Sunday, July 16, 2006

How to Tell the Difference Between a Cold and an Asthma Attack in a Toddler

I've been thinking a lot about this lately. I sometimes feel like I take my kids to the pediatrician or the pulmonologist too often -- like every time they have a cold. I always ask myself, am I overreacting? Am I one of those parents doctors loathe?

My kids don't wheeze audibly, so it can be hard to tell when their asthma's acting up. B's getting older, so he can tell me - but Oz can be a little mysterious.

Then it occured to me: I've never had a non-asthmatic toddler! I've rarely (if ever) had a preschooler who *just* had a cold.

So, based on conversations with friends and my own observations, here is how you can tell your kid may be having an asthma attack (or "flare," if you're using the new, non-violent lingo). As always, CALL YOUR DOCTOR if you suspect your child's asthma is acting up:

1. Regular kids with colds usually act like normal kids; they just have runny noses and coughs. If your toddler has a cold, is crying constantly (or like mine, begging to be carried everywhere), whining like mad, and /or not eating, it may be more than a regular cold. (Of course, it could also just be a sore throat or ear infection - make sure your doctor checks for those, too.)

2. Your child has a dry, hacking cough that disappears as quickly as it appeared.

With Oz's recent flare, he was miserable for 48 hours. His cough came on suddenly, but after two days of alternating DuoNeb and Xopenex, it literally dissipated (along with his whining) over the space of a few hours.

3. Finally, your child has a cough that responds miraculously to albuterol or xopenex - particularly after nothing else has worked.

Again, this is non-scientific, and I'm NOT a doctor. I've got nothing like a medical degree. I thought these tips might be helpful to others whose kids have the elusive variety of asthma my kids seem to have -- but if you think your child might be flaring, definitely call you doctor. I can't reinforce that enough.

Friday, July 14, 2006

Mama's 35th Birthday and an Update: B still has rash (from Singulair?), Oz's asthma is flaring

B's finally looking better. I switched from a 1% cortisone cream to .5% gel, and it seems to be working well. Only two weeks!

Not sure if I mentioned it before, but the doctor seems to think the rash may have been caused by his Singulair. Sure, he's been on it for nearly three years, but he was on Flovent for three-and-a-half years, and since corticosteroids like Flovent are immunosuppressant, they suspect the Flovent supressed the reaction to the Singulair. As a result, the rash appeared when we tooke the steroids out of the mix.

In other news, I'm taking Oz to the PP today. He's not doing too well. He started coughing Tuesday, so I kept him home and nebbed every four hours. Yesterday, he seemed better, so I nebbed in the AM, and sent him to school with his albuterol MDI.

He was okay yesterday, but he did wake up from his nap coughing. The daycare called and I had them give him an extra dose of albuterol, which seemed to help. He was happy enough when he came home, and he slept relatively well.

He was a bit rough this morning, but that's usually a bad time for my kids. I gave him a neb and some Dimetapp, then we ran a few errands before landing at daycare. By the time we got there, he was so sad and clingy, I knew I'd have to turn around and take him home.

Now he's sleeping (totally uncharacteristic) and he's definitely a little bluish around the eyes and very goopy. No fever -- just the dry cough.

It could just be a cold, but we've only been off the Flovent for two weeks, so I'm not taking any chances!!!

Quite a way to spend my 35th Birthday. :-(

Sunday, July 09, 2006

B looks worse -- getting really concerned!

Just an update -- little B's rash is worse, and it's been 9 days now since it started. He's a little lethargic (as mentioned in the previous post) and he woke up a bit congested today.

At least the congestion gave me an excuse to start albuterol.

The worst part is that we've scared him with our concern. He was uncharacteristically teary and melancholy tonight (more from exhaustion, I'm sure) and he asked me, "Am I going to be alright, Mom?"

So, add guilt to my concern now.

Honestly, it's hard to not be concerned -- I'm damned near panic, quite frankly. He really looks THAT bad. All I need is one good wheeze, and I'm off to the ER.

Saturday, July 08, 2006

Bad News: B looks AWFUL. Steroid Acne or Asthma Attack Brewing?

So, they're off corticosteroids. That's the good news.

Here's the bad news: Bryn looks AWFUL. It may just be what the dermatologist determined was "steroid acne", but he's get a red rash around his eyes, on his nose and on his cheeks and chin that looks terrible! His eyes are red-rimmed, as the rash or acne is actually on his eyelids, too, and bloodshot. He's really pale, too.

He looks apalling, but seems fine otherwise...maybe just a little lethargic.

I'm so worried about him. I've called four doctors (yes, really) and they all think I'm nuts. Our PP and her nurse-practioner are both on vacation (the nerve of them, vacationing at the same time! Didn't they know I'd need them?), so I've had to speak to two other doctors in the practice who think I'm a looney hypochondriac who wants her kid back on steroids. We actually *saw* our pediatrician, who was baffled but largely unconcerned, and a dermatologist who thought it was steroid acne (as mentioned above).

Any thoughts? This all started just as we were tapering him off the Flovent. I feel like we're working up to a major blowout flare. And he really looks so bad that I'm considering a trip to the ER.

Good News -- We're off Flovent!

Just a quick, two-weeks overdue update: The boys are off Flovent! This the first time in over three years for little B. We're thrilled! He's also off the Nasonex.

Ozzie will stay off indefinitely; B will go back on a low dose for the winter. We're so happy that they've been healthy long enough to go drug free. Yea!