive more responses, if you address your posts to Members Only. Some are reluctant to get on a public site, and I know I choose what I share very carefully. Took me awhile to realize this.

Blessings, hugs, and prayers, Great-Gram

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