I just returned from taking Madoc to see Dr. Adrian Wu, a Hong Kong specialist in asthma and immunology. I have been in such need of more information, that the visit was extremely productive and I am so grateful to him for the information he provided. I asked him as many questions as I could - but of course I now have hundreds more. Following is what we found - I hope this information also helps other parents with children who suffer from "reactive airways" and asthma.
1) Children who catch RSV before the age of 2 and have a wheez at the same time (Madoc did) have a 10-fold chance (he couldn't give me actual numbers) of developing Asthma. I must research this more...
2) Children who have excema have a very high chance of developing Asthma (Madoc did not). If Madoc had this and RSV and dust mite allergy, Asthma would have been a sure thing.
3) If you combine an allergy to dust mites (specific only to this allergen) to either of the above, the child has a significantly increased risk of developing asthma unless this allergen is managed. (And yes, we found out today that Madoc has a significant reaction to dust mites. And yes, dust mites are a MAJOR problem in Hong Kong because they thrive in humid conditions). The good news is that there are now studies that show that if you start your kids on allergy shots at the age of 5 to build immunity to dust mites, there is a significant decrease in asthma cases.
I asked the doctor about the inhalers. Are they habit forming. Am I giving her the right dose. Etc. And he said that the latest research indicates that it's best to only give steroid inhalers as needed -- not as a preventative. He also said there is a new trend in creating inhalers with both steroids and Ventolin that you use until the cough stops.
I asked him if there was any way to build her immunity. He said it has been proven that Vitamin D absorption has been proven significant in fighting Asthma. The latest study he read links the significant increase of Asthma cases in Australia, to the fact they smother themselves and children in sunscreen, thus blocking vitamin D absorption. The study tested loads of kids and found the majority were Vitamin D deficient. Definitely worth looking into ....
So the good news is that Madoc does not actually have an allergy to dairy. Or soy. Or gluten. Or cats. (Poor thing hasn't had any dairy in 6 weeks!) But she does seem to be developing a fierce allergy to dust mites. But the good news is dust mites can be controlled pretty well (at least at home). Bad news - airplane rides are about the worst thing we can do her. The re-circulated air, the dust and dirt, and germs, the dry air -- are all a recipe for disaster. He recommended she wear a cotton mask, to help keep moisture in, germs and dust out. Hmmm, we'll see how that goes over on 24 hour plane ride.
I asked him if living in Hong Kong was aggravating the problem - as the air is so polluted. He said that from an allergy perspective, that unless you live in Denver (SERIOUSLY!), there are always going to be allergens around. He said Denver doesn't have dust mites, which makes it ideal for Madoc. (Note, he didn't say the air pollution didn't matter, he just thinks there are a lot of variables that go into this)
So good news/bad news. But at least I have more information. And at least Madoc can now eat Macaroni and Cheese and Pizza - she is so excited!