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Suggest treatment for breathing difficulty and chest pain while having asthma

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Pulmonologist
Practicing since : 2003
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Hi, my 13 year old daughter has asthma and some tree nut allergies. Breathing has been an ongoing issue. She swims competitively.
This weekend she told me that over the past few weeks she's had pain in her chest, sometimes through to her back and gets short of breath very easily. She typically swims many miles in one week, now after a few laps she is winded. She has a rescue inhaler which is not working and about three months ago she switched from Asmanex to Symicort as her daily maintenance medicine as the allergist thought she can get better results.
I took her to the ER on Saturday after a swim meet. EKG was fine, chest x ray fine. BP and pulse fine. lungs sounded clear. Gave her nebulizer. She swam again last night and was short of breath after a few laps. Chest hurt.
She gets short of breath during gym and going up a few sets of stairs as well.
Have an apt with her allergist next week.
Thu, 19 Apr 2018 in Lung and Chest disorders
 
 
Answered by Dr. Jnikolla 31 minutes later
Brief Answer:
probably uncontrolled asthma

Detailed Answer:
Hello and thank you for asking in HCM.

I can understand your concern

As you explain the history probably her asthma is not well controlled recently.

In such situation we recommend to stop the activity (swimming ) for sometime.

It is indicated to start the nebulizer with steroids and bronchodilatators twice for up to a week and probably the steroids orally or in intravenous route and antibiotic if needed. Probably a chest x ray will be needed to evaluate better the lungs and a spirometry test too

Then when the situation normalizes than it can be returned to the previous treatment.

She will feel better again soon

Please discuss with her doctor for the above.

Regards and feel free to ask me again
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