Friday, August 26, 2005

Asthma? Or just sinuses?

We went to the peds. pulm. yesterday for a checkup, which is, in itself, somewhat miraculous. We've never been able to do one of those because every time I'd schedule one, my son would have an attack and we'd end up having a sick visit instead.

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

Asthma-Vaccination Connection?

Anyone who reads this blog knows how I love to blame anyone and anything within reach for my son's asthma....

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
medication dispensings.

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

Question for you guys -- Breathing better on one side?

Quick question for my loyal consituents: Because of the congestion noted in my last posts, of course I was in the boys' room every few hours last night, checking their resp rates. (Don't even tell me you don't do this!!)

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....

Congested Again -- Seeing Doctor Thurs.

A week after we finished antibiotics for a sinus infection (BOTH boys) they're both congested again. I think I can fairly blame this on my parents who came back from a "jaunt" in Russia with persistent, nasty colds.

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

Annual Checkup

FYI, we had checkups for both boys yesterday -- 4 year for the big one, 15 month for the baby. All is well, fortunately!

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

Cheryl's Pulmicort Question

From the comments gallery:

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

Per Barbara's Comment: On DuoNeb

Thanks to everyone for your comments on the last post. I really appreciate your views and questions!

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, 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 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 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

Another Post on the Singulair Debate

Just FYI -- another Mom chimed in on the Singulair debate mentioned in my last post. "AsiaMommy" is more to the point and less obnoxious than I am, but she seems to be following the same idea.

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

The Great Singulair Debate

Dear readers, you all know what a horrible loudmouth I can be. How awful. How opinionated. It's kind of who I am -- and why I started a blog.

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 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 - A Big Pile of Poop

Did I once, back in May, actually recommend

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, 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

He's 4 today.

Hard to believe I gave birth to that little monkey four years ago. Sometimes it seems like yesterday, sometimes it seems like a decade ago.

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.