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!)


Freadom said...

Excellent advice. It's really difficult to actually diagnose asthma on a child under 2, so we in the medical field pretty much go by a) family history of asthma (it is genetic) and b) the child's response to albuterol and c) child's history.

Just FYI, Albuterol and pulmicort will not do anything for pneumonia, nor will it get rid of the virus that causes RSV, but if either of these ailments cause your child to have bronchospasms, the Albuterol will work like a charm. And the pulmicort will reduce inflamation and create more receptor sites for the Albuterol to land on, and, thus, make the lungs stronger in that regard.

RSV is usually caused by a virus, of which usually leads to a head cold in adults, but in children can cause secretions to drain into the lungs. One of the most effective things we do in the hospital setting is suction out the nose to improve work of breathing. I have some research on this I can link you to.

There really is no medicine to get rid of the virus causing RSV, so therapy is pretty much to treat the symptoms.

Pneumonia is normally caused by a bacteria, and is treated with an antibiotic. That would explain the Amox. If that doesn't resolve the pneumonia, there are alternative antibiotics that might be tried.

Oh, and recent studies show that RSV almost always starts with an ear infection caused by a virus. And, again, an antibiotic will not fight a virus. However, he the DR. might have ordered the Amox for the EI just in case it is a bacteria or, perhaps, the child has pneumonia.

Anyway, there is some ammo for Jeniffer. This is all based on the latest research.

Freadom said...

Here is a link to a post I wrote, which has many links to the latest RSV research. There's nothing better than being armed with the most recent research.

Aimee said...

Thanks, Freadom. So glad to have your contributions!!!

I remember the moment we realized Oz had asthma. He was coughing til he vomited after eating, right around his first birthday, which we assumed was *just* reflux. At the PP's suggestion, we tried giving him albuterol...and were actually heartbroken to realize that it WORKED. The reflux was triggering a bronchospasm...which wouldn't typically happen in a non-asthmatic child.