One flare; one mystery symptom

Just wanted to update y'all -

Oz had a minor flare last Tuesday and Wednesday - nothing we couldn't manage with a little DuoNeb. I was a little nervous that he might miss his Thanksgiving play...but he was through the flare by Wednesday afternoon.

I don't think we're 100% out of the woods...there was a lot of sniffling today, all of a sudden. But I don't see a trip to the ER in the near future, either.

Ig's going to the doctor tomorrow. He's had these very red eyes since Friday. No discharge or crust or anything....just bloodshot eyes. How weird is that?

I've heard him cough a handful of times, and he may be a tiny bit congested, but the eyes are just odd.

Called the pediatrician today, and she suggested we give him some antihistamine, but I don't think it helped at all. She did ask if he was urinating, and I *think* he is...but truth be told, now that he's potty trained, I'm not sure how often he goes. He's not like Oz, who at 5.5, still announces each and every trip to the potty to the entire household.

So...maybe he isn't urinating as frequently. Anyone know what this might be a symptom of? It's so hard with Ig. With his communication skills so impaired, I don't even know if he *feels* sick.

Having a Moment (Autism, not Asthma)

I'm having a rough time.

I know my posts are generally asthma-related, but I actually have two boys who are on the autism spectrum, too.

#1 son, B, has Aspergers Syndrome. He's totally mainstreamed in school and, if anything, his particularly brand of autism makes him better-behaved than average kids. I think he honestly believes the world will burst into a fiery ball if he breaks a single rule. He definitely has anxieties and feels the stress of everyday life more than most, but he's a great kid.

Oz, son #2 is a completely typical 5 year old - smart, gorgeous, snarky. He's great.

#3 son, Ig, who will be 4 in December, was recently diagnosed PDD-NOS - that is "Pervasive Developmental Disorder, Not Otherwise Specified." The "NOS" part typically means there's no delay in speech development.

Although Aspergers is frequently catagorized as a PDD-NOS diagnosis, I can tell you that Ig and B are unbelievably dissimilar. Where B and I were having full conversations (about snakes, usually) by the time he was three and a half, Ig can't carry a conversation at all. He has the vocabulary. What he lacks are the semantic and pragmatic language skills. He just doesn't "get" conversation at all.

A little clarification on that "semantic pragmatic language disorder":

Semantic-Pragmatic Disordered children have many more problems than just speaking and understanding words, so it is called a communication disorder rather than a language disorder. We think that the difficulty for children with S.P.D. may be in the way they process information. Children with S.P.D. find it more difficult to extract the central meaning or the saliency of an event. They tend to focus on detail instead; for example the sort of child who finds the duck hidden in the picture but fails to grasp the situation or story in the picture or the child who points out the spot on your face before saying 'hello'. "

So, vocabulary is there, language skills aren't. But there are so many more problems than that.

Every day is a struggle for Ig. I don't think he understands that there is a world around him that functions independently of him and without regard for what he wants or needs. This includes time, which has no meaning for him. If he wants something, he wants it now, and there's no explaining that he has to wait for it, or that the zoo is closed, or that we have to leave for school right this instant.

It's hard enough that he doesn't get these things in the first place, but then you can't even discuss them to attempt to reason with him. Conversation is impossible, although I do believe he understands quite a bit more than we give him credit for.

And when he doesn't get what he wants, he tantrums. These used be typical toddler tantrums - screaming, crying, kicking, hitting. Now they're just small, random acts of violence - hitting or biting one of his brothers, throwing a toy, kicking the dishwasher, whipping me in the back of the legs with his security blanket. If we put him "time out" for one of these offenses....THEN we get to see a good, old fashioned temper tantrum.

You can understand then, maybe, why I've kind of given up. In the past, I was the mom who removed her child from the restaurant at the first wail. My kids go to time out for talking back. They don't get dessert if they don't finish dinner. I'm an old fashioned parent in so many ways. But Ig has just worn me down. I let him get away with murder because it's easier. It's SO much less work.

I realize that I can't do that, and today I resolved to stop doing that. And I know it's going to get worse before it gets better. It always does.

Ugh. I love this kid so much, and I know that he needs me so much more than my other guys do right now. Seriously, I don't think anyone's ever loved me or trusted me the way he does! But he's so tough. He can be so sweet one minute, and trying to punch me the next. He's completely unpredictable.

The most frustrating thing? I can't afford to see the behavioral therapist as much as I need to. We've made so much progress with him, but insurance doesn't cover the visits. (NJ mandated insurance coverage for autism-related therapies back in August, but it doesn't take effect until February.) I would have the guy move in with us if I could! And we live pretty comfortably - we're not millionaires or anything - but the therapies really do cost THAT much.

I'm ranting (whining?) now...too tired to make sense. I just feel so alone with this. No one in my world understands how tough it is to live with this guy, but really - after nearly four years, I've only just started to feel like he's not running the household. And I'm scared of what the future holds for him. Will he ever be able to make friends? Will he find ways other than violence to relieve his frustration? Will he have to go to special schools? Can we afford all the therapy it will take to help him lead a happy, satisfying life?

Will anyone be able to see the glimpses of the smart, beautiful, loving little boy I see?

To Med, or not to Med?

Hi, all!

I'm happy to say, things have been quiet around here (apart from autism-related behavioral stuff, that is) - no one's coughing right now. Ig even made it through a nasty side infection without a single neb! But alas, it's flu season, so I'm cautious with my optimism.

This just came in via comments, and I thought I should address it, since it's definitely an evergreen topic.

Great blog! I found you by wandering around looking for a comparison of albuterol and xopenex. My DD (5) had a cough and a fever for four days so I took her to see the Ped, who promptly prescribed albuterol inhaler and antibiotics.

I freaked out (my kids have never had prescription meds for anything ever before) and decided NOT to follow Ped's suggestion, hoping that Ped was just CYA and DD could kick it on her own.

Well, fast forward three days and DD is weezing. Now, I'm reconsidering but a friend suggested Xopenex instead. *throws hands up* When I read your blog and the experience of the other parents, I get so frustrated because it seems like once you start, there's no getting off the moving sidewalk of meds. However, DD is miserable and I just want her to get better. *sigh*

First of all, WOW - I can't believe your kids have never been on prescription meds before. That's awesome!

But...y'know what? I think you should consider listening to your pediatrician and starting them. Respiratory illnesses (especially during this particularly creepy flu season) can become very serious, and albuterol - or Xopenex - will help your child breathe more easily.

While they may make her hyper, please remember that your child is probably having difficulty breathing if she's wheezing and coughing. For young kids - heck, even for US! - this is a scary situation. Fast-acting inhalers like albuterol and Xopenex will help her feel better right away. (And if you delay starting the meds, you end up having to put her on Orapred. Horrible!)

I totally get the idea of not completely trusting your docs, believe me - there's tons of research that shows that doctors will prescribe antibiotics and other meds because they think patients expect them. (A direct result of DTC advertising, but that's a whole 'nother kettle of fish...) My peds know that I often won't fill certain prescriptions they write for my kids (like antibiotics for minor illnesses that may be viral). At least not right away.

But with respiratory stuff, I don't take chances. There's too much room for something to go horribly wrong. I've taken my kids to the ER far too many times to risk it.

In a perfect world, you'll have pediatricians that you trust with your kids lives - literally. But if you question a respiratory diagnosis, find a pediatric pulmonologist or an asthma and allergy specialist.

In this case, please don't wait. If you're questioning the diagnosis, see that specialist ASAP.

And granted, I'm not a doctor or a medical professional or any kind, but as the mother of three asthmatic kids, I hope you'll start the nebs while you consider your options. There are no known long-term side effects to albuterol or Xopenex, and they'll literally help your daughter breathe easier.

Best of luck to you and your little girl. Please feel free to email me or continue our conversation via comments. And apologies if I sound sanctimonious at all - I don't mean to!

BTW, definitely check out the Mothers of Asthmatics site. It's a GREAT resource.

Are your kids getting the flu shot?

I haven't decided yet.

B can't get it, since he's allergic to eggs. (The vaccine is "grown" in eggs, so egg-allergic patients cannot be vaccinated.)

I'm not a fan of the vaccine, as many of you know. And here's why:

• In past years, quality has been an issue. Remember Chiron and the tainted vaccine in 2004? And then more problems in 2006.
• It's predictive, which means it may or many not actually work to prevent the flu. The two years my kids got the flu, the strain was not covered by the vaccine. (One year they'd been vaccinated, one year they hadn't.)
• It typically contains thimerosal a preservative derived from mercury. There are thimerosal-free shots out there if you ask for them, but don't expect your insurance to cover these.

Nonetheless, I probably will vaccinate, if only because I'll be forced to. And now that my kids are older (and two are already on the spectrum anyway), thimerosal isn't quite as scary, although I don't like the idea of ANY mercury being injected into humans - especially not my kids. Whoever thought that was a good idea?

And yes, I know it's smart to vaccinate your kids against the flu, especially when they're asthmatic. But I have lots of reasons to distrust big pharma, so I'm wary. I do solemnly swear, however, to religiously clean my house, wash my kids hands, keep them home when they are sick, and encourage them to cough into their elbows.

Are you vaccinating? Share your thoughts on why or why not.

Singulair Black Box

From comments:

Hi I just found your blog while doing endless searches on pediatric asthma. I have a few questions for you if you don't mind. What is the Singulair black box warning, is it about depression/ suicide? And I also had a question about your personal experience with flovent. My son has just been prescribed it, and he is two. Have you noticed any growth supression, and have you noticed any serious behavioral changes? I am so worried about giving him this drug, and the doctor and pharm just try to play down the side effects, but when I search online I find LOADS of unhappy mothers about them! Thanks for your posts!

First of all, your welcome! I'm so glad you find my blog helpful. Regarding Flovent - we never noticed any behavioral changes, but we actually did see suppression of growth. #1 son was pretty tiny when we took him off the stuff, and probably shot up a foot over that summer. He's grown astronomically since then. It's hard to say how much of that was just natural though.

What I can tell you about Flovent is that once he started it, we never had to go to the emergency room again. We haven't had any hospitalizations for any of our kids since we started them on Flovent. We don't love that they've been on steroids for years, but the results are well worth it for us. If you look through the comments on this blog, I think you'll find that *most* readers agree

As for Singulair - yes, there was a concern about Singulair causing suicidal thoughts and other behavioral problems. Our pulmonologist promptly yanked my kids off the stuff as soon as the warning was issued, despite the fact that none of them ever experienced side effects of any kind. (I do appreciate her caution though!)

As far as I know via my very quick research, Singulair has never been black-boxed, although many consumers seem to be pushing for this.

As recently as June 2009, Merck has been pushing back against the FDA on the basis that Singulair has proven to be incredibly helpful to many asthma and allergy patients.

Merck is confident in the efficacy and safety of SINGULAIR, a medicine that has been prescribed to tens of millions of patients with asthma and allergic rhinitis since its approval more than 11 years ago.

"For the millions of people suffering from either asthma or allergic rhinitis, SINGULAIR is an important treatment option for appropriate patients," said Scott Korn, M.D., vice president, Clinical Risk Management and Safety Surveillance, Merck Research Laboratories.

SINGULAIR is indicated for the prevention and chronic treatment of asthma in adults and pediatric patients 12 months of age and older, for the relief of symptoms of seasonal allergic rhinitis (SAR) in adults and children 2 years and older, and for the relief of symptoms of perennial allergic rhinitis (PAR) in adults and children 6 months and older. The efficacy and safety profile of SINGULAIR is supported by available data from controlled clinical trials, in which more than 20,000 patients received SINGULAIR, and from a review of post-marketing adverse event reports collected since the drug was approved by the FDA. ...

In clinical studies in patients with asthma, adverse events were generally mild and varied by age. The most common adverse events in clinical trials in adults and adolescents with asthma ages 15 years and older were headache, influenza, abdominal pain, cough and dyspepsia. In clinical studies in patients with allergic rhinitis, SINGULAIR was generally well tolerated with a safety profile similar to placebo. The most common adverse events in these clinical trials included sinusitis, upper respiratory infection, sinus headache, cough, epistaxis, headache, otitis media, pharyngitis and increased alanine aminotransferase (ALT). Less common side effects that have happened with SINGULAIR include behavior and mood related changes [agitation including aggressive behavior, bad/vivid dreams, depression, feeling anxious, hallucinations (seeing things that are not there), irritability, restlessness, suicidal thoughts and actions (including suicide), tremor, trouble sleeping].

On August 28, the FDA updated its page regarding the review of Singulair and similar drugs. Regarding the status of this review, the FDA now recommends that:

Patients and healthcare professionals should be aware of the potential for neuropsychiatric events with these medications.

Patients should talk with their healthcare providers if these events occur.

Healthcare professionals should consider discontinuing these medications if patients develop neuropsychiatric symptoms.

I don't know if this is FDA code for "Black Box" - anyone?

Behavioral issues from Pulmicort and Singulair?

Another comment to address:

My son is on singulair and plumicort. He has had "asthma/breathing" problems since he was six months old. He was put on the meds the summer bw pre-k and kindergarten. He was a perfect student in Pre-k, but ever since he has been in trouble in school. He just started the first grade and his teacher has asked me to have him tested for ADHD. I do not want to medicate him anymore than I have to. I have read that singulair and plumicort can have these side effects on children. But he needs them to survive!! The dr told me today I can take him off the singulair for a week and see if there is a difference.

So, keep in mind that Singular and Pulmicort absolutely CAN cause behavioral side effects...but they don't always. We were fortunate enough to never see those side effects (I assume, but I've never been able to talk Ozzy off the stuff!), although we did have others. We did see jumpiness from Albuterol and Prednisone, but not from the maintenance meds.

I would follow your teacher's advice. Talk to your pediatrician about your teacher's report and try to understand if her concerns seem related to the medications. Talk to your pulminologist if he or she might have a better understanding of the side effects. If your pediatrician thinks it's warranted, take your son for the evaluation. If your behavorial psychologists and/or pediatric neurologists handle evaluations in a manner similar to the way our doctors do, you'll find the evaluation an enlightening experience. My kids and I have actually enjoyed those appointments, believe it or not.

And if your child does have ADHD, you'll be able to get the treatment he needs. Not all doctors medicate for it - and not all kids require medication. (Our Ig was recently diagnosed with PDD-NOS, and I was warned that he probably has ADHD as well, although he's too young to diagnose. Like you, I don't want to medicate. I don't like those meds! If we have to do it, we will, but we'll do everything we can to avoid it.)

So, in summary, do the evaluation. Your child's classroom issues may not have anything to do with the asthma meds. But once you have a diagnosis (or not), you'll be able to make informed decisions about how to help your child succeed in and out of the classroom.

Good luck - and please keep me posted.

H1N1 - and all flu - require vigilance

Have to adress this comment that came in as a response to my swine flu post from July:

No offense, but it seems very unwise to say H1N1 is no big deal and then make an offhand remark at the end of your post that your child was on an anti-viral medication. And it's possible that the negative flu test was indeed accurate, and it was not the flu. This response is written in September after the resurgence of the flu and I believe it is has to be taken seriously. According to the CDC, 30% of the children who have died from H1N1 had no pre-exisiting health condition. It has been proven that young people and children with asthma are at particular risk. This flu has the ability to penetrate deep into the lungs and replicate there, unlike the "regular" seasonal flu. This was suspected at first (shown in animal testing) and confirmed by testing done at the CDC. This explains why it is causing pneumonia in some people who wouldn't normally get it form the flu. For most people it WILL be a relatively mild illness but no one yet truly understands this new virus - all parents of children with asthma should remain educated and vigilant.

Defensively, I have to make to comments (and yes, I know it's stupid for me to get defensive):

First: Do you remember they hype around H1N1 in June and July? At that point, the virus was affecting far fewer people than a typical seasonal flu outbreak - and with far fewer serious and fatal cases - yet the media was treating it like we were amidst an outbreak of bubonic plague.

If I seemed to have been taking things lightly, it's only because it was only because the flu we had was shockingly mild.

Secondly, my kids were WELL into the their flu by the time they started antivirals. I would say they were already "over the hump."

That said, we NEVER take the flu lightly, and I apologize if I seemed offensively flippant. We've had enough chest X-rays, Prednisone, round-the-clock nebs and hospitalizations to last a LIFETIME, believe me!

We will vaccinate (thimerosal-free, cause I'm weird like that) when possible, and we'll see the doctor at the first sign of anything. We'll keep our hand-washing up, and, like any responsible mother, I will keep my kids home if they seem sick. I hope you'll do the same.

I actually haven't been keeping up with the state of the flu so well... If you have updates on stats and symptoms, please share.

Flu, in hindsight

So, now that everyone is back at camp/daycare, I have this to say about the summer flu....

It wasn't so bad.

Oz was VERY sick for a day. Then he was kinda sick for a day. Then he was fine, but had to stay home for four more days. He had one really bad asthma flare on the tail end of it (coughed til he threw up), but we've had worse.

B ran a fever, but never got very sick.

All in all, while it sucked having the flu in July, I think this was a pretty mild strain. Certainly no worse than what they faced in November, and not nearly as bad as the strain B caught in January of 2004.

So...all the hype about H1N1. Just hype. Granted, the Tamiflu may have had a greater impact than I'm giving it credit for, but really... I don't think this is as bad a flu as the media made it out to be.

Starting Tamiflu

So...quick update...went to the pulmonologist today. (She's at the hospital, so we had to wear masks. Horrible!)

She's sure ENOUGH that Oz has flu that she prescribed Tamiflu. And if he's not better by Thursday, she wants a chest X-ray.

Sigh.

He seemed more energetic today, but still not eating much (a little Kraft macaroni and cheese at dinner, that's about it)... but still running around 102 and looking pretty poo-ey.

I'll keep ya posted.

Oz might have the flu

MIGHT have the flu.

After a mild flare yesterday, my monkey woke up with 102 - and ran that fever all day long. He didn't complain of a sore throat, but did complain that his legs hurt and his head hurt, and occasionally that his stomach hurt. He could barely keep his eyes open all day.

At daycare, of the 70 kids or so enrolled, an alleged 23 were absent. A few tested positive for strep, a few had suspected flu cases. The Board of Health called while I was there dropping Ig off.

I took Oz to the doctor, and after waiting an hour, he tested negative for strep and negative for flu...HOWEVER, the rapid flu test has a 25% false negative rate. The doctor thought his symptoms looked enough like the flu that she's not allowing him to return to daycare until Monday. (And that's the date she put on the note he needs to go back!)

She also wants me to call the PP to see if they want him to go on Tamiflu, before the final flu test comes back from the lab.

I'll one-up them on that: I'll take him to the PP. Given his history of pneumonia, I think I want him to be seen. Especially the way he's coughing right now!

Perioral Dermatitis - from Comments

Got this comment from Lauren about Perioral Dermatitis:

Aimee, I found your site while looking for a possible link between discontinuing Flovent and my son's rash around his mouth appearing a day later. Your blog entry and the comments by others were the only information I could find about perioral dermatitis caused by flovent or stopping flovent. Have you had any more experiences with it since your post?

The pediatrician and the allergist both had never experienced anything like it. He got a topical antibiotic cream and I suspected it wouldn't work after reading your blog, but gave the doctor the benefit of the doubt. It actually mostly cleared up with the cream, but then rebounded quickly as soon as he stopped using it. He's now back to using the cream plus on an oral antibiotic. I'm wondering if we should be reporting this to the drug company (GSK) since it seems to be an undocumented side effect that doctors have no idea about.

So, yeah - periorial dermatitis can DEFINITELY be caused by Flovent, or any inhaled steroid. I'm surprised that more pulmonologists don't talk about it!! #1 son had it so bad, it was terrible. It made him so sad - it looked like had terrible acne. And we had to go to several doctors before received an accurate diagnosis and treatment. One doctor referred to it as "steroid acne," which I think is accurate - but didn't prescribe a strong enough treatment.

Ultimately, it required a three-week course of SERIOUS oral antibiotics and a topical antibiotic gel. It's pretty serious stuff.

Lauren - I'm in support of your approaching GSK with this one. It should be listed as a side effect.

Thanks for bringing the topic back up. I'm sure there are plenty of other moms out there who could use this info

For Erica: Yes to Flovent!

Got this via comments:

hi, I have a 2 year old that was recently diagnosed with asthma They put her on pulmicort and she does fine with it, my problem is she HATES to sit there and take the medicine. It seems to take forever!!! So my doctor said I could put her on flovent and take it through the inhaler, I am kinda scared about switching her. I hate the fact that she has to take medicine anyway, but switching makes me nervous. Have you ever used it? What do you think?? Thanks so much for your time, Erica

Flovent is essentially the same medication as Pulmicort, but it's delivered via an Metered Dose Inhaler (MDI) instead of a nubulizer. You'll need a spacer, like Vortex or an Aerochamber, but it's easy to use and takes about fifteen seconds to administer!

One tip: Flovent can cause thrush, so we always do our meds immediately before brushing our teeth. It's just become part of the AM/PM routine at my house, and compliance is not even an issue. (Talking with the mask on is....)

I'm sure you'll do really well with the switch. Good luck, Erica!

Superintendent Apparently Harrassed Over H1N1 Scare. Poor Guy.

When you live in an upscale suburb, you get to know how the parents can be. Let's just say, I wouldn't want to be a teacher in my town. The "catch more flies with honey" strategy isn't a popular one. The "I'll sue your ass!" strategy definitely has more takers around here.

So...I can't say I was surprised when I got this email last night from the Superintendent of Schools. You'll recall he sent out an initial email yesterday announcing a single case of swine flu.  Another email, confirming that yes, in fact, it was just ONE case followed shortly. And then, God bless him, he sent this out last night: 

Dear Parents/Guardians:

Many parents/guardians have contacted my office and the schools seeking additional information regarding the student who has been diagnosed with H1N1 influenza and the risk to students throughout the district. More specifically, an e-mail is being circulated amongst the parent community claiming many more H1N1 influenza cases and I feel it is critical that I address the concerns contained within that e-mail.

As stated before, and confirmed by the <> Health Department, only one child within all of our schools has been diagnosed and confirmed with the H1N1 influenza virus. This student, along with other students in our secondary schools, attended a religious retreat over the Memorial Day weekend. It was learned Thursday evening, from parents of other students who attended the same religious retreat, that other students have subsequently experienced flu-like symptoms. As of this e-mail, we have heard from one other parent whose children are being tested for H1N1 influenza after one of their children tested positive for Type A influenza. The results of that test, for H1N1, are not available.

H1N1 influenza is a Type A strain of influenza and it is estimated that there is a 75% chance Type A influenza will test positive as H1N1 influenza. Flu-like symptoms include fever, headache, exhaustion, dry cough, sore throat, runny or stuffy nose, muscle aches, and stomach ailments such as nausea, vomiting, and diarrhea.

To date, neither the Health Department, the Department of Health and Senior Services, or the Centers for Disease Control and Prevention recommend school closures. It is important to remember that unless we all remain in our homes, there is no sure way to prevent transmission. We are all susceptible by going to the mall, a restaurant, a movie theatre, a youth retreat or other public place. There is no definitive information that school closure prevents the spread of H1N1 influenza.

Health professionals are learning more about H1N1 influenza every day, and most believe that the longest survival rate of the virus on any surface is eight hours or less. This means that H1N1 influenza virus cannot survive overnight in any building or in any of our schools.

If your child develops flu-like symptoms you should contact your primary care physician and your school nurse. If your child is symptomatic, you should keep them and their siblings home from school. I encourage all of us to exercise proper hygiene and most importantly washing our hands. It is important that this is reiterated to your children at home. It will help reinforce what they are learning in school.

It is has not been recommended, by local and State health officials, that we close our schools. Public Schools remains vigilant in ensuring the safety of our students. We will continue to monitor and assess any abnormal absentee rates and keep you apprised of any important information. We will continue to evaluate and be diligent with regard to possible cases of H1N1 influenza. Rumors regarding students exhibiting flu-like symptoms must be confirmed and I encourage you to contact your child's school nurse if you feel you have information about a student/family that is not being reported.

Rather than frequent e-mails regarding this issue, we will be updating our website, www.townshop.org, with any other information regarding our schools and H1N1 influenza.

Sincerely,

Superintendent of Schools

Think the guy was harrassed much yesterday? Sheesh!

H1N1 in our school. Should I be worried?

I just got an email from the superintendent of our school district. 

Dear Parents/Guardians:

 We have just received word that the test results from the student who attended the religious retreat last weekend were positive for the H1N1 influenza.  As my email stated last evening, the ill student did not attend school this week.  We are happy to report that the student is feeling much better and is resting at home.  

Some students from the trip, who were not exhibiting any symptoms, did come to school on Tuesday morning, however they were sent home as soon as we were alerted of the possible exposure.  The rest of the students who were on the trip, along with their siblings, were kept out of school for 72 hours;  24 hours longer than the advised incubation period of 48 hours.  No other students from this trip have exhibited any symptoms and the incubation period was over on Tuesday.

 We are working in conjunction with the (local)Health Department and are following all of the tracking and precautionary measures advised by them and the State Health Department.  The number one advisory from both health departments is strict hand washing.  However, we do encourage parents/guardians to educate themselves about the H1N1 influenza and the best resource is the Center for Disease Control and Prevention website, www.cdc.gov.

(Our local) Public Schools (have) taken and will continue to take every step necessary to ensure the health and safety of its students and staff.  As always, a parent/guardian has the choice to keep their child home from school;  however, please be advised that regular attendance procedures apply.

 If you have any questions please feel free to contact your school nurse.

Sincerely,

 

XXX

Superintendent of Schools

 I should probably, as the mother of an asthmatic child in the district, be more concerned...but I'm not. It's the flu. Its a weird summery flu that comes from pigs, but it's the flu. B's allergic to eggs and can't be vaccinated anyway, so it's really no greater risk than any other flu.

Semantic Pragmatic Disorder

Holy S**t! This is it - this is my Ig!  Check it out: http://www.brighttots.com/Semantic_pragmatic_disorder

Spring Asthma Update

Hey, all - just checking in. It's been quiet on the blog, I know, but believe me...not so much at home!

While we've kept the asthma at bay well enough, sons #1 and #3 have had horrible allergies this season (ironic, since #2 is the only one with diagnosed allergies).  I really need to get them both to the peds - runny noses, wet coughs, all kinds of icky booger nastiness. #1 is 7 now and really uncomfortable. He's getting a little relief with Zyrtec, but not nearly enough.

More time consuming and concerning has been the story of #3, our little Ig, now 3.5 years old. As my longtime readers know, #1 son has Aspergers Syndrome, a mild form of autism. (He's 100% mainstreamed at school, doing beautifully and has absolutely no disciplinary issues.  He's a gift and a blessing in every way.) So we have some experience with developmental concerns. And we think Ig has some kind of developmental delay. We're not sure what, but we're trying to get answers.

The last few months of my life have been spent (apart from changing jobs and restarting my singing career at night - another story!) trying to get help for Ig. This has involved a long process with the school district's Child Study Team, several unreturned calls to the nearest Child Development Center (finally got an appointment - in August) and a visit with a family therapist...along with many tears and a lot of shouting.

Ig is a beautiful little soul, but so difficult that he's thrown off the balance we had as a family. He obstinate, combative, and prone to tantrums. He has no impulse control whatsoever, which concerns me every single waking moment (he WILL run out the door of the daycare center and into the driveway. He WILL leave the house while I shower) and he is immune to discipline. What concerns me most though are his communication skills.  He's not capable of any kind of meaningful conversation - only  brief, immediate chats about what we're doing in that moment. And I'm concerned that a lot of what he does say is echolalia.

Because I can't modify his behavior, I've modified mine. When I shower, I put on his favorite TV  show and bolt the doors.  (I plan to put a latch up high on the door, as well.) I park at the back of the daycare center, so the car can butt up to the sidewalk, instead of having to cross the parking lot and driveway to get to the door. I choose weekend activities for which he doesn't necessarily have to stay put or stay quiet - like going to our local zoo. (We went twice this weekend!)  He needs to have his own story at bed time, so I have to read twice as much (one story for B and Oz, one for Ig) so I can keep the routine we've had for him since infancy.  

And I've given up on getting him to sit and eat at dinner time. We try to eat as a family as much as possible, but Ig won't sit  (or eat) for more than a few minutes, so I just have a safe activity lined up for him when he leaves the table.

It's exhausting. And it's not fair to B and Oz. Ig requires so much of my time and attention that I worry that the two older boys are missing out - or worse, feeling like I love Ig more than them. I'm desperate to find out what's going on with him so he can get the help he needs - and so I can pull my family back together.

So...at least the asthma's been under control, right?

Civilization as the Cause of Asthma - Amazing Article

I just happened across this astounding article on the Atlantic Online - absolutely had to share it with you! It's from 2000, but still incredibly relevant and eye-opening. Here's a quote:

Martinez, who came to the United States after launching his career in asthma research, is one of a number of specialists who believe that modern life may be responsible for the developed world's asthma rates -- but in a very unexpected
way. It is not tobacco smoke or pollution that is at the heart of the problem, these specialists believe, but modern hygiene practices and antibiotics that foreclose the need for the young immune system to tackle microbial and parasitic challenges. "Just as you need to use your eyes to develop sight and your legs to develop the muscles to walk," Martinez said, "your immune system develops through its experience. By legitimately protecting our kids from dangerous infections we may have kept parts of their immune systems from maturing."

This could explain why children in the developing world, who are repeatedly infected by bacteria and parasites, are unlikely to contract asthma, whereas children in the developed world, who are inoculated against infectious diseases and frequently given antibiotics, are contracting asthma in ever greater numbers. (Martinez quoted estimates that an astonishing 40 percent of children in the United States are given antibiotics for a period of a month or more in their first year of life.)

Read on. Have your thoughts provoked.

Special AccuClean Air Filtration Offer from Mom Central

So...I got a call from Mom Central last week. While I'm a marketer by trade, I don't typically use this blog to promote stuff, but the material they asked me to post is 100% relevant and helpful. And admittedly, I'm kinda flattered to be on their radar!

They're working with American Standard (yes, the toilet people) to share info about allergy and flu prevention - and to give you a chance to win their AccuClean whole home air filtration system.

Since allergy season is pretty much here (at least in NJ. Does it ever LEAVE NJ?) But yeah - we're just about reaching those days when our cars are blanketed in a fine layer of yellow dust. (Pollen, people. I'm talking about pollen!)

Staying in doesn't help much either. According to Mom Central, it turns out that indoor air is four to five times more polluted than outdoor air, of particular concern because most of us spend as much as 90% of our time indoors (and we wonder why obesity's a problem? Sheesh!), according to the U.S. Environmental Protection Agency. So keeping our home’s indoor air quality high ensures that our kids (and even we) will be able to breathe more easily and suffer fewer symptoms during allergy and flu season.

American Standard's Heating & Air Conditioning’s AccuClean™ whole home air filtration system can makethe air in your house virtually pollution-free. (It attaches to your existing furnace or air handler, so there's no major renovation required to install it.) AccuClean removes allergens from the air in every room of the house, not like plug-in air cleaners that work in only one room. It removes 99.98% of all allergens in your house. It also removes more than 99% of the common flu virus, which I didn't honestly know air filters could even do. And apparently, it's pretty easy to clean, too. You just vaccuum it.

Hannah Keeley, one of Mom Central's consulting principals and founder of www.TotalMom.com, has been working closely with American Standard Heating & Air Conditioning over the past two years and has met with moms who have experienced, firsthand, the difference AccuClean can make in families’ homes and lives. Hannah shared this with us:

Keeping the dirt and dust out of your house is easier said than done, and cleaning every day is simply not an option for today’s busy families. AccuClean prevents unwanted dust and dander from continually circulating in your home, ensuring the indoor air your family breathes is cleaner and healthier.

Mom Central asked me to post this special offer for Kansas City, MO and Charlotte, NC families. Click the links below for more information and a chance to win a system for your home.

• Kansas City link
• Charlotte, NC link

I'm actually going to look into this too -- our pulmonologist won't let us use humidifiers, so maybe this is a good option for us to have more breathable air in our house.

Everyday Health on Inhaled Steroids

Since posts on this topic are always catalysts for comments and lively discussion, I thought I'd share this one. Everyday Health answers this question:

"My son has been on steroids for asthma since he was 18 months old. He has been on Flovent since March 2006, one puff twice a day, 110 mg. He turned three on June 9, 2006. I have two questions: Are there any studies that show long-term effects of taking this steroid other than affecting growth? Could Flovent be causing him to be hyper? He is a very busy, active boy."

The answer, by an asthma specialist, might make you feel a little better about keeping your kids on Flovent or Pulmicort.

My take (as always): I hate the stuff as much as the rest of you, but it does tend to keep my kids out of the hospital. If helping them breathe means their a little more active and a little shorter...I'll take it!

Chest tightness? S**t, maybe I DO have asthma!

So...I think I've mentioned this in previous posts, but I've been sick since before Thanksgiving. I've had a dry, chesty-cough, and I had a pretty crazy flue-like thing just before Christmas.

Turns out I've had a very persistent sinus infection, which has triggered reactive airways. The cough is really only present at night, or when I hit a blast of cold air. Or eat/drink something really cold. Or encounter a strong scent or fumes.

I'm on my second course of antibiotics (had to cut the first short when I had an allergic reaction!) and albuterol as needed.

But here's the thing: I've seen what albuterol can do to my kids, so I use it pretty conservatively. I have to be coughing a lot to take out the MDI (ProAir HFA).

But right now, I'm coughing less, but my chest feels really tight. I was trying to determine earlier if it was from the pec workout I did yesterday, heartburn, or actual tightness in my airways.

I think it is actually respiratory - and it's kinda creeping me out!! I'm going to buckle down and take some albuterol. We'll see if it helps!