Help my son and daughter both have asthma!?

Question

Help! my son has asthma and its quite bad he is just about to start primary school what can i do to make sure he dosent have an asthma attack at school? My daughter also has asthma hers is servere and she is coming up to all her GCSE's and all the pressure is making he asthma really bad especially in pe at school.What can i do to let the teachers know just how seriuos it is they have never seemed to care about her asthma? how do i let them know that this is serious and not a joke i have had lots of phone calls from her asking me to pick her up from school cos of it. What can i do?

Answer 1

Dear Asthma Kids Mom:

I hope you left out a lot of the story because otherwise you are not going to like this answer at all.

Asthma is the most common chronic childhood disease of all, # 1. Literally millions of children of children have it and the frequency is getting worse. But it is also one that, with diligent work from the parents for kids of your ages, and cooperation and a bit of understanding about why we are asking them to do certain things from the kids, 90% can be perfectly well managed and do what every non-asthmatic can. They just need to take some medicine either ever once in while or regularly depending on how bad their asthma is, and maybe do some other things with little non-threatening toy-like devices that measure their air flow through their lungs. All they do is blow hard through it. It's fun at first, then becomes pretty tedious, but for those who need it (like maybe your daughter) it is indispensible.

Now here's the first part you're not going to like - if you did not know everything you just read already, you need a new doctor. You are not getting proper asthma management care for your children. I don't care how nice a person this doctor is, he/she does not know how to take proper care of a child with asthma.

Second - and this is just one of our standard questions and response for a lot of problems but especially asthma. And I was not always this polite in the way I asked it, which I found to be too confrontational so I reluctantly changed my approach. If you smoke, or anone who has any contact with your kids smoke, please stop yesterday. You already know why, you've seen it on TV and in magazines, etc. Nicotine is a more powerful addictive substance than cocaine so I know what I am asking is not only hard but one of the greatest challenges that anyone can face. But we have ways to help now so you can still wean yourself off nicotine without generating smoke. See an adult doctor.

Moving along - the first step in managing asthma is to determine severity and triggers. You have already identified stress and exercise as triggers for your daughter. Stress can be managed but NOT with drugs. Biofeedback is the most effective method and children are the best and most responsive candidates. A proper asthma doctor knows this and will deal with it.

Exercise is probably the most common trigger. There are several ways to handle it but one of them is NOT to avoid exercise. We do have several inhaled medicines that block exercise induced asthma if used about 15 minutes before, and rescue inhalers to stop it if it occurs anyway or if the blocker is forgotten. Here's where the school's cooperation is required. Many (actually most) schools prohibit students from carrying any type of medicine on their person or in their backpack. Asthma inhalers are an ABSOLUTE exception and your proper doctor should write, without you even having to ask, a note in just those terms to the principal. NOT the nurse, the principal.

When it comes to the care of an asthmatic in school, always go directly to the top where you have reasonable certainty that your doctor's orders (and they are orders, not requests) will be implemented.

You should have an asthma plan - it's on one page and divided into red, yellow, and green zones. For younger kids who can't use a Peak Flow Meter (that's what the blow in toy is called) you will use how the child looks and acts as a guide as to what category to put him in. For the kids who can, you will use the results of the PFM. Each zone lays out a different set of instructions. The green zone represents good days where the PFM shows normal air flow (there's a range) for your child. Depending on the particular child you may do nothing, or just use his maintenance medicine(s). Yellow = caution, getting worse, maybe add another medicine which has already been decided and is written on the plan. Red = problem. Do what is written on the plan and see the doctor.

The nurse AND principal should have a copy and should have a peak flow meter with your child's name on it because many schools now do not have a full time nurse. There will probably be quite a few. Your child, if old enough, should carry one with her so if she feels funny or is short of breath she can measure her peak flow and know what to do. She should have a laminated copy of her plan.

A conference should be held with BOTH parents, the nurse, the school person responsible for supervising recess and PE, and of course our favorite, the principal. Take several copies of the plan, the doctor's orders and other instructions which should include a mention that very few children need to sent home because of asthma these days. With the modern medicines most attacks can be resolved within 15 - 20 minutes IF they occur. But the whole goal is to prevent them, which as I began, is absolutely possible in most kids.

PS: While not absolutely necessary, it's very desirable to find a doctor or a doctor's group (MUST be pediatricians by the way) that have a nurse practitioner who deals with the asthma patients in addition to the doctor. At the beginning these patients are enormously time consuming just educating them and their parents and setting and explaining the plan the doctor has decided. The nurse practitioner can take that time - that's part of what she gets paid to do. She will see you quite often early on until it's clear that you are familiar and comfortable with the medicines and the plan. And commonly she's more reachable than the doctor for elective questions. But if you call any pediatrician's office who deals with asthmatic patients and say "red zone" you'll be in an instant.

Best of luck to you. I think you're going to do fine.

Answer 2

if you need to raise a concern try the following in order

Form tutor

PE teacher

Head of year

head of PE

head of school

ofsted inspectorate

your MP/MP of the area the school is in

the trouble is that often people put up with issues like this when they need to be assured that their kid's health is taken care of at school (personally i cant see why they cant put a plaster on a child but CAN take them for an abortion without informing parents)

Answer 3

Go in and talk to the school nurse.  Let her know their symptoms, triggers, medications, medical history (if they've had frequent ER visits or hospitalizations for their asthma, or if they've had pneumonia or other problems).  Schedule a conference with the teacher, too, and even the gym teacher if you're very concerned.  If there are things at school that are triggering her (chalk dust, school pet, mold, etc.) that's something you need to talk about with the school nurse, teacher, and possibly principal, as well.  A letter from your pediatrician emphasizing your kids' triggers might help, also.

My daughter has infrequent but very severe asthma, and a dangerous tendency not to tell anyone when she experiences early symptoms of an attack and to say she's "fine" when she's so bad she can't talk and actually needs to be in the ER on oxygen.  I always talk to the nurse and the teacher before the beginning of the year.  Our school nurse will administer inhalers and also nebulizer treatments, and call for me to come pick her up if the treatments don't help.

Also talk to your pediatrician.  You can find out if it makes sense, for example, for your daughter to use her inhaler right before gym.  Are your kids on any daily controller medications? If they're routinely having problems, that can be a lifesaver.  Singulair and Flovent have dramatically improved my daughter's life (and my stress level!)

As for pressure from tests, if stress is so severe that it's causing asthma attacks, I'd definitely talk to the teacher about the pressure level, talk to your daughter, perhaps teach her some stress-reduction methods (deep breathing, yoga, etc.), and ultimately consider getting a referral to a psychologist if stress is really repeatedly making her physically ill.

Answer 4

Yell loudly at their schools. My son has asthma and I've never had a problem with his school.

Answer 5

well u can give the kids meds or watever they take to the school nurse mytwins have asthma and its very hard to take care of the y r both in k. im a first grade teacher so i no wats happenin

Answer 6

Well, why haven't you given them a doctor's note before now, regarding her asthma? While you are getting one for her, get one for your son too, and make sure the school nurse has meds for each of them (aspirator, whatever), in case they need it.