Saturday, December 27, 2008

Tracy's Question: When the Asthma Action Plan Needs Revision

Tracy posted this question to a post, and I thought it was worth adressing front and center:

"I am new, but desperate to find some advice. My 4 year old has asthma and has been on albuterol, pulmicort, singulair, and prednisone for a few years on and off. His 6 year old sister brought a cough/cold home from school last week and now he is battling it. All of the parents of asthma children know that when they get a cold/'s SOO much worse for them over other children. I'm at my wits end, he is coughing and coughing for days now. The doctor told me to do the regular routine...albuterol/pulmicort in his machine. It doesn't seem to be helping, he has made himself vomit 2 times from his coughing attacks. It's now Saturday night, 6:30 pm and he's coughing nonstop. He isn't wheezing, but his breathing is fast. The cough is the worst, and I don't seem to be getting much help from his doctor.

Any advice on how to help the cough even a little bit other than his albuterol/ pulmicort/ prednisone. I feel like I'm overmedicating him today. I'm so stressed, he can't stop coughing. I'm not sure if it's time for a trip to the ER, but not sure what else they can do for him, we have all the meds right here, it just doesn't seem to be helping. "

I don't know if it's documented anywhere, but I swear some kids develop a resistance to albuterol.

So here are my questions for Tracy, right off the bat: Are you seeing a regular pediatrician, or do you see a pediatric pulmonologist or asthma/allergy specialist? If you read this blog regularly (and considering you came in via a post from 2005, I'm guessing you might!) you know how important I believe this is: Pediatric pulmonologist just "get" pediatric asthma better than pediatricians do. We have seen our pediatrician and been told our child was "moving air well," then seen the PP a few hours later - only to be promptly sent for a chest x-ray!

Question 2 for Tracy: When did you last have your action plan updated? It may be that your son has outgrown his current dosages, or needs stronger meds. Our middle guy is fine on Flovent 44 for the summer, but needs to be on Flovent 110 this time of year. Last year, we bumped him to the 220 for the winter months.

When it comes to the emergency meds, I always have albuterol and Xopenex stockpiled, but have found that when things get really dire, we need DuoNeb and Combivent, as well, which are stronger. (I don't know if they're typically prescribed for kids, as they seem to be COPD meds, but they definitely take care of those evil coughing fits.)

I've also been lucky enough to have a great PP with a great staff. They know I've learned to treat mountains as mountains and molehills as molehills (it took a few years...), so they've empowered me to take certain measures at home. If things are really bad, I'm allowed to administer three doses of albuterol 30 minutes apart. If there's no relief from that, we either go straight into the office, or straight to the emergency room. Note - DO NOT do this without the permission of your own doctor. I will only take these measures after calling the office and checking in first!

One more trick we keep up our sleeve: Dimetapp. If your doctor allows it, we find that this alleviates coughing caused by upper respiratory symptoms. It's not a cough supressant, so it's OK for asthmatic kids to take. Bonus: Helps them sleep, too!

So, Tracy, I hope this is helpful. I'm frequently in your shoes, and I know what you're going through. Of my three boys, Oz, my 4 YO, is currently the worst asthmatic. He will cough until he gags. Sometimes, he can't get through a sentence without coughing. It's awful, and I will do whatever I can to make it stop.

We've had a good winter so far, but he has started coughing today - and I'm visiting my in-laws in Canada without the nebulizer, so I hope I didn't just jinx myself.

Please feel free to respond via comments or email.

Saturday, December 13, 2008

Do I have asthma, too?

I've had a cough for about 3.5 weeks now, and I went to the Minute Clinic (LOVE the Minute Clinic!) for a second time. The cough had gone from clearly a "tickle" to something that sounds a little more dry and chest-y.

In a nutshell, the nurse practictioner at the clinic said that the only reason anyone would have a cough that long would be either chronic sinusitis or exercise-induced asthma. So I plan to follow up with my doctor this week. (OK, I plan to find a *new* doctor and then follow up.) The NP can't really treat asthma, so she just continued the treatment for acute bronchitis, which was my previous dx.

I did a little research, and it really sounds like I have cough-variant asthma. I wake up fine, but after walking from my car to my office in the cold air, alongside a major highway, I'm hacking up a lung by the time I get to my desk. Seems like cold air and fumes are my big triggers.

I got my very own albuterol HFA. Pretty crazy.

Truthfully, I'm a little skeptical about the diagnosis. But on the other hand, I grew up in a house with two smokers - my mom smoked a pack a day in our broadloom-covered house for the 21 years I lived at home. My brother was just diagnosed with asthma. And let's not forget that I live in New Jersey!!!

Funny PS - my mom was far more skeptical about the dx. She gets coughs all the time, she tells me. Coughs that are triggered by cold, and coughs that make her cough til she gags, like I do. But it's just a cough, she says. It's not asthma!!

...this from the woman who STILL smokes a pack a day and NEVER goes to the doctor for anything!!!

Monday, November 17, 2008

Health Day: Acetaminophen Linked to Childhood Asthma

I have to laugh when I think about all the things linked to pediatric asthma. Seems like we moms can't do ANYTHING right! Now even Tylenol is a culprit in the pediatric asthma epidemic!!

According to Health Day:

Children given acetaminophen during the first year of life to reduce fever are more likely to develop asthma later on, a new study finds....

"If this association is causative, it would suggest that acetaminophen use is a risk factor for asthma and may explain the asthma has become more common," said lead researcher Dr. Richard Beasley, from the Medical Research Institute of New Zealand in Wellington.

Since this study can't definitively say that acetaminophen is a cause of asthma, its use for children shouldn't be changed, Beasley added. "Acetaminophen is the preferred drug for relief of pain and fever in childhood," he said.

Just remember, Moms: Everything you do is wrong.


Tuesday, October 21, 2008

Asthma in Children and the Fear of Pulmicort

New Question - Just In:

HELP!!!!! My son is 7, was dx w/ asthma this past winter after a lifetime of treating what different ped's "thought" were simply nasal infections with antibiotics. We have recently went from zyrtec, to oral steroids, now on to pulmicort, albuterol and Singulair. I am VERY afraid as my son is already a sensitive and emotional boy. It sounds like the pulmicort is simply a BAD med??? Does anyone have any homeopathic advice on treating asthma? My mom is permanently disabled from medications that were not properly tested and monitored...I am in search of help, not more hurt!!! - Tammy

Tammy, I'm *not* a doctor, but I have a few insights I can share from experience:

First of all, many of us who have used Pulmicort and Flovent (same med essentially, delivered differently) have found that Flovent may tend to have less "roid rage"-type side effects.

Personally - and I do have sensitive boys - I haven't seen any negative behavioral effects from the steroids. (At least not that I remember!) Certainly albuterol has them bouncing off the walls, but I give Xopenex as often as I can to aovid that.

I can tell you that it works - WELL. For children with asthma acute enough to require daily inhaled steroids, there aren't many alternatives. None of us likes the fact that our kids are taking steroids every day, but it certainly beats the alternative of not being able to breathe!!

The best recommendation I can give you, though, is SEE A SPECIALIST. If you've read this blog at all, you'll know that I love my pediatricians. But when it comes to asthma-related issues, I call the pulmonologist first, then make a courtesy call to the regular peds to keep them in the loop. Pediatric pulmonologists know more about asthma than general pediatricians do, and understand the subtleties, the latest meds, and so much more than any other doctor.

If there are no pediatric pulmos in your area, look for an allergy and asthma specialist.

On the holistic side, I know many parents who have seen benefit from taking their kids off dairy. Others have seen a lot of success with sinus washes (now sold as "netti pots" at your local CVS) particularly if their kids' asthma is typically triggered by upper respiratory infections.

Again, I'm not a doctor or medical professional of any kind, but this is my best mom-to-mom advice.

I would also refer you to the Asthma-Parents group on Yahoo, which has been a great resource for me over the years. Two other sites:

Hope this is helpful. Best of luck, Tammy!

Saturday, September 27, 2008

Speaking of working mothers' guilt...Daycare Drama

I'm switching the little boys' daycare this week. The one they've been in was B's third, but he's in 1st grade now -- and this is the only daycare the two little guys have ever known. So you can imagine how grueling a decision this has been.

The place was really nice for the first few months we were there. I should have known, when the director who showed me the place departed on our first day there, (departed *for good*, I should add) that the outlook might not have been good. And now, four directors later, I can say that it was, at times, very good. But right now, it sucks.

After the last director left, the new one, Miss R. came in very quickly. Rob and I call her "Miss America" because she literally comes to work with pageant hair and full makeup - including eyelashes. She's built like a beauty queen, too, and loves to wear tasteful, expensive-looking, very fitted clothing to show it off.

Miss R looks very professional, but she - like the rest of the staff - is very young, with no children of her own. She's concerned with things like ratios, and classroom supplies. She loves the cute kids, but hasn't an inkling what it's like to leave your children with strangers every day.

So, needless to say, she's part of the problem. She hires young staff, doesn't announce when they leave, doesn't announce when new staff joins, and doesn't communicate well with parents. When I talk to her about concerns I have, I often feel like there's a language barrier or something. I can practically see everything I say fly right over her perfectly styled head.

Turnover is a problem, too. Half the time, someone I've never met is handing my kids to me at the end of the day. There's only one teacher who's been there as long as we have.

That's the background. Here are the actuals:

1. Frequently, when I drop Ig off, his room is over ratio. Now, if this place didn't already push state limits, it probably wouldn't be such a big deal. But on a GOOD day, there are two very young women with 14 2.5 year old. I can barely manage 1 two-year old. But seven? So if there are 16 kids in there, I will wait until kids and teachers are shuffled appropriately and I can feel safe leaving my son. The waiting makes Ig uneasy and me late for work. And it's an ongoing issue.

2. When I pick up, the boys will sometimes be together in one room, with a teacher I barely know watching tiny little Ig with a bunch of older 4YOs. Which wouldn't be so bad if the teacher was actually watching and if Ig weren't so tiny and immature for his age.

3. On 3 separate occasions, Ig has come home with no pullup and no undies. Funny the first time, downright concerning by the third. He doesn't have tear-away pullup. He has to take offf his pants and undies to do this. Which means he's got to be alone in the bathroom for close to five minutes to accomplish this task. And did I mention that he slipped in the bathroom and had to get stitches a few months ago?

4. Ozzy had an asthma flare last week. I would have kept him home if I had any flexibility at work, but I coudln't. So I nebbed him up and sent him to daycare with an alubterol MDI. I filled out all the forms for him to get the meds....and he didn't. They forgot to give him his 4 o'clock dose. They. Forgot. To. Give. Him. Asthma. Meds.

...and that was the final straw.

So I'm moving them away from their friends to a nearby center. The new place is about half the size and family-owned. It's clean. And Ig's room has 8 boys and two *mature* caregivers. Ozzy's room has three teachers; one of them is the owner.

I feel good about the move, but it's a LOT more a time when no one has a LOT more money for everything. And it's disruptive to all of us.

I wish this wasn't a necessary step, but I don't think our current childcare situation is repairable. Miss America takes responsibilty for nothing. She blamed Ig for the diaper removal. While her business manager admitted to forgetting Ozzy's medicine, she lied to corporate -- and essentially blamed Ozzy for lying about the missed dosed! She blamed the teachers for Ig's stitches and the business manager for the ratio issues. I can't work with someone who can't own their mistakes. Doesn't she realize that her staff is reflection of herself? That if she were on "The Apprentice," the Donald would have sacked her ass?

Hopefully, the kids and I will be happier at the new center. Ig's been very clingy at drop-off lately - a new behavior for him, probably sympomatic of the chaos he has to deal with once I leave.

As my co-worker so aptly put it, "It's OK to *miss* your kids while you're at work, but you can't *worry* about them."

Ain't it the truth?

Monday, September 15, 2008

Working Mothers of Asthmatic Children - Time to Lose the Guilt!

A sigh of relief, courtesty of our friends at the American Lung Association. Got this from their excellent email, The Weekly Breather (which I wish I had more time to read):

Day Care May Cut Kids' Asthma Risk...WebMD reported on September 9 that infants and toddlers who attend day care are less likely than other children to develop asthma symptoms by age 5, a new study shows. The research adds support to the so-called "hygiene hypothesis" -- the idea that early exposure to infections and germs helps protect against allergies and asthma.For the full story: click here

See? You're not such a bad mom after all. Don't you feel better now?

Thursday, July 17, 2008

Place Blame for Asthma Here: Stomach Germs and Peanut Butter Sandwiches

Yesterday, my co-worker shared with me an article that stated that eating too much peanut butter during pregnancy may increase the likelihood that your child will develop asthma.

Now I know that I craved - and indulged in - many peanut butter sandwiches during one of my pregnancies...but was it child one, child two, or the miscarriage before both? (I know it wasn't child three - I was too busy to EAT during that one!)

It's a theory I can get behind because, having the traditional "mother's guilt", it puts the blame on me. I can take responsibility for my kids' asthma once and for all. Pretty messed up, huh?

But another theory that seems a little sane is this one: A study at the NYU Langone Medical Center found that H pylori, a bacterium that used to be common in the human stomach, seems to prevent pediatric asthma, allergies and hayfever. Prior to WWII, this was a familiar germ, but with the advent of antibiotics and antibacterials, resulting in cleaner homes and schools, it's become pretty rare. Here are some stats and quotes from the study worth sharing:

"In our study we asked the question, is there any relationship between having H. pylori in the stomach and having asthma and other allergic disorders," said lead researcher Dr. Martin J. Blaser, the Frederick H. King Professor of Internal Medicine and chairman of the department of medicine at the New York University Langone Medical Center in New York City.

"We found a strong inverse association between H. pylori and childhood asthma, childhood hay fever and childhood allergies," added Blaser, who's also a professor of microbiology and has studied H. pylori for more than two decades.

Blaser thinks that H. pylori may protect the body against asthma. "When children have H. pylori in their stomach, their immune system is different than if they don't have H. pylori," he said.


Among children in the survey, just 5.4 percent born in the 1990s tested positive for H. pylori. In addition, 11.3 percent of the children under 10 had taken antibiotics in the month before the survey.

Blaser and Chen found that among children 3 to 13 years of age, those who carried the stomach bug were 59 percent less likely to develop asthma than children without H. pylori. These children were also 40 percent less likely to suffer from hay fever and other allergies, such as eczema or rash.

Among children aged 3 to 19, the researchers found that those who harbored H. pylori reduced their risk of asthma by 25 percent.

OK...if there's an experiment related to this study, can I bring my kids?

Sunday, May 11, 2008

Unhappy Mothers Day

Where to start, with everything going on around here?

B is having an "off" day - getting frustrated easily, getting stuck in grooves that we can't quite pull him out of. There are days when the characteristic autistic behaviors are more apparent. This is definitely one of them.

Ozzy started Mother's Day with a time out -- how many time do I need to ask the kid to get dressed? How many???

(B is like a little timebomb at the dining room table right now. He's working on one of his mysterious projects, and he's either going to throw it down and rip it to shreds - or burst into tears. I keep hearing say, "I hate paper. I hate it!" I'm watching him, ready to help or hug when needed.)

Ozzy, by the way, had a BRUTAL asthma attack last Sunday. DuoNeb was only holding him for an hour at a time, and when it wore off, he'd cough until he gagged or vomited. It was horrible, and we had to put him on orals for two days.

Ig, last but not least, was diagnosed with his 50,000th ear infection, we had to put him on Omnicef and schedule surgery for new tubes and adenoid removal.

Within two days of starting the antibioitics, he broke out in a flat, lacy rash for which I promptly called the peds. After three days on Omnicef, they told me his ears were clear and took him off the stuff. That was Tuesday.

Today, he's pulling at his ears and running a low-grade fever. Are you surprised? needless to say, it's been a rough couple of weeks. All I wanted for Mother's Day was a nice diner breakfast and a trip to the zoo. I wanted to see my kids having fun, and I didn't want to have to yell at anyone. Not so much to ask, right.

Apparently it was. I had three out of four boys seriously grumpy. Dad, B and Ozzy were all cranky today. What a bummer! Thank goodness Iain was happy.

It's still early, so hopefully we'll make up for it on the playground later. I just want to have some fun with everyone before Ig's surgery on Thursday.

I'm going to take a little nap now - my Mother's Day present to me.

To the rest of you SuperMoms -- enjoy your day!

Monday, April 21, 2008

Utter Madness - But We're All OK

I've been the absentee blogger lately, I know...

In a nutshell, I left the job I've loved for four years and started someplace new. That was about 7 weeks ago now.

The new job is fine -- I have a decent life/work balance, which is critical for me. Obviously.

It is taking a long time to get ramped up though, which is frustrating. I don't really have a budget for my online marketing programs, and the two guys I work with, who have complimentary positions, are very, very smart, and very, very busy. So I feel kind of stupid and lazy right now. It's a little challenging.

At home, I'm still getting used to the routine of the new job. Different commute. Different stress level...scared to be late or to ask to work from home...but I do both anyway...

The kids are doing well regardless. I'm definitely yelling at them a little less. The stress of the new job is a heck of a lot lower than the stress of the old job as it was petering out.

The old job was so wonderful...loved every minute of it until the company was acquired. Then it was something like watching a beloved grandparent succumb to Alzheimers. Everything you love, all the memories just dying away, until you don't recognize each other anymore. I'm writing in a rush right now...but you get the idea. It was painful and horrible, but I know the company I loved really doesn't exist anymore. And I don't recognize -or trust - what's grown in its place.

So those last few weeks, with a new boss and a new CEO, were VERY stressful, and I felt like I was losing patience with the boys a lot in the morning. I'm not, by nature, a yeller, so it was weird for all of us to have me screaming at them (especially Ozzy, who's just going through a PHASE right now).

Things are quieter now, but it's still challenging. And I dont' feel like I have time for anything at all these days. By the time I've gotten those three guys off to bed, I want to go lie down myself!!

Anyway...enough about me! Here's the deal with the guys:

  • Ozzy: Coughing. I went to on my first business trip in a while - and my first plane ride in 8 years! - this past week, and of course he had a flare. I got called on my cell phone mid-meeting in Atlanta...he was being sent home from daycare because he was coughing so much! I called the husband and made sure he understood the action plan. Then called every two hours to check in. Sounds like it was a rough day or two, and he's still coughing at night, but he's doing OK overall. He was dropped from Flovent 110 to 44 about two weeks ago, and taken off Singular, so we'll evaluate the meds situation if he's not better in a few days.
  • B: Still coughing a bit. It's been about three weeks now, and he's doing MUCH better. Oddly, he's on Augmentin right now for (of all things) a severely infected hangnail. (So gross...) I suspect the cough is from a lingering sinus infection, so the Augementin would clear that up, if I'm right.
  • Ig: Bad diapers, a few sleepless nights, and digging in the right ear. Could we be en route to another ear infection? If so, we're down for new tubes AND an adenoidectomy. We'll see...

I *may* have heard a cough from Ig this morning, and he did insist on taking his blankee to daycare today. Never a good sign.

Sorry for the very long and poorly (quickly!) written post, but gosh it feels good to bring you up to speed!

Monday, April 07, 2008

Oz is FOUR today!

Happy Birthday, Monkey! I wish you a year free of flares and Orapred.

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Saturday, April 05, 2008

Singulair: Believe the hype!

I hope by now you know me well enough to know that I'm no alarmist. I report, I offer my opinion, but I generally don't freak out over things.

So with the news of Singular and possible suicide ideation, along with other emotional symptoms, I followed the news, but I didn't react much. My kids are so there really any risk or suicide, even of depression, in a six-year-old?

Apparently, there is. We went to the pediatric pulmonologist on Thursday, and she's taking all kids off Singulair over the next month.

Now, this is a woman who is against anti-bacterial hand soaps, who aggressively prescribes inhaled steroids...and someone I tend to think of as reasonable and level-headed.

For her to take B and Oz off of Singulair so abruptly was a bit disconcerting. The office is taking the new - and still unconfirmed - research very seriously. They even sent an email to their patient base about it.

B's been on Singulair since he was 26- or 27-months old, way before his ASD diagnosis. We never considered that the night terrors he suffered might be from Singulair. Nor did we consider that the lack of mirth we've seen in him since September might be related to the drug. There's been so much ELSE going on...Kindergarten, for starters! New friends, my husband's new job and new schedule....MY new much. It would be hard to trace the changes in him back to just the Singulair.

But we'll see. He's got a cough right now - first one since the early fall - so he's on the stuff through May 8.

Ozzy's already off, and all I can say is that I'm HOPING for an improvement in behavior!! He's been on Singulair for as long as I can remember.

Lately, his behavior has been horrible. He's been tuning us out, talking back - he even HIT me yesterday. (He was tired, so I'll cut him some slack...but really, that's unacceptable!)

Maybe there's some small chance that the Singulair is behind that nasty attitude.

Maybe I'm totally dreaming.

Thursday, March 20, 2008

Ig's Ears

As good as my pediatricians are, sometimes they're in a rush. They've got a busy practice.

Today, I got one of the docs to slow down and read the file.

Ig, as it turns out, DOES have another ear infection. Dr. G listened to my reports about Ig's two weeks of low-grade fever and persistent cough (upper respiratory, thankfully). She flipped through his file and noted that we'd had a rough time pretty much since New Year's. Lots of coughing, fevers, plenty of ear infections. I'm not exaggerating when I tell you the kid was there every two weeks.

She prescribed a 10-day course of Omnicef, but recommended we keep him on for two full weeks if he's not completely symptom-free.

She also recommended that we see the ENT again, since he's had so many ear infections. Hopefully we won't need tubes again. Although, we all slept a lot better when he had them!

Mostly Quiet

It's been a little quieter around here as allergy season looms ahead!

Ig is still coughing a bit, and I do believe he has an ear infection...but overall, not so bad.

The big headache is that we've changed insurance, and the new company - ExpressScripts - is giving us a hard time filling B's Singular Rx. Shocker, right?

Anyway, taking Ig to the peds AGAIN this afternoon for the ear, so I'll keep y'all posted.

Friday, March 14, 2008

New Study -- Aspirin Reduces Asthma Risk Among Older Women

From the Washington Post:

Taking a small dose of aspirin every other day seems to reduce the risk of developing asthma among older women.

The study, appearing in the online issue of Thorax, essentially mirrors a similar study in which men taking aspirin saw the same
reduced risk.

Interesting, right? But check THIS out...

The incidence of asthma is on the increase, possibly due to obesity, dietary factors, exposure to antigens and environmental factors. But the trend also coincides with a decreased use of aspirin as people have switched to other over-the-counter pain relievers, or have avoided aspirin use in children due to concerns about Reyes syndrome.

That led some researchers to wonder whether the reduction in aspirin use was contributing to the rise of asthma.

Discuss amongst yourselves...

Monday, March 10, 2008

Oz Is Better; Ig Is Coughing

It just never ends!

We finally managed to get Ozzy's cough under control Friday afternoon, after about 36 hours of DuoNeb treatments. It was pretty scary for a while there -- we were prepped and ready to take him to the ER if needed. And I'm amazed that we made it through that one without orals!

...but then, he's still coughing a little, so I should probably refrain lest I jinx myself.

His fever, by the way, hovered over 102 for a full three days, but then just broke out of nowhere Saturday afternoon.

Meanwhile, it's been two weeks since Ig was sick, so I guess we're due there. I heard him cough once or twice yesterday, and then at dinner tonight he let out a few seriously croupy barks.

So...I'm going to bed now. Since I probably won't sleep. Again.

Thursday, March 06, 2008

Holy Virus!!!

I just heard from the PP ... based on my description and the peds assessment, they think it's a virus that they're seeing a lot of. Here's the skinny on the virus --
  • Fever of up to 105 lasting 5-7 days.
  • Cough is so acute, they're recommending DuoNeb every 4 hours
  • They are hospitalizing kids with this
If I can be selfis and even sacreligous for a second here: 5-7 days?? God, did you plan this because I was starting a new job? Is this a sign that I shouldn't have left the old one? I mean, my new boss is a mom, too...but a whole WEEK???

Secondly, how scary and POOR OZ! I've never heard my PP, as aggressive as she is, prescribe DuoNeb only every four hours. She usually has us alternate between DuoNeb and albuterol.

I just pray that 1) Oz gets well quickly and without a trip to the ER and 2) that the others don't get this.

Think of me at 4:00 AM while your sleeping and I'm nebbing away. I hope they have Law & Order reruns on then.

Oz is sick - not strep, not flu

Terrible day! I started a new job last week, and while I *will* have flexibility ultimately, I do need to put on a good show and be at my desk for now.

But Oz let out a few croupy coughs overnight Tuesday, and had a moderate cough yesterday. I started albuterol, just to be safe.

Last night, he woke up with a fever, and my husband ("B") stayed home with him today. I gave him some ibuprofen a neb before I left for work, and told B to call me if he had any concerns.

B called at 11:30 - Oz was coughing uncontrollably, until he gagged. He'd already had a second neb, and I told B it was OK to give him Dimetapp. (Yes, I know about the warnings. Please don't call family services on me. The stuff WORKS, and the situation was dire!)

Dimetapp didn't work, so B gave him DuoNeb, which helped a little, but I was already paging the peds and the pediatric pulmonologist from my cube!! The peds were able to see him immediately.

Of course, B's car is in the shop and I have the (hideous, horrible) minivan, but thank goodness our neighbor was home and willing to loan us their car. I'm sure Oz will love sitting in their daughter's Disney Princess car seat.

They tested for strep and flu (both negative) and chalked it up to something viral. They said his chest sounded clear. Unsurprised sinced the kid had three nebs in less than four hours.

I'm waiting for a call back from the PP.

Keep y'all posted --

Tuesday, March 04, 2008

Pulmicort 'Roid Rage - response to question in comments

This came in today via comments:

I'm not sure I'm typing in the correct spot... I'm new at this. I was hoping to find some answers to a question I had concerning my son. I was wondering if you have heard of any children becoming aggressive or violent from the medicine Pulmicort? My son just turned 3 and since on Pulmicort has been exhibiting some very violent behaviors. Maybe just hit at the same time???? who knows? Do you have any advice or help?

I've been fortunate to have never experienced this, but I've definitely heard about it before.

Pulmicort is a steroid, and sometimes kids will react to it the same way grownups react to, say, anabolic steroids.

While some parents are OK if their kids "occasionally kick the dog," as one mom so quaintly put it, so long as they can breathe, sometimes the behaviors are a lot more extreme and hard to live with.

I've heard, on the Asthma-Parents Yahoo group, that other parents have seen better results simply by switching steroids. So ask your doctor if Flovent or Qvar is an option for child. Ad there's an added bonus: Being a "Flovent Mom" myself, I can assure you that administering a metered-dose inhaler (or MDI) twice a day is a LOT easier than holding a three-year-old down for a nebulizer treatment every single day.

Singular is another commonly-used maintenance med for preschoolers. I've rarely heard of adverse reactions from it, but it does work differently than inhaled corticosteroids like Pulmicort and Flovent, so it may not be right for your son's needs. In fact, my kids have needed to be on both Flovent AND Singular during peak season.

So...I hope this helps. Definitely talk to your doctor about alternatives. You shouldn't have to live with a psychotic preschooler when there are other options available.

Other parents, please feel free to share your experiences and wisdom!

Friday, February 29, 2008

Hark! I hear a cough!

Just heard a NASTY cough from down the hall...think it was Ig.

No surprise. He was wiping his nose on his hand (love that) and digging his finger way, way into his ear while I was reading to him tonight.

Might I just add that the timing is ideal, since I started a new job on Monday. I absolutely need to tell them I need to work from home ALREADY because one of the boys is sick. Nothing like showing the new boss what a liability you are early on.

At least she's got kids, too.

Thursday, February 28, 2008

New Vaccine Risk from Merck

Y'all k now how much I love Big Pharma and unnecessary vaccines... (Polio=necessary, chicken pox=unnecessary.)

Here's some exciting news from our friends at Merck!

Monday, February 11, 2008

Ig Again

On 1/21, I posted that Ig had Scarlet Fever.

On 2/7, he was diagnosed with Strep AGAIN! And he ruptured his eardrum - AGAIN. What kind of luck do this boy and I have? And is it luck, or is it just daycare?

He's been on antibiotics since Thursday, and I started nebs on Saturday because his cough just had that edge to it. It only took two nebs for the cough to all but disappear, but I'm keeping him on albuterol for a few more days to be safe.

On another, sunnier note....posted a new link in the side bar to The Shortest Blog in the World. If you need a good laugh (like I frequently do) check it out!

Friday, February 01, 2008

Jennifer's Question on RSV/Asthma

Had to post this one -- probably a lot of this, now that it's Flu/RSV season:

I came across you blog by searching google for asthma treatments. My son 8 months tomorrow has had RSV once and now pneumonia twice. This since early December.My head is spinning thinking that this is potentially a lifetime problem. He is on Orapred now with albuterol Not to mention Amox. for an EI. He was on singulair after the first bout with pneumonia. I thought it was working, but then he came down with a cold and within a day it was in his lungs. The dr. is going to switch him to pulmicort now I just have so many questions. I was wondering if you could perhaps help me or just talk me through it the best advice any parent of an asthmatic child can give you is find a pediatric pulmonologist or asthma/allergy specialist, if you haven't already. Pediatricians are generally wonderful, but because asthma - particularly in a child as young as yours - can be VERY subtle, a specialist (if you have access to one) is the way to go.

I've found that finding the right combination of meds is an exercise in trial and error, even with the best doctor. I admit surprise that your son wasn't put on Flovent or Pulmicort from the start, but all docs have their own preferences.

It could be that your son will be what seems like a LOT of medication for a while. My oldest was best on Flovent 220, Singular and Nasonex when he was 2-4 years old. I've never met a mom who was happy about all this maintenance medication, but the good news is, it typically is NOT a permanent situation.

B was on a ton of medication for a year or so before we were able to lower the Flovent and phase out the Nasonex. And once we took his adenoids out (sinus infections were his biggest trigger) we were able to phase out the Flovent as well.

Now he's just on Singular, and has maybe two asthma flares a year -- and they've been mild ones, too.

My other guys are still on Flovent, but comparatively low doses, and they're doing well so far.

I do think that our PP is more aggressive with medication than others, but it seems to have worked will for my boys.

One resource I highly recommend is the Allergy and Asthma Network. You can call them directly with your questions and concerns. (They also offer discounts on medical equipment - definitely a bonus!)

Saturday, January 26, 2008

Probably Parvo

Doc just called...probably Fifth Disease, but if he has a fever in the AM, we'll take him in for a Strep test.

Awesome. I'll bet the other two have it, too. That would explain why Ozzy's been such a whiney little cranky-pants all day -- and why he was running 100.2 yesterday.

B has a weird rash...

...on his chin, cheeks and the insides of his forearms. I'm thinking it might be Fifth Disease(Parvo) since it itches. But I've already called the doctor, since Ig had Scarlet Fever last week.

He's been really off behaviorally this week, and Fifth would explain it...but I'm bummed that we might have to cancel his playdate tomorrow. We had to cancel one last week because of Ig's little plague, and B will be devastated if he has to miss another. :-(

Oh, and he coughed once, so I've got the albuterol primed and ready for action.

Monday, January 21, 2008

Cold Meds and Toddlers

I would be remiss if I didn't mention the latest warnings for cold medications....

From EverydayHealth....

..."We strongly recommend that over-the-counter cough and cold products should not be used in young children under 2, because serious and potentially life-threatening side effects can occur from use of these products," Dr. Charles Ganley, director of the FDA's Office of Nonprescription Products, said during a morning news conference. "We have not come to a final decision on the use of cough and cold products in children aged 2 to 11 and continue to work within [the] FDA to arrive at a decision."

"We were concerned that parents would continue to use these products in children under 2, even with all the publicity," Ganley added.

Glad Ig's two now, because I don't know what I would do without my industrial-sized bottle of Dimetapp. And just in case the FDA bans it for kids up to 11, I'm going to stockpile the stuff. Please don't report me to DYFS.

I have bronchitis, Ig has Scarlet Fever

What a fun weekend. We had big plans for the holiday, including a big playdate (2 kids at our house) and a trip to the big science museum....but unfortunately, we've had to work in shifts this weekend, and I stayed with Ig most of the time.

Ig started spiking fevers on Friday night, and developed a funny rash on his chest, tummy and back by Saturday afternoon. I called the peds, and they told me that they'd see him Sunday morning if he was still sick. (LOVE my peds!)

He spiked up somewhere near 105 on Saturday night, so we were in on Sunday. Turns out he has Scarlet Fever -- and an ear infection. The tubes he got in March are pretty much out, so I guess we can expect more infections from now on. Poor kid, he was up screaming because of the "boo boo in the ear!"

Here's the funny part...while we were waiting for the doctor, I had a little coughing fit - not uncommon for me over the last month. When she came in, she listened to his chest, said it was clear, but noted that his cough sounded pretty croup-y.

"Ummm..."I smiled sheepishly, "He doesn't have a cough. That was me." She made me open MY mouth, checked MY throat, and told me to back to my doctor and tell him that my son has strep (even though my throat looked fine).

I hadn't actually seen a doctor. I'd gone to the new Minute Clinic at our local CVS. What a great thing that is for adults! It's a nurse-practitioner who works 8-8, and you don't need an appointment. AND they take my insurance. Mind you, I wouldn't take the kids there, but for me, it's fine.

I've had this cough for a month or so. No other symptoms, no chest tightness or anything -- just a tickle in my throat that makes me cough until I gag or cry. I actually didn't think much of it (despite my husband's complaints that I was keeping him up at night...pretty funny that he should complain considering I've been living with his snoring for 15 years!)... until my assistant was diagnosed with bronchitis. She was prescribed antibiotics.

The N-P at the clinic told me I had bronchitis, but that it was probably viral. Apparently it's a crapshoot - 50/50 whether it's bacterial or viral. She gave me a prescription, non-narcotic cough suppressant and told me to call my doctor if it wasn't better within a week or so...but that bronchitis can last up to 6 weeks.

I've never had bronchitis before - or at least, I've never been diagnosed with it before - but I can tell you that this cough, while it isn't as frequent, definitely sounds chestier. I still don't feel it anywhere but my throat, though.

Regardless, I'll try to get in with the GP today or tomorrow, and I'll keep an eye on the kids, too.

Wouldn't it be ironic if the GP put me on albuterol?

Thursday, January 17, 2008

Alternative Asthma Treatments (Psych!)

I love this article from Everyday Health. It lists all these great alternative treatments for asthma, like herbs, acupuncture, chiropractic...then explains why they don't work. Way to be open-minded!

Friday, January 11, 2008

Osgood File on Autism: "Defect"? Really?

I hope this rant gets me some big links, because this one REALLY pissed me off.

Yesterday, I was listening to a local news radio station on my way into work, as I normally do. And as usual, I listened to "The Osgood File," which I usually find pretty fun and educational. (And no, I don't listen to NPR in the morning...sorry to disappoint.)

The "File" this morning was on a new genetic link to autism, so, naturally, I cranked it.

Interesting enough story, but the doctor, a Dr. Jon LaPook, continually referred to autism as a "defect." Seriously.

Here are some quotes from the actual transcript on the Westwood One site:

SOT - Dr. Jon LaPook "This problem accounts for about one percent of the cases of autism. So, if you're a child who happens to have this defect, this will help you get an early diagnosis. And we know the earlier you get the diagnosis, the earlier you get treatment, and the better the outcome." So, Dr. LaPook says it makes sense for some parents to take advantage of the genetic testing now available, if they can afford it. SOT - Dr. Jon LaPook "It's an expensive test right now. It costs two-to-three thousand dollars. It's available in large medical centers, research labs. But if you're a family who happens to have a child who has this defect, it can be terrific because not only can you get a diagnosis --- and therefore get treatment --- but you can start maybe making plans in terms of other children, figuring out what are the risks that my other children are gonna have this problem."
Defect? Really? Why don't you just call it an "abnormality?" How about a "retardation?"

Are you saying my son, who has Aspergers Syndrome, is DEFECTIVE? He's a CHILD, not a can of peas, people.

Let's substitute the words "defect" and "problem" with kinder terms like "difference." Again, we're talking about PEOPLE here.

Equally, and perhaps more offensive, is this suggestion:

"...but you can start maybe making plans in terms of other children, figuring out what are the risks that my other children are gonna have this problem."

Awesome. Gotta weed out those defective kids. Got one child with an autistic spectrum disorder? Please refrain from any further breeding.

I'm so disappointed by CBS radio, Osgood and this Dr. LaPook.

Seriously, WTF???

Monday, January 07, 2008

Oz is out of control

Quick one since I'm at work --

Oz's asthma is a little out of control. I feel like he's been gray and coughing for the last four weeks. He's certainly had a runny nose, so I would say -at the very least- that he has a sinus infection.

He thew up after his first swimming lesson yesterday, and has been coughing ever since. This morning, he was coughing until he gagged, and it took a dose of Claritin and a double-dose of Combivent to alleviate the cough.

He's also been waking up and coming into our room every night for the last week. Twice a night, at least. Seriously annoying, especially since Ig, who was sick last week (virus - not asthma-related) has been up, as well. I suspect it's because he's not satting well overnight.

Calling the PP today for a checkup. Don't know if we need to adjust meds, or if it's even just upper-respiratory, but poor Ozzy really is a mess!