Still some grunting...but very quiet around here!

Just an update -- Oz does still seems to have a bit of grunting in the morning, but otherwise things are quiet. No flares, no colds, no sinus infections, even in the worst allergy season we've ever seen here on the eastern seaboard.

We'll be going to the PP soon just for a check up for both boys. We'll see how that goes. I'm hoping to get Ozzie off the Flovent for the summer (although with the grunting, I don't see that happening) and big B down to the 44. Considering he was on Flovent 22o less than a year ago, 44 is an ambitious goal!

I'm also supposed to take Baby Iggy for a chest Xray. Not sure if I'll do it. I guess I should...what with respiratory distress at birth, a possible case of pertussis and then his turning blue. And he's barely five months old!!! I just hate to do it, not only because of the radiation, but it is such a pain in the ass to take your baby for an Xray at a major teaching hospital. It takes hours, it's horrible...there's just nothing nice about the experience. Maybe they'll let me go to the imagine center here instead.

Anyway. There's your update.

Ozzy's Asthma Flare? More Grunting, Retracting Now, Too

You'd think with one asthmatic kid, I would know when a second one is having an attack.

But Oz's asthma seems completely different. I feel like I'm learning asthma all over again. All the doubting and denial, the wondering if I'm overreacting...it's all so exciting and new again. And I don't mean that in a good way.

Tonight, as with many nights before, Oz was very fussy at bedtime. He wasn't coughing or wheezing as far as I could tell, but he got really whiney and cranky when I put him to bed. You'd think that was just a normal two-year-old thing, but it's not something he habitually does. Usually, he'll just happily climb out of bed and silently find something better to do. (I've found him playing with the glider in the nursery, "reading" in my bed, etc.) He doesn't usually CRY.

When I got into his bed to console him, he was grunting again. When I looked at his belly, it looked like he was retracting a bit. Hard to say - I'm no expert on retractions. But it looked like the skin was sucking in between his ribs a bit. And his breathing was definitely labored.

I wasn't sure...I don't always trust myself when it comes to my kids' asthma. After all, I didn't go to medical school. But even though I half-doubted what I was seeing - I mean, he's TWO, who's to say he's not going to start suddenly crying at bed time - I got out the albuterol MDI and Aerochamber.

Sure enough, he was breathing more comfortably within minutes...and sound asleep.

Guess I'll be calling the pediatric pulmonologist tomorrow.

You Know You're Done Having Babies When...

...You can watch the birth segment of "A Baby Story" and not cry.

I'm there!

New Asthma Resources

Seems like big pharma is really catching on to the asthma craze these days. Suddenly, there are "sponsored" information sites left, right and center. And although I'm more cynical than usual these days, some of these sites are actually pretty useful:

http://everydaykidz.com (Astra Zeneca: Pulmicort)

http://asthmamatters.com (Novartis: Xolair)

http://www.asthmacapitals.com/ (Seems to be related to the Xolair site)

and this non-pharma one:

http://noattacks.org/ (EPA/Ad Council)

And of course, my favorites:

http://www.breatherville.org

and

http://www.lungusa.org

Check them out -- there's not much new to learn at this point, but refresher courses for parents and better ways to explain things to your kids are always a help.

Grunting - is it an asthma thing?

Ozzie climbed into bed with me this morning, and, when he wasn't pulling on my earrings or trying to stick his fingers in my ears, nostrils, or mouth, and just trying to sleep, I noticed that he was grunting on every breath. Not a low grunting sound, but higher, like almost in his regular vocal pitch, and only on exhale.

Anyone know if this is a regular asthma thing?

He's also been especially cranky upon waking up and a little whinier than usual. But...he's also two years old.

And, can I just say, he is absolutely one of those two-year olds who would shove a sandwich into the VCR. It's a good thing he's sooooo cute.

Baby Violet Gets Her First Neb -- Jen, Ben: Start Reading My Blog

Baby Violet Affleck had her first trip to the ER - and, presumably, her first nebulizer treatment - when she was rushed to the emergency room back on April 8. Apparently, baby Violet was having difficulty breathing.

According to the article I read: "Ben Affleck and Jennifer Garner's daughter Violet Affleck was rushed to a Century City medical office because she was having trouble breathing. The 4-month-old was then treated and tested for asthma before being released an hour later, said an insider."

Tested for asthma. Really? How did she do? I didn't realize there was a definitive test for asthma! I'll have to alert my pediatric pulmonologist. I'm sure she'll be pleased to hear the news. Gosh, when I think of all the time we've wasted on pulse oximeters, chest x-rays and peak flow meters. And all this time, there was a test!

Maybe you have to be an A-List Celeb to get one. Sort of like a scheduled C-section (for no reason other than to accommodate Mom's busy schedule).

Oh, and I loved this comment on that post:

"Asthma can be very scary, but it is also very treatable if it not too severe.... The good news is if she does have asthma, the odds are extremely good that she will outgrow it by the time she is 4. Childhood asthma is much more common than most people think. Hopefully, she will be okay and all will be well!"

And it's all good ..until the part about outgrowing it by age 4. Another bit of good news for me! Who knew that we could have taken #1 son off his Flovent, Singulair and Nasonex eight months ago, when he turned 4? Think of all the time and money we could have saved....

Sorry if I'm being uncommonly bitchy, but ignorance REALLY pisses me off.

Baby Iggy Turns Blue; Ozzy has a Flare

Briefly, yes, it's true -- 4-month old Iggy went cyanotic on me on Friday. He fell asleep in his swing, facing me, during the afternoon. He woke up, fussing, and when I went to take him out of the swing, I noticed that his lips were blue. Not blue-tinged -- BLUE.

I didn't completely panic, because he was still fussing and breathing well. But I did put an emergency call in to the peds, who told me to bring him right in.

He was fine by the time we got there, although I was (not surprisingly) a mess. The doctor told me this would probably never happen again. But she said that if it did, it would happen soon, within a few days.

So again, not surprisingly, I haven't slept much this weekend.

Also, Ozzy was coughing all day Saturday, but seemed to do well after lots of albuterol. This morning, though, he was grunting a lot while he was sleeping. I started the albuterol again, and I'm calling the PP now.

What a rough few days!!!

Scheduling with a Pediatric Neurologist: A Nightmare on So Many Levels

I've mentioned before that #1 Son has some "tics" and is currently in a special preschool where he gets physical and occupational therapy. (That's right, folks. My son rides the Special Bus.)

He's an astoundingly smart, outgoing kid. He's articulate, friendly...at age 4.5, he's writing, very close to reading, adding small numbers. And he's nice and polite, too.

The problem is that he's got problems with his fine and gross motor skills and motor planning. He has a hard time holding a pencil, and he tires easily when he's running or climbing things. But he's great at building towers of blocks and he loves to draw things like snakes and spaceships.

He also has problems that, while less inhibitive than the motor skills problems, confound his therapists. He flaps his arms when he's excited. He walks on his toes a lot of the time. He has low muscle tone. These, to me, are quirky things, but they're also some of the visible manifestations of autism -- although my guess is that my son isn't on the spectrum.

So he has these problems, which we've only identified in the last six months or so. (He's always flapped his arms, but we had no reason to think he wouldn't outgrow it.)

Now, as we draw to the end of the school year, his special preschool (which is part of the public school system) is recommending that he wait to start Kindergarten.

#1 Son does have an August birthday, so holding off on Kindergarten a year wouldn't be unheard of. Lots of parents do it. But I do have some concerns about going this route:

• He's already writing, adding, and ready to read. Is it fair to condemn him to another year of colors and shapes?
• Public school = free. Another year of daycare = $10,000. I hate to bring that up, but I do have #2 and #3, both of whom will be in daycare. It's a little financially dehabilitating, quite honestly.
• Will another year of special preschool really help? Or would a year of kindergarten with PT and OT be just as (or more) effective?

In answer to the third question, I've been attemtping to schedule an appointment with a pediatric developmental specialist.

For three months now, I've been attempting to schedule this appointment.

The peds. dev. specialist I've been trying to get him into at the big regional hospital my insurance company prefers (and I love) is so popular, I can't even get a return phone call. If they ever do call me back, I'll have to wait six months for his appointment.

So I tried the big, regional hospital around the corner, which both my insurance company prefer slightly less. Here's how that went:

1. Dialed, got auto-attendant
2. Option 2 asked me to leave a message (ha! cos I've had such luck with that at the other hospital!) or hold for an attendant. I hold
3. Six minutes later, I ask for the doctor suggested by my insurance company suggested, who is a pediatric development specialist.
4. I'm informed that this doctor hasn't been with the practice for four years, and I'm referred to another doctor.
5. Doctor #2 is one I've been asked to avoid by my friend, and anyway, she has no appointments available until AUGUST
6. The attendant recommends a pediatric neurologist -- who isn't on my plan
7. The attendant recommends another pediatric neurologist -- who *is* on my plan
8. I hold for about ten minutes while she finds an available appointment
9. I make an appointment for early June
10. I smile as the attendant passively dismisses my request to be put on a cancellation list

As if having an asthmatic child with "preschool disabled" classification wasn't enough. Sheesh!

Baby Iggy's Day at the Pediatric Pulmonologist

I left the pulmo Friday with two things I fully expected to leave with: a prescription for Iggy's first chest Xray, and one for Ozzy's full battery of allergy tests. (He just turned two, so we can do all the food allergies now.)

The rest wasn't quite what I expected. For starters, his lungs really did sound clear. This wasn't so surprising, his cough had really tapered down to nothing -- thank God! It had been two weeks since it started, after all.

She did, however, think the cough he had was Pertussis, aka Whooping Cough. She figured he had a mild case, since he'd already had one course of the vaccine. But apparently, it's been going around, and the way I described his cough sounded about right to her.

She asked if I'd given him albuterol for the cough. I explained that, as Iggy is FOUR MONTHS OLD, I wouldn't presume to give him albuterol. Especially since he'd never been seen by a pediatric pulmonologist before! She said that, given our family history, it would be alright to do so. Since his airways are still very, very tiny (AWW!), he'd only get as much as he needed if we administered the stuff via nebulizer.

I'm glad she trusts me to administer medications to my babies like that, but I still think I'd prefer to call her and/or have her SEE the baby before I go and administer an emergency bronchodilator to an infant.

As for the chest Xray, I may well skip that. I'm not sure he needs it at this point.

I'm almost excited to see what Ozzy's allergic to, on the other hand. There's so much he won't eat, I wonder if he's actually allergic to some of those things. That's how #1 son was. He wouldn't eat eggs after they made him throw up once or twice. Turns out, he's allergic.

I'm betting Ozzy's slightly allergic to grapes...and I'm curious to see what else! Bets, anyone?

One last bit of good news: I'm bringing Li'l B and Ozzy in next month for checkups, and there's a good chance we'll be able to lower B's Flovent to 44 (awesome, considering he was on 220 about a year ago!) and take Ozzy off the stuff completely for the summer. Yeah!

Taking the baby to the pulmonologist tomorrow

I may be overreacting, but baby Iggy (aka #3) is going to the peds. pulmonologist tomorrow.

He still has a trace of that cough, 2 weeks later, and I'd rather be safe than sorry. I mean, the kid's not even four months old yet!

We went to the regular peds two weeks ago, and they didn't hear any wheezing, but still... this cough sounds seriously scary. Scary enough that all the cousins had this blanched-looking expression on their faces when they heard it at dinner last week.

If nothing else, this will get him on Dr. W's patient roster. This way, if he does have a, um, *concerning* illness later on, I can page her directly. And if I think he has RSV, we can get him in with her right away.

And if, God forbid, there is something wrong right now, we can get the action plan started right away.

Meanwhile, I've gotta get the other two in with her next month. I'm hoping to lower #1 son to Flovent 44 (down from 220 last year!) and #2 off the stuff completely for the season.

But that's another post...!

Baby's cough - please, no!

Just a quick update -- took #3 (now 3 months old) to the pediatrician Friday. He was congested and had this horrific sounding cough!! The doctor said his lungs were clear, no wheezing...still. He's coughing that horrible cough only after eating now, so I can only guess that it's reflux, which we all know can be related to asthma.

Not optimistic. But why would I be?

Little B is doing better -- I didn't hear him cough once today. Hardly any snot either, thankfully. I was just about to take him to the PP for a sinus infection. So, good news there.

#2 son seems fine.

Can it be? Will we make it through the week without anymore albuterol? Might be a record!

Dyspraxia -- not asthma related (I don't think)

If I haven't mentioned this before, #1 son is in a special preschool to work on his motor skills and a possible sensory integration dysfunction. He's really smart and outgoing, but he has always had some "quirks." He flaps his arms when he's excited, he (more and more frequently) walks on his toes, and we're starting to see that he has low muscle tone. He also may be a little more dependent on routines than other preschoolers.

Members of my family had concerns that he had an autistic spectrum disorder, but he's so smart and so demonstrative, even our doctors dismissed the concern.

But when I started to see his quirks beginning to interfere with his activities and possibly his education, I requested that he be evaluated for the special needs preschool in our town. As stated, he's enrolled, and while he's getting PT and OT through the program, it's his "autistic tendencies" that are really beginning to concern me.

My cousin, who's an Occupational Therapist, thinks he may have Dyspraxia, which I'm trying to learn more about. I'm not finding too much -- I don't even know if it's on the autistic spectrum, but it does seem to make sense, based on his behaviors. But I'd like to do a little more research before even mentioning it to our pediatrician.

I've found that other kids on the asthma-parents list have kids with ASDs or SI dysfunction, so I'm wondering....

If you have a child with and ASD or SI dysfunction, or if you can link to any Dyspraxia info, please share!!!

Thanks.

Near miss - coughing, green snot, but that's about all!

#1 had a rough week; lots of coughing, green gunk, etc. but he seems to be fine. A little Combivent, and we're under control.

Here's the rant, though. I went to daycare on Monday with instructions to give him albuterol at 11:00 and 3:00 every day this week. Monday, he seemed to have gotten it. Yesterday, he told me he didn't get his medicine. My husband asked the director if she gave him the meds, and she said yes, but little B said she didn't. His teacher said she "didn't *see* him get it." (Note the politically correct wording there.)

Today, he told us he got it ONCE. Not twice.

So tomorrow, we'll have to have his teacher call us before she administers each dose.

Little B may be only 4, but the kid really doesn't lie. I take his word over the director's any day.

Ear Infection with No Asthma Attack. Phew.

//okay, just a *minor* asthma attack//

Just a quick update -- I took Oz to the doctor Saturday, and he had a pretty bad ear infection. I was concerned because he was REALLY congested and coughing a lot. Plus, paranoid as I am (hello, whole blog dedicated to my kids' asthma!) I couldn't help but remember that he did develop an ear infection when he had RSV in November.

So, PS, the weekend utterly sucked. He was so miserable Sunday, I think I would have thrown myself under a bus if I thought it would make him feel better! He was spiking fevers, his ear obviously killed, and he was just crusted with snot. (Fortunately for him, he's actually cute enough to pull off that crusty snot look. Kidding.)

But of course, by Monday, when I needed to work from home (huge amounts of work to do, too) he was just about fine, and as high-energy and cranky as any two-year-old in the world. Welcome to my world. But at least he was feeling better!

I did have him on a three-day course of Zithro, as well as DuoNeb/Albuterol. It all seemed to work. He's still a bit cranky, but hey -- isn't that what the terrible twos are all about?

My rant: What's with the Asthma Epidemic? Flouride? Vitamin D?

From a recent email I sent to the A-P list:

I'm not saying all kids got asthma from their drinking water. The vitamin D theory didn't work for me either.

Certainly not ALL asthma is caused by fluoridated water...asthma definitely predates treating public water! Genetics, possibly more than any other factor, will definitely predetermine which kids get it and which don't. But the number of kids with asthma has definitely skyrocketed in recent generations, and I'm always poking around to figure out why that is.

Pollution, for sure, is a factor, too, but I don't know that it's THE cause. I mean, I'm 34. I had exactly one friend with asthma in school. Now that I'm a parent in the same town, almost everyone I know has a nebulizer for their kids! Can the pollution have become that toxic in the last 30 years?? (Yes, diagnostics are different/better now, but I don't think it's the only reason!)

What changed? Was it just the environment? Or was it something we DID to the environment? Was it the vaccines we gave our kids, or something we did or didn't do (or take) while pregnant? Something they're using to treat road surfaces??

If you look at the numbers of kids with asthma, with autism, with life-threatening peanut allergies....all of these things (and other conditions) have become way too prevalent -- only very recently. And I just find it hard that this is simply evolution at work. Something, or perhaps a combination of things, has to have caused it.

I'm not a paranoid consipiracy theorist. The numbers are just too crazy to dismiss.

Forgive the rant!

Asthma related to Maternal Vitamin D intake?

Look at this.

SATURDAY, March 4 (HealthDay News) -- The link between maternal health and
childhood asthma is becoming clearer.
Researchers presenting new studies at
the annual meeting of the American Academy of Allergy, Asthma and Immunology in
Miami Beach have recorded associations between maternal nutrition and stress
with asthma in children.
One study found that expectant mothers who take
higher amounts of vitamin D may decrease their child's risk for asthma.
Vitamin D deficiency is common in areas where asthma is also widespread,
raising the suspicion that the two are linked, said Dr. Carlos Camargo, senior
author of the study and an associate professor of medicine and epidemiology at
Harvard Medical School in Boston.

I was just talking to a friend the other day who thought fluoridated water was the reason for the asthma epidemic. Definitely a new theory. Perhaps a kooky one, but I'll do some research!

Sick Boys

Just and update -- both of the older boys have nasty runny noses and coughs. Oz (#2 son) was up crying twice on Wednesday.

Both are on albuterol 3X daily. Maybe I should be a little more aggressive than that.

Let's just hope the baby stays healthy.

Asthma Journal - So bummed to be posting this!

Before I forget the real reason I ever started this blog:

#1 Son: Gooky green stuff in nose started on Sunday. Coughing started today (Wednesday). Coughing is very infrequent, but I started albuterol because our action plan says to "at first sign of a cold."

#2 Son: Gooky green stuff today, but not enough to start albuterol.

All winter long, I've felt just a little too lucky as far as their health...like I've been waiting for the other shoe to drop.

Hopefully, that's not what this is. (I know. I get so melodramatic when they start coughing!)

About that rash -- I think it's from the Flovent!

So #1 son had that rash on his face for ages. I called the pediatrician about it a few times, and finally I spoke to a nurse. She said she thought it looked fungal.

"Fungal?" I said. How could he get a fungal rash on his FACE??? She said, "Well, it could be from a number of things," and rattled of a list. When she mentioned thrush, the lightbulb popped on.

"Thrush," I said. "Can't Flovent cause thrush?" "Yes," she said.

And while Bryn didn't have the white tongue usually associated with thrush, this was the only explanation that seemed to make sense.

The rash was a little resistant to Lotrimin cream, but ultimately, it did work! Mystery solved!

It's also a hint that I probably need some new spacers!

The Flovent Shortage

I just got a letter from ExpressScripts, our prescription mail order house, that they can't fill Oz's Flovent prescription. It's on backorder!

They actually sent the script back, which says to me that this is probably going on for a while.

Our pulmo warned me this could happen back in December/January. When the local pharmacist was able to fill the Rx I didn't think it would be a problem. And I certainly didn't think it would be a problem so many months later!!

Weird isn't it? Why would there be a Flovent shortage? Is it just the Flovent 440, or are the 110 and 220 in short supply as well? Can I give him one shot of 110 twice a day or a single puff of 220 daily instead?? Is there a Qvar shortage, too??

The worst part is paying the $40 co-pay for one MDI instead of paying $40 for three, which is what I'd pay if Express-Scripts was filling it....

Asthma Journal - 2/14/06

It occurred to me today that I started this blog in response to a suggestion of the Nurse-Practioner at our pulmonologist. She recommended that I start keeping a journal of my sons' asthma symptoms, so that when I spoke to her or the doctor, I would know how long each kid had been coughing, or wheezing, or pale, or had a rash, etc.

So I started a blog instead of a regular journal becuase - hey - I'm a professional Web marketer, after all.

It's become sort of an all-purpose asthma bulletin board, but I really do need to remember to use it as a journal. It's pretty key in keeping up with the boys' health -- especially now that I have three of them!

So...#1 son is home sick today. That rash on his face cleared up for a day or two, then came back badly yesterday, along with a low-grade fever. He's been coughing a little here and there for weeks, but BADLY since Saturday. I've got him on nebs every three hours today.

#2 seems okay, but he was in bad shape Sunday. Seemed to be non-asthma related...whiney, cranky, bad diaper rash, yukky diapers. I suspect he's allergic to grapes, and that was the culprit. But don't know for sure...

Have a call into the PP now. We'll see if #1 son needs to be seen, or if I'll get the usual action plan:

Alternate albuterol and DuoNeb every three hours via nebulizer; Dimetapp at bedtime; keep up Flovent 110 (2 puffs, 2x daily), Singulair, and Nasonex.

$10 bucks on that, unless they want to test for flu.

New two-drug treatment for asthma

From http://abcnews.go.com/Health/wireStory?id=1567005

Rather than easing constriction and swelling, researchers are working on a
treatment that would actually reduce mucus production in the lungs:

A two-drug treatment may one day help restore healthy breathing in those
with asthma and chronic bronchitis, according to a study at Washington
University in St. Louis.

Dr. Michael Holtzman and other researchers found that some cells lining
the air passages of the lungs transform into another cell type in mice and
humans with those disorders, leading to the overproduction of mucus in the
airways.

Though researchers expect it would take at least a few years for
further testing of the treatments, they think that combining two drugs
ultimately could prevent the harmful transformation of the lining cells,
allowing for healthy airway function.

Even if it is a few years off, it's still a glimmer of hope!!

What's up with this kid?

#2 son seems better, after three days of nebs...but I'm concerned about #1. He's looking a little better, but still not right. He's still pale, and he's got that weird rash on his cheeks that he gets during an attack. It's odd. Just a pimply rash on his cheeks and occasionally on his eyelids. He seems fine; just that mucus-y sounding cough every now and then. But he's happy and normal, otherwise.

To be continued....

#2 Son's Diagnosis

...in case you were wondering.

It seems an upper respiratory infection has hit his lungs. Typical - we used to see this in #1 son all the time.

The PP said that "he wasn't moving air well" and his resp rate was up, although his sats were fine. And the poor baby looks and clearly feels miserably.

Bottom line: Nebs every 3 hours around the clock. Alternating DuoNeb and Albuterol (or Xopenex). Zythromax. Continued Flovent. Dimetapp if needed. Hopefully, no Predisolone necessary.

The 'round the clock' bit should be especially fun, since I'm nursing a six-week-old. I'll be in great shape tomorrow!!!

But it beats the PICU, any day.

Bandwidth for Babysitting

Quick one -- both the preschoolers are sick. #1 son is manageable, but #2 is pretty sick again. The peds pulmonologist asked me to bring him over right away, but of course, that meant loading him and the newborn into the car -- and exposing the newborn to all those germs at the hospital. Plus, I'd have to jockey the carseats around because I drive a PT Cruiser, and it only holds two car seats, despite having LATCHes for three!!!

Anyway, as luck would have it (for a change) my best friend asked to come over to use my wireless Internet. She just got a new Compaq laptop, and the wireless card wasn't working. She needed to call tech support from a location with an available wireless connection.

So - long story short - I let her use the wireless in exchange for a few hours of babysitting! #2 son got his emergency PP visit, the baby got to sleep safely through the whole thing in the comfort of his own home, and I got to do significantly less schlepping than I thought I would. And to make it a *real* win-win, Compaq tech support was able to resolve my friend's wireless issues.

Sometimes, life can be beautiful.

Lethargy - Asthma-Related? Or Just a Growth Spurt?

#1 son, though only four, has been behaving more like a sixteen year old for the past few weeks.

On two seperate occasions, he's come home from preschool, declined dinner, sacked out on the couch, and crashed. And then he slept straight through til morning.

How weird is that?

Now, granted, we're moving next week (albeit six houses away), he's just gotten a new baby brother, and he's gearing up to start kindergarten next year. If he *was* sixteen, it'd be a sure bet that he was suffering from adolescent depression.

But at age four?

Sure, it could be depression, but I really do think he's a happy kid. He loves his little brothers, he's psyched about having a playroom in the new house, and I don't think he's quite grasping the whole moving-to-a-new-school thing for next year.

More likely, he could be having a growth spurt. He's barely fitting into a 4T at age 4.5, and after two years on corticosteroids, it's about time he shot up a few inches!

But could it be a new asthma symptom? Is that possible? I'm sure I learned at our hospital's pediatric asthma class lethargy is a classic symptom. (MENTAL NOTE: retake that class!)

Just to be safe, I'm keeping an eye on his breathing these days.

Isn't it great how we asthma-moms love to make ourselves crazy??

AngryAsthmaMama Featured Blog at Genetics Health

I'm so proud! I have the featured blog for the week on Genetics and Health.

...I'm also a little embarrassed, as I'm a little behind on posting. Blame Baby Iggy -- it's a little tough to keep up with him, work, moving AND blogging!

*So* over breastfeeding....

Just a little rant here -- it's been two and a half weeks, and I'm already SOOOOO sick of nursing!

I'm committed to it, as I already have two asthmatic sons, and I'm determined to give Iggy the best possible odds for beating asthma. And since I nursed my other two, I definitely owe him this.

But, God -- it just SUCKS. I'm so sore, I'm too big for any bra on this planet (seriously, Pamela Anderson would be jealous), and if I do wear one (like if I have to actually see an adult who isn't an immediate relative) I end up with a painful plugged duct.

I know this is temporary. After six weeks, it will be a piece of cake, but this is just HELL.

Ah, the things I do for my boys. (But I promise to never, EVER hold this over any of them!)

For Aisha

Thanks so much for your comment! I'm so sorry your little girl's having such a hard time with her asthma. Sounds like you're doing a great job...and since I'm not a doctor or anything close to a medical professional, there's not much I can recommend.

But here's what I would suggest: Get a referral to either an Asthma/Allergy specialist or a Pediatric Pulmonologist, if you're not already seeing one.

Since your daughter's asthma clearly isn't under control yet, there are a few different things your doctor might recommend. Possibly, you could increase her Flovent dosage. Or, you could add another medication -- we've got both Singulair and Nasonex in addition to Flovent on my oldest's action plan. It may be something as simple as adding an over-the-counter antihistamine to your daughter's nighttime routine. We find that helps a lot, but I don't know if it's even an option for someone as young as your little girl.

But see a specialist if you haven't yet. Hopefully, there's one near you and on your insurance plan. There's a huge difference between a pediatrician and a pediatric asthma specialist. For us, it made an enormous, life-saving difference.

Some other resources: http://aanma.org - Everything from discount nebulizers to news. But Nurse Christy, an asthma educator you can speak to for free, is by far their best offering.

I also HIGHLY recommend the joining the Asthma Parents discussion list at http://asthmatrack.org/list.html. You'll learn more than you ever thought possible from these wonderful, supportive moms!

Baby Iggy Joins the Family - After a Day in the NICU

Welcome baby Iggy to the family of the Angry Asthma Mama!

Iggy entered the world on December 20, 2005 at 5:52 pm, weighing 6 lb., 7 oz. We didn't know whether to expect a boy baby or a girl baby, and honestly, I didn't have a preference. I just wanted an asthma-free child for a change.

Hah!

After a mercifully short, natural labor, I was handed my warm little Iggy to snuggle. His first APGARs were pretty good, but a few moments later, it was obvious that our little boy was having some trouble breathing. He was whisked away to the nursery, and shortly thereafter, transferred to the NICU, where he stayed for a full 24 hours.

Apparently, because my labor was so quick, Little Iggy was left with some fluid in his lungs. The relatively small number of contractions were not sufficient to clear it all. He was retracting, flaring and grunting. (And if you're an asthma parent, you'll know what all that means.)

The good news: He was fine within 24 hours. The distress resolved itself, and the doctors assured me that this condition is not necessarily a harbinger of asthma later in life. (The fact that he has two asthmatic brothers, on the other hand, probably is!)

Another less-than-encouraging sign: my latest little monkey already appears to have eczema AND his first allergy: to Pampers!! Guess this will be Huggies baby....

Anyway, welcome, Iggy! We're so happy to have you in our family, and we wish you strength and good health in the New Year (and every year)!

Xopenex MDI

Check it out - now you can have kids who can breathe in under fifteen minutes -- without turning them into hyperactive nightmares.

XOPENEX HFA(TM) Metered-Dose Inhaler Now Available by Prescription for Patients with Asthma and Chronic Obstructive Pulmonary Disease (COPD) Symptoms

MARLBOROUGH, Mass.--(BUSINESS WIRE)--Dec. 12, 2005--Sepracor Inc. (Nasdaq: SEPR) today announced that XOPENEX HFA(TM) (levalbuterol tartrate) Inhalation Aerosol, a hydrofluoroalkane (HFA) metered-dose inhaler (MDI), is now available by prescription in pharmacies nationwide. XOPENEX HFA is a short-acting beta-agonist indicated for the treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease. The XOPENEX HFA MDI is a portable, hand-held device consisting of a pressurized canister containing medication and a mouthpiece through which the medicine is inhaled.

Read the whole release.

Baby Due Any Minute! Will S/He Have Asthma Too?

As some of you may know from this or my (grossly neglected) other blog, I'm pregnant again.

I don't know what I'm having, but boy or girl, I'm just praying this one is not asthmatic. It would be nice to have a helathy child in this family! Perhaps the third time is a charm.

Here's where it might get interesting in comparing the three. Let's assume it's another boy, for argument's sake. (It probably is.)

With #1 son, I ate beautifully. I'm a vegetarian, and I made sure I got my daily (or nearly-daily) serving of pretty much every color vegetable. I steered clear of simple carbs, with the exception of an occasional trip to Johnny Rockets. (Veggie burger, cheese fries and vanilla milkshake. Yummmmmm....) I went for whole grains. I added wheat germ to my yogurt. I drank whole milk. I also walked every day and did yoga regularly.

I intended to deliver naturally, but the hospital wasn't so supportive. I ended up with a nasty episiotomy and some kind of IV drug. Also, this hospital routinely dispenses the Hep B vaccine to newborns.

With #2, I was unemployed for the last trimester, so stress was a little higher as we actually needed money. We also had our house on the market, which was stressful, too. I didn't eat quite as well, but I was still pretty good. I got lots of rest. The weather wasn't suitable for too much walking, but I did some yoga.

#3 is a different tale altogether. I've been working full-time at the office, eating a ton of processed foods (but still probably eating better than most people!), and exercise? Remind me what that is...? Is that the act of walking up the hill to my car every night?

#2 was delivered naturally by a midwife and avoided all unnecessary interventions and vaccinations. #3 will have the same treatment.

So, what are the odds that #3 will develop asthma, too? If he or she doesn't, I guess we'll know for sure it has nothing to do with Mom's eating habits....

Honestly, let's just pray that s/he doesn't develop asthma. It would be nice to have one child that I don't have to administer corticosteroids to. It would be nice to not have to CRANK the monitor every night so I can listen to the babies breathe.

Sigh. I can dream.

Discount Aerochamber Spacers?

I'm trying to trackdown a reliable source for Aerochamber Spacers - the pediatric one with the little mask. Best price I've found is $30 at Achooallergy.com. (No, I'm not an affiliate.)

If you have another source, of if you've bought from AchooAllergy -- can you share your experience?

Thanks!

Baby's all better...we beat the RSV

Thanksgiving week was nothing short of a nightmare. At 35 weeks pregnant, my husband and I were up giving nebulizer treatments around the clock -every three hours- to keep #2 son out of the hospital. We alternated between Xopenex and DuoNeb for a few days before switching to Xop only. And of course, there was the Orapred.

But we beat it. After a full week of treatments, we avoided pneumonia and kicked the RSV. Thank God. He's on Flovent 44 daily now, but he seems to be healthy again.

(Of course, he's got a nose full of yellow snot again as of yesterday, but hopefully it's just a cold.)

On another note....sorry I've been so lame about posting. I'm a little preoccupied with the pregnancy, and I've got a TON of work to do before the baby gets here. This must be the way working women nest...instead of cleaning the house, I'm determined to get all my projects done by 12/15. DETERMINED. If I have to work around the clock until them, I'll get those projects done, damnit!

And there will be NO RSV in my house when that little newborn comes home, so help me...

Baby has RSV -- From now on, I call the peds. pulmonlogist FIRST

I trusted my instincts and didn't fill the Biaxin Rx...and took #2 son to the Peds. Pulmo instead.

Good thing I did. She listened to him for about two minutes, then promptly ordered a nebulizer treatment, chest X-ray, and tests for RSV and Flu. She said she heard "wheezing in the front and crackling in his back."

Sure enough -- four hours of my prego self dragging the toddler around the massive hospital later -- we got confirmation. He has RSV.

A few hours later, the results of the chest X-ray were back. Apparently, he's had it for a while (so the peds. missed it) because the irritation and inflammation in his lungs is pretty bad.

I don't know why I alwaya question my instincts. I could have called this two weeks ago, before he started the Omnicef. Now I'm really mad that I didn't!!!

Up until yesterday, he was pretty happy during the day, just the spikey fevers at night, along w/rapid, shallow breathing. And the cough, of course.

But last night, the breathing was really bad - and his fever didn't shoot up. Today he's been positively miserable, and -- frighteningly -- not responding well to treatments. He was about 48 resps per minute during his nap, but then he shot up over 50.

I gave him a DuoNeb treatment, and an hour later, he was still at 58. So I did another treatment (per the PP) and gave him his Orapred a few hours early. He dropped into the forties.

Now, less than two hours later, he's well into the 50's again. I'm going to do another treatment, and if he doesn't drop by at least 10 breaths per minute, I'm paging the PP again -- no matter how much of a pain in the ass I appear to be!!

I so don't want this baby to have to deal with being in the hospital -- he's not even 20 months old, and it would be so scary for him. But at the same time, I almost wish they would take him. It's so frightening not knowing what's going on with him. He was at 100% oxygen saturation yesterday, but today -- who knows? I don't own a pulse-oximeter. (Wish I did.) Plus, I'm supposed to be doing nebulizer treatments every three hours around the clock. That's a lot of work. Thank goodness we can sleep in tomorrow (assuming the kids let us).

So...that's the tale so far.

Happy freaking Thanksgiving, right?

Warning for Asthma Drugs Sought

Thanks to the brilliant moms on the asthma-parents email list for this one:

Warnings for Asthma Drugs Sought

ReutersSaturday, November 19, 2005; Page A08

U.S. regulators yesterday asked the makers of three popular asthma medications to add warnings to their labels stating that the drugs could increase the chances of severe asthma episodes that could result in death.

The warnings involve long-acting bronchodilator medicines Advair and Serevent, made by GlaxoSmithKline, and Foradil from Novartis AG. Patients use them daily to relax bronchial muscles and prevent asthma attacks.

In a public health advisory issued on its Web site, the Food and Drug Administration said drugs in the class known as long-acting beta 2-adrenergic agonists should only be used after other medicines fail to control asthma.

Read the whole thing...

#2 Son sick AGAIN

It's been six weeks (at least) since #2 son had his first fit of coughing til he gagged this year. (Last year we blamed those fits on a poultry allergy. Hah - caught that error early on!) The pediatrician, at that point, diagnosed him with a sinus infection and gave us Zithromax. (#2 is allergic to Amox.)

Ten days after we finished the Zithro, he was full of green and yellow gunk and coughing again. And he had a fever again, too. By this point, I'd already taken him to the Peds. Pulomologist for the first time, and he'd gotten an official diagnosis of "mild" Reactive Airways Disease. (I've still yet to find a real definiton of RAD. If anyone has one, please feel free to post it - or a link to it - in the comments. As much as I love our PP, I take the RAD dx as a diagnostic cop-out.)

Anyway, so when the fever persisted, I gave in and put him on Omnicef, largely because the regular ped. said he also had an ear infection.

Five days after finishing the Omnicef, my poor 19-month-old was packed full of mucus again. He started coughing the next day, and the day after that he was spiking fevers of 104. We went through two nights of that, combined with labored breathing and coughing til he gagged...and took him to the regular ped. today.

She said his lungs sounded "pretty clear" (what the heck does that mean?) and she thinks he has a recurrent sinus infection. She wants him on Biaxin, which is pretty hard core. Besides the fact that it tastes awful, it would undoubtedly leave the kid with diarrhea and a diaper rash. Plus, it's really strong for a baby who's not even two yet. Do I want him on such powerful stuff already, unless I know for sure that he needs it?

I normally wouldn't question my pediatrician - who I really respect - so intensely, except for this: Our peds. pulmonologist doesn't seem to believe that toddlers CAN develop recurrent sinus infections. They're sure it's viral.

I guess we'll see when I take #2 there tomorrow.

I just hope it's not RSV.

Anyway, just wish me luck tonight. I've got six weeks of this pregnancy left, I'm pretty darned exhausted, and that little boy is sure to keep me up half the night....I would just love for him to *get* healthy, and for me to *stay* that way!!!

AANMA on the Danger of "Mild" Asthma

Just an important item to share from AANMA's Allergy and Asthma Today: In a small article on page 9 of the issue, there's a really, really urgent reminder.

"Mild Asthma Myths" reminds us all that 'The risk of severe asthma exacerbations seems to be unrelated to the symptom severity." So a child diagnosed with mild asthma is no less likely to suffer a SEVERE attack than a child diagnosed with severe, persistent asthma.

It's a wakeup call for me to always keep that MDI and spacer on hand, whether I'm traveling with Persistent Asthma Boy or Mild RAD Boy.

In a somewhat morbid footnote to the article, moms are invited to order a free copy of the booklet, "Mikey's Mom Didn't Know Asthma Could Kill" by calling AANMA. Is it just me, or is that seriously creepy?

A note to my "regulars"

FYI...I apologize for the infrequency of posts lately, but I've been working my tail off at the office!! I've got our biggest trade show on 11/7, I've got two companies to look after there (we're launching a sister company at the show) and - oh, yeah - I'm seven months pregnant.

I'll be back in "full force" next week!

AANMA launches "Breathe: It's the Law" Campaign, BreatheAtSchool.org site

Allergy & Asthma Network/Mothers of Asthmatics is on the warpath, fighting for kids to carry Epi Pens and MDIs at school. Yes, it's the law, but there are still plenty of schools that make it difficult for kids to get the meds they need. And what do you do whne your five- or six-year old asthmatic child goes to a public school that only has a part-time nurse.

Learn the rules and your rights at http://breatheatschool.org. And kudos to AANMA on their 20th anniversary and the many, many victories they've won for us all.

#2 Goes to the Pulmonologist; #1 Starts Coughing Again.

As mentioned, took #2 son to the peds. pulmonologist today. He was diagnosed with mild Reactive Airways Disease. No big surprise there!

She gave us an action plan and recommended daily Pulmicort. I opted to hold off for a bit...I don't think we really need it yet. But we've got RXs for albuterol & Xopenex, and she gave us spacers and neb stuff for now, until the cough clears up. (It's much looser and better now.)

We had a chest Xray, too...but we haven't gotten the results yet. I suspect they're clear - although I wouldn't have said that a few days ago.

I just realized that she didn't take his sats. Wonder why...?

I'm so relieved that we have that diagnosis now. It's comforting to know we can page the PP if he ever has a cough like that again! Just having an action plan is comforting. When you have a sick kid, nothing feels better than knowing you're able to give them the care they need. It's all you want, as a parent.

On the other hand, #1 son was coughing again this morning. Nothing new there...same old junky cough we hear three times in the morning and twice at night.

Only we heard it about 10 times tonight. And he was sniffling today. And he was coughing REALLY hard at bedtime.

I gave him Dimetapp and albuterol before bed, and that seems to have helped.

I only pray that we'll get a break this time....! I don't want him to be sick again. And I don't want to have get up three times a night to neb, either!!

How #2 Son Got a Reactive Airway Disease Diagnosis

So...#2 son was diagnosed with Reactive Airway Disease today. (You'd think I would've remembered to ask for an info sheet so I could've gotten a proper definition, after my last post!)

Just to document how this came about, here are some snippets from emails I sent to the asthma parents' list over the last week or two:

From 10/14: Oz is still coughing. Let's just hope they don't decide to share illnesses. As they do share a room, there's little I can do to prevent it, but really -- let's hope!!!

From 10/17: BOTH boys are coughing now, and #1's cough has picked up a little punch. I'm still going with the albuterol 3-4X a day. He didn't cough much (if at all) overnight, but definitely started up again this morning. The fever had broken by Sunday AM, and he hasn't thrown up since Friday.

Oz's cough is getting worse (louder, more frequent, still wet), so I need to check my notes to see when that started. Since I had him at the doctor last Weds., I'm guessing it's been about 10 days since the cough started, maybe longer. Mucus is yellowish now, but it was clear for the first week or so. Could be a sinus infection, but I've never seen one start with a cough. Don't know...

From 10/19: Oz is doing much better with the pinkeye, but he was coughing a LOT last night. I gave him some Dimetapp, which dried the cough up but didn't stop it. Even though he's not officially RAD, the doc said I can give him a neb of Xopenex if he has another night like that.

From 10/20: Had a REALLY bad night with Oz, not #1. Gave him Dimetapp at 8:00pm, but ended up needing two nebs at 11:00 and 4:30 as tight coughing would not stop. Could be bronchiolitis. Have a call into the ped's office (he's not with a PP - yet!) to see about a Zithro RX, or another appt.

From 10/21: Now, about the kids -- Oz is a MESS. He's so much worse today. We were up three times over night. He's responding well to Xopenex, but he's running 101.5 right now. He sounds terrible (need to neb him now, actually) and he's not drinking well. He was coughing his head off overnight when the nebs wore off.

Took him to the ped today, who changed his RX to Zithromax (thank you!) for a sinus infection. She said he may have RAD, but said she didn't hear any wheezing, that his lungs sounded clear. But she said I should call our PP, given his history, and see if she wants to start seeing him.

So I did. And we're going Monday.

Honestly, I think he has RSV, and I'll be amazed if we're not at the ER over the weekend. But I'm a freak, could be wrong. If he doesn't respond to the Zithro and he's still sick on Monday, $100 says that the PP here's something and that his sats are around 95%.

Ugh. Thank goodness he's happy. He sounds so, so awful, it makes me want to cry

Later that night: Ugh. Oz woke up from his nap with 101.5 and sounding SO MUCH WORSE. Sounds really chesty now. I nebbed at 4:00, which helped. By 7:00, as we were finishing dinner, he was coughing til he gagged. Almost paged the peds., but held off.

Nebbed at 8:00, and gave him Dimetapp. Definitely took the edge off the cough. He went right to bed afterwards.

It's 9:30 and he's just starting to cough again. I have a feeling he won't last beyond 11:00, and I'll have to page to make sure he can have his nebs 3 hours apart instead of 4.

I'll be amazed if we get through this weekend without a trip to the ER.

From 10/22: Miraculously, not much coughing overnight and very little this morning. He's definitely not himself, though. Yesterday, when he was coughing his little head off, he was still acting like a happy little toddler. Today, he's much quieter, not eating or drinking. Also more visibly congested.

LATER....Zithro is for a sinus infection, which I'm not convinced he has.

He was doing surprisingly well all day, then we noticed he was breathing really fast at dinner. I was going to neb him, but I noticed he felt really warm. Turns out his fever spiked back up to 102.1, after being 99.5 earlier. Ugh. He fell asleep, and I'm going to check his resps in a little while. (I managed to get some Motrin into him.)

October is sucking, so far.

Bird Flu Update, Roche & Tamiflu and More in "Weekly Breather"

Asthma parents, if you're not getting the American Lung Association's 'Weekly Breather,' you're missing out on a valid resource. This is by far the best, most reliable means of getting helpful asthma news.

Here are a few highlights from this week's issue:

WHO: Bird Flu Human Risk Greatest in Asia...An October 17, 2005 Associated Press report said cases of bird flu can be expected to appear in many countries, but Asia is most at risk. According the the World Health Organization, avian flu has become endemic in some areas of Asia, creating multiple opportunities for a mutation to occur that would result in the virus’ ability to spread among humans. This weekend, tests on birds from Romania indicated that bird flu had arrived in Europe. Two days earlier, cases had been confirmed in Turkey. However, the vast majority of cases, and the greatest risk of viral mutation, remain in Asia. Bird flu has killed more than 60 people in Southeast Asia in the last two years. Most cases have resulted from contact with infected birds, but experts fear a genetic mutation could produce a global pandemic.

For the full article: click here.

Roche may allow others to make Tamiflu...Reuters reported in an October 18, 2005 article that on Tuesday Swiss drug maker Roche said it would consider granting other firms licenses to make the antiviral drug, Tamiflu. The company is under pressure to step up production of Tamiflu as cases of bird flu have appeared in Europe. Tamiflu, known generically as oseltamivir, is the most effective antiviral drug currently available for avian flu and is one of a class of treatments recommended by the World Health Organization (WHO) for use in the event of a flu pandemic. Mike Ryan of WHO said Tamiflu supplies were insufficient if the avian virus were to mutate and spread among humans. Roche said it would consider allowing companies and governments in developing nations to produce the drug in preparation for a bird flu pandemic. Governments are rushing to build stocks of Tamiflu; 40 countries have placed bulk orders with Roche, including Turkey where cases of bird flu were reported last week.

For the full article: click here.

...and there's so much more, just in that issue. To sign up yourself, click here.

Normal Respiratory Rates in Children vs. Tachypnea

This came up on the asthma-parents list. #2 son was going haywire yesterday, coughing until he gagged. (He's going to the pulmonologist for the first time Monday.) More on that later...

Anyway, I was completely freaking out, so I checked his resp rate about a dozen times overnight. But I don't know what the normal resp rate is for an 18-month-old. (Obviously, if he was at 50-60 breaths per minute, I would have rushed him to the ER.) So I sent an email to the other asthma moms....and they didn't exactly know either.

So, in typical "Angry Asthma Mama" fashion, I hit the search engines. Here's what I found, per my email to the moms:

"Tachypnea was defined as a respiratory rate >60 breaths/minute in children 2 >50 breaths/minute in children 2 to 12 months of age, and >40 breaths/minute in children =" border=0>1 year of age."

According to this article, presence of fever raised the rate by 10 breaths per minute. The article's actually pretty interesting if anyone wants to read the whole thing -- it's about using resp. rate to diagnose pneumonia. Here's a link: Tachypnea is a useful predictor of pneumonia in children with acute respiratory infection.

That article led me to this one, which has a fuller age range:

"The World Health Organization's age-specific criteria for tachypnea are the most widely used: a respiratory rate of more than 50 breaths per minute in infants two to 12 months of age; more than 40 breaths per minute in children one to five years of age; and more than 30 breaths per minute in children older than five years. (14)"

And yes, the context was diagnosing pneumonia.

Hope someone else finds this useful!

Reactive Airway vs. Asthma

Those of you who've been reading this blog for any length of time know that I think the diagnosis of "Reactive Airways Disease" is a load of bologna with a capital "BS."

Well, on the asthma parents list, the topic came up, so I thought I'd delve into a bit in the place where I can be as opinionated as I like. (So glad blogs were invented!) Here's my little rant, followed by some legit info:

The way I see it, it's either asthma, or it's not. Nothing pissed me off more than the doctor at some practice or other who once corrected me when I referred to little B as being asthmatic. "He has Reactive Airways," she said. No, you stupid cow. He has asthma. Any kid who's on Flovent 220 and Singulair year-round, has been on Orapred more than half a dozen times before his third birthday, sees a Pediatric Pulmonologist on a regular basis, and has spent more time in the ER than both his parents put together deserves to be properly diagnosed. Don't use your stupid, namby-pamby, politically and legally safe terms to describe MY kid's asthma.

And while you're at it, give us parents some credit. We're very much in control of our son's health, and I think we know what we're dealing with.

Okay. Off the soapbox..

Here's the stuff I found about "Reactive Airway Dysfunction" (or "Disease," depending on your source):

From eMedicine:

Background: Not all children who wheeze have asthma. Most children younger than
3 years who wheeze are not predisposed to asthma. Only 30% of infants who wheeze go on to develop asthma. Reactive airway disease has a large differential diagnosis and must not be confused with asthma.

Clinical factors suggestive of childhood asthma include recurrent wheezing, symptomatic improvement with a bronchodilator, recurrent cough, exclusion of alternative diagnoses, and suggestive peak flow findings...

(Hmm...How are they getting peak flow readings from kids under the age of 3??)

Here's an interesting paper on RAD and Irritant-induced asthma (IIA) by Thomas H. Milby, MD. Just one interesting snippet:

Once symptoms do become clinically apparent, both RADS and IIA behave clinically
like non-allergic asthma, which, of course is what they are.

Hah!

Interestingly, this paper mentions nothing about RAD as a "pre-asthma."The author describes it more as a reaction of the respiratory system to an external substance, like a toxic gas or something. And the difference between RADS and IIA is the period of time before the reaction occurs. To me, this sounds like the most appropriate definition of the term "Reactive Airway." Read the article. See what you think. (This article also backs up the definition.)

Hmmm. Hold the phone. These are describing "Reactive Airway Dysfunction Syndrome." Is that different than "Reactive Airway Disease?" Must research. Must learn.

88888888888888888888888888888888888888888

Ugh...I've spent over an hour looking for definitions for both, and I haven't found a THING. I suspect they are different. I'll keep looking and post more tomorrow.

"Coughing Syndrome"

Well, I talked to the nurse-practioner at our pulmonologist's office today, and she said there is a "syndrome" going around. Kids are hacking like mad for two weeks. Seems to be viral. They're treating a lot of their patients for this now, most of them NOT responding to albuterol.

She said if #1 son had a bad night tonight that I should call tomorrow and they'll slot him on Friday.

He's not coughing that much, although it sounds bad when he does. Really, just before bed and in the morning, and he is responding to albuterol. He looks better today, too. I'm not anticipating a bad night with him. (Famous last words, right?)

#2 son is doing much better with the pinkeye (I've posted about that, right?), but he was coughing a LOT last night. I gave him some Dimetapp, which dried the cough up but didn't stop it. Even though he's not officially RAD, the doc said I can give him a neb of Xopenex if he has another night like that.

**Confession: I could/should have given it to him last night, but I was so freaking tired that I just didn't. I'm a terrible mother. I PROMISE to do it tonight if he's coughing!

The news from the PP's office has me holding off on Omnicef, anyway, which the pediatrician wrote an RX for the other day, just in case. He'd been coughing for almost 10 days, maybe more, when we went in for the pinkeye on Monday.

I'm also wondering now if I shouldn't have the PP see #2 son. There've been so many times the ped has seen #1 and said his lungs were clear -- then next thing I know the PP has me taking him for a chest X-ray because he's "not moving air." I've learned that peds. asthma is so subtle sometimes, regular peds. who aren't specially trained miss the wheezing or lack or movement.

Of course, I could just be amazingly paranoid. There's always that possibility, right?

Started albuterol

The cough's tightened up over the last day or so, even though I started albuterol on Sunday. We'll see where it goes from here... (This is #1 son)

The baby has conjunctivitis and, possibly, a sinus infection. He's been coughing for 10 days or so. I just wonder if it isn't viral, and that's what #1 son has. I'll give it another day before starting antibiotics.

Ah, the trials of motherhood.

Stomach Virus Triggering Attack???

The morning after I'm told to take it easy by my midwife (I have an infection that put me at risk for preterm labor), #1 son wakes up with a fever. I saw this coming, as his coloring's been off for days and he had a cankar sore -- which always means something's coming.

I thought he just had a stomach virus. He was complaining that his tummy hurt (which can also mean his chest hurts, you never know) and had no interest in eating. He did have half a Dunkin Donuts pumpkin muffin and some soy milk mid-morning, but after napping for a bit, he brought it all back up. (So much for my resting -- I had to clean the sofa and the boy!) But I figured that was it. I just tried to get him to drink small sips of water or Pedialyte for the rest of the day.

This morning, he woke up still looking feverish and puffy. He hadn't thrown up again, but he was still nervous about eating, and he was really lethargic. He napped for a few hours, and then seemed much better.

Except that he was coughing!

It wasn't the typical, tight asthma cough. It was loose and junky, and completely lacking in punch. (I equate his "regular" asthma cough to a snare drum.)

After hearing these messy sounding coughs for much of the morning, I gave him some albuterol this afternoon. I didn't really think it was asthma related, but two puffs of albuterol...better safe than sorry.

Guess what? The coughing stopped.

I don't know if that's good or bad. On the one hand, I'm glad he's not coughing. On the other hand -- that junky cough responded to asthma meds. I can see how any cough might respond to albuterol via nebulizer; that's like standing in a room with a steaming shower. But this was via MDI. Does that automatically mean the cough is asthma- related? Or does any cough respond to albuterol, even administered through a spacer?

I guess we'll see. I'll post an update tomorrow.

BTW -- if I haven't posted as frequently, it's because I've become really involved the Asthma Parents mailing list through Yahoo! groups. I highly recommend this group; they're a great bunch of knowledgeable, supportive women.

Vent: Fox News on Flu Pandemic

Just sent this to the fabulous new list-serv I joined for parents of asthmatics. The list is amazing....I'll report back on what the response is, assuming they don't kick me off!!!------------------
Have to vent about this -- the Fox news affiliate here just ran the most sensational and downright terrifying ad for a report about the bird flu pandemic scare. It featured lots of children's smiling faces, of course, along with creepy, dramatic music. Oh, and the tagline, "Billions could die -- tens of thousands in New York City alone."

Now, I know that there is a very real risk of a bird flu pandamic, but I also know that the World Health Organization and CDC are on it, antivirals are being stockpiled as funding permits, and an epidemic was already contained in Thailand. Of course, there's still a risk, and it's still horrifying, but I like to think that WHO and CDC are better organized than FEMA.

But really, isn't this scary enough as it is? Why do the cheesey news shows have to go around scaring everyone?

It's more than terrifying to face another flu season with an asthmatic preschooler, a toddler and a baby due in the thick of it all. I want to go down to Fox News in midtown and wring some irresponsible necks for these scary, ridiculous ads!!!!!! It's so infuriating!

Asthma / Reflux Connection Explained

Found a few things already:

A good explanation of the whole deal on InfantRefluxDisease.com

Some interesting info from ClinicalTrial.gov

And a bunch of info at NationalJewish.org, including:

Gastroesophageal Reflux Disease (GERD)
In some people, the muscle between the esophagus and stomach may allow some back flow of stomach acid into the esophagus. This may cause heartburn, as well as a reflex response that can result in asthma symptoms

It's a start...

Asthma-Reflux Connection

A million thanks to Meg for her comment on my post about the baby last week.

Meg points out that there is a connection between Reflux and Asthma, so I'm off to do some research, which, natch, I'll be posting. I do recall the peds. pulmonologist saying something about this last year when I commented that #1 son tended to burp a lot, and she recommended giving him Tums...but I don't remember why, exactly. Was it that reflux triggers asthma, that they're interconnected...?

Hence the quest for research.

Meg and anyone else -- if you have anything, please share!!

New Resources: Asthma Action Plans

So, I've been hanging out at HealthBoards since my run-in at BabyCenter, and I've just met this great mom whose 5-year-old daughter has asthma. She's miles from a good hospital or pulmonologist, and her doctor hasn't been fab with the asthma advice.

So who better to help than the Mama????

Her doctor never gave her an action plan (could you strangle the guy?) so I tried to dig up some resources to help her out.

Here's what I found -- good for all of us to have and read.

• FDA on Asthma Action Plans (NOTE: good to quote for next message board argument)
• Sample Asthma Action Plans (Really meant for those old enough to use a PFM)
• Medscape on Action Plans (Medscape is a great resource - even if you do need a dictionary and a copy of Gray's Anatomy to get through most articles.)

Diary of a Paranoid Asthma Mom

Ugh. In my constantly paranoid state, I was convinced that #2 son was breathing too shallowly. He'd had mild cold symptoms for a few days with a slight cough. And I thought his breathing was little shallow and a little fast.

I watched him for a few days, and worried a lot.

Then, Monday, I couldn't bear it anymore. I called the doctor at lunch and scheduled an appointment.

And of course, he's fine. He's not wheezing. I'm crazy.

Does anyone else do this? Do we all make ourselves nuts with worry?

Bear in mind, this time last year, this little boy was coughing til he vomited a few times a week. The doctors said it was reflux, but I'm still not convinced. Especially when he was diagnosed with bronchiolitis the same season.

So I may be crazy, but at least I have a reason to be. (Does that even make sense??)

Separation Anxiety Nightmare

Not much to do with asthma here, but I have to share this....

Little B, who just turned 4, has been going through THE WORST separation anxiety phase over the last few weeks. I mean, hysterically screaming and clinging to my leg every morning when I drop him off. It's been a total nightmare! Each day when I drop him off, I'm scared to death he's going to trigger an attack, because he has had his worst attacks after night terrors. And the hysteria's pretty similar.

Meanwhile, his 17-month-old brother actually toddles down the hall to his classroom practically by himself each morning, and barely says goodbye!

At first I thought this started because he had an attack coming on. Now I'm not sure if there's an underlying school-related problem (his teachers assure me it's not, and he's had no specific complaints) or if it's somehow related to my pregnancy. We did go through something similar with my last pregnancy, when he was two, and he does seem to be going through some weird oedipal phase right now.

I just can't wait till this is over. Or we find out what's REALLY going on.

Aid for Katrina Victims

I know this has nothing to do with my blog, but it has to matter to everyone.

Please donate whatever you can to the Red Cross. There are still thousands of people - adults, kids, seniors - stranded in the hardest-hit areas, just waiting to be rescued, to get food and water. If you can do anything to help, please do.

Asthma? Or just sinuses?

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

We actually stopped scheduling checkups because it seemed to be a jinx!

So, it was a good sign that we actually made it to a checkup yesterday. He's coughing a little bit, but fortunately, it seems to be more of an upper than lower respiratory issue at the moment.

He does seem to have his second sinus infection of the season, though, which is a bit worrying. We recently finished our non-refillable Nasonex prescription, and I wonder how much that has to do with it. (I did get a new Rx for it.) And he just wrapped up a course of Amoxicillin about 14 days ago.

If the congestion continues for another week (it's been about one week now), she's going to send him for a CT scan. He probably needs it, but I shudder to think what's going to happen if they find something. He's already had his adenoids out, so what would the next thing be? How traumatic, painful and horrible will it be? What more do I need to put this kid through???

I guess for now, I'm just glad the infections haven't triggered asthma attacks as they've done in the past. But are chronic sinus infections -- even if they're not life-threatening-- any better for a four-year-old' s quality of life than chronic asthma?

Asthma-Vaccination Connection?

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

I just found this on BabyCenter, an article exploring the possibility of a connection.

Then I found this article, discounting a connection between the pertussis vaccine and asthma. (Which also led me to this great resource.)

And then I found this article, which says a connection between childhood vaccines and atopic conditions (including asthma) is unlikely -- but doesn't discount it entirely.

Here's one from the Vaccine Education Center at Children's Hospital of Philadelphia. Guess what it says?

By far the most compelling one is here. You need a medical dictionary and possibly an interpreter to get through the whole thing, but here's the executive summary:

Background: A few previous studies have suggested that childhood vaccines, particularly whole cell pertussis vaccine, may increase the risk of asthma. We evaluated the suggested association between childhood vaccinations and risk of asthma.

Methods: Cohort study involving 167 240 children who were enrolled in 4
large health maintenance organizations during 1991 to 1997, with follow-up from
birth until at least 18 months to a maximum of 6 years of age. Vaccinations were
ascertained through computerized immunization tracking systems, and onset of
asthma was identified through computerized data on medical care encounters and
medication dispensings.

Results: In the study 18 407 children (11.0%) developed asthma, with a
median age at onset of 11 months. The relative risks (95% confidence intervals) of asthma were: 0.92 (0.83 to 1.02) for diphtheria, tetanus and whole cell pertussis vaccine; 1.09 (0.9 to 1.23) for oral polio vaccine; 0.97 (0.91 to 1.04) for measles, mumps and rubella (MMR) vaccine; 1.18 (1.02 to 1.36) for Haemophilus influenzae type b (Hib); and 1.20 (1.13 to 1.27) for hepatitis B vaccine. The Hib result was not consistent across health maintenance organizations. In a subanalysis restricted to children who had at least 2 medical care encounters during their first year, the relative risks decreased to 1.07 (0.71 to 1.60) for Hib and 1.09 (0.88 to 1.34) for hepatitis B vaccine.

Conclusion: There is no association between diphtheria, tetanus and whole cell pertussis vaccine, oral polio vaccine or measles, mumps and rubella vaccine and the risk of asthma. The weak associations for Hib and hepatitis B vaccines seem to be at least partially accounted for by health care utilization or information bias.

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

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

I noticed that #1 son was at 24 breaths per minute when sleeping on his right side, but that his rate was significantly increased when he slept on the left.

I'll definitely ask the peds. pulm. about this on Thursday, but I can't help but speculate. Does one lung function better than the other? Is there congestion or are there constricted airways on one side only? Or is it just nasal congestion?

Love to hear from you if you've experienced this or even if you just care to make some moderately educated speculation....

Congested Again -- Seeing Doctor Thurs.

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

My four-year-old isn't coughing (yet) but was showing off some nasty blood-tinged mucus by the end of the day yesterday. Pretty nasty!!! The baby, on the other hand, is coughing a LOT.

Just to be safe, I started albuterol last night. I also gave him Dimetapp before bed.

We'll see. #1 Son is due for a checkup with the pulmonologist anyway, so I'm taking him Thursday afternoon.

Annual Checkup

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

But asthma boy is definitely a little runty! He's 25th percentile all around. It's fine; he's definitely healthy. But I can't help but wonder if it's due to the inhaled steroids.

This is a kid who was literally off the growth charts until just after his first birthday. (He wore a size 24mo outfit to his first birthday party.) Now he's a little peanut.

I can't worry about it too much. I'm sure I've heard his doctor say that once they're off the Flovent (or whatever corticosteroid they're on) they actually "catch up," making up for the growth they may have missed.

It sounds weird, but I'm sure I've heard it. Maybe I'll troll for confirmation data.

Anyway, I'll deal with short. Heck, I'm only 5'2"! I'd rather have him breathing than tall!!!

Cheryl's Pulmicort Question

From the comments gallery:

Well, we're going to see our peds allergist next week to see whether we go back
to Pulmicort. I'm bummed -- the Singulair is soooo much easier on all of us.
But I'm wondering if I'm overreacting. Do your kids cough and if so, how
much and how often, on a regular basis? It's probably crazy to think we
could eliminate his cough entirely, but then parenting is pretty much crazy
as it is. Also, tell me about Flovent vs. Pulmicort. How old do you need to
be to use it -- with a MDI and spacer, right? I'm just so tired of strugglng
with a daily nebulizer treatment!!!! Cheryl

From my experience (disclaimer: NOT a doctor, just an asthma mom!): My son coughs occasionally. When he develops a cough, it will start with the occasional evening cough. He'll maybe cough 5 times a day between 6:00PM and 7:30AM. We'll usually start him on albuterol 2-3 times per day, and we're often able to head things off. But not always.

We switched him from Pulmicort to Flovent ages ago, when he ceased to cooperate with the nebulizer. Flovent's the same medication, but used with and MDI and spacer - just as you noted. We started him on it around the time he turned two, maybe even a little before then.

He's been on Flovent 220 most of the time since then, although he's back to 110 right now. We've never experienced any noticeable side effects, but we'd love to get him off the stuff someday. There is a possibility of stunted growth, and he is kinda small... Lots of other parents have found that their children are irritable when on Flovent, same as with Pulmicort.

And working with the MDI/spacer is really easy, once they're used to it. It takes about 15 seconds, and we need to do two puffs, twice daily. Just make sure your doctor gives you a demo in the office, and that you're comfortable doing it by the time you leave.

It has been a miracle, though. His asthma has been remarkably better since we started the stuff. His peds. pulm. is pretty sure it's kept him out of the hospital a bunch of times. In fact, we made it all of last winter without a single pneumonia or trip to the ER.

BTW, Cheryl -- he's on Flovent AND Singulair. And for us, that's really been the "silver bullet."

Everyone else -- please chime in with your thoughts and experiences!!!

Per Barbara's Comment: On DuoNeb

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

Barbara -- regarding your DuoNeb question...

Would any of you reading this know if DUONEB can cause sinus problems??? My
father is in bad shape and his ENT doc is a major a** and dont seem to care
since his insurance ends on 8-25. So he seems to think that the duoneb might
have caused him sinus infection (that drains into his lungs) after he had to use
his nebulizer with a mask. And believe me, he went thru all the possible
traetments and the doctor (not ENT) says he dont know whatelse to do. Any
suggestions?? Would really appreciate it....

I do know that DuoNeb is NASTY stuff. My son needs that and/or its MDI companion, Combivent, when his attacks are bad, but even our peds. pulm. tries to limit the amount he gets. It's never more than every other dose (alternating w/ albuterol) and never more than a 36-hour course.

You can find info on the side effects of DuoNeb here, at Drugs.com, and at DuoNeb's own site. I didn't see anything about sinus infections as a side effect. (I did some quick news searches, too.)Asthma attacks were listed as a side effect though...

HUH?

You might want to try posting on the asthma boards at About.com and yes, BabyCenter. There are some really knowledgeable folks who know wayyy more than me. Some of them are even medical professionals, which I certainly am not. There's also tons of great info at Breatherville.org and the American Lung Association's site.

Good luck with your Dad. I hope you're able to get the information you need -- and of course, the treatment, to get him well.

(Also, special thanks to Cheryl and littleguysmommy for your advice & support. You guys rule!)

Another Post on the Singulair Debate

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

Thanks to all of you for your comments -- I really appreciate hearing other voices out here!

Not only is it comforting to know that someone's reading all this stuff....but I feel like I'm not so crazy after all!!!

The Great Singulair Debate

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

But you also know how passionate I am about pediatric asthma. The kernel of what I believe on this front is:

• That every asthmatic child should have both a great pediatrican and an even better pediatric pulmonologist; and...
• That every asthmatic child needs an appropriate, adhered-to asthma action plan. Be it albuterol when symptoms occur, inhaled corticosteroids seasonally, whatever. The kids just need action plans, and the parents need to understand them.

So...when I go to the message boards I frequent (usually on About.com and/or BabyCenter) I usually repeat those mantras pretty much ad-nauseum. I get really scared when I see posts by parents who have taken their kids off Pulmicort because of the side effects. I mean, it's fine if you've talked to your peds. pulm. and they're monitoring everything, but you can't just *take your kid off Pulmicort* if they need it! If they need maintenance meds, they need them!!

Okay, so what was my point here. My point was that I've gotten into a somewhat heated debate on BabyCenter with someone who's taken her child off Singulair. In my usual, big-mouthed way, I posted what I knew about Singulair's side effects (not much -- haven't seen anything alarming), and just urged her - and anyone else reading - to get an updated action plan from their doc.

Well, perhaps I should just stick to blogging. I've really annoyed this woman. She may even hate me. (Which sucks. I hate having bad karma out there!) But I do really worry about this stuff. If a child needs maintenance meds, they need them!!! Her child was exhibiting aggressive behavior as a result of the Singulair. It's listed as a secondary side effect, and I can totally see why you'd want to switch meds if your kid went psycho from their asthma meds. But I just wanted to make sure her peds. pulm. was supervising this.

So...okay. I'm venting. But I feel really bad about ticking this woman off so much! We all only want what's best for our kids, natch.

She did say she had some info on long-term effects of Singulair, so I'm interested in seeing those -- and I'll definitely share them if she does.

Anyway, you can view the whole thing here. As always I welcome your comments, especially if you've got something on Singulair.

And if your advice is to stay off the boards and stick to blogging...ugh. Consider me advised!

AsthmaFactor.org - A Big Pile of Poop

Did I once, back in May, actually recommend http://www.asthmafactor.org/?

Where was my brain? What was I thinking?? Was it the pregnancy hormone wreaking havoc on my intelligence???

The site is nothing but a bunch of hoo-ha. They're pushing some BS dairy-free diet and some truly risky advice for naive asthmatics. Headlines like, "Asthma is a false disease caused by chronic dehydration and body's drought management efforts, says doctor" are DANGEROUS.

Want REAL advice on asthma? If you're an asthma mom, visit http://www.breatherville.org, the official site of the AANMA and Mothers of Asthmatics.

Ugh. I'm so embarassed that I ever linked to that site in anything that may have appeared to be an endorsement. Apologies!!!

He's 4 today.

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

I'm so lucky to have that kid. With the problems I'm having with this pregnancy, I'm more aware of that than ever.

But I've always been grateful for this boy. He is so unique, so sweet, so special. Always creative, orginal and eager to please, he's unlike my expectations of a four-year-old boy. He's not the dirty-faced tree-climber I'd expected. My son is affectionate and almost weird with his intelligence and uncanny memory.

This is a boy who can name half a dozen poisonous snakes (and their habitats) without blinking or pausing. I imagine, if pressed, he could tell you if their venom is a neurotoxin or hemotoxin. He can tell you the make and model of 90% percent of the Hot Wheels in his extensive collection, who gave the car to him, when, and under what circumstances. It's quite shocking, the things he remembers.

When I drop him off at daycare in the morning, I give him a quick goodbye before making his brother comfortable in the infant room. And on my way out, at his orders, I must go return to Pre-K to deliver his "kiss, hug and high-5." He's very particular about this.

He never hesitates to say "I love you," and will drop whatever he's doing if I ask him for a hug or kiss. If his baby brother kisses him, he kisses back or just smiles.

The happiest part of my day is when I put him to bed at night. At that point, we sit in bed together and we talk. We talk about the baby in my tummy, what's going on at school the next day, the snake we saw on TV, whatever. But we chat, and it's lovely. And, of course, we snuggle. (I always tell my husband, snuggles with my boys are "my happy place." Nothing could be more gorgeous.)

My son is a very, very special boy. I am truly blessed by having this child in my life.

May his birthday be full of fun and joy, and this next year be blissful and HEALTHY.

Asthma News: Advair Stays on Market, Florida Covers Pulmicort

Two key news stories y'all should be up on:

FDA panel recommends asthma drugs remain on market

A Food and Drug Administration advisory committee unanimously recommended
Wednesday that three asthma medications, one of which is GlaxoSmithKline's
top-selling drug, remain on the market. But the committee urged more research to
determine whether the medications might actually worsen asthma in certain
patients.
The FDA had asked the panel to review the safety of Glaxo's
Serevent and blockbuster Advair — a combination product containing Serevent and
a corticosteroid — and Novartis' Foradil, which belongs to the same class of
drugs as Serevent.

Medicaid to pay for asthma drug mistakenly left off list
The children's drug was not included until doctors and parents complained.

TALLAHASSEE -- Florida's Medicaid program will begin paying for an asthma medicine needed by thousands of children, responding to a mistake that had left the drug off a new list of covered medications.Under a new law that took effect this month, the Medicaid program redrew its list of drugs it will pay for, in most cases only putting on the list drugs made by companies that will give the state a bulk discount.

Doctors can get approval to prescribe off the list -- but some have said it can be a cumbersome task and could be dangerous because doctors may first try drugs on the list that may not work on that particular patient.

When the new list was drawn up, an asthma treatment for children called Pulmicort Respules was left off, meaning doctors who wanted to prescribe it would have to get prior approval.

Can you imagine if Pulmicort wasn't covered? I swear, we would have been on welfare if we'd had to pay for that every month!

To My Anonymous Commenter - Please Be Careful!

Thanks so much for your comment last week -- but I have to post a reply.

I'm so happy that reflexology is working so well for your son, but please, please, please - continue to see a pediatric pulmonlogist.

Asthma is a tricky, tricky illness, and not one to be taken lightly.

As the daughter of a pharmacist, I'm particularly cautious about overmedicating my kids. I question every prescription (to the great dismay of my doctors), and they're well aware of the fact that I often will not fill the scripts they give me for antibiotics. Not right away anyway.

But I've learned not to mess around with asthma. Despite the possible negative effects of inhaled corticosteroids and albuterol, I know that these are the drugs that help my little boy breathe.

This child is the absolute love of my life, and I've seen him suffer too much. I've seen him hooked up to a nasal canula with oxygen being pumped into his lungs, and it's something I never, ever want to have to see again.

I'm aware that Flovent and/or Pulimicort could stunt his growth. I know Albuterol makes him cranky and flighty, that Orapred makes him unbearable, as do Combivent and DuoNeb. (But really, I'd rather he be short than struggling to breathe, if it has to be a choice.)

But I also know that Flovent and Pulmicort have kept him out of the ER many, many times. That Albuterol has helped us prevent what could have been a very serious attack. That Orapred has sidetracked hospitalization from pneumonia. And that Combivent and DuoNeb may have actually saved his life.

That said, you can see why I don't mess around. I've had the good fortune to find a pediatric pulmonologist I trust as well as I trust my best friend. She understands my reluctance to increase (and at times, decrease) the drugs on his action plan. She supports my efforts to try non-medical, non-traditional alternatives to medications -- while continuing his prescribed maintenance medications. I respect that she wants my baby to have normal childhood. We have a great relationship.

I hope you find the same. Find a doctor who's open to your desire to ultimately get your son off medication.

But please, please, stay in touch with your doctor and keep your son on his maintenance meds until your doctor advises you that it's okay to change routines.

I don't work for the drug companies -- I'm just speaking from my heart and my experience.

Best of luck to you both.

Update: The Cough Continues

Not as bad, though. We've still got the congestion (over a week now) but he's only really coughing at night and in the morning. So we're back to where we were in the spring, really.

I'll keep an eye on the congestion, though...Thank goodness I started this blog. Now I know it's only been a little over a week. (Naturally, I never write this stuff down like I'm supposed to.)

But things seem to be pretty well under control, so I won't bother calling the doctors yet. We'll see. If he's still this stuffed up a week from now - or Friday, even - I'll assume it's a sinus infection.

Still, this summer's been good so far. Historically, he gets sick on his birthday (we had to cancel his party two years ago because he had almost 105, Strep, and an asthma attack). We've got two weeks, so I'll stay vigilant!!!!

When it comes to asthma, Mother knows best

Man, can I call it or what?

Friday night, he started coughing again, so I gave him Albuterol before bed.

Same deal Saturday night.

Sunday morning, there was more coughing, accompanied by some LOVELY green mucus. So, more Albuterol, in the morning, at lunchtime, and at bedtime.

He also decided not to eat yesterday. Just wasn't hungry.

I'm going to go out on a limb and say that the kid's coming down with something. And not to say "I told you so," but I did predict this last week.

While it sucks that my son is sick again (although we have had a great summer so far), I do have to admit, it's nice to always be right about one thing.

Symptoms Again - Waiting it Out

It's ever-so-subtle, but the Asthma Mom learns to be sensitive to the onset of an attack even at its earliest stages. We're like lionesses in the savannah, listening to prey rustling in the grass half a mile away. I swear, we're just that attuned.

Little B started coughing again just before the holiday. Not a lot, just 2 or three times a day, very early in the morning or around bedtime. It's a little bit "junky" sounding, but not too bad. But it's there. It's a cough.

And over the weekend, he was uncharasterically whiney and clingy. He's usually not an annoying kid, which really, is saying a lot for a preschooler! But really, he's generally an easy going, sweet boy. While he certainly *can* be a little annoying atg times, he usually doesn't get on my nerves the way he did over the past few days.

Now granted. That could be me. I'm wrapping up the first trimester of this surprise pregnancy, and let's just say it's not making the most graceful exit.

So yes, it could have been my dramatically reduced patience, but I think a lot of it was him. Add to that the fact that I found him in bed, under the covers at 11:00 in the morning on Saturday (this from The Boy Who Would Not Nap), and I'd wager that he's not feeling well.

We'll wait and see. We lionnesses have a fair amount of patience (especially in the second trimester).

Nasonex - A small miracle

I can't believe what a difference the Nasonex is making. For the first time in half a year, my kid can breathe through his nose, doesn't snore, and can pronounce all of his consonants correctly.

Why didn't we have the opportunity to try this sooner???

We don't have any refills, so we'll see if there's a change for the worse when we run out. Then I can call the peds. and beg for more!

Meanhwile, we're doing OK on the Flovent 110. He's still got that "junky" cough at night and in the AM, but overall, he's doing really well.

Keep your fingers crossed!

Asthma Update

So Dad and #1 son just got back from the pulmonologist. Our doc is still on maternity leave, so they saw the chief of the practice and an intern.

To my surprise, they said that we're doing everything right, and sometimes he'll have attacks.

Now, call me crazy, but this kid went almost a year without an attack until they lowered his Flovent. And before that, he never had an attack unless he had some other kind of infection or virus.

Now he's had two attacks in two weeks. He's on two additional medications.

I know I'm doing everything right. My question is....are they???

I'm not asking them to necessarily put him back on the higher dose of Flovent, I just want an answer I can trust and believe in. I'm not sure I need the pat on the back anymore. I just want reassurance that my son's asthma is under control.

Right now, I don't think it is. And I'm half expecting him to have another attack within the next few weeks.