Its a little after 2am. I’m Googling where the nearest emergency room is. My phone gives off a pale light yet the darkness seems nearer, the world beyond hostile. My four year old son lies next to me, his rasping breaths come fast and desperate, and from the depths of his chest comes a single persistent note as if someone is attempting to play an oboe but can only summon a flat bleat. When he coughs it terrifies me: it sounds as though his lungs have turned to liquid.

My son is having as asthma attack.

We’re on holiday. Nothing is familiar. I don’t know where anything is, who I can trust. His rescue pump is not relieving him. This happens when he has a full blown attack. We are all rendered powerless. He sits up, his eyes are wide, his shoulders rise sharply with each attempted breath. I suppress the urge to panic. My child can’t breathe. He can’t breathe.

I am an informed mother, a prepared mother. But asthma doesn’t care, it laughs in the face of my caution, monopolizes on what I cannot control. Germs. Dust. Dog hair that stubbornly lingers in a room months after the animal has vacated. Particles that cannot be seen. Clean is never clean enough. Taken in isolation we stand a chance, but a perfect storm is brewing. It gathers strength in silence while we eat ice cream and laugh in the sun. All the while insidious fingers close slowly around vessels, organs, lives.

By the time I see the first sign it is too late. The first sneezes, a small trickle of clear liquid from one nostril. The vortex is spinning, pulling everything into it. Frantic preventions will be of no use now.

Its not fair. I’ve been diligent, over cautious. I’ve administered my son’s preventative medications regularly. I’ve been good, my son hasn’t missed a day, hasn’t missed a dose. I’ve followed our doctor’s advice. My son washes his hands many times a day, we’ve avoided germs as best we can. Our holiday accommodation is smoke free, pet free, and I asked specifically for the apartment to be aired and vacuumed extra thoroughly to minimize dust.

But clean is never clean enough. There are always things beyond my control. I cannot purge the world of animals, of dust, of people. And so despite my efforts, despite my diligence, I have lost. Asthma has won this round. I’ve let my son down, my four year old boy who is so strong, who never complains, who knows the drill.

We’re in the car. We’re hurtling to the emergency room, husband at the wheel, me in the back with our child, our little trooper who would protest if he had the breath to speak. We have a night of waiting rooms, insurance forms, nebulizers and oxygen ahead of us. But after a few hours of treatment our energetic, happy, hilarious boy will be back, and I’ll promise myself I will never let this happen to him again.

Its a promise I know I can’t keep.

Tips for travelling with an asthmatic child

As a mother of an asthmatic child I’ve visited countless websites looking for answers, tips and tricks to avoid asthma attacks, especially when we travel. Most of them I find to be well meaning but utterly useless against the unpredictability of my son’s asthma. There are just too many variables to control. I know now that I can only do what I can do, take every precaution I can to avoid him succumbing to an attack. If we’re lucky it remains under control.

1. Consult your child’s doctor or specialist before you go on holiday. They may want to tweak your child’s medication slightly. When we road-tripped through France and Spain last summer our doctor instructed us to double dose our son with his everyday preventative pump for three weeks before and three weeks after. He had no problems at all on that trip.
2. Always ensure you have your child’s medications with you and that they are easily accessible. It sounds obvious, but make sure you have enough to last your entire trip. Take extra pumps if any feel like they might be less than half full. On a recent trip to the UK, we used a whole entire pump in a few days as the doctors at the emergency room instructed us to use it as a nebulizer giving ten puffs at a time!
3. Another obvious one but make sure you know ‘off by heart’ which medications to give when. My son has two pumps, an everyday pump and an emergency relief pump. But he also has prednisolon tablets and antihistamine syrup as well as other medication that opens his lungs if necessary. I need to know what to give when, and it can sometimes get complicated.
4. Try to avoid travelling when your child has a cold or respiratory infection. This is such a tricky one! You can’t put your kid in a bubble for a month before you go on holiday, and young kids are little walking petri dishes of germs. All you can do is make sure they wash their hands well, and try to keep them healthy as best you can. My son had had a cold on and off for weeks before our recent trip to the UK. I knew we were tempting an attack to travel with him, but I didn’t want to cancel the big family Christmas we had planned (my family lives all over the world and rarely all come together for Christmas). Yes, we ended up in the emergency room.
5. Know your child’s triggers and try to minimize exposure. Again, this is really hard to do! We always book smoke free, pet free accommodation, but realistically what does that mean? Cat and dog hair can linger in a room for up to six months, despite being vacuumed. So whilst a hotel or airbnb apartment may say they are pet free, it’s still possible that there may still be triggers if an animal has ever been into the room. Besides, dust is EVERYWHERE, you can’t escape it.
6. Know what your plan of action is if you need to take your child to the emergency room. Where is it? Is it open 24 hours? How will you get there? Always have your insurance documents with you. Make sure your phone has international roaming, and take an iPad or some form of entertainment along for your child (and you), nights in the ER can be long!
7. Google what ‘asthma attack’ and ‘nebulizer’ are in the local language. Chances are the doctor will speak English, but you never know.
8. Whilst treatment is pretty standard across countries (Nebulizer, oxygen), be prepared for differences in the system. In South Africa my son was seen immediately, no waiting, and his symptoms were taken very seriously. His oxygen level of 96% was seen as low, and he was admitted to hospital. In the UK over Christmas, we waited for four hours just to be seen, and his oxygen level of 96% was no big deal. A 10 minute nebulizer and we were sent on our way. Our son improved that night but was wheezing by morning again. My point is be prepared to fight for what you think your child needs.
9. Visit websites such as: The Asthma Mom; Kids Health and a simple Google search will provide you with many websites giving advice (but not much comfort).

Do you travel with your asthmatic child? Do you have any tips or stories to share?