Friday, December 30, 2005
Iggy entered the world on December 20, 2005 at 5:52 pm, weighing 6 lb., 7 oz. We didn't know whether to expect a boy baby or a girl baby, and honestly, I didn't have a preference. I just wanted an asthma-free child for a change.
After a mercifully short, natural labor, I was handed my warm little Iggy to snuggle. His first APGARs were pretty good, but a few moments later, it was obvious that our little boy was having some trouble breathing. He was whisked away to the nursery, and shortly thereafter, transferred to the NICU, where he stayed for a full 24 hours.
Apparently, because my labor was so quick, Little Iggy was left with some fluid in his lungs. The relatively small number of contractions were not sufficient to clear it all. He was retracting, flaring and grunting. (And if you're an asthma parent, you'll know what all that means.)
The good news: He was fine within 24 hours. The distress resolved itself, and the doctors assured me that this condition is not necessarily a harbinger of asthma later in life. (The fact that he has two asthmatic brothers, on the other hand, probably is!)
Another less-than-encouraging sign: my latest little monkey already appears to have eczema AND his first allergy: to Pampers!! Guess this will be Huggies baby....
Anyway, welcome, Iggy! We're so happy to have you in our family, and we wish you strength and good health in the New Year (and every year)!
XOPENEX HFA(TM) Metered-Dose Inhaler Now Available by Prescription for Patients with Asthma and Chronic Obstructive Pulmonary Disease (COPD) Symptoms
MARLBOROUGH, Mass.--(BUSINESS WIRE)--Dec. 12, 2005--Sepracor Inc. (Nasdaq: SEPR) today announced that XOPENEX HFA(TM) (levalbuterol tartrate) Inhalation Aerosol, a hydrofluoroalkane (HFA) metered-dose inhaler (MDI), is now available by prescription in pharmacies nationwide. XOPENEX HFA is a short-acting beta-agonist indicated for the treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease. The XOPENEX HFA MDI is a portable, hand-held device consisting of a pressurized canister containing medication and a mouthpiece through which the medicine is inhaled.
Tuesday, December 13, 2005
I don't know what I'm having, but boy or girl, I'm just praying this one is not asthmatic. It would be nice to have a helathy child in this family! Perhaps the third time is a charm.
Here's where it might get interesting in comparing the three. Let's assume it's another boy, for argument's sake. (It probably is.)
With #1 son, I ate beautifully. I'm a vegetarian, and I made sure I got my daily (or nearly-daily) serving of pretty much every color vegetable. I steered clear of simple carbs, with the exception of an occasional trip to Johnny Rockets. (Veggie burger, cheese fries and vanilla milkshake. Yummmmmm....) I went for whole grains. I added wheat germ to my yogurt. I drank whole milk. I also walked every day and did yoga regularly.
I intended to deliver naturally, but the hospital wasn't so supportive. I ended up with a nasty episiotomy and some kind of IV drug. Also, this hospital routinely dispenses the Hep B vaccine to newborns.
With #2, I was unemployed for the last trimester, so stress was a little higher as we actually needed money. We also had our house on the market, which was stressful, too. I didn't eat quite as well, but I was still pretty good. I got lots of rest. The weather wasn't suitable for too much walking, but I did some yoga.
#3 is a different tale altogether. I've been working full-time at the office, eating a ton of processed foods (but still probably eating better than most people!), and exercise? Remind me what that is...? Is that the act of walking up the hill to my car every night?
#2 was delivered naturally by a midwife and avoided all unnecessary interventions and vaccinations. #3 will have the same treatment.
So, what are the odds that #3 will develop asthma, too? If he or she doesn't, I guess we'll know for sure it has nothing to do with Mom's eating habits....
Honestly, let's just pray that s/he doesn't develop asthma. It would be nice to have one child that I don't have to administer corticosteroids to. It would be nice to not have to CRANK the monitor every night so I can listen to the babies breathe.
Sigh. I can dream.
Friday, December 09, 2005
If you have another source, of if you've bought from AchooAllergy -- can you share your experience?
But we beat it. After a full week of treatments, we avoided pneumonia and kicked the RSV. Thank God. He's on Flovent 44 daily now, but he seems to be healthy again.
(Of course, he's got a nose full of yellow snot again as of yesterday, but hopefully it's just a cold.)
On another note....sorry I've been so lame about posting. I'm a little preoccupied with the pregnancy, and I've got a TON of work to do before the baby gets here. This must be the way working women nest...instead of cleaning the house, I'm determined to get all my projects done by 12/15. DETERMINED. If I have to work around the clock until them, I'll get those projects done, damnit!
And there will be NO RSV in my house when that little newborn comes home, so help me...
Wednesday, November 23, 2005
Good thing I did. She listened to him for about two minutes, then promptly ordered a nebulizer treatment, chest X-ray, and tests for RSV and Flu. She said she heard "wheezing in the front and crackling in his back."
Sure enough -- four hours of my prego self dragging the toddler around the massive hospital later -- we got confirmation. He has RSV.
A few hours later, the results of the chest X-ray were back. Apparently, he's had it for a while (so the peds. missed it) because the irritation and inflammation in his lungs is pretty bad.
I don't know why I alwaya question my instincts. I could have called this two weeks ago, before he started the Omnicef. Now I'm really mad that I didn't!!!
Up until yesterday, he was pretty happy during the day, just the spikey fevers at night, along w/rapid, shallow breathing. And the cough, of course.
But last night, the breathing was really bad - and his fever didn't shoot up. Today he's been positively miserable, and -- frighteningly -- not responding well to treatments. He was about 48 resps per minute during his nap, but then he shot up over 50.
I gave him a DuoNeb treatment, and an hour later, he was still at 58. So I did another treatment (per the PP) and gave him his Orapred a few hours early. He dropped into the forties.
Now, less than two hours later, he's well into the 50's again. I'm going to do another treatment, and if he doesn't drop by at least 10 breaths per minute, I'm paging the PP again -- no matter how much of a pain in the ass I appear to be!!
I so don't want this baby to have to deal with being in the hospital -- he's not even 20 months old, and it would be so scary for him. But at the same time, I almost wish they would take him. It's so frightening not knowing what's going on with him. He was at 100% oxygen saturation yesterday, but today -- who knows? I don't own a pulse-oximeter. (Wish I did.) Plus, I'm supposed to be doing nebulizer treatments every three hours around the clock. That's a lot of work. Thank goodness we can sleep in tomorrow (assuming the kids let us).
So...that's the tale so far.
Happy freaking Thanksgiving, right?
Monday, November 21, 2005
Warnings for Asthma Drugs Sought
ReutersSaturday, November 19, 2005; Page A08
U.S. regulators yesterday asked the makers of three popular asthma medications to add warnings to their labels stating that the drugs could increase the chances of severe asthma episodes that could result in death.
The warnings involve long-acting bronchodilator medicines Advair and Serevent, made by GlaxoSmithKline, and Foradil from Novartis AG. Patients use them daily to relax bronchial muscles and prevent asthma attacks.
In a public health advisory issued on its Web site, the Food and Drug Administration said drugs in the class known as long-acting beta 2-adrenergic agonists should only be used after other medicines fail to control asthma.
Read the whole thing...
Ten days after we finished the Zithro, he was full of green and yellow gunk and coughing again. And he had a fever again, too. By this point, I'd already taken him to the Peds. Pulomologist for the first time, and he'd gotten an official diagnosis of "mild" Reactive Airways Disease. (I've still yet to find a real definiton of RAD. If anyone has one, please feel free to post it - or a link to it - in the comments. As much as I love our PP, I take the RAD dx as a diagnostic cop-out.)
Anyway, so when the fever persisted, I gave in and put him on Omnicef, largely because the regular ped. said he also had an ear infection.
Five days after finishing the Omnicef, my poor 19-month-old was packed full of mucus again. He started coughing the next day, and the day after that he was spiking fevers of 104. We went through two nights of that, combined with labored breathing and coughing til he gagged...and took him to the regular ped. today.
She said his lungs sounded "pretty clear" (what the heck does that mean?) and she thinks he has a recurrent sinus infection. She wants him on Biaxin, which is pretty hard core. Besides the fact that it tastes awful, it would undoubtedly leave the kid with diarrhea and a diaper rash. Plus, it's really strong for a baby who's not even two yet. Do I want him on such powerful stuff already, unless I know for sure that he needs it?
I normally wouldn't question my pediatrician - who I really respect - so intensely, except for this: Our peds. pulmonologist doesn't seem to believe that toddlers CAN develop recurrent sinus infections. They're sure it's viral.
I guess we'll see when I take #2 there tomorrow.
I just hope it's not RSV.
Anyway, just wish me luck tonight. I've got six weeks of this pregnancy left, I'm pretty darned exhausted, and that little boy is sure to keep me up half the night....I would just love for him to *get* healthy, and for me to *stay* that way!!!
Wednesday, November 02, 2005
"Mild Asthma Myths" reminds us all that 'The risk of severe asthma exacerbations seems to be unrelated to the symptom severity." So a child diagnosed with mild asthma is no less likely to suffer a SEVERE attack than a child diagnosed with severe, persistent asthma.
It's a wakeup call for me to always keep that MDI and spacer on hand, whether I'm traveling with Persistent Asthma Boy or Mild RAD Boy.
In a somewhat morbid footnote to the article, moms are invited to order a free copy of the booklet, "Mikey's Mom Didn't Know Asthma Could Kill" by calling AANMA. Is it just me, or is that seriously creepy?
I'll be back in "full force" next week!
Learn the rules and your rights at http://breatheatschool.org. And kudos to AANMA on their 20th anniversary and the many, many victories they've won for us all.
Monday, October 24, 2005
She gave us an action plan and recommended daily Pulmicort. I opted to hold off for a bit...I don't think we really need it yet. But we've got RXs for albuterol & Xopenex, and she gave us spacers and neb stuff for now, until the cough clears up. (It's much looser and better now.)
We had a chest Xray, too...but we haven't gotten the results yet. I suspect they're clear - although I wouldn't have said that a few days ago.
I just realized that she didn't take his sats. Wonder why...?
I'm so relieved that we have that diagnosis now. It's comforting to know we can page the PP if he ever has a cough like that again! Just having an action plan is comforting. When you have a sick kid, nothing feels better than knowing you're able to give them the care they need. It's all you want, as a parent.
On the other hand, #1 son was coughing again this morning. Nothing new there...same old junky cough we hear three times in the morning and twice at night.
Only we heard it about 10 times tonight. And he was sniffling today. And he was coughing REALLY hard at bedtime.
I gave him Dimetapp and albuterol before bed, and that seems to have helped.
I only pray that we'll get a break this time....! I don't want him to be sick again. And I don't want to have get up three times a night to neb, either!!
Just to document how this came about, here are some snippets from emails I sent to the asthma parents' list over the last week or two:
From 10/14: Oz is still coughing. Let's just hope they don't decide to share illnesses. As they do share a room, there's little I can do to prevent it, but really -- let's hope!!!
From 10/17: BOTH boys are coughing now, and #1's cough has picked up a little punch. I'm still going with the albuterol 3-4X a day. He didn't cough much (if at all) overnight, but definitely started up again this morning. The fever had broken by Sunday AM, and he hasn't thrown up since Friday.
Oz's cough is getting worse (louder, more frequent, still wet), so I need to check my notes to see when that started. Since I had him at the doctor last Weds., I'm guessing it's been about 10 days since the cough started, maybe longer. Mucus is yellowish now, but it was clear for the first week or so. Could be a sinus infection, but I've never seen one start with a cough. Don't know...
From 10/19: Oz is doing much better with the pinkeye, but he was coughing a LOT last night. I gave him some Dimetapp, which dried the cough up but didn't stop it. Even though he's not officially RAD, the doc said I can give him a neb of Xopenex if he has another night like that.
From 10/20: Had a REALLY bad night with Oz, not #1. Gave him Dimetapp at 8:00pm, but ended up needing two nebs at 11:00 and 4:30 as tight coughing would not stop. Could be bronchiolitis. Have a call into the ped's office (he's not with a PP - yet!) to see about a Zithro RX, or another appt.
From 10/21: Now, about the kids -- Oz is a MESS. He's so much worse today. We were up three times over night. He's responding well to Xopenex, but he's running 101.5 right now. He sounds terrible (need to neb him now, actually) and he's not drinking well. He was coughing his head off overnight when the nebs wore off.
Took him to the ped today, who changed his RX to Zithromax (thank you!) for a sinus infection. She said he may have RAD, but said she didn't hear any wheezing, that his lungs sounded clear. But she said I should call our PP, given his history, and see if she wants to start seeing him.
So I did. And we're going Monday.
Honestly, I think he has RSV, and I'll be amazed if we're not at the ER over the weekend. But I'm a freak, could be wrong. If he doesn't respond to the Zithro and he's still sick on Monday, $100 says that the PP here's something and that his sats are around 95%.
Ugh. Thank goodness he's happy. He sounds so, so awful, it makes me want to cry
Later that night: Ugh. Oz woke up from his nap with 101.5 and sounding SO MUCH WORSE. Sounds really chesty now. I nebbed at 4:00, which helped. By 7:00, as we were finishing dinner, he was coughing til he gagged. Almost paged the peds., but held off.
Nebbed at 8:00, and gave him Dimetapp. Definitely took the edge off the cough. He went right to bed afterwards.
It's 9:30 and he's just starting to cough again. I have a feeling he won't last beyond 11:00, and I'll have to page to make sure he can have his nebs 3 hours apart instead of 4.
I'll be amazed if we get through this weekend without a trip to the ER.
From 10/22: Miraculously, not much coughing overnight and very little this morning. He's definitely not himself, though. Yesterday, when he was coughing his little head off, he was still acting like a happy little toddler. Today, he's much quieter, not eating or drinking. Also more visibly congested.
LATER....Zithro is for a sinus infection, which I'm not convinced he has.
He was doing surprisingly well all day, then we noticed he was breathing really fast at dinner. I was going to neb him, but I noticed he felt really warm. Turns out his fever spiked back up to 102.1, after being 99.5 earlier. Ugh. He fell asleep, and I'm going to check his resps in a little while. (I managed to get some Motrin into him.)
October is sucking, so far.
Saturday, October 22, 2005
Here are a few highlights from this week's issue:
WHO: Bird Flu Human Risk Greatest in Asia...An October 17, 2005 Associated Press report said cases of bird flu can be expected to appear in many countries, but Asia is most at risk. According the the World Health Organization, avian flu has become endemic in some areas of Asia, creating multiple opportunities for a mutation to occur that would result in the virus’ ability to spread among humans. This weekend, tests on birds from Romania indicated that bird flu had arrived in Europe. Two days earlier, cases had been confirmed in Turkey. However, the vast majority of cases, and the greatest risk of viral mutation, remain in Asia. Bird flu has killed more than 60 people in Southeast Asia in the last two years. Most cases have resulted from contact with infected birds, but experts fear a genetic mutation could produce a global pandemic.
For the full article: click here.
Roche may allow others to make Tamiflu...Reuters reported in an October 18, 2005 article that on Tuesday Swiss drug maker Roche said it would consider granting other firms licenses to make the antiviral drug, Tamiflu. The company is under pressure to step up production of Tamiflu as cases of bird flu have appeared in Europe. Tamiflu, known generically as oseltamivir, is the most effective antiviral drug currently available for avian flu and is one of a class of treatments recommended by the World Health Organization (WHO) for use in the event of a flu pandemic. Mike Ryan of WHO said Tamiflu supplies were insufficient if the avian virus were to mutate and spread among humans. Roche said it would consider allowing companies and governments in developing nations to produce the drug in preparation for a bird flu pandemic. Governments are rushing to build stocks of Tamiflu; 40 countries have placed bulk orders with Roche, including Turkey where cases of bird flu were reported last week.
For the full article: click here.
...and there's so much more, just in that issue. To sign up yourself, click here.
Anyway, I was completely freaking out, so I checked his resp rate about a dozen times overnight. But I don't know what the normal resp rate is for an 18-month-old. (Obviously, if he was at 50-60 breaths per minute, I would have rushed him to the ER.) So I sent an email to the other asthma moms....and they didn't exactly know either.
So, in typical "Angry Asthma Mama" fashion, I hit the search engines. Here's what I found, per my email to the moms:
"Tachypnea was defined as a respiratory rate >60 breaths/minute in children 2 >50 breaths/minute in children 2 to 12 months of age, and >40 breaths/minute in children =" border=0>1 year of age."
According to this article, presence of fever raised the rate by 10 breaths per minute. The article's actually pretty interesting if anyone wants to read the whole thing -- it's about using resp. rate to diagnose pneumonia. Here's a link: Tachypnea is a useful predictor of pneumonia in children with acute respiratory infection.
That article led me to this one, which has a fuller age range:
"The World Health Organization's age-specific criteria for tachypnea are the most widely used: a respiratory rate of more than 50 breaths per minute in infants two to 12 months of age; more than 40 breaths per minute in children one to five years of age; and more than 30 breaths per minute in children older than five years. (14)"
And yes, the context was diagnosing pneumonia.
Hope someone else finds this useful!
Friday, October 21, 2005
Well, on the asthma parents list, the topic came up, so I thought I'd delve into a bit in the place where I can be as opinionated as I like. (So glad blogs were invented!) Here's my little rant, followed by some legit info:
The way I see it, it's either asthma, or it's not. Nothing pissed me off more than the doctor at some practice or other who once corrected me when I referred to little B as being asthmatic. "He has Reactive Airways," she said. No, you stupid cow. He has asthma. Any kid who's on Flovent 220 and Singulair year-round, has been on Orapred more than half a dozen times before his third birthday, sees a Pediatric Pulmonologist on a regular basis, and has spent more time in the ER than both his parents put together deserves to be properly diagnosed. Don't use your stupid, namby-pamby, politically and legally safe terms to describe MY kid's asthma.
And while you're at it, give us parents some credit. We're very much in control of our son's health, and I think we know what we're dealing with.
Okay. Off the soapbox..
Here's the stuff I found about "Reactive Airway Dysfunction" (or "Disease," depending on your source):
Background: Not all children who wheeze have asthma. Most children younger than(Hmm...How are they getting peak flow readings from kids under the age of 3??)
3 years who wheeze are not predisposed to asthma. Only 30% of infants who wheeze go on to develop asthma. Reactive airway disease has a large differential diagnosis and must not be confused with asthma.
Clinical factors suggestive of childhood asthma include recurrent wheezing, symptomatic improvement with a bronchodilator, recurrent cough, exclusion of alternative diagnoses, and suggestive peak flow findings...
Here's an interesting paper on RAD and Irritant-induced asthma (IIA) by Thomas H. Milby, MD. Just one interesting snippet:
Once symptoms do become clinically apparent, both RADS and IIA behave clinically
like non-allergic asthma, which, of course is what they are.
Interestingly, this paper mentions nothing about RAD as a "pre-asthma."The author describes it more as a reaction of the respiratory system to an external substance, like a toxic gas or something. And the difference between RADS and IIA is the period of time before the reaction occurs. To me, this sounds like the most appropriate definition of the term "Reactive Airway." Read the article. See what you think. (This article also backs up the definition.)
Hmmm. Hold the phone. These are describing "Reactive Airway Dysfunction Syndrome." Is that different than "Reactive Airway Disease?" Must research. Must learn.
Ugh...I've spent over an hour looking for definitions for both, and I haven't found a THING. I suspect they are different. I'll keep looking and post more tomorrow.
Wednesday, October 19, 2005
She said if #1 son had a bad night tonight that I should call tomorrow and they'll slot him on Friday.
He's not coughing that much, although it sounds bad when he does. Really, just before bed and in the morning, and he is responding to albuterol. He looks better today, too. I'm not anticipating a bad night with him. (Famous last words, right?)
#2 son is doing much better with the pinkeye (I've posted about that, right?), but he was coughing a LOT last night. I gave him some Dimetapp, which dried the cough up but didn't stop it. Even though he's not officially RAD, the doc said I can give him a neb of Xopenex if he has another night like that.
**Confession: I could/should have given it to him last night, but I was so freaking tired that I just didn't. I'm a terrible mother. I PROMISE to do it tonight if he's coughing!
The news from the PP's office has me holding off on Omnicef, anyway, which the pediatrician wrote an RX for the other day, just in case. He'd been coughing for almost 10 days, maybe more, when we went in for the pinkeye on Monday.
I'm also wondering now if I shouldn't have the PP see #2 son. There've been so many times the ped has seen #1 and said his lungs were clear -- then next thing I know the PP has me taking him for a chest X-ray because he's "not moving air." I've learned that peds. asthma is so subtle sometimes, regular peds. who aren't specially trained miss the wheezing or lack or movement.
Of course, I could just be amazingly paranoid. There's always that possibility, right?
Tuesday, October 18, 2005
The baby has conjunctivitis and, possibly, a sinus infection. He's been coughing for 10 days or so. I just wonder if it isn't viral, and that's what #1 son has. I'll give it another day before starting antibiotics.
Ah, the trials of motherhood.
Saturday, October 15, 2005
I thought he just had a stomach virus. He was complaining that his tummy hurt (which can also mean his chest hurts, you never know) and had no interest in eating. He did have half a Dunkin Donuts pumpkin muffin and some soy milk mid-morning, but after napping for a bit, he brought it all back up. (So much for my resting -- I had to clean the sofa and the boy!) But I figured that was it. I just tried to get him to drink small sips of water or Pedialyte for the rest of the day.
This morning, he woke up still looking feverish and puffy. He hadn't thrown up again, but he was still nervous about eating, and he was really lethargic. He napped for a few hours, and then seemed much better.
Except that he was coughing!
It wasn't the typical, tight asthma cough. It was loose and junky, and completely lacking in punch. (I equate his "regular" asthma cough to a snare drum.)
After hearing these messy sounding coughs for much of the morning, I gave him some albuterol this afternoon. I didn't really think it was asthma related, but two puffs of albuterol...better safe than sorry.
Guess what? The coughing stopped.
I don't know if that's good or bad. On the one hand, I'm glad he's not coughing. On the other hand -- that junky cough responded to asthma meds. I can see how any cough might respond to albuterol via nebulizer; that's like standing in a room with a steaming shower. But this was via MDI. Does that automatically mean the cough is asthma- related? Or does any cough respond to albuterol, even administered through a spacer?
I guess we'll see. I'll post an update tomorrow.
BTW -- if I haven't posted as frequently, it's because I've become really involved the Asthma Parents mailing list through Yahoo! groups. I highly recommend this group; they're a great bunch of knowledgeable, supportive women.
Tuesday, September 27, 2005
Have to vent about this -- the Fox news affiliate here just ran the most sensational and downright terrifying ad for a report about the bird flu pandemic scare. It featured lots of children's smiling faces, of course, along with creepy, dramatic music. Oh, and the tagline, "Billions could die -- tens of thousands in New York City alone."
Now, I know that there is a very real risk of a bird flu pandamic, but I also know that the World Health Organization and CDC are on it, antivirals are being stockpiled as funding permits, and an epidemic was already contained in Thailand. Of course, there's still a risk, and it's still horrifying, but I like to think that WHO and CDC are better organized than FEMA.
But really, isn't this scary enough as it is? Why do the cheesey news shows have to go around scaring everyone?
It's more than terrifying to face another flu season with an asthmatic preschooler, a toddler and a baby due in the thick of it all. I want to go down to Fox News in midtown and wring some irresponsible necks for these scary, ridiculous ads!!!!!! It's so infuriating!
Monday, September 26, 2005
Found a few things already:
Gastroesophageal Reflux Disease (GERD)
In some people, the muscle between the esophagus and stomach may allow some back flow of stomach acid into the esophagus. This may cause heartburn, as well as a reflex response that can result in asthma symptoms
It's a start...
Meg points out that there is a connection between Reflux and Asthma, so I'm off to do some research, which, natch, I'll be posting. I do recall the peds. pulmonologist saying something about this last year when I commented that #1 son tended to burp a lot, and she recommended giving him Tums...but I don't remember why, exactly. Was it that reflux triggers asthma, that they're interconnected...?
Hence the quest for research.
Meg and anyone else -- if you have anything, please share!!
Wednesday, September 21, 2005
So who better to help than the Mama????
Her doctor never gave her an action plan (could you strangle the guy?) so I tried to dig up some resources to help her out.
Here's what I found -- good for all of us to have and read.
- FDA on Asthma Action Plans (NOTE: good to quote for next message board argument)
- Sample Asthma Action Plans (Really meant for those old enough to use a PFM)
- Medscape on Action Plans (Medscape is a great resource - even if you do need a dictionary and a copy of Gray's Anatomy to get through most articles.)
I watched him for a few days, and worried a lot.
Then, Monday, I couldn't bear it anymore. I called the doctor at lunch and scheduled an appointment.
And of course, he's fine. He's not wheezing. I'm crazy.
Does anyone else do this? Do we all make ourselves nuts with worry?
Bear in mind, this time last year, this little boy was coughing til he vomited a few times a week. The doctors said it was reflux, but I'm still not convinced. Especially when he was diagnosed with bronchiolitis the same season.
So I may be crazy, but at least I have a reason to be. (Does that even make sense??)
Thursday, September 15, 2005
Little B, who just turned 4, has been going through THE WORST separation anxiety phase over the last few weeks. I mean, hysterically screaming and clinging to my leg every morning when I drop him off. It's been a total nightmare! Each day when I drop him off, I'm scared to death he's going to trigger an attack, because he has had his worst attacks after night terrors. And the hysteria's pretty similar.
Meanwhile, his 17-month-old brother actually toddles down the hall to his classroom practically by himself each morning, and barely says goodbye!
At first I thought this started because he had an attack coming on. Now I'm not sure if there's an underlying school-related problem (his teachers assure me it's not, and he's had no specific complaints) or if it's somehow related to my pregnancy. We did go through something similar with my last pregnancy, when he was two, and he does seem to be going through some weird oedipal phase right now.
I just can't wait till this is over. Or we find out what's REALLY going on.
Thursday, September 01, 2005
Please donate whatever you can to the Red Cross. There are still thousands of people - adults, kids, seniors - stranded in the hardest-hit areas, just waiting to be rescued, to get food and water. If you can do anything to help, please do.
Friday, August 26, 2005
We actually stopped scheduling checkups because it seemed to be a jinx!
So, it was a good sign that we actually made it to a checkup yesterday. He's coughing a little bit, but fortunately, it seems to be more of an upper than lower respiratory issue at the moment.
He does seem to have his second sinus infection of the season, though, which is a bit worrying. We recently finished our non-refillable Nasonex prescription, and I wonder how much that has to do with it. (I did get a new Rx for it.) And he just wrapped up a course of Amoxicillin about 14 days ago.
If the congestion continues for another week (it's been about one week now), she's going to send him for a CT scan. He probably needs it, but I shudder to think what's going to happen if they find something. He's already had his adenoids out, so what would the next thing be? How traumatic, painful and horrible will it be? What more do I need to put this kid through???
I guess for now, I'm just glad the infections haven't triggered asthma attacks as they've done in the past. But are chronic sinus infections -- even if they're not life-threatening-- any better for a four-year-old' s quality of life than chronic asthma?
Wednesday, August 24, 2005
I just found this on BabyCenter, an article exploring the possibility of a connection.
Then I found this article, discounting a connection between the pertussis vaccine and asthma. (Which also led me to this great resource.)
And then I found this article, which says a connection between childhood vaccines and atopic conditions (including asthma) is unlikely -- but doesn't discount it entirely.
Here's one from the Vaccine Education Center at Children's Hospital of Philadelphia. Guess what it says?
By far the most compelling one is here. You need a medical dictionary and possibly an interpreter to get through the whole thing, but here's the executive summary:
Background: A few previous studies have suggested that childhood vaccines, particularly whole cell pertussis vaccine, may increase the risk of asthma. We evaluated the suggested association between childhood vaccinations and risk of asthma.
Methods: Cohort study involving 167 240 children who were enrolled in 4
large health maintenance organizations during 1991 to 1997, with follow-up from
birth until at least 18 months to a maximum of 6 years of age. Vaccinations were
ascertained through computerized immunization tracking systems, and onset of
asthma was identified through computerized data on medical care encounters and
Results: In the study 18 407 children (11.0%) developed asthma, with a
median age at onset of 11 months. The relative risks (95% confidence intervals) of asthma were: 0.92 (0.83 to 1.02) for diphtheria, tetanus and whole cell pertussis vaccine; 1.09 (0.9 to 1.23) for oral polio vaccine; 0.97 (0.91 to 1.04) for measles, mumps and rubella (MMR) vaccine; 1.18 (1.02 to 1.36) for Haemophilus influenzae type b (Hib); and 1.20 (1.13 to 1.27) for hepatitis B vaccine. The Hib result was not consistent across health maintenance organizations. In a subanalysis restricted to children who had at least 2 medical care encounters during their first year, the relative risks decreased to 1.07 (0.71 to 1.60) for Hib and 1.09 (0.88 to 1.34) for hepatitis B vaccine.
Conclusion: There is no association between diphtheria, tetanus and whole cell pertussis vaccine, oral polio vaccine or measles, mumps and rubella vaccine and the risk of asthma. The weak associations for Hib and hepatitis B vaccines seem to be at least partially accounted for by health care utilization or information bias.
Monday, August 22, 2005
I noticed that #1 son was at 24 breaths per minute when sleeping on his right side, but that his rate was significantly increased when he slept on the left.
I'll definitely ask the peds. pulm. about this on Thursday, but I can't help but speculate. Does one lung function better than the other? Is there congestion or are there constricted airways on one side only? Or is it just nasal congestion?
Love to hear from you if you've experienced this or even if you just care to make some moderately educated speculation....
My four-year-old isn't coughing (yet) but was showing off some nasty blood-tinged mucus by the end of the day yesterday. Pretty nasty!!! The baby, on the other hand, is coughing a LOT.
Just to be safe, I started albuterol last night. I also gave him Dimetapp before bed.
We'll see. #1 Son is due for a checkup with the pulmonologist anyway, so I'm taking him Thursday afternoon.
Friday, August 19, 2005
But asthma boy is definitely a little runty! He's 25th percentile all around. It's fine; he's definitely healthy. But I can't help but wonder if it's due to the inhaled steroids.
This is a kid who was literally off the growth charts until just after his first birthday. (He wore a size 24mo outfit to his first birthday party.) Now he's a little peanut.
I can't worry about it too much. I'm sure I've heard his doctor say that once they're off the Flovent (or whatever corticosteroid they're on) they actually "catch up," making up for the growth they may have missed.
It sounds weird, but I'm sure I've heard it. Maybe I'll troll for confirmation data.
Anyway, I'll deal with short. Heck, I'm only 5'2"! I'd rather have him breathing than tall!!!
Tuesday, August 16, 2005
Well, we're going to see our peds allergist next week to see whether we go back
to Pulmicort. I'm bummed -- the Singulair is soooo much easier on all of us.
But I'm wondering if I'm overreacting. Do your kids cough and if so, how
much and how often, on a regular basis? It's probably crazy to think we
could eliminate his cough entirely, but then parenting is pretty much crazy
as it is. Also, tell me about Flovent vs. Pulmicort. How old do you need to
be to use it -- with a MDI and spacer, right? I'm just so tired of strugglng
with a daily nebulizer treatment!!!! Cheryl
From my experience (disclaimer: NOT a doctor, just an asthma mom!): My son coughs occasionally. When he develops a cough, it will start with the occasional evening cough. He'll maybe cough 5 times a day between 6:00PM and 7:30AM. We'll usually start him on albuterol 2-3 times per day, and we're often able to head things off. But not always.
We switched him from Pulmicort to Flovent ages ago, when he ceased to cooperate with the nebulizer. Flovent's the same medication, but used with and MDI and spacer - just as you noted. We started him on it around the time he turned two, maybe even a little before then.
He's been on Flovent 220 most of the time since then, although he's back to 110 right now. We've never experienced any noticeable side effects, but we'd love to get him off the stuff someday. There is a possibility of stunted growth, and he is kinda small... Lots of other parents have found that their children are irritable when on Flovent, same as with Pulmicort.
And working with the MDI/spacer is really easy, once they're used to it. It takes about 15 seconds, and we need to do two puffs, twice daily. Just make sure your doctor gives you a demo in the office, and that you're comfortable doing it by the time you leave.
It has been a miracle, though. His asthma has been remarkably better since we started the stuff. His peds. pulm. is pretty sure it's kept him out of the hospital a bunch of times. In fact, we made it all of last winter without a single pneumonia or trip to the ER.
BTW, Cheryl -- he's on Flovent AND Singulair. And for us, that's really been the "silver bullet."
Everyone else -- please chime in with your thoughts and experiences!!!
Monday, August 15, 2005
Barbara -- regarding your DuoNeb question...
Would any of you reading this know if DUONEB can cause sinus problems??? My
father is in bad shape and his ENT doc is a major a** and dont seem to care
since his insurance ends on 8-25. So he seems to think that the duoneb might
have caused him sinus infection (that drains into his lungs) after he had to use
his nebulizer with a mask. And believe me, he went thru all the possible
traetments and the doctor (not ENT) says he dont know whatelse to do. Any
suggestions?? Would really appreciate it....
I do know that DuoNeb is NASTY stuff. My son needs that and/or its MDI companion, Combivent, when his attacks are bad, but even our peds. pulm. tries to limit the amount he gets. It's never more than every other dose (alternating w/ albuterol) and never more than a 36-hour course.
You can find info on the side effects of DuoNeb here, at Drugs.com, and at DuoNeb's own site. I didn't see anything about sinus infections as a side effect. (I did some quick news searches, too.)Asthma attacks were listed as a side effect though...
You might want to try posting on the asthma boards at About.com and yes, BabyCenter. There are some really knowledgeable folks who know wayyy more than me. Some of them are even medical professionals, which I certainly am not. There's also tons of great info at Breatherville.org and the American Lung Association's site.
Good luck with your Dad. I hope you're able to get the information you need -- and of course, the treatment, to get him well.
(Also, special thanks to Cheryl and littleguysmommy for your advice & support. You guys rule!)
Sunday, August 14, 2005
Thanks to all of you for your comments -- I really appreciate hearing other voices out here!
Not only is it comforting to know that someone's reading all this stuff....but I feel like I'm not so crazy after all!!!
Thursday, August 11, 2005
But you also know how passionate I am about pediatric asthma. The kernel of what I believe on this front is:
- That every asthmatic child should have both a great pediatrican and an even better pediatric pulmonologist; and...
- That every asthmatic child needs an appropriate, adhered-to asthma action plan. Be it albuterol when symptoms occur, inhaled corticosteroids seasonally, whatever. The kids just need action plans, and the parents need to understand them.
So...when I go to the message boards I frequent (usually on About.com and/or BabyCenter) I usually repeat those mantras pretty much ad-nauseum. I get really scared when I see posts by parents who have taken their kids off Pulmicort because of the side effects. I mean, it's fine if you've talked to your peds. pulm. and they're monitoring everything, but you can't just *take your kid off Pulmicort* if they need it! If they need maintenance meds, they need them!!
Okay, so what was my point here. My point was that I've gotten into a somewhat heated debate on BabyCenter with someone who's taken her child off Singulair. In my usual, big-mouthed way, I posted what I knew about Singulair's side effects (not much -- haven't seen anything alarming), and just urged her - and anyone else reading - to get an updated action plan from their doc.
Well, perhaps I should just stick to blogging. I've really annoyed this woman. She may even hate me. (Which sucks. I hate having bad karma out there!) But I do really worry about this stuff. If a child needs maintenance meds, they need them!!! Her child was exhibiting aggressive behavior as a result of the Singulair. It's listed as a secondary side effect, and I can totally see why you'd want to switch meds if your kid went psycho from their asthma meds. But I just wanted to make sure her peds. pulm. was supervising this.
So...okay. I'm venting. But I feel really bad about ticking this woman off so much! We all only want what's best for our kids, natch.
She did say she had some info on long-term effects of Singulair, so I'm interested in seeing those -- and I'll definitely share them if she does.
Anyway, you can view the whole thing here. As always I welcome your comments, especially if you've got something on Singulair.
And if your advice is to stay off the boards and stick to blogging...ugh. Consider me advised!
Tuesday, August 09, 2005
Where was my brain? What was I thinking?? Was it the pregnancy hormone wreaking havoc on my intelligence???
The site is nothing but a bunch of hoo-ha. They're pushing some BS dairy-free diet and some truly risky advice for naive asthmatics. Headlines like, "Asthma is a false disease caused by chronic dehydration and body's drought management efforts, says doctor" are DANGEROUS.
Want REAL advice on asthma? If you're an asthma mom, visit http://www.breatherville.org, the official site of the AANMA and Mothers of Asthmatics.
Ugh. I'm so embarassed that I ever linked to that site in anything that may have appeared to be an endorsement. Apologies!!!
Wednesday, August 03, 2005
I'm so lucky to have that kid. With the problems I'm having with this pregnancy, I'm more aware of that than ever.
But I've always been grateful for this boy. He is so unique, so sweet, so special. Always creative, orginal and eager to please, he's unlike my expectations of a four-year-old boy. He's not the dirty-faced tree-climber I'd expected. My son is affectionate and almost weird with his intelligence and uncanny memory.
This is a boy who can name half a dozen poisonous snakes (and their habitats) without blinking or pausing. I imagine, if pressed, he could tell you if their venom is a neurotoxin or hemotoxin. He can tell you the make and model of 90% percent of the Hot Wheels in his extensive collection, who gave the car to him, when, and under what circumstances. It's quite shocking, the things he remembers.
When I drop him off at daycare in the morning, I give him a quick goodbye before making his brother comfortable in the infant room. And on my way out, at his orders, I must go return to Pre-K to deliver his "kiss, hug and high-5." He's very particular about this.
He never hesitates to say "I love you," and will drop whatever he's doing if I ask him for a hug or kiss. If his baby brother kisses him, he kisses back or just smiles.
The happiest part of my day is when I put him to bed at night. At that point, we sit in bed together and we talk. We talk about the baby in my tummy, what's going on at school the next day, the snake we saw on TV, whatever. But we chat, and it's lovely. And, of course, we snuggle. (I always tell my husband, snuggles with my boys are "my happy place." Nothing could be more gorgeous.)
My son is a very, very special boy. I am truly blessed by having this child in my life.
May his birthday be full of fun and joy, and this next year be blissful and HEALTHY.
Friday, July 22, 2005
A Food and Drug Administration advisory committee unanimously recommended
Wednesday that three asthma medications, one of which is GlaxoSmithKline's
top-selling drug, remain on the market. But the committee urged more research to
determine whether the medications might actually worsen asthma in certain
The FDA had asked the panel to review the safety of Glaxo's
Serevent and blockbuster Advair — a combination product containing Serevent and
a corticosteroid — and Novartis' Foradil, which belongs to the same class of
drugs as Serevent.
Medicaid to pay for asthma drug mistakenly left off list
The children's drug was not included until doctors and parents complained.
TALLAHASSEE -- Florida's Medicaid program will begin paying for an asthma medicine needed by thousands of children, responding to a mistake that had left the drug off a new list of covered medications.Under a new law that took effect this month, the Medicaid program redrew its list of drugs it will pay for, in most cases only putting on the list drugs made by companies that will give the state a bulk discount.
Doctors can get approval to prescribe off the list -- but some have said it can be a cumbersome task and could be dangerous because doctors may first try drugs on the list that may not work on that particular patient.
When the new list was drawn up, an asthma treatment for children called Pulmicort Respules was left off, meaning doctors who wanted to prescribe it would have to get prior approval.
Can you imagine if Pulmicort wasn't covered? I swear, we would have been on welfare if we'd had to pay for that every month!
Monday, July 18, 2005
I'm so happy that reflexology is working so well for your son, but please, please, please - continue to see a pediatric pulmonlogist.
Asthma is a tricky, tricky illness, and not one to be taken lightly.
As the daughter of a pharmacist, I'm particularly cautious about overmedicating my kids. I question every prescription (to the great dismay of my doctors), and they're well aware of the fact that I often will not fill the scripts they give me for antibiotics. Not right away anyway.
But I've learned not to mess around with asthma. Despite the possible negative effects of inhaled corticosteroids and albuterol, I know that these are the drugs that help my little boy breathe.
This child is the absolute love of my life, and I've seen him suffer too much. I've seen him hooked up to a nasal canula with oxygen being pumped into his lungs, and it's something I never, ever want to have to see again.
I'm aware that Flovent and/or Pulimicort could stunt his growth. I know Albuterol makes him cranky and flighty, that Orapred makes him unbearable, as do Combivent and DuoNeb. (But really, I'd rather he be short than struggling to breathe, if it has to be a choice.)
But I also know that Flovent and Pulmicort have kept him out of the ER many, many times. That Albuterol has helped us prevent what could have been a very serious attack. That Orapred has sidetracked hospitalization from pneumonia. And that Combivent and DuoNeb may have actually saved his life.
That said, you can see why I don't mess around. I've had the good fortune to find a pediatric pulmonologist I trust as well as I trust my best friend. She understands my reluctance to increase (and at times, decrease) the drugs on his action plan. She supports my efforts to try non-medical, non-traditional alternatives to medications -- while continuing his prescribed maintenance medications. I respect that she wants my baby to have normal childhood. We have a great relationship.
I hope you find the same. Find a doctor who's open to your desire to ultimately get your son off medication.
But please, please, stay in touch with your doctor and keep your son on his maintenance meds until your doctor advises you that it's okay to change routines.
I don't work for the drug companies -- I'm just speaking from my heart and my experience.
Best of luck to you both.
I'll keep an eye on the congestion, though...Thank goodness I started this blog. Now I know it's only been a little over a week. (Naturally, I never write this stuff down like I'm supposed to.)
But things seem to be pretty well under control, so I won't bother calling the doctors yet. We'll see. If he's still this stuffed up a week from now - or Friday, even - I'll assume it's a sinus infection.
Still, this summer's been good so far. Historically, he gets sick on his birthday (we had to cancel his party two years ago because he had almost 105, Strep, and an asthma attack). We've got two weeks, so I'll stay vigilant!!!!
Monday, July 11, 2005
Friday night, he started coughing again, so I gave him Albuterol before bed.
Same deal Saturday night.
Sunday morning, there was more coughing, accompanied by some LOVELY green mucus. So, more Albuterol, in the morning, at lunchtime, and at bedtime.
He also decided not to eat yesterday. Just wasn't hungry.
I'm going to go out on a limb and say that the kid's coming down with something. And not to say "I told you so," but I did predict this last week.
While it sucks that my son is sick again (although we have had a great summer so far), I do have to admit, it's nice to always be right about one thing.
Tuesday, July 05, 2005
Little B started coughing again just before the holiday. Not a lot, just 2 or three times a day, very early in the morning or around bedtime. It's a little bit "junky" sounding, but not too bad. But it's there. It's a cough.
And over the weekend, he was uncharasterically whiney and clingy. He's usually not an annoying kid, which really, is saying a lot for a preschooler! But really, he's generally an easy going, sweet boy. While he certainly *can* be a little annoying atg times, he usually doesn't get on my nerves the way he did over the past few days.
Now granted. That could be me. I'm wrapping up the first trimester of this surprise pregnancy, and let's just say it's not making the most graceful exit.
So yes, it could have been my dramatically reduced patience, but I think a lot of it was him. Add to that the fact that I found him in bed, under the covers at 11:00 in the morning on Saturday (this from The Boy Who Would Not Nap), and I'd wager that he's not feeling well.
We'll wait and see. We lionnesses have a fair amount of patience (especially in the second trimester).
Thursday, June 16, 2005
Why didn't we have the opportunity to try this sooner???
We don't have any refills, so we'll see if there's a change for the worse when we run out. Then I can call the peds. and beg for more!
Meanhwile, we're doing OK on the Flovent 110. He's still got that "junky" cough at night and in the AM, but overall, he's doing really well.
Keep your fingers crossed!
Friday, June 03, 2005
To my surprise, they said that we're doing everything right, and sometimes he'll have attacks.
Now, call me crazy, but this kid went almost a year without an attack until they lowered his Flovent. And before that, he never had an attack unless he had some other kind of infection or virus.
Now he's had two attacks in two weeks. He's on two additional medications.
I know I'm doing everything right. My question is....are they???
I'm not asking them to necessarily put him back on the higher dose of Flovent, I just want an answer I can trust and believe in. I'm not sure I need the pat on the back anymore. I just want reassurance that my son's asthma is under control.
Right now, I don't think it is. And I'm half expecting him to have another attack within the next few weeks.
Tuesday, May 31, 2005
I kept him on the Combivent/DuoNeb through Sunday, and gave him a dose Monday AM, but he's back on Albuterol only now.
Funny story: He was coughing at breakfast this morning, and he looked at me and said, "Mom, I need Al-bu-ter-ol." He's not even four yet. Is that cute -- or just terribly sad??
Anyway, we'll see how long we can go before the next attack. Clearly, I'm not optimistic. We'll see how fast his regular doc puts him back on Flovent 220. She's back from maternity leave in 2 weeks.
Meanwhile, the baby's running 103. Some holiday weekend.
Saturday, May 28, 2005
His dad tried his best to take care of things - and did a surprisingly adequate job, I have to say. First he tried Albuterol, and when that failed, he whipped out the neb and hooked the little guy up with some DuoNeb.
When that barely changed things, I paged the doctor.
I kinda expected him to tell me to get some Robitussin DM. But no...he prescribed the most hard-core regiment of meds I think we've ever heard of -
- DuoNeb every half-hour - three times.
- Flovent back up to 220 for several days.
- If he's too hyper from the DuoNeb to deal with, hit him with some Dimetapp. (Or take some myself!)
- Also called in some Orapred to the pharmacy, just in case.
This'll be a fun holiday weekend....
More later. Gotta start another neb treatment.
Thursday, May 26, 2005
Then, all of a sudden, this morning he let out a brief coughing spell that ended in a gag. Yikes! A few nasty-sounding coughs later, I grabbed the Albuterol.
I called the Respiratory Center this morning and spoke to the nurse practitioner. She said we should probably extend the antibiotics for another week and a half (she's right - we've typically done three weeks for sinus infections in the past) and start doing Combivent/DuoNeb again. (Oh, joy!)
But, she warned, this may not be an attack. There's some kind of viral "syndrome" out there causing kids to cough uncontrollably for up to 5 days. Every asthma mom's dream! She said they're even allowing the kids to take a cough supressant - usually a BIG asthma no-no - for this particular ailment.
Even worse, they're seeing a lot of walking pneumonia this week.
Add to that the fact that the weather here in the Northeast SUCKS this week - loads of pollen and mold in unseasonably cold temperatures - and it really could be anything.
So...bottom line: We're watching and waiting, MDI in hand.
Wednesday, May 18, 2005
Tuesday, May 17, 2005
I don't know why -- they never hear anything, even when he has pneumonia! I love our peds, but with the kid's tiny little bronchioles, it seems to take well-trained peds. pulmonologist to determine how serious the attacks are.
It's stupid, but since our regular (wonderful and stunningly fabulous) pulmonologist is on maternity leave, I feel like I'm bothering the other doctors when I call.
It's the height of parental stupidty, I know. But I think we all do it. Every parent, facing the "great unknown" of children's health, feels vulnerable and intimidated when calling doctors. We're paranoid, they're innundated with the time-consuming calls of hypochondriac moms. They're brusque; we feel foolish, hypersensitive and ever-so-slightly abused. I don't blame the doctors and nurses - although I probably should. They should try to be a little more understanding.
I don't page my physicians very often; I'm not an alarmist. But I'm so often dismissed by the doctors at the respiratory group who don't know me well. They're all wonderful doctors, and I trust all of them. But they don't know me, and they don't know my son.
And that's why I went to the pediatrician first. I knew I wouldn't get exactly the care I needed, but I knew I'd be listened to, that every symptom would be taken into account, and everything treated. And if they felt the asthma was a serious factor, they'd *send* us to the respiratory group.
I was right. They checked for Fifth Disease. They checked his throat, ears, nose. They listened to his chest. They listened to the account of last night's events and a brief history of life after adenoidectomy.
Then they prescribed antibiotics for the sinus infection and nasal steroids for the *chronic nature* of the sinus infection.
THEN I went home and called the respiratory group.
Surprisingly, they weren't even remotely dismissive. In fact, they were far more aggressive than I could have predicted.
For those of you who have experience with this stuff, we're bypassing Albuterol altogether. We're doing Duoneb or Combivent every four. As a trusted asthma parent, I've got permission to do three doses two hours apart (enough medicine to give an elephant a coronary, quite frankly) if necessary.
We're doin' saline spray 10 minutes prior to the Nasonex, and we're definitely not lowering the Flovent this month.
This'll be fun. Nothing like have your preschooler on a rigid schedule of inhaled speed, after all.
Even better, he has to stay home because there's no way in HECK I'm trusting his daycare to administer meds on schedule, much less identify an asthma attack.
Cool. A preschooler. At home. On speed. While I'm trying to work.
Hey, let's just put him on Orapred too, while we're at it.
Last night: We've been letting B stay up til 9 since daylight savings time started, since he doesn't like to go to bed while it's light out. I should have put him to bed earlier yesterday, since he seemed a bit overtired and "snakey" - but I didn't.
When I told him it was bed time, he got all teary and said, "But my tummy hurts!" I asked him to show me where it hurt.
He pointed to his chest.
So, one Singulair, one puff of Flovent, two puffs of Albuterol, a teaspoon of Dimetapp and two sniffs of saline later, he's off to bed.
Not an hour later, I hear whimpering, so I head upstairs. B's crying. I went to give him a hug and realized he was still sleeping.
Uh-oh again. It's a night terror. God, I hate these things.
And it's a bad one. He's hysterical, screaming and sobbing like an infant. Dad has to take the baby downstairs because he's starting to freak out (that's Dad AND the baby).
Problem is, he's crying and screaming so hard, he's triggered an asthma attack. He's coughing til he gags, and by the time it's all over, he's got petechiae all over his face.
I page the pediatrician, natch, and she tells me to bring him in in the morning -- and to give him another shot of albuterol.
So, I head upstairs, MDI/spacer in hand, and give him another dose. Which arouses him and starts off another night terror. Yea.
When it's all over, he's calms down and goes back to sleep, but he spends the night breathing at 40 resps/minute, and he's moaning a lot in his sleep.
I can't complain too much -- he hasn't had an attack in AGES. We've had a great winter. But I hardly slept last night because I was so worried.
And I can't help but wonder if lowering his Flovent was a baaaaaad move.
Monday, May 16, 2005
As a marketer and parent, I have a very strong opinion on this, and here it is: As a parent, I am responsible for what my small children see, experience and eat. If you're a parent, you are, too.
Don't go blaming McDonald's for your child's obesity. It's your fault, not theirs. If you're child is eating too much fattening, unhealthy foods which lead to obesity and/or asthma flareups, I fail to see how it's McDonald's fault.
Feed your child wholesome, healthy foods. Don't let your toddler or preschooler watch television with commercials or inappropriate characters. If you choose to let them watch things like Nick or Disney Channel, make sure they know what they're watching. Supervise. Explain why they can't have everything in the commercials and why they can't have milkshakes for dinner.
It's called parenting folks. Our moms and dads did it -- we can to.
You know can't do it? Your TV. And corporate America.
(soapbox down, angryasthmamama quiet.)
Thursday, May 12, 2005
Steroid use for asthma no more effective than placebo, study finds (So be sure to switch your child to sugar-based inhalers to test for yourself.)
Toxic chemicals in the home cause asthma in children, says study (So make sure you use vinegar and lemon oil only to clean and disenfect your home..._
Asthma inhalers actually worsen asthma; cow's milk and chronic dehyration are the root cause (And we're back to the sugar inhalers.)
But one happy story:
Damn -- this site's a GOLDMINE!
"Asthma is a false disease caused by chronic dehydration and body's drought management efforts, says doctor"
Now, children, there are 17 million children in America, probably more because the numbers rise every year, who have asthma, and the reason is, at the same time, children have been consuming more and more sodas. Three year olds to five year olds have been consuming three times as much soda in the last ten years than in the ten years before that. So these people are getting dehydrated, they are consuming more sodas, which doesn't function in the same way as water, and that is why they get asthma. Now, give these children water, and their asthma will disappear very quickly, in a matter of a few hours, completely the breathing becomes normal. The need for these inhalers will disappear.
Sure. That's it. Replace the Coca-Cola with water and your kids will be fine. And sorry, my kid was diagnosed at 18 months. He'd never even HAD soda -- and still gets it pretty darned rarely.
And just to get you a little more ticked off, here's how the article opens:
Mike: I'd like you to elaborate a little more on asthma, and the idea that the body is managing its water supply deliberately in a way that produces symptoms that are called asthma.
Dr. B: Yes, well you see, drought management means that you have to clog the holes where water is lost from the body. Water is the most precious commodity in the interior of your body, and when not enough is coming in and more is being lost, this is a no-no situation for your body. The intelligence behind the design of the body has it such that a drought management program will kick in, and then allergies are a sign of dehydration because the system that regulates water balance of the body suppresses the immune system, because it's an energy-consuming situation. Then you get asthma.
Interest (or bile) piqued? Read the whole thing. It's positively baffling.
Monday, May 09, 2005
A peds ER doctor had diagnosed her child - who had collapsed and turned pale and blue with O2 level of 89 - with severe asthma. The pediatrician had "corrected" the diagnosis and called it Stridor.
Now, I've been an "Asthma Mom" for two years now, and I have never heard of "Stridor."
So, being the research geek I am, I Googled it. Here's the best info I found:
Stridor is the audible symptom produced by the rapid, turbulent flow of air
through a narrowed segment of the respiratory tract, more specifically, the
large airways. It is often the most prominent symptom of airway obstruction
in the pediatric patient. Proper management is possible only after a precise
diagnosis has been established.
Stridor is a symptom and not a diagnosis. It cannot be managed appropriately on
the basis of a presumptive or inferential diagnosis.
Stridor is most often inspiratory. It typically originates from the
larynx, upper trachea, or hypopharynx. The term stertor has been
used to describe the low-pitched inspiratory snoring sound typically
produced by nasal or nasopharyngeal obstruction.
So, basically, stridor is pretty much the sound your wheezing child makes on the inhale. It is *not* a diagnosis. And it seems to occur most often during a case of croup, as far as I can tell.
I have to think that the asthma mom on the babycenter board misunderstood her doctor. Either that, or the guy got his med school degree from IDG ("Pediatrics for Dummies?")
But either way, I hope she takes my advice and finds a peds. pulmonologist!
Friday, May 06, 2005
He was diagnosed with eczema yesterday and put on a steriodal cream. Ah yes, his first (topical) taste of corticosteroids.
It wouldn't be so bad if (1) it had started BEFORE I put him on regular mild; (2) he hadn't had those many, many incidents of coughing til he turned purple and gagged and (3) he hadn't already had bronchiolitis.
Let's tie that in with the fact that (oh, yeah) his big brother's asthmatic.
But really, I'm trying to be optimistic. Really. I am. Seriously.
Thank GOD they're really good kids, right?
Things are looking so good, the doctor is talking about lowering him to Flovent 44 for the summer. Considering we were on 440mg this time last year, it's really almost too good to be true.
His regular pediatrician says this is because we treated the asthma so aggressively in the early days.
So I guess all that Orapred has paid off. It's nice to know I didn't spend all the days with a near-psychotic toddler for nothing.
Thursday, April 14, 2005
I read about these in Taunton's Inspired House recently. If I had a lot of money and lived in Arizona or New Mexico, I would totally do this for my kids.
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>> Read more about Econests
Thursday, March 31, 2005
On 3/22, we took Bryn to another pulmonologist (at the same practice). His lungs were clear, so the doctor lowered his Flovent from 220 to 110.
This past Monday (three days ago), Bryn woke up for school and begged me to keep him home. That's so unlike him. He loves school. He never wants to stay home.
That night, when I went to run an errand, he threw himself at me and begged me not to go. Again, totally unlike him.
Was it the Flovent reduction?
Besides that, he continues to wake up with blood-streaked mucus clogging up his little nose. He really hasn't had a clear day since the adenoid surgery. His face looks kinda puffy, too.
So...is this pleasant new mood related to what appears to be yet another sinus infection, or is it the Flovent reduction?
Being the mother of an asthmatic preschooler is so cool! (not)
Monday, March 21, 2005
Child Asthma Rates Quadruple
(12/1/04) Asthma rates among children have quadrupled since the 1970s,
according to a major new survey.
More than 2,700 children from schools across south Wales were involved in
the 30-year research project carried out by experts at Cardiff University.
The findings are being published at a meeting of the British Thoracic
Society (BTS) in London on Wednesday.
Dr Michael Burr, who led the survey, said more than 1.4m children across the UK suffered from asthma.
The first study, which was carried out in 1973, diagnosed asthma in 5.5% of the children.
Read the whole article.
And then there was this one:
Wales 'has highest asthma rate'
Asthma causes almost 30% more hospital cases in Wales than anywhere else in
the UK, a new report claims.
Asthma UK Cymru said one in 10 children and one in 12 adults in Wales are being treated for a condition - one of the highest rates in the world.
Hmmmm. Bad genes? Or just coincidence?
SUNDAY, March 20 (HealthDay News) -- Adding the drug Xolair to an asthma
patient's medication regimen helps cut emergency medical visits, new research
The research, a pooled analysis of seven prior studies, was
presented Sunday at the annual meeting of the American Academy of Allergy,
Asthma and Immunology in San Antonio.
The fact that the pool analysis
contained more than 4,300 patients, about half of whom were on Xolair, does give
these conclusions more credibility than any single study, said study co-author
Dr. Phillip Korenblat, a professor of clinical medicine at Washington University
School of Medicine in St. Louis.
Let's, of course, keep in mind that the study was conducted by Novartis.
A few more tidbits on the drug:
- It's a once-monthly injection (and the doctor'd better do, cos I won't!!)
- Xolair (generic name omalizumab) is a monoclonal antibody that heads off allergy-triggered asthma
- "Individuals who used Xolair on top of their usual treatment had a 47 percent reduction in total emergency visits. That meant a 52 percent reduction in hospital admission, a 61 percent reduction in trips to the emergency room and a 47 percent reduction in unscheduled doctor visits"
Thursday, March 17, 2005
First off, here's the article from the LA Times.
Now, here's the connection. Throughout this blog, I've ranted time and time again about pharmaceutical companies -- how they encourage unnecessary vaccines, etc. It may not seem like a bad thing that they're incouraging vaccinations for things like chicken pox and the flu, but in fact, it may be. Read on.
While this study (funnily enough) doesn't specifiy it, skeptics like me have been questioning the link between autism -- and other disorders (like asthma) -- and vaccines. Both asthma and autism have reached epidemic proportions over the last generation or so, and many blame the last version of the MMR vaccine, which contained a mercury binding called thimerosal. (Thimerasol also binds the flu vaccine)
Since the speculation began, pharmaceutical companies have denied any connection. Which, to me, seems ridiculous. If you're injecting your baby with a known neurotoxin like mercury -- I don't care how small the amount is -- bad things are bound to happen.
Finally, this new study, which links the two. They do chicken out a bit, citing mercury in the air and water, and funnily not in injected vaccines. But at last, a connection. In writing.
And according to the article, autism rates over the last 20 years have jumped from 1 in 2000 to as high as 1 in every 166 children. Terrifying.
I'd love to see where asthma rates are today. And a study brave enough to reveal what's really causing the epidemic. (Vaccines? Latex paint? SUVs?)
Monday, March 14, 2005
On Saturday night, I paged the pulmonologist because Bryn was breathing really badly when he went to bed. It was odd, because he was so happy and totally fine before then. ( Okay, he coughed a few times and was a bit congested, but that's it.)
When I gave him his Flovent before bed, I thought I heard something funny, so I asked him to take a deep breath for me. When he did, I was surprised to hear an audible whistle. My husband is *sure* this was due to nasal congestion, but I'm almost positive he was breathing through his mouth.
Anyway, I gave him some albuterol.
When he fell asleep, he breathing was very noisy and he was retracting like mad. I gave him another shot of albuterol less than an hour after the first, which our doc has told me to do if he's unresponsive.
It didn't help, so I paged.
I got the oldest doc in the practice, who asked a battery of questions. He then told me that what I was seeing may be a result of continued swelling from the adenoid removal, but that he was probably suffering from sleep apnea, and that I should consider a sleep study.
(We did a sleep study last year. It sucked harder than anything I've known as a parent.)
But he may have hit on something. The night after the surgery, Bryn had a night terror. He used to get those a lot, but this was the first in well over a year. It was also the most intense, lasting at least 10 minutes.
Funnily, my mother-in-law was convinced it happened because we'd let him watch Shark Tale, which she instead was too scary and too intense for him. And while I'm not a huge fan of the film and won't let him watch it again anytime soon, I know that night terrors aren't caused by external stimuli.
I figured it was from the anesthesia, possible combined with albuterol. But I guess I was wrong too.
Either way, looks like we may have something new and exciting on our hands. Better hit the books (and the Web) again.
Thursday, March 10, 2005
I just heard this on the WB 11 News at 10 and I feel like crying. The FDA even says the products should *not* be used on babies at all!
Here's the Reuters Report.
Y'know...you try to do what's best...
Tuesday, March 08, 2005
Do sane moms do this, or is it just me?
Honestly, he seems well. He's congested and coughing a bit, but he's happy and eating well. I'm probably making myself crazy for nothing.
Sunday, March 06, 2005
I brought him to the pediatrician (for the second Sunday in a row) because he had a rash. And while he seemed fine and happy, the doc was surprised to hear a wheeze when she listened to his chest. She'd recognized the rash immediately as viral, but she was as shocked as I was to find that he had bronchiolitis.
He's on Albuterol exery 4-6 hours (you can imagine how he loves the nebulizer), and he seems to be okay...but of course I'm checking on him every 45 minutes to make sure he's breathing normally.
Hopefully, it won't get any worse this. He's already high-risk for asthma; I'd rather not have another RSV situation like we had with his older brother.
While I'm sure I could take care of another asthmatic baby...I'd really rather not. One healthy kid would be nice.
My friend, the wise wife of a rabbi, once told me that I shouldn't ask why I was given a little boy who was so sick. She said I should look at it differently. It's a blessing, she said, that God gave us the tools, patience and love to care for a child as special as ours. Imagine if, with all his health problems, he'd been delivered to another family -- one without the caring and (frankly) the insurance coverage to look after him.
She's right, of course, and it is helpful to look at that way. We have wonderful, beautiful, and very special sons. And we'll do absolutely anything we have to to make sure they stay happy and healthy.
Thursday, March 03, 2005
But to the point: Bryn's doing really well. He can barely move his neck, but he hasn't complained at all. He hasn't developed a major post-op asthma attack or hemorrhaged as I feared (I'm totally paranoid - I admit it) and I still have a full bottle Tylenol with codeine. He's said once that his mouth hurts, and he cried once because he hit his head, which apparently hurts more than it would if he hadn't had the surgery.
But he's coughing like mad and he's *still* breathing through his mouth, so we'll see... I'm just not convinced this was the best (or the only) option.
The real kicker...when we got home from the hospital with Bryn, the baby was running 102. Turns out he had strep...and so did I. We both went on Amoxicillan (so all three of us were on it) and while I got better, his fever continued for days.
Turns out, he's allergic to Amoxicillan. Does this bode well?
Monday, February 21, 2005
Bryn and I have talked about it, and he seems to understand. ("My add-en-oids are making me sick. The doctor's going to take them out. I won't go to school, but I can watch Thomas videos all day.") He's such a good boy...I hope this doesn't suck too much for him.
I'm nervous as hell. I'm glad we opted to go to the children's hospital, where they have a pediatric anesthesiologist on full-time. We could have donet his outpatient, and a lot closer to home, but we would have been taking a gamble with the anesthesiologist. And, as my dad astutely pointed out, anyone can take out adenoids. It's the anesthesia that's tricky. And, might I add, especially when you're dealing with an asthmatic preschooler.
Really, what's worst for me is the idea of watching him go under. I did this last year, when he had a optical surgery. I walked him to the OR and held his hand as he went under. To see him walk down the hallway in that blue gown (which was too big for him) looking so much like a little angel, and then to watch him so agreeably put on the mask for the anesthesia (this is, after all a kid who's been on nebulizer treatments for two years) then lie there so frighteningly lifeless on the table -- well, it was the most terrifying thing I've ever seen.
The "AngryAsthmaMama" is usually pretty good about handling the illnesses of her children. After all, like all parents, I do what I have to do, particularly when it comes to my kids' health. But that moment in the OR was haunting and terrible. I completely lost it. As I left the OR, leaving Bryn in the hands of relative strangers bearing scalpels, I positively crumbled. I felt so frightened and helpless. I wanted to rip him off the table and take him home.
This is the scariest part for me. Usually, I take the advice of my doctors - about 85% of it - and administer treatments myself. I call for backup when I need it; I offer all the hugs and kisses and positive reinforcement I have to in order keep my kid as healthy and wonderful as he is.
But in the OR, I leave Bryn (and myself) prone and vulnerable and in the hands of a doctor I suddenly don't know enough about. It's not a control thing - it's a protection thing. I want to be there, not running the surgery, but holding my son's hand throughout his ordeal.
God, I just love that little boy more than words can ever express.
Say a little prayer; pray that everything goes well tomorrow.