Expert: Marc Rubin, RPh Asthma Educator - 1/22/2011

Question
Hello,
My daughter is 14 months old and we have been dealing with reflux since 8 weeks.  She has progressed in her meds to Nexium 20mL and Zantac 2mL per day. She also is taking Singular 4mL, Budesonide 0.5 mL once a day and albuterol 3 vials a day.  Her Gastro doctor has now recommended a sweat test.  We see a pulmonologist, but he has not recommended this test.  Is this standard protocol prior to a Ph probe or upper GI?
We live in Miami, FL and we have one dog at home.  Abby is a Belgian Malinois.  Madison, my daughter, is currently in day care 5 days of the week.  She is under the care of a pulmonologist, gastroenterologist, pediatrician and an ENT.  We have an upcoming appointment to have tubes put into her ears.  Should the adenoids be inspected as well?  She has had double ear infections since October.  

Thank you,
concerned mom

Answer
Hello Carman,

The sweat test to rule out cystic fibrosis is automatically done at birth, here in Illinois. It was mandated by state law. I'd contact the maternity unit at the hospital at which your daughter was born to see if, at that time, they were automatically doing it. If they weren't, I'd go ahead and have the test done, to insure peace of mind. It is most common in Caucasians of North America and northern Europe, then in significantly fewer numbers in Afro-Americans, and outright rare in the Asian population of Hawaii. Based upon this, assuming you don't belong to any of the above groups, the chance of cystic fibrosis is extremely low, which is why your pulmonologist feels it would be a waste.

Have you ever had your daughter evaluated by an Allergist/Immunologist? This is the specialist whose main focus is allergies and related conditions such as asthma. To find a board certified allergist, you can go to:

http://www.aaaai.org/physref/

Regarding the dog, not a good mix with a person with asthma. Although some breeds create less issues than others (and this is NOT one of those breeds), there are not any hypoallergenic dogs (or cats, birds, etc.).If giving the dog to another family is out of the question, then it is extremely important to follow some basic rules to reduce allergy risk:

1) pet is NEVER allowed in the bedroom of the asthmatic. This is due to the fact that the dander will contaminate the bedding, and worsen night-time breathing.

2)talk with your veterinarian regarding a shampoo product to minimize the animal dander, and how often to bathe the dog.

3)if you have a forced air heating/cooling system in the home, change air filters every 2 months with a high quality filter. Otherwise, I'd suggest getting a HEPA Air Filtering system for the bedroom. You can just Google "HEPA Air Cleaner" for some examples. They do an outstanding job on eliminating dander, dust and pollen. Do not get the "Ionizing Filter Units" as the ozone they create irritates the lungs.

Finally, in regards to the EENT and tubes for ear infections, the EENT normally will check the adenoids to see the degree of swelling, and may feel it is too soon.

I hope this helps you out.

Sincerely,

Marc