1. My 12-year-old son’s pediatrician has been treating his asthma for two years. He takes Singulair and uses albuterol when he has a flare up. Should I take him to an asthma specialist or is the regular pediatrician okay?
There are certain criteria for referral to an asthma specialist set up by the National Institutes of Health, which include the following:
- You or your child has had a life-threatening asthma episode
- You or your child requires daily oral corticosteroid therapy (anti-inflammatory medicine such as prednisone or prednisolone) or high dose corticosteroids by inhaler, or you’ve received more than two treatments with an oral corticosteroids in the past year
- Your child is under age three and requires daily anti-inflammatory medication (e.g. inhaled corticosteroids)
- You or your child has recently been hospitalized for asthma, or been seen in the emergency department or urgent care setting more than once during the year
- You or your child has a limited activity level due to asthma symptoms despite treatment
- The treatment plan the doctor has prescribed is not working the way you would like it to and you have discussed this with the doctor previously
- You or your child has severe persistent asthma with continual symptoms
- Additional diagnostic tests are needed (e.g. allergy testing)
- Consideration for immunotherapy (allergy shots) has been recommended
- More education and guidance is needed than is currently being provided
- Confirmation of a history of occupational or environmental causes that provoke or contribute to asthma is needed
Asthma can be a life-threatening illness whether mild or severe. Therefore, Allergy & Asthma Network Mothers of Asthmatics (AANMA) believes anyone diagnosed with asthma deserves a complete evaluation by an asthma specialist at the time of initial diagnosis and as often as necessary for follow-up and reevaluation as determined by the physician and patient.
2. Do you know of a good asthma specialist in my state, or how I would go about finding one?
There are several ways you can find an asthma specialist (board-certified allergist or pulmonologist) in your state or nearby vicinity:
- The American Academy of Allergy, Asthma & Immunology (AAAAI) has a Web site at www.aaaai.org which includes a physician directory that allows you to search for a board-certified allergist or pulmonologist by state. AAAAI also offers a toll-free physician referral and information line at 800-822-2762.
- The American College of Allergy, Asthma and Immunology (ACAAI) provides an Allergist Locator section on their Web site at http://allergy.mcg.edu. The ACAAI operates a nationwide allergist referral service as well at 800-842-7777.
- Allergy & Asthma Network Mothers of Asthmatics (AANMA) maintains a list of member physicians - not all of which are allergists, pulmonologists, or immunologists - that belong to their organization. See the Physician Locator in the Breatherville™ Medical Center. You’ll also find information about how to find a good doctor along with definitions of the different specialty physicians that may be needed for asthma care.
- Ask your physician or child’s pediatrician for a referral to an appropriate specialist.
- Talking to others with asthma, friends, and/or family can also be helpful in your search.
Many people contact me with questions they are hesitant to ask their physician. Sometimes they're afraid of the answer or embarrassed to admit they don't understand. Other times they seem to assume their concerns are not important enough to ask. So I spend much of my time reassuring them that their questions are important and helping them plan how to approach their healthcare provider.
Whether you're in the midst of a medical crisis or at a routine appointment with your family healthcare provider, it can be tough to be your own advocate. But it is critical that you speak up, ask questions and take action to get the results you want.
Follow these six steps to create a healthy working relationship with your medical care team:
Find a healthcare provider you trust and feel comfortable with. Although word of mouth from family and friends can be helpful in finding a good provider, do not feel tied to that choice when it is not right for you and your family. If you are not getting the help you need, seek a second opinion.
Address your biggest concerns first – not last. Raising important questions first gives your healthcare provider plenty of time to address them during your appointment. Before you leave, find out how to get answers to those questions that pop up later. The only "bad" question is the one not asked.
Be persistent. It's okay to ask your provider to repeat an answer or ask for more explanation if you need it. If you walk away confused or unsure about your condition and treatment plan, you may not see improvement.
Identify your goals. What is your "wish list"? What do you hope is going to change as a result of your visit? Tell your healthcare provider and nurse educator so they can include these goals in your treatment plan. If you have trouble following the plan or using specific medications, contact your provider right away. It is important to eliminate any barriers that prevent you from following your plan or taking your medicine.
Tell the truth. This is no time to hide the facts or your fears. Be honest about the severity of your symptoms, about smoking or pets at home, or whether you can afford the prescribed medications. Your challenges are more common than you think and your medical care team can only help if you let them. Your provider will tailor your treatment plan based on a medical assessment and the information you provide.
Be a "learnaholic." Read, ask questions and expect practical answers. Acquire knowledge from credible sources, then use that knowledge to overcome – not cope with – symptoms. Ask your provider for reliable local and national resources. AANMA's Web site – breatherville.org – is a great place to start!
Most of us know these six steps work, but we often forget to apply them. Be proactive in your asthma treatment to ensure success. Your treatment plan has to fit with your goals and lifestyle to make it work!
Learn More... about finding a doctor.
