My Thirteen Year Old’s Severe Asthma

Patient: My child is 13 years old. He has had asthma all his life. Recently it has gotten worse. He has had 5 ICU stays in 3 months, and has a best peak flow of 250. He is now on advair 500/50, singulair, dulera, albuterol through a nebulizer PRN, and prednisone PRN. He also gets xolair shots. His oxyegn sat has been consistantly below 90%, and his Peak Flow has usually been about 125, wheezing, coughing, etc. He has pretty much been connectedto his neb all day. I don’t know what to do. My doc recommended 24/7 oxygen to bring his 02 sat up, buti don’t know if this is good. What else should I do. By the way I had really severy asthma as a kid, and I still have pretty bad asthma and allergies!

Symptoms: Coughing, wheezing, chest tightness

Doctor: