Reactive Airway disease

My 8 year old was initially dx with asthma this summer.  I took him for a second opinion and he was thoroughly tested.  He has no allergies.  The blood tests showed mycoplasma. He was treated with Biaxin, given singulair, and Maxair to use before swim team and tae kwan do. His mycoplasma levels dropped from 4,300 to 400 after the Biaxin. The doctor said he may not have asthma.  He had 2 colds this fall and did fine with the maxair. However, he just got a chest cold and was unable to beat it.  He's now on orapred, combivent, and zythromax.  The latter is for the mycoplasma.  The working dx now is reactive airway disease. He had pneumonia twice under the age of three. However, after that, he never had any of these issues until he started swimming competitively.  He swims year round 3-4x a wk. Is it possible that his disorder is being caused by the conditions around swimming. That is, getting out of a warm pool, but shivering and getting cold air when he comes out.  Or sometimes the pool is a bit cold and he shivers for a while until he warms up.  My mom says that it's the climate issue around the swimming.  Please give me your opinion.  Like I said, he never had this congestion until he started swimming.  Thanks

[National Jewish]

It is unlikely that swimming is the cause of this problem.  However, the conditions you have described can certainly be a triggering factor.  Reactive Airways Disease is simply another term for asthma.  There is no difference between these.  It is unclear as to when this condition began, the earlier two episodes of pneumonia, the infection with Mycoplasma or other.  Studies have shown that children with Mycoplasma infections are at a higher risk of developing asthma.

As far as the swimming, it is a good idea to make sure that your son has adequate medication to control wheezing before this activity.  This can be an anti-inflammatory medication and a bronchodilator.  Then, look for any situation surrounding the swimming that aggravates the situation and try to control it.  This could be the environmental factors you mentioned or the fear of having an attack when swimming competitively, to the fear of failing in competition.  All of these are possible triggers of an attack.  Work with your son's doctor to get the best possible state of control of the asthma.

[Sebastians Mom]

I can't help but feel for you. My 3 year old has been going thru it for over a year now. We first were told RAD then Asthma. But he does have allergies to dust and mold and we finally started immunotherapy for them.

My thought is that your son probably does have asthma (incidentally, RAD is basically asthma...they just don't like to call it asthma until it's been chronic). He is probably sensitive to the chlorine or other chemicals in the water.

Also, if he's anything like my son, he has a lot of trouble with colds turning into infections and usually pneumonia.

I would take him to either another asthma Dr. and explain the pool thing to him/her. Or you could try a Pulminologist since allergies have been ruled out. He might do well using an inhaled corticosteroid medication, such as Pulmicort.

Hope this helps!

[Sebastians Mom]

Here's a link you might find informative:
http://swimming.about.com/cs/allergyasthma/

It's all about swimming and asthma

[Soco]

Thanks.  He actually has had NO illnesses since age 5.  Common colds that go away.  We used Sudafed for these.  His problems started when he started swimming.  Thanks for the website info.

[Soco]

Thank you for responding.  My son doesn't wheeze when he is swimming or competing.  He started swimming last summer.  I feel that the event that may have triggered his first epsiode was one day when the temp. in the water was dropped and he was shivering and freezing.  He developed a cold, which we treated with over the counter stuff.  However, he continued to swim 7x a week.  He developed an ear infection, nasal congestion and then it went into his chest and he was dx with asthma/mycoplasma.  After all of this cleared, he uses the Maxair inhaler before swimming.  But he has never felt that he needs it. The times that we have forgotten to do the inhaler, he has reported that he really didn't need it. He has been fine for the past several months and now again the weather has changed, he got a chest cold and he's got RAD.
I just read an article that says that training in a poorly ventilated pool has the potential to cause illnees through reathing chloroform.  Is there any validity to this?  Two of his swim mates were dx with pneumonia in December.  However, it seems like most of the kids in his class are having similar symptoms as well.  Several of the kids in his class have been dx with Asthma.  All I know, is that he went from the age of 3 to the age of 7 1/2 without any serious problems with congestion and since he started swimming he's had these two episodes.  He swims out of two different pools.  However, the two episodes have occured after swimming in the same pool.
He also is a black belt in tae kwan do and competes pretty regularly.  Again, he's used the inhaler because the doctor told him to use it.  He doesn't see a need except during the two episodes of asthma/mycoplasma already mentioned above.

Thanks.

[Soco]

Hi,
I responded to your response, but I don't know if you got it. Please check when you have a chance.  I didn't know if I was supposed to pose it as another question or respond again. Thanks. SOCO

[SSS]

May be your son is allergic to the  molds and fungus that are pretty much a permanent part of the indoor pool/ locker room setting?  If so, may be some sort of anti-inflamatory or even an antihistimine will help him.  Otherwise, it may be time to switch sports.  (Spoken as one who LOVED swim team -- my stroke was butterfly.  Really!)