Tuesday, December 21, 2004
Monday, December 13, 2004
In conjunction with his new meds, he's now being fed smaller meals more frequently. And, since I'm still nursing, I've had to go on a low-acid diet, complete with (GASP) reduced coffee intake. I was at two cups, maybe three a day max - perfectly within the limits recommended by La Leche League, mind you - but I've cut it down to one small cup a day. Barely enough to satisfy my cravings for my dark aromatic lover, yet still enough to keep the withdrawal migraines at bay.
While the Zantac will take another week or so to kick in, the baby has been vomiting less. He's still coughing a lot at night, though...so, in my eyes, it remains to be seen whether or not this is really Reactive Airway.
But I'll give it the full two weeks. I may be paranoid, but at least I'm patient. Occasionally rational, even.
For $15, I'm going to give it a shot. I'll post the results. And if any of you, my dear readers, have tried this thing, please let me know your thoughts!
According to the article, kids who miss one in four doses of their inhaled steroids are WAYYY more likely to end up in hospital.
And parents who let their kids miss one in four of their inhaled steroid doses deserve every last penny of those hospital bills.
Monday, December 06, 2004
My infant, now nearly 8 months old, has been suffering from something asthma-like for the past month or so. Snurfling through the night, coughing until he vomits, etc.
And while I'm unbelievably concerned for him - his long-term health *and* his comfort - my rant has to focus on this: I haven't had a full-night's sleep in at LEAST six weeks. I feel like utter poo. My sleep sensor is set to "light" since I need to be prepared to race in and rescue the baby the moment he starts couging. So I'm up at least once or twice a night, usually more frequently, for an hour or more.
So while the baby is wonderfully happy, sweet and peaceful throughout the day, I now feel (and look) a little bit like the Grinch Who Stole Christmas.
To the guys I work with: Good luck.
Here's a helpful article straight from the CDC:
It's surprisingly clear and useful.
Monday, November 29, 2004
Sunday, November 28, 2004
A trip to the doctor Saturday morning left us with a prescription for Amoxicillan and the suggestion that it was probably a sinus infection...but it could be Reactive Airway. (Newbies: "Reactive Airway Disease" is the new noncommittal language pediatricians use to tell you your baby or toddler probably has asthma.)
As I've said: Strangely familiar.
After another Exorcist-esque episode and the realization that I had nothing on hand to relieve this violent cough, I paged the pediatrician again (I'm pretty fearless with the paging) to find out what the hell I should do until the Amox kicks in.
And she suggested my old friend, the nebulizer and some Albuterol.~ My turn to pull an Exorcist moment.
The good news/bad news finale to my story? The Albuterol (actually, Xopenex) worked like a dream. Fabulous that it worked so well -- he's a million times better.
And horrible that it worked so well. What we've basically got is a diagnostic test with positive results: the baby probably has asthma.
I'll be seeing my buddy the pulmonologist tomorrow to find out how dramatically I'm jumping to conclusions. But I think it's that mother's intuition. Sometimes we just know.
Wednesday, November 24, 2004
We'll be taking him to an allergist next week to be sure.
Way to start the holidays, right? Ho, ho, *HACK!*
Tuesday, November 23, 2004
(When it comes to coughing, that is. When it comes to numbing pain...I think most women already knew this.)
Monday, November 15, 2004
"Instead of worrying about air pollution, they can focus their efforts on preventing and treating the real wintertime threat to their children's health -- colds and other respiratory infections," Rabinovitch said.
...but the fact is, with pre-schoolers, it's probably easier to protect them from pollution than it is to protect them from colds!
Monday, November 01, 2004
It's so reassuring to know that, not only is it next-to-impossible to know whether or not you have any medication left in the MDI, now you can't even be sure if the stuff's any good!
Wednesday, October 20, 2004
Honestly, I'm glad that big pharma's actually allocated funds to something other than arthritis medications that cause heart attacks; I'm just too tired and cranky to even read the whole article tonight.
Friday, October 15, 2004
And, hey, can someone get me a subscription to Chest magazine for the holidays?
Thursday, October 14, 2004
This health day article focuses on how most families make errors when administering medication via MDIs -- largely (and most seriously) because, as we parents of asthmatics know, there's no accurate way to tell how much is left in the damned canister!!
It's one thing with Flovent -- four puffs a day from a 120-dose MDI is easy enough to estimate. But with Albuterol, which is given only as needed, and for which I have several MDIs.... well, unless I take a razor-pointed Sharpie and make a little checkmark on the case every time I use it, I'll never know how much is left.
I've been using the flotation method (mentioned in above article) to determine whether the MDIs are empty, but apparently that's both inactive AND dangerous. Who knew?
So - my point (and yes, I do have one) is that big pharma should really stop putting up funds for high-tech gas treatments (I mean, what the hell is GERD, anyway? And aren't Gaviscon and Mylanta good enough for most people?) and come up with an MDI that actually tells you that it's empty. That way asthmatics can either stop wasting money by throwing away still-useful MDIs (and for those of you who don't know, Flovent costs about $200/month) or putting themselves at risk by sucking on empty canisters -- and not getting the medication they need.
Wednesday, October 13, 2004
There are a few things I'm not understanding: If asthma risk is greater in kids born July-December than in kids born January-March, how does the risk for kids born March-July measure up?
If the risk is reduced for children who have siblings, why is the risk increased if a sibling is already asthmatic? Is the risk only reduced for multiples or people who *didn't* already have asthma in their families? Wasn't the latter group already at a reduced risk?
The study also puts at higher risk "if their primary-care provider was a pediatrician." Ummm....who should the primary-care provider for my preschoolers be? A pulmonologist?
Seriously, I have *never* gotten a flu vaccine. First off, it wasn't even offered to me until a few years ago. Secondly, when it was, it was understood that the vaccine couldn't and wouldn't cover all strains and mutations of the virus. With so many strains of flu every year, why bother? And won't a vaccine just cause a resiliant virus to mutate further?
Which brings me to why I won't get the vaccine -- or give it to my kids. The number one reason? It's made with thimerosal, a mercury-based binding. (See Wikipedia on this: http://en.wikipedia.org/wiki/Thimerosal) Thimerosal has been linked in some studies the enormous surge in autisim over the past few years.
Another reason, Asthmatic Bryn (who, by the way, can't get the shot because he's allergic to eggs) got the flu last year. And it developed into pneumonia (natch). And guess what? The nasty strain he got would not have been covered by the vaccine.
So, by giving him the shot, I would have put him at risk by taking him unnecessarily to the doctors office where, undoubtedly other sick kids would be running around, and at risk(small risk, granted) for autism. And he would have gotten the flu/pneumonia anyay.
But to my original point, when did the flu become so incredibly dangerous that we all need an annual vaccination? Isn't this just pharmaceutical companies capitalizing on the SARS scare?
Or am I just a paranoid, fanatical lunatic?
Tuesday, October 05, 2004
So, if you're up for a thimerasol fix, better get a move on.
Monday, October 04, 2004
Apparently, we've found the cause of Asthma. And it's got a really funny name.
Anyway, here's the link: http://health.yahoo.com/search/healthnews?lb=s&p=id%3A63466
Meanwhile, Bryn's just (hopefully) recovering from what's essentially been a six-week long attack. Brutal. It started with mild cold symptoms that persisted for about two weeks. Dr. W and assumed this was another sinus infection, so we did another course of Augmentin.
...and no recovery. The slight cough he'd had became a bad cough, and his teachers reported coughing fits after exercise at school. That was new -- we'd never seen exercise-induced asthma before.
The cold symptoms disappeared, but the cough got worse during weeks 4-5, and he was often so short of breath, he couldn't get through a short sentence without 3-4 breaths.
So, we started doing DuoNeb or Combivent every eight hours, alternating with Albuterol. And when that didn't help too much, we started doing it twice as often.
Man! Can I tell you what it's like having a 3-year-old pumped up on Albuterol and Combivent? I should have just handed him a large (Venti, whatever...) Starbucks French Roast. The results probably would have been similar. The poor kid was so wired, he couldn't sit still. His teacher at preschool didn't know what to do with him. I just kept him as busy and active as I could.
Today, he's finally seeming a bit better, so I took him off the Combivent. That stuff's just EVIL. I know it works, but Lord Almighty -- I hope I never have to use it again (but I know I will). And Lord help us all if he's got to be on that and Orapred at the same time. It will be like living with the Tasmanian Devil!
Wednesday, September 08, 2004
Surely corporate just didn't realize what editorial was up to!
Thursday, September 02, 2004
Bryn's now two weeks into a bout of congestion, which probably means another sinus infection, at the very least. Poor guy. Over the last two weeks, we've seen the following symptoms:
- Shortness of breath after activities requiring little effort
- Spells of poor appetite
- Night waking
- Inexplicable crankiness and/or tantrums
- Sporadic, dry coughing
I often wonder how many of these symptoms are in my head, but two weeks of mispronouncing "n" and "m" are indisputable.
So...it's off to the pulmonologist. I'll feel better (or, possibly, terrified) when I see his pulse-ox numbers. Admittedly, I may also feel incredibly foolish (and elated) if she listens to his chest and hears nothing.
Life will be just *that* much easier when he's old enough to use a peak flow meter. For now, I sure wish I could get one of those little pulse-ox finger meters!
Wednesday, September 01, 2004
Check it out: http://www.washingtonpost.com/wp-dyn/articles/A47827-2004Aug30.html?nav=rss_health
I mean, I want Bryn to get better, but I might need some time to support the family, too! (And sleep...)
Thursday, August 26, 2004
But since the winter, he's become a different boy. Suddenly, he can articulate his thoughts and feelings (to some extent, anyway), he's potty-trained, he's just more mature.
So a lot of the signs I associate with his attacks aren't necessarily valid anymore. He may not open and close doors the way he used to. He never did wheeze. He may not even act as cranky as he did with previous attacks. So how will I know when an attack is brewing?
Pat recommends plotting things on a calendar: he was pale today; he coughed three times; he didn't eat; he was cranky. Next day: Ate breakfast; cranky before bed; coughed once.
Not a bad idea. It does all sort of go mish-mashy in my brain after a while. I know he's had mild cold symptoms since last Wednesday, but was he cranky? I remember that he barely ate all weekend, but I can't remember how his cough sounded.
So...plotting it on a calendar seems the way to go. Guess I'll have to start acting a little more "Type A" now.
Tuesday, August 24, 2004
Apparently, there are these breathing exercises you can do that seem to strengthen the lungs and bronchial system. Pretty wild.
I won't be taking Bryn off his steroids in favor of this -- yet! Until he can tell me how he's feeling and/or use a peak flow meter so we can actually see how well he's breathing, we'll probably keep him where he is. After all, he's been doing pretty well on the reduced dosage of Flovent.
Maybe we'll even be able to take him off it next summer. Keep your fingers crossed.
Friday, August 20, 2004
I didn't think I'd see stories like this. I have a million questions: Was she in treatment? Did they try a rescue inhaler? Did she have allergies, as well, or was her asthma triggered by viruses? Or aerosols?
Obviously, it doesn't get worse than this. My heart goes out to that poor girl's family.
Tuesday, August 17, 2004
In truth, no news is good news. If I'm not posting, you can pretty safely assume that asthma issues are the furthest thing from my mind.
Which means there's a healthy, happy three-year-old boy running riot somewhere in New Jersey.
Wednesday, August 04, 2004
A major branch of the study has shown that children with a small difference in their lungs caused by something before or just after birth makes them more susceptible to asthma.
Dr. Martinez has found that children that develop respiratory infections such as bronchialitis and pneumonia at a very young age or before birth started life with lungs that were different, and they are predisposed to develop asthma.
He said that if mothers smoke or the child is born prematurely, they are at a greater risk of developing these infections. Preventing these infections early in life is easier than trying to erase the asthma.
So it WAS the RSV, most likely. In most other kids, it would have just presented as a cold. But for some reason, although he wasn't born prematurely, Bryn was susceptible to bronchial ailments. (He'd had a mishandled bronchiolitis just after his first birthday.)
Right. More research to be done, Mama.
...but we already knew that, didn't we?
Thursday, July 15, 2004
...and here's my thought on this: not only must you have a great relationship with your doctor, you also have to read everything. You can't only trust your doctor - s/he's not going to know everything. Take responsibility for taking care of yourself and/or your child and your treatment.
Monday, July 12, 2004
Gotta hear Allison's comments on this one. (For those of you visiting, Allison is my best friend and a Chiropractor -- therefore, notoriously anti-vaccine. But considering her love for Bryn, her thoughts on the subject will be pretty intriguing!)
My thoughts -- can we test it on something larger than a mouse before hailing it as a cure? (Although the thought of animal testing turns my stomach...)
And: Using a dust mite gene? How does that affect kids like Bryn who developed asthma after two bouts of bronchiolitis? His asthma isn't necessarily dust or allergy related.
Do we need a more comprehensive definition of asthma here?
I know everyone just thinks I'm being horribly negative when I say, "Actually, he probably won't outgrow his asthma..." but see? See? It's true!!!
Our pulmonologist has told me this a thousand times, and even my own husband doesn't believe it. The truth is, when you have a "tricky" respiratory system, it just stays tricky. But treating asthma aggressively within the first few years of diagnosis can really help the resp sys grow healthier over time. Which means that Bryn probably won't be on Flovent forever. By the time he's a teenager, he'll probably just need to carry Albuterol around, "just in case."
So while this headline isn't the best news in the world -- I would rather have seen a headline saying, "Asthma DOES Go Away as Kids Get Older" -- it's nice to have some substantiation for my comments.
Thursday, July 08, 2004
News for today, we're lowering Bryn's Flovent dose to 1 puff of 220, twice a day. That's half his usual dose.
We tried this last month, and he developed a cough within a week. Hopefully, we'll have better luck this time.
I'll post some *real* news tomorrow...
Thursday, July 01, 2004
Sunday, June 27, 2004
...but then it occurs to me that its this new culture of sticking your kids in daycare at 6 weeks of age that's probably to blame. (Yes, I know about the Australian study that showed lower incidence of asthma in daycare kids. But, hello, that's the other side of the freaking planet from here!)
Seriously, babies are meant to be with their mothers (or fathers)for the first few years. I'm a total feminist, but I absolutely believe that's true. They should be home -- not in virtual petrie dishes brimming with bacteria from other kids' snot. That's probably why so many kids are getting RSV (which, most of the time, presents like a cold) and why so many are, consequently, developing asthma.
Think about it -- most of us parents didn't leave home without our folks until age 3 or 4 for nursery school. How many of us have asthma? I knew one kid. That's it. Heck, I hadn't even heard of a nebulizer until my son got RSV.
Okay -- so that's it. I'm crucifying American culture now. It's not the daycare centers. It's US for creating the demand for them.
I'll skip the first few paragraphs, which outline the general background info -- asthma responsible for 14 million missed school days, growing epidemic, yada, yada, yada.
Here's the meat-and-potatoes (or TVP and cous-cous, in my case!):
Dr. Deborah Gentile, an asthma specialist at Allegheny General Hospital, in Pittsburgh, said immunologists are increasingly coming to understand asthma as a genetic disorder -- at least, in its beginnings. "We're thinking that there are different types of asthma driven by different genes."
A child with one parent who has asthma has a 30 percent chance of developing the airway condition herself. If both parents have it, her odds of getting it approach 70 percent -- not a given but a stacked deck.
Gentile said there are three factors that contribute to a person's risk of asthma. The first is the genetic legacy from parents; the second is exposure to infections and irritants that "program" the immune system and make it sensitive. The third is timing: It seems that the immune system is particularly sensitive during the first two years of life, Gentile said, so children with the right combination of genes and the right mix of exposures early in life are at the greatest risk of developing asthma.
skipping irrelevant stuff...."It's important to distinguish exposures that cause asthma versus those that exacerbate existing asthma," Camargo said. "Although these are, at times, the same, there are also factors that worsen existing asthma but are unlikely to cause disease," such as strong odors like perfumes, he said.
And you can find the whole article here: http://www.healthcentral.com/news/NewsFullText.cfm?id=519749
My thoughts: If I'm understanding the research correctly, this reinforces the theory that the bronchiolitis and RSV Bryn had suffered by 18 months probably DID cause his asthma -- in conjunction with his dad's history of severe allergies.
What it doesn't explain in the least is why asthma is reaching epidemic proportions...
Thursday, June 24, 2004
There have been days when I've taken Bryn to his regular pediatrician, she's listened to his chest and back and told me he sounds fine.
The same afternoon, I'll take the boy to his pulmonologist, she'll listen to him, and she'll tell me that he's *not* moving air well, and put him on either Duoneb or Orapred.
She tells me that there are subtleties to pediatric asthma that you have to really be trained to here. I've heard this from respiratory therapists in the Peds ER, too.
So, while I love, love, love our pediatrician, when it comes to Bryn's breathing, I always call the pulmonologist first.
After reading the "Camp Super Lungs" article, I wonder how many people just trust their pediatricians and *never* see a pulmonologist. Case in point: the kids photographed for the article, a brother and sister, are, well, pretty darned overweight. While I know this can happen when you spend a lot of time on steroids, obesity is probably a little bit of a hindrance when you're already having a hard time breathing. I imagine there are plenty of parents out there who are scared to let their kids run around if they're asthmatic -- but you should probably find out if that's one of your kid's triggers before condemning them to life as a couch potato. (I'm NOT saying that's the case with the kids in the photo.)
Another example -- we have friends whose pediatrician put their kid on Flovent, but only when he's having an attack. Now, I could be wrong, but I'm pretty sure inhaled corticosteroids are intended for LONG term use. I mean, do they even work in the short term? Our doc recently said something along the lines of, "a year of Flovent is like 5 days of Orapred." So I can't see that short-term use of Flovent does much good.
...So my thought to all the pediatricians out there: If you think a young patient of yours has asthma, PLEASE -- send them to a pulmonologist! I'm sure most insurance companies would cover a few visits.
The camp is sponsored by Summit Health, and it's intended to teach kids about their asthma. But I mean, if you have serious enough asthma to actually go to camp for it, shouldn't you also have a doctor who educates and supports you and your family?
Wednesday, June 23, 2004
That's the headline for another one of today's stories. "One of the most commonly prescribed medicines to treat America's 16 million asthmatics may actually make asthma worse and contribute to heart problems, two studies find."
When I first read this, I was (as you can imagine) a little upset. But then I read on: "Salpeter and her team reviewed studies conducted from 1966 to 2003 of asthmatics taking beta-agonists. They found that patients who took the drug daily developed a tolerance and had more inflammation in their lungs than those not taking the drug at all, making them more susceptible to a potentially deadly attack."
...which led me to ask, why would any asthmatic take Albuterol every day? Isn't it just for treatment during an attack? That's how it's been prescribed to us.
And then I remembered: Advair. The wonder drug that toddlers cannot take because it doesn't work with a spacer. Advair is a combination of Serevent (fast-acting bronchiodialator) and Flovent (corticosteroid).
So if you're taking Advair every day -- and you would do -- I'm guessing that you may be doing more harm than good? I haven't found any articles specifically implicating Advair, but, hey, this is just today's news.
That might be fodder for tomorrow's post.
But what a drag: my first blog post, and I can't even drag my soap box out for a good lengthy rant.
Nevermind. I'm sure you'll hear plenty from me in the near future.
Here's the story -- and I might add that our pulmonologist could have told us all this:
TUESDAY, June 22 (HealthDayNews) -- Changes in weather may influence rates of asthma and eczema in children, says a study in the journal Occupational and Environmental Medicine.
The study of nearly 670,000 children concluded that season-to-season variations in temperature, humidity, altitude, and latitude all affected asthma and eczema rates.
Researchers at the University of Ulm, Germany, analyzed data collected between 1992 and 1996 from children ages 6-7 and ages 12-13 in more than 50 countries. The study found that, in Western Europe, every 10 percent increase in indoor humidity was associated with a 2.7 percent increase in asthma rates for both age groups.
House dust mites, a major allergen for asthmatics, thrive in moist air. Humidity also encourages the growth of mold, a possible respiratory irritant.
Lower rates of asthma were identified in areas where the average outdoor humidity drops below 50 percent for at least one month a year. Lower rates of asthma were also associated with higher altitude and greater seasonal temperature variations.
Higher rates of eczema were associated with increasing latitude, while lower eczema rates were associated with higher outdoor temperatures.
This link between climate and asthma and eczema suggests that climate change caused by global warming may influence rates of these diseases in the future, the study authors wrote.