To my musical, eccentric, gorgeous boy,
You turned six today. You will never know the joy it gives me to see you thriving; at school, with friends, and at play (you know how you love the water). It wasn’t always this way my darling. When you were little, you were sick so often. At times it seemed like asthma had taken over our lives. I remember curling up with you in your hospital cot, I was heavily pregnant with your brother at the time and there was nowhere else for me to sleep in the hospital room. The next time you were admitted Dad was away, working with the Flying Doctors and I had to pay someone to hold your newborn brother in their arms while I tried to contain you, hyperactive from all the reliever medicine you required. Being a doctor, I was initially passive, not wanting to step on toes and so let the hospital staff do their job without interrupting. I learnt though that I had to be stern with triage nurses and junior doctors who all too easily dismissed the severity of your illness because your medication high had you bouncing off the walls. Firmly I would point out the warning signs – the muscles between your ribs that were receding and that you were breathing ever so fast. I would insist they measure your oxygen saturation, and when they did, they would hastily cross out their provisional diagnosis of “upper respiratory infection”, change your low triage category to a high one and transfer you to a resuscitation bay in the emergency department.
You were taking oral steroids at least once a month back then. I have learnt to warn parents that kids on oral steroids can become aggressive – nobody ever told me that in medical school. Your reliever also suppresses your appetite which caused me no end of stress as you already had failure to thrive, and were undersized. It was normal for me to go three nights in a row with no sleep, listening to your noisy breathing, checking on you, being so scared.
What a profound blessing that your health has improved since then. One reason for this is that you are older now and growing out of the worst of your asthma. The real improvement though has come as a result of your preventer medicines – the tablet you take every night – you still call it your “tabby”, like you did when you were little. The preventer puffer you take at night has also helped. I don’t know how may hospital visits these medicines have prevented.
I am so proud of you dear, that you remember to check that your reliever and spacer are in your school bag, and that when you have asthma you take your reliever now without a fight. Your school has a copy of your asthma plan, and I know you will tell your teacher if you are getting wheezy.
We have travelled the world with you. Everywhere we go, whether it is away for just a weekend or all the way to China, your asthma medicines go with us. Your spacer, reliever and preventer puffer go in my hand luggage, and we take your nebulizer (your bubbles machine) too, just in case things get really bad.
I hope that you out-grow your asthma completely but I suspect it will stay with you, at least a bit for the rest of your life. I am still the boss of you, for now and will keep caring for you with you asthma, helping you prevent exacerbations and managing them when they come along. You are growing up though, and there will come a time eventually when you have to take responsibility for your own health. You will need to remember to see your doctor every three to six months, for a check up of your asthma symptoms – even when you are feeling well. When the time comes, and I am not there to nag, do remember to take your preventer medication every day, and always have a relieving inhaler on hand, just in case. I know as a young man it will be low on your priority list, but remember to vacuum under your bed because dust makes your asthma worse. I know you hate needles but it is a good idea to be vaccinated against the flu every year. And please, please, please my darling, never smoke. There so many reasons why smoking is a bad idea, but with your history of severe asthma, I am truly scared of what may happen if you take it up.
I have to go now sweetheart, to prepare your birthday tea. Your mind will be full, when you come home from school with pirates and football and I’m sure you will be nagging, wanting to watch a movie tonight. I think I will put this letter away and give it to you in a few years.
All my love,
Mum xo
This post is an entry in the 2014 National Asthma Council Australia Asthma and Allergy media Awards.
About the author: Danielle Esler is a medical doctor and mother to three young children. Her eldest child has had severe asthma that is currently well controlled with preventive medications.
If you believe your child may have asthma, or their asthma symptoms are not under control take them to visit your GP. You can read more about asthma on the National Asthma Council Australia website.
So beautifully written-brought a tear to my eye.
Kristina, I got a little teary myself writing it…
This is beautifully written. As parents we all worry about our kids so much, and it’s hard, as they grow up to balance the letting go and independence especially when it’s to do with their health. My son has food allergies and is usually okay with us (we are very careful obviously) but often gets ill and is easily exhausted. I have learnt (am learning) that he still needs his freedom, but it can be hard. With love to you both and happy birthday to your son!
Happy sixth! A very sweet post. Sounds like some scary times in the past.
Thanks. Yes, scary in the past but much better now thankfully.
This is so lovely and so sad at the same time. My sisters both have asthma and it was particularly bad when they were babies and I’ve seen them growing up experiencing attacks and taking lots of different medication and I always wondered if they were going to be ok, it must be horrible as a mother!
I didn’t know about children potentially being aggressive with the medication, but I did wonder if you’d found that the medication had in any way affected your son’s teeth? I believe my sisters experienced some problems.
Lovingly written, I hope all is well now. Happy sixth birthday to your little one!
Bx
Thank you. Fortunately as my little guys lungs get bigger he is doing better and better. I have never heard about the common asthma meds ventolin, or inhaled steroids causing teeth problems though.