Sorry this is so long, but I wanted to be comprehensive.
For maybe a year or so, our son (now age 12 1/2) has experienced periods of a chronic, nagging cough that would continue for maybe 2 weeks or so. Not huge coughing fits, just periodic, throughout each day, annoying, irritating, nagging coughs. Those periods of time usually followed a cold, but sometimes they'd appear out of nowhere. I just assumed they were seasonal allergies and gave Allegra or something like that. But eventually, my brain started humming. Both my mother and father have been taking Advair for several years due to what they call asthma-like flare-ups or bronchial issues. Not severe asthma attacks. Just nagging coughs, like our son. This past Saturday, our son stared coughing again, just like that, right in the middle of the day.
We got a recommendation from multiple parents in our town for a local physician who specializes in pediatric allergy and asthma. The parents all swore he's the best of the best. The appointment was today. Our son was skin tested for allergies and showed a reaction to grass pollen (his previous long bout of coughing was maybe early June, so that's interesting). Nothing else. The doctor said his lung function was 70%. Based on that and his history of coughing, he prescribed BREO.
Since coming home and doing research, I now have questions. I'll call the doctor to ask, but I thought I'd get thoughts from you experts here in the meantime.
1. The doctor didn't seem to think 70% was terrible. From my research it looks like it's not severe/dangerous, but it's not exactly borderline either. I should say that on Monday evening he came down with a cold, and it was really cruddy yesterday. I called the doc's office and they said it didn't really matter and he could still come in today. He's much, much better today (minus the cough, which started a couple of days before the cold), but I again during the appointment asked if this posed a problem for the lung test. The doctor said it wouldn't affect it in a meaningful way. Hmm.
2. Why would the doctor start with a combo inhaled corticosteroid/long acting beta agonist vs just starting with a steroid? Is it because his lung capacity was so low? Or because he's already in the middle of another round of coughing?
3. I think (could be wrong), BREO comes with a 100mcg dose and a 200mcg dose. He's starting our son on the 200mcg one. Again, isn't this a bit much for starters?
4. The doctor didn't definitively say he has asthma per se. I wonder why? He used some other term but can't remember. We're sort of in the middle of some testing and medication decisions with our older son (epilepsy) so my brain is just fried this week.
5. During the allergy test, our son also developed a small welt and itching on the clams area. Odd. He's eaten clams, eaten them often, and eaten them fairly recently, maybe a couple of months ago. He did not show a reaction to any other shellfish. The doctor didn't seem at all concerned, said he doesn't believe our son is actually allergic to clams, and said that it's good to be aware when he eats them but that he truly believes it's safe. So.. yeah, I'm confused.
If you made it through ask that.. well then, thanks!!! Any thoughts are GREATLY appreciated.