Asthma Attacks Girl at School!

Dear Dr. Mom,
I teach at a city school. One of our students has started having asthma attacks very frequently since Thanksgiving. I suspect it is a food reaction. We have also investigated the possibility of chemicals, perfume, chalkdust and dust in the air. Her doctor is giving her Benadryl.

Since she eats right after she gets there, it is going to be hard to tell whether the problem is a food or inhalant. Take her pulse when she sits down to eat. Record everything she eats. Then take it immediately after. If it goes up 20 bpm or more, write down what she ate as a "positive". Write "negative" if it doesn't go up. Also take her pulse outside different classrooms or the building. Most reactions will show up ten minutes after the food. Chemicals can take days to show up, but not likely at her age. Remember, you are the detective. After a week or two, you should have a database which will allow you to rule out or identify a food reaction. Also, see if you can get permission to give her baking soda or Alka Seltzer Gold when she starts with an attack. Cite Dr. Rapp if you need to.

Somebody should also inform her parents that antihistamines like Benadryl are not recommended in asthma, (read the label), because it thickens lung secretions. Also antihistamines do not stop food reactions! They are ONLY for inhalants. She needs to have the doctor treat her asthma. The newest, best standard of care is now is three inhalers. Cromolyn sodium is taken regularly to prevent attacks. An inhaled steroid like Beclovent for severe inflammation is taken regularly to calm down the lining of the lungs, and a brochodilator with "vent" in its name (Proventil, Ventolin) for severe acute attacks. Our local American Lung Association has an annual asthma camp where they show knds how to relax their lungs and how to use their inhalers properly. If she needs help inhaling they can prescribe a "spacer" for her so she can take her time. There is no reason for kids to suffer from asthma anymore.