“I think we need to call an ambulance.”
My heart sank as I looked at the pediatrician in front of me.
It wasn’t that bad, was it? The last few days, my daughter had a little bit of a runny nose and had been breathing fast off and on, but surely she didn’t need to go to the hospital.
I looked down at my two-year-old daughter on my chest, holding a breathing mask to her face as cool medicated steam flowed out into the air. The hissing of the machine cut the silence as I thought about what to do next.
“Can we just give her another breathing treatment?”
The doctor looked at me, then looked at my daughter, and then back at the pulse-ox wrapped around her little toe. She hesitated, then said, “Let’s watch her for a little bit longer and maybe try one more treatment, but I don’t like how she looks.”
We waited together for another 30 minutes in the cramped triage room of the clinic as my baby girl began to get her color back. Her dad arrived a little later and we stayed until we got the okay to go.
We made it through her first asthmatic episode.
It was the first of eight that year.
As a mom of a child with asthma and allergies, I understand how management can be complicated and necessary for the health of our littles. In extreme cases like my daughter (and mild to moderate cases as well), finding a medical team that will partner with us to help care for our children and their asthma/allergy needs was essential. I didn’t know my options for treatment until I met with MUSC Children’s Health’s Allergy & Immunology specialists, Dr. Maria Streck (left) and Dr. Kelli Williams.(right)
Does My Child Need to See a Specialist?
The short answer is probably. A typical visit to the pediatrician for your child’s allergies and asthma symptoms may be able to address the symptoms, but further investigation by a specialist can dig deeper to discover the root causes.
Many times, parents are not referred to a specialist until symptoms cause multiple crises and interrupt daily life. Emergency department (ED) visits, multiple breathing treatments at home in a short period, or worsening of symptoms can all signal a referral by a clinician.
But what if you could get ahead of the problem before it gets bad enough for a referral?
Thankfully, MUSC Children’s Health Allergy and Immunology specialists can see your child without a referral by a clinician. If you have any cause for concern for your child’s allergy or asthma symptoms, rest assured that your child is in the best care possible with the expertise of the staff at MUSC Children’s Health.
In Dr. Maria Streck‘s words, “It is important for parents to choose a physician for their child who has expertise in the treatment and diagnosis of allergies and asthma. Our clinic at MUSC Children’s Health offers this while providing individualized care for the child and their family to achieve the best possible outcome.”
Asthma, Allergy & Immunology at MUSC Children’s Health: What to Expect
The Allergy and Immunology Specialists at MUSC Children’s Health have a few goals to stabilize the health of your asthmatic or allergy-prone child:
- Investigation into the causes of symptoms.
- Accurate diagnosis of your child’s condition.
- Recommendations for appropriate treatment for the best quality of life.
- Coordinated care with you and your other family clinicians.
- Assessment over time for possible adjustments.
At your first appointment, the provider will ask you a series of questions regarding your child’s condition. Because asthma and airborne allergies can have environmental causes, they will begin a social-environmental history of your child. Indicators such as water leaks, household animals, and the amount of time spent outdoors can suggest that your child’s asthma or allergies could be environmentally derived. According to Dr. Williams, it can take a few years for children to form seasonal allergies like adults because they must have repeated exposures to develop the immune-system responses to outdoor allergens like pollen (though they can still react to them), and they only see these key pollens once a year.
The doctors may also do a variety of medical exams and allergy tests (like skin or blood tests) to see if and/or what may be triggering your child’s symptoms. Dr. Williams mentioned that oftentimes, people can develop worse allergies after moving to Charleston. Therefore, it is possible that an adult or child will need to get re-tested after acclimating to the region-specific flora.
Which came first, asthma or allergies? That’s one area doctors must determine in your child’s diagnosis. Allergies can play a key part in triggering asthma in children and may cause Asthma to present in unsuspecting ways. Asthma may present as the inability to breathe after physical activity and requires the use of an inhaler (also known as bronchial hyperactivity). Other children may present with an unrelenting cough.
Asthma can also be caused by viral infections, which is actually the most common trigger in children. Like my daughter, an asthma exacerbation can be caused by something as simple as a virus that causes a slight runny nose that can inflame the bronchi in the lungs, making it more difficult to breathe. This can be very serious in children, cause wheezing, and can result in a visit to your local ED. Accurate diagnosis and understandings of the cause of your child’s asthma are very important for appropriate treatment.
In airborne-related allergies, allergens can be environmental, such as pet dander, mold, and dust mites. Even vermin-like rats or roaches can cause allergic reactions.
Recommendations for Treatment Based on Lifestyle & Patient’s Age
Once all investigations are finished, Dr. Streck or Dr. Williams (based on who you schedule your appointment with) will create an individualized treatment plan for your child, based on your comfort level and the most effective treatment with the least amount of life disruption. Parental education and understandings of their child’s test results are crucial. Dr. Streck and Dr. Williams will walk you through the results so you are an active part of the treatment process with your child.
“Allergies and asthma are chronic diseases that affect both children and adults. They can cause frequent and/or severe reactions, which can be very scary for the patient. At our clinic, we provide an academic and evidence-based approach to managing these conditions in a personalized way. We work with the patients and parents to come up with a treatment plan that will work for them/their lives and also improve patient outcomes.” –Dr. Kelli Williams, M.D., MPH
There are many options available for the management of asthma and airborne-related allergies, starting with removing or minimizing the environmental triggers in your home. Other options include allergy medicine, the use of a daily preventative inhaler, or allergy shots.
MUSC Children’s Health Allergy and Immunology experts are very familiar with team-based care of patients, especially with those who have pre-established MUSC Children’s Health providers. Dr. Williams and Dr. Streck regularly work with pulmonologists, ENT’s, and general practitioners to coordinate care for their patients.
Dr. Streck and Dr. Williams also desire to partner with your child, based on their level of maturity and understanding. Teaching personal responsibility in one’s health journey and informing of helpful tools such as smartphone apps are ways that your child can feel empowered in their healthcare journey.
Dr. Streck and Dr. Williams will also be joined by Dr. Emily Campbell in August as the newest provider to join MUSC Children’s Health Allergy and Immunology. Dr. Campbell will be accepting new patients (children and adults) in both the West Ashley and Mount Pleasant locations.
Assessment for Potential Adjustments
Once your doctors have discovered what they believe to be the key causes of your child’s allergies and asthma (genetic or environmental) and prescribe a treatment plan, a follow-up will be scheduled to assess how well the treatment plan is going and if adjustments are needed.
MUSC Health Ben Sawyer Primary Care
Telehealth is also available for follow-up appointments.
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