Please Help - asmatic 16 year old - with chest pain

[christined570]

Hi, I'm looking for guidance.  16 year old daughter has asthma which was diagnosed at 3 years.  It is under control quite well, and she has allergies.  Three days ago, she called me from school - chest pain (middle of chest) upon deep breathing and pain located at her lower ribcage.  It came on sudden.  She had gym with no problems, this occured at lunchtime.  Her coloring isn't good.  Went to Dr. - prescribed steriods.  She is not wheezing at all and they said her lungs were clear.  Next day - pain in chest still, Dr.s office said to go to ER for testing.  X-ray done, and bloodwork (they were also looking for bloodclot because she is on BC pills).  They said tests were okay and dx'd pleursy(sp).  Yesterday, to to reg. Dr. and he said he wasn't sure it was pleursy, and he didn't think it was asthma.  He said he didn't know what it was! ... She is not responsind to the steriods - still has pain.  Her peakflow is only reading 200 - in the hosp. they did a peak flow and nebs and it went to 215.  Her oxygen level is good.  What should I do?? I am so worried!  Thank you!!!

[christined570]

thank you for responding.  her oxygen level was in the 95-98 range which is good?  the nebulizer didn't seem to do very much - from 200-215 isn't that great is it?  her normal peak flow range is about 400.  she takes inhaled steriods daily, along with singulair and allergy meds.  she just had her tonsils out in september (chronic infections and very large tonsils).  I am just so worried that this may be a blod clot.  She doesn't have a specialist, because she's been well controlled for years now.  This is something new and scary.  I am waiting for the Dr. to call me right now (he said yesterday he didn't know what was wrong) - Really?  I am going to take her to the ER if I don't hear from him in the next few minutes.  Hopefully we can get some answers.  

[bsmsl]

Does she have an asthma specialist?  Either an allergist or a pulmonologist.  If she doesn't, I would recommend asking for a referral to an allergist ASAP (pulmos are harder to get in with and can take a month or more).  

You didn't mention what her normal peak flows are, but 200 sounds very low.  For most people that is 50% or lower which would mean hospitalization on most action plans.  

What is her oxygen level?  In what way is her color off?

Many asthmatics in a bad flare will not wheeze because there is little to no air movement to produce the wheezing sound.  I was there a few weeks ago.  The PA said there were no breath sounds.  

For now I would suggest that you stay in close contact with the dr and hold him/her accountable to find answers or get you to someone who can.  It sounds like nebs are helping,  so I would continue those are frequently as she needs them.  Does she take inhaled steroids daily?  I was unable to use an MDI when I was sick and had to switch to nebbed pulmacort.  That with the constant albuterol helped a lot.  She may need to switch to a nebbed ICS while she is sick.

Praying for you and her.

[christined570]

Typo - Asthmatic ..