Your Sick Kid Could Kill My Asthmatic Kid…or not?

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Her baby almost died, and it’s all the germs, asthma, parents, schools, the worlds fault. Keep them away!

I came upon a picture of a very sick asthmatic girl this morning while browsing social media. She was in the hospital connected to an IV and oxygen mask, suffering from a severe respiratory infection and asthma. I was well acquainted with the stress, terror, grief, anger, and helplessness that the family was experiencing. My heart wept for them as I read through the article, written by the mom about how parents should keep their sick kids home. If only it were that easy.

Being a seasoned school nurse and a mom, I have experienced and seen all sides of this conundrum. Allergies, excessive school absences, no sick days, no babysitter, hypochondriacs, take time off and the rent doesn’t get paid, are just some of the reasons.  It’s not always clear-cut and never an easy decision. For example, specimen one, my daughter, has a runny nose, sneezes, and coughs fifty percent of the year. She was diagnosed early on with allergies. The problem with allergies is you never really know when it’s the actual allergies causing the symptoms, and not a virus or bacteria. The only way to know for sure is to have her mucous or blood tested every single time her nose runs. This is not feasible for anyone.

Specimen two is my son. He has had Reactive Airway Disease (RAD) then Asthma ever since he came down with RSV (Respiratory Syncytial Virus) at seven months old. This he contracted from specimen one. She had her typical symptoms and he ended up with a respiratory infection. She obviously was contagious. Unfortunately the natural order of being a sibling, cooped up in a small space for most of the day, is sharing germs. It’s inevitable that they both will get sick. Specimen two has been in the same situation as that little girl; very sick and in the hospital.

The problem is I can’t keep him away from sick kids. Specimen one is THE sick kid among many others. I know other households have this problem. So how do we prevent living in the hospital? Certainly not by relying on others to keep their kids home and a human bubble just wouldn’t fit in the car.

I have answers! First, teach him to protect himself by HAND WASHING, practicing good personal space, touch only what you need to, no licking communal toys, no sharing snacks, keep your mouth off the water fountain, staying clear of other kids with symptoms, not going to enclosed places heavily trafficked by children on a school-free day in the winter. Whatever your kid does to germ swap, try to stop the behavior. This is the first line of defense!

Second, If your kid does have Reactive Airway Disease (RAD) or Asthma, during flu and cold season keep him on a small running dose of a mild steroid. I also start this in off-seasons the second I see even a drip from his nose. The medication (budesonide) takes 2-3 days of administration just to start working but can take up to 3 weeks for therapeutic levels to be reached. This regimen was prescribed by his asthma specialist and agreed upon by his pediatrician. Most people do not want their children on a maintenance dose of medication. I don’t want my kid on it. But in his case, it could save his life especially during flu season. It’s a scary thing watching your kid struggling to breathe. If you need further convincing, one burst dose of prednisone for severe respiratory distress is equal to 1000 doses of your inhaled maintenance steroid. Yes, ONE THOUSAND. Check it out.

This is what you want to prevent.

Teach your kids, practice prevention and talk to your doctor about a maintenance medication.  We cannot rely on others to keep their sick kids home and we certainly can’t keep the world away from our asthmatic children. The world is a petri dish and this is not going to change.

 

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