Tiffany Teether (not asthma-related...just a MamaRant!)

I reading about last week's Fisher-Price recall, when while scanning the list, I noticed this older item:

CPSC, Tiffany and Company Announce Recall of Farm Teether Rattles

Tiffany & Co. makes teethers? Oh, dear...I had to read on, of course.

The following product safety recall was voluntarily conducted by the firm in cooperation with the CPSC. Consumers should stop using the product immediately unless otherwise instructed.

Name of Product: Farm Teether Rattle
Units: About 3,700
Manufacturer: New England Sterling of Attleboro, Mass., for Tiffany and Company of New York, N.Y.
Hazard: A metal bar on the rattle can break off during use, releasing small round beads and small farm animal figures that roll off the crossbar when the soldered joints break. The beads can pose an aspiration hazard to young children. The breakage also can create ragged edges on the ring, posing a laceration hazard.

OK -- hold it right there. Metal? I get the 'small beads' inside the rattle, but small farm animal figures? Do your rattles and teethers have any metal and choking-hazard sized animals on them? Moving on...

Incidents/Injuries: CPSC and Tiffany and Company have received one report of a farm animal figure that was found in the mouth of a 7-month-old child. The child
was not injured.
Description: The recalled rattle is designed for children ages 3 months and up. The Farm Teether Rattle is a hollow, sterling silver ring approximately 3 inches in diameter with a bar across its center. The bar is attached to the interior of the ring at two points and has three farm animals (sheep, duck and cow) and two beads that rotate on the bar. Small plastic beads inside the ring rattle when the product is shaken. Inscribed on the rattle is “© 2002 TIFFANY & CO. 925.”

It's sterling silver?? It's STERLING SILVER TEETHER? Are you freaking kidding me??? It's TEETHER that you have to POLISH. Oh, that's brilliant...
And don't get me started with the engraving for authenticity...

Sold at: Tiffany and Company sold these rattles in its retail stores and from its catalogs and Web site from November 2002 through early March 2004 for about
$150.

Manufactured In: United States

Remedy: Consumers can return the product to Tiffany and Company for a full refund, credit or a new rattle.

Are you kidding me? About 3,700 people spent $150 on a sterling silver teether? Who ARE these people? Do they all share the last name Hilton?

And damned straight Tiffany & Co. had better issue a "refund, credit or new rattle" for their high-society choking hazard.

Only in America, folks. Only in America.

Oh, and just another sad-state-of affairs note: The CPSC recall list is SO long and so frequently updated, they really should provide an RSS feed.

Albuterol Test, part deux

I have to really scrap the last albuterol test -- Ig was running a fever on Saturday, so he may have had some virus that was keeping him up. He slept PERFECTLY with the fever, though.

Of course, he was up again the next night, so I tried the "albuterol test" again last night. He slept through til 5:00 AM. (GREAT for him.) He woke up really happy, too - despite some icky green goo around his nose.

I'm calling the PP this week to schedule a seasonal visit for all three monkeys, so I'll keep the test up for a few more nights and report the results back to her. $10 says he's back on Flovent by next week.

In other news -- I'm taking B to the podiatrist Thursday (praying he doesn't need full orthotic - NO ONE covers those things) and the developmental peds. in October. Let's here it for back-to-school!

Iggy's Sick

Yesterday, when I dropped Ig off at daycare, I noticed his friend Jack had a croup-y sounding cough. Jack's a first baby, and his very sweet mom often asks me for advice. I told the caregivers in the room that they should keep an eye on Jack and watch his breathing at naptime. His cough, to me, sounded a little like bronchiolitis.

I mentioned this to my husband last night at bedtime, after telling him that I had given Ig albuterol again.

Naturally, when we woke up this morning (Ig slept right through!), Ig felt a little warm to me. I took his temp - 100.6. Not SUCH a big deal, since he ALWAYS seems to be running a low temp. But was getting cranky, so I gave him some ibuprofen.

Then I noticed, as I was changing him, that he seemed to be breathing a little fast, almost panting. He had some crusted mucus under his nose (also kind of a standard look lately), so I figured it might just be upper respiratorty stuff, but I gave him some albuterol anyway. Hey, our action plan says, "at first sign of a cold."

And THEN, about an hour later, I noticed a steady stream of green goo coming out of his nose. Awesome.

So...I'm refreshing my memory on the symptoms of bronchiolitis (so paranoid, I know) and keeping a close eye.

Meanwhile, I gave him some Dimetapp and put him down for an early nap. $10 he wakes up with a cough and AT LEAST 101.5. Can't seem to get a break with their health this summer...

UPDATE: In fact, Iggy woke up with 102.6, but no cough. He was fever-free by Sunday, but the green goo still lingers.

Happy Birthday, B!

It's B's sixth birthday today. I can't believe it's been six years since I gave birth to that wonderful kid.

The year begins with promise: His asthma is well under control - he's not even on meds right now. The Aspergers Syndrome that has the potential to threaten his social skills is barely perceptible. He is among the most popular with teachers and students a like. Sure, he sucks at sharing, but how many 6-year-old boys can boast "shares Transformers well" as a social skill?

I have nothing but optimism for his first year in public school, for his health or his happiness.

Happy Birthday, B! I love you!!

Albuterol Test Results

He was up at 2:00AM. I don't know if this was a failure of the test or due to the fact that my darling husband hasn't the slightest idea what it means to TIPTOE when he goes to the bathroom at night.

Give it one more night. He slept through after I gave him albuterol at 2:00.

The Albuterol Test.. and Yea, ME!

I've probably mentioned in several of the last posts that Ig hasn't been sleeping lately. It's an ongoing motif in my world. I've learned to function -- heck, even earn a PROMOTION -- on 4-6 hours sleep. (I used to swear I couldn't get by on less than 10.)

Ig, now 19 months old, wakes up at 11:00 almost every night, usually at exactly the moment I'm turning off the TV to go to bed. If he sleeps beyond 11:00, he's up at 2:00. Sometimes, he wakes up at 11 AND 2.

And he doesn't just wake up, he SCREAMS. It's horrible. There's not letting him cry it out -- no one would sleep if we did. And honestly, I'm not inclined to. My mom-sense tells me there's something really wrong, something beyond separation anxiety.

In the past, when Oz was waking up like this, we found out that we needed to put him back on Flovent. When Ig was waking up during the winter, we learned that he had chronic ear infections and needed tubes. So for me, the net-net is, if he can't sleep, he's either in excrutiating pain or not breathing well.

I brought this up with the peds at his 18-month checkup last week. She thinks it's just separation anxiety, and that I'll end up with this kid sleeping between his dad and me until he hits puberty....but she agreed we should see the pulmo "if I'm concerned."

Duh.

Anyway, as he's getting over strep, he did sleep a few nights when we dosed him up with Dimetapp and Motrin. But then the screaming started again, so...for a test (YES, I'M GETTING TO MY POINT NOW) I gave him albuterol before bed last night.

And guess what...he slept til 5:00 AM.

So, I'm trying again tonight, to make sure it wasn't just a fluke. It's only 10:20 now, so I can't say yet, but I'll post a quick update in the AM.

One final note...I've won an award for this blog! Did ya notice the new bling in the right-hand nav? I'd always hoped to win a Tony Award, but y'know...this'll do!

I'd like to thank HealthCentral for this honor, my loyal readers, Google - for the free blogging platform, my stunningly smart co-workers, and of course, my wonderful children...(OK, I'll stop now).

Adopt the Sky

Check this out: http://adoptthesky.org/ - it's a petition to raise ozone level standards. Great cause, cool site.

Not Asthma Related -- New Autism/Fragile X Research

As many of you know, one of my guys, in addition to being asthmatic, also has Asperger's Syndrome. Asperger's is on the autistic spectrum, but considered a form of "high functioning" autism. Like his asthma, the origin of this condition is unknown...we plan to test for Fragile X syndrome, which will determine if it's genetic. But it could have been caused by a vaccine, or by some other factor. (I try not to harp on this aspect of things too much.)

So research on Autistic Spectrum Disorders is as interesting to me as asthma research. Today's news was particularly fascinating, as researchers at MIT seem to be having success in treating lab rats with Autsim and Fragile-X related retardation with a particular enzyme.

Here's a snippet:

In a series of experiments on mice, the MIT investigators showed that they could undo the brain damage seen in a condition called Fragile X syndrome by inhibiting a key brain chemical called PAK....

The study raises the intriguing possibility that the brain damage seen in children with the condition can be rolled back and identifies a specific target for potential drug therapies.

"It opens up a new avenue for drug research to treat this condition," said Susumu Tonegawa, a neuroscientist at the Massachusetts Institute of Technology in Cambridge, Massachusetts, and lead author of the paper.

Read the full article.

Antibiotic Use Linked to Peds Asthma

Just when I thought I was running out of things to be angry about.,..

From the IHT:

The use of antibiotics in the first year of life is associated with an increased risk for asthma at age 7, a new study has found, and the reason may be that antibiotics destroy not only disease-causing microbes, but also those that are helpful to the developing immune system.

Antibiotic use had a greater impact on children who would otherwise be considered at lower risk — children who lived in rural areas and those whose mothers did not have asthma — than on those who were already at increased risk because of an urban environment or genetic predisposition.

More here.

Swimming Bad for Infants' Lungs?

Just saw this article in the ALA Weekly Breather, which I rarely get to read anymore. It's so good, though -- I highly recommend that newsletter to all parents of asthmatic kids.

Anyway, here's the article. Have to say I'm not a big fan of teaching anyone younger than 3 to swim -- no one that unstable walking should be near a pool without a vigilant grownup nearby anyway!!

Infant Swimming: Chlorine Lung Risk?...WebMD Medical News reported on June 4, 2007 that infant swimming lessons may lead to problems with children's lung development and possibly make asthma more likely, a new study suggests. The researchers included Alfred Bernard, PhD, of the public health department at Catholic University of Louvain in Brussels, Belgium. They studied 341 Belgian schoolchildren who were about 11 years old, on average. The children provided blood samples and had their lung health tested. Bernard's team noted that 43 of the children had taken infant swimming lessons in indoor pools. The researchers also noted other lung health hazards, including maternal smoking during pregnancy and exposure to secondhand smoke. The lungs of children who had had infant swimming lessons appeared to be predisposed to developing asthma and recurrent bronchitis, according to the study, which appears in Pediatrics.

For the full article: click here.

Staying on Singulair

I think I've got three kids with sinus infections right now. B has been sniffling and coughing (goopy cough - not dry and/or tight) since he came off his Flovent three weeks ago. We were going to take him off the Singulair this summer, but I would say, with these symptoms...not bloody likely.

Also, I can't even TREAT the infection yet because he's still on Erythromycin (sp?) for the perioral dermatitis (rash) that he developed from the Flovent. We'll need to start Augmentin as soon as he's done with that three week course. Guess I'll be putting him on acidopholus then, too!!

Poor guy. I can barely treat the symptoms. He can't take Dimetapp because it knocks him out too much. And since he's such a heavy sleeper already, if I give it to him at bedtime, he will occasionally wet the bed -- which makes him sooooo sad.

I tried Claritin syrup, but it doesn't really help. Maybe we'll give Sudafed another shot. He's so low-energy anyway, might perk him up a bit. (Ah, I love jokes about drugging the kids.)

Meanwhile, Ig's on albuterol for a croupy-sounding cough, and Oz is just picking his nose a lot. :-)

Never a dull moment.

That was my 200th post.

Should I pop open the champagne?

Ig is sick AGAIN

Can you even believe this? Every two weeks this kid has something!! There's roseola going around school...my boss must LOVE me. :-)

Two Off Flovent (Yea!); One on Orapred (Awwww!)

Good news: We went to the PP last Thursday and B and Ig are both of Flovent for the summer! In fact, B can even go off Singulair for the first time starting next month.

Bad news: B started developing Perioral Dermatitis again within a day of going off the steroids. Poor guy. I'm actually on hold with the dermatologist now. B is sooo bummed that the rash is back. He looks awful, and he knows it. So sad for a 5 year old to go through this!

More bad news: Not only is Oz still on the Flovent, he's on oral steroids right now, too. Saturday night, he had one of the worst attacks ever - it took two back-to-back nebs to quiet him down that afternoon. And three back-to-back to stop the coughing over night.

He's much better today, but still looking unwell and not eating. We're off the the PP in an hour.

Two on Albuterol

Quick update -- Ig has another ear infection, and I suspect he may have brochiolitis too. He's mouth-breathing and it sounds a little labored. He's happy, though. At least, he's happy til 4:00 AM.

Ozzy's just been off. Coughing since last week, lots of green goo, and yesterday, he complained that his chest hurt. That is, he said his tummy hurt, but he pointed to his chest.

Both are on albuterol. I'm tapering Oz down, since we seem to have gotten ahead of his flare. Ig's only 16 months old, though, so I'm taking him to the doctor in the AM. (Regular peds -- we see the pulmonologist on Thursday afternoon.)

Keep ya posted.

All Quiet on the Pulmonary Front

Just checking in -- it's been quiet around here, thankfully. Apart from Iggy occasionally retracting and Oz's occasional AM grunts, there's really nothing to report. Isn't that nice?

Hope all is peaceful in your worlds, too.

I have to schedule a checkup for the monkeys with the PP before summer. Here's my prediction:

B: Off everything but Singulair - and maybe even that - for the summer
Oz: Down to Flovent 44 for the summer
Ig: Stays on Flovent 44 for the summer

I'll keep you posted.

Of course, I'm not completely off the hook. We just found out that Oz has astigmatism in both eyes, Ig is spiking fevers today, and B's just been a little off lately - possibly related to the Asperger's. But at least they're all breathing well!!

Poor Ig! Another ear infection, pinkeye AND wheezing!

Post title says it all, right? The kids 15 months old and he's on his NINTH ear infection. The tubes seem to be working -- I can see all kinds of yellow goo in his ear. Blecch.

I have a feeling there's more to this. (Genius that I am.) I mean, let's see - it's his ninth ear infection and he's already GOT tubes, he's running a low-grade fever more often than not, he's got a goopy nose and he's retracting fairly regularly.

Who wants to bet a case he needs his adenoids out before...let's say...Halloween?

Really, I just want to figure out what's wrong with this kid. Between the pain he's clearly in and the amount of days I have to work from home and take care of him, we really need to get some answers.

Ear Tubes, All of a Sudden

Quickly, because there's a baby screaming down the hall --

Finally took Ig to the ENT on Wednesday. We had to wait over a month for the appointment. He's had 8 infections since October, including one that resulted in a perforated eardrum. Never mind that he's rarely slept an entire night since birth, instead waking up halfway through and screaming for up to two hours. (Sure, let him "cry it out." HAH!)

So, the ENT said that Ig's ears are so badly infected, he'd like to do the tube surgery the following morning. (This during one of the busiest, hairiest week's I've had at work in a good, long time, I might add. But, priorities...)

The surgery is done on Thursday morning. We're at the surgical center at 6:45, we're home by 9:30. The baby is seranading me over waffles by 10.

And yet, he's still not sleeping. Even as I type this, he's screaming his head off. Are his ears still hurting, or have I just spoiled him, letting him sleep with me every time I knew he was in pain? (He'd literally KEEP crying for HOURS, and the big boys and I have to sleep, too.)

Anyone with advice on this, please post a comment! I need help!

Iggy's Mystery Illness

So, by now you may have noticed (if I've kept up-to-date with my posting, that is) that Iggy gets sick every two weeks. Every other Friday, I work from home because he's running a fever, coughing, has an ear infection, a stomach virus...something exciting like that.

This week's illness is just WEIRD. He has "the cough", but I only hear it a few times a day. Per the doctor, who - by the way - now thinks I'm completely neurotic, his ears are clear, his throat's only a little red, and his chest is clear. And he's negative for Strep. He's had little or no fever in the morning for the past few days, but he's gone up to 102+ at night. His diapers have been nothing short of repulsive -- but normal in number.

During the day, he's irritable and lethargic. My normally sweet, cuddly boy is grumpy and tantrum-prone. He's not eating well, he's not playing...he'd rather snuggle than toddle aorund, but after a while, he'll start crying and writhing -- then he won't let you put him down, or continue to hold him, or put him in his crib. Not without screaming.

So...knowing that there've been cases of mono and flu in the area, I'm wondering if either of these could be a possibility.

Does anyone have any thoughts, ideas, suggestions, experiences to share? I could definitely use some advice, and I don't feel like I have my pediatrician's attention right now.

BTW, we're in the NY Metro area, if that helps.

How much time do you spend at the Peds Pulomonologist?

D asked this question in a comment, and I realize that there's enough of an answer here to be a post -- AND a full conversation.

First off, I have to admit (in response to the first part of D's question) I love Denial. I spend a great deal of time there myself! I'm there right now, in fact. Went to the pediatrician instead of the PP today. (I suspect the pediatrician is slightly deaf because she said both little ones were moving air well. That despite tight coughs and Oz complaining that his chest hurt.)

So here's the thing with PPs...the amount of time you spend there is directly proportionate to the amount of time your child is sick. BUT - if you come up with the right combo of meds right away, you may only go a few times a year.

It also depends on how quickly you can be trained as an Asthma Mom. We have a unique skill set and toolbelt. You'll see.

My oldest monkey has not a file, a BINDER at our PPs office. When he first got sick, we were there constantly, and when we weren't there I was on the phone with either the PP or her nurse practioner.

But once we got the right balance of meds (Flovent 220, Singulair, Nasonex) and the right Asthma Action Plan, we were able to manage most illnesses with a phone consultation and called-in prescriptions.

At this point, I have the office on speed dial and a closet full of supplies (nebulizer, cups, tubes and masks for said nebulizer, albuterol, Xopenex, saline, giant bottles of Dimetapp...) Oz and Ig have regular files, and the nurses like me a lot better these days.

Hope this helps. You may want to join the Asthma-Parents email list and see if someone else lives near you and can recommend a good Pediatric Pulmonologist.

Monday Fun: Your Monster Name (not asthma-related)

Yes, all my kids are coughing right now, but I thought I'd shelve that post for a bit, and bring some fun instead.

Check out my Monster Name!

Get Your Monster Name

How much fun is that?

When to switch to a Peds Pulmonologist and other questions answered!

Got a great comment today with a lot of good questions...some of which I can actually answer!

I'd love to ask you some questions since I feel like I'm kind of a
beginner in this whole thing...like at what point do I take him to a
pulmonologist vs. the regular ped? When and how does he get officially diagnosed
with asthma? What about allergy testing--when is it recommended? I never feel
confident in deciding whether or not to neb...how do you decide? Stuff like
that.

So here's answer #1 -- Take your child to the pulmonologist as soon as you suspect your child is asthmatic. Assuming you have insurance coverage and a pediatic pulmo nearby, GO. Many pediatricians -- even the fantastic ones -- miss the subtleties of peds. asthma. Go to a PP or an Asthma/Allergy specialist as soon as you every think you should.

Answer #2 -- Children often keep the "Reactive Airways" diagnosis until age 5. Asthma is a type of RAD, but doctors seem to be skittish about making the hard diagnosis. I'm not sure why. My PP diagnosed B with asthma at age 2, but other specialists still insist on referring to his condition as "Reactive Airways," even when I correct them. I mean, JEEZ, I think my pediatric pulmonologist may have been qualified to make the diagnosis.

Answer #3 -- With the allergy testing...our PP sent all three of my kids out for blood panels at their first appointments with her. Now that B is 5, he's going to an allergist for more in-depth testing. So it may be another "age 5" thing.

Answer #4 -- As far as nebbing, always call your doctor first...but we prefer to err on the side of caution. When in doubt, neb. At first sign of a cold, neb. Think you hear a wheeze? NEB.

See a pattern?

Bottom line...get a pediatric pulmonologist on your team. It all falls into place from there.

Hope this helps, Miss D!

New Site for Asthma Parents

I referenced this before, but I think I wasn't so clear --

I started a MySpace for asthma parents... check it out and let me know what you think!

Click here to join Asthma Parents!About Asthma ParentsIf "nebulizer" is part of your every day vocabulary, you know the difference between an MDI and an HFA, and you have a pediatric pulmonologist on speed dial, we're with you.
Labels: asthma, asthma news, asthma resources, pediatric asthma

Article on Flu Shots for Asthma Kids

This article just caught my eye on Yahoo! Health. It's about how children with asthma should get flu shots, but very few do.

I have a number of thoughts on this, especially since I have an egg-allergic child on the autistic spectrum (the vaccines are grown in fertilized chicken eggs).

• Thought #1: Perhaps if all flu shots were thimerosal-free, I wouldn't think twice about it. But thimerosal-free vaccines are only an option -- and not all insurance companies cover them.
• Thought #2: Flu strains mutate over the course of a single season. The vaccines are selected on the assumption that the strains covered will be effective for that season. It's not always accurate. Even if you decide to vaccinate, you're not guaranteed a flu-free season.

Given the risks the flu poses to asthmatic kids, I'm pretty well pro-vaccine if you can go Mercury-free. Just know that it's not a perfect solution.

Now here's article:

Ch

ildren with asthma should get flu shots to protect them, but only 3 in 10 do, U.S. health officials said Thursday.

We were surprised at how low the number was," said Susan Brim of the U.S. Centers for Disease Control and Prevention, lead author of a study that looked at flu shot data from 2005.

The study represents the first national estimates on flu vaccination rates for asthmatic children.

Children with asthma, a chronic lung problem marked by wheezing, coughing and labored breathing, can die from flu complications, such as pneumonia and acute respiratory disease. And they are at higher risk for those problems. Inactivated flu vaccine is recommended for asthmatic children older than six months.

The study's findings came from an analysis of a 2005 national survey of the parents of children ages 2 to 17. About 5,100 kids were represented in the data, and 557 of them had asthma.

Only 29 percent of the asthmatic children had gotten flu shots during the 2004-05 flu season. The lowest vaccination rates were among children ages 5 to 12 who had not had an asthma attack or episode in the previous year.

The survey came after a flu vaccine shortage that caused long waiting lines for shots. Brim said it's not clear what impact that had on the study results: Asthmatic children were prioritized for the scarce shots, so the shortage may not have hurt — and possibly might even have boosted — vaccination rates that year, she said.

The low rates may have to do with family's misperceptions about flu shots, said Dr. Gerald Teague, a pediatric pulmonary specialist at Emory University.

Many patients seem to mistakenly believe flu shots can trigger asthma attacks or flu symptoms, and it's important that doctors talk to families and address such concerns, Teague said.

"Influenza in a child or adult with asthma can be fatal," he said.

...Nothing like ending things on a positive note!

Asthma Parents on Ning

I started an Asthma Parents Group on Ning.

What's Ning? It's new social networking site where, essentially, you can start your own, focused version of "MySpace."

Here's the invite:

Come join me on Asthma Parents!

Click here to join Asthma Parents!

About Asthma Parents
If "nebulizer" is part of your every day vocabulary, you know the difference between an MDI and an HFA, and you have a pediatric pulmonologist on speed dial, we're with you.

Ig at the Cardiologist

I've mentioned a few times that Ig has gone cyanotic on me -- from turning fully blue to just going blue around the lips. The pulmonologist thinks is probably just reflux triggering a bronchospasm, but she wanted us to see a cardiologist -- just in case.

So we went to the pediatric cardiologist this morning, nearlhy 2 months after getting the appointment. (Guess we're lucky to even have one nearby and under our insurance, right?)

Of course, Ig is sick again, and of COURSE he pooped right through his diaper the minute we were leaving...but beside the point...

The appointment was very long and very thorough, and at times, very unnerving. During the ultrasound, for example, the tech kept zooming in and taking more and more pictures of one area, and all I could think was, "Oh, no. She's found something."

Even worse, at one point, they took his sats and he was only 83. Normally, I would question that, but the cardiologist is actually in the same clinic as our PP and shares the same nurses, so I was fairly certain the nurse how to get a correct pulse-ox on my baby.

But actually, everything was FINE. Not only were his sats perfect, there wasn't really anything wrong with his heart at all. One wall *may* be a little thick, but apparently, that's nothing to worry about, and it may be "a normal variant" for Ig. But we'll check it again next year, just in case.

What a RELIEF.

Levalbuterol (Xopenex) No Better Than Albuterol, Says Public Citizen/ WorstPills.org

Hah! Guess they've never had to deal with kids on albuterol. (For the uninitiated, you may as well give them a twelve pack of Red Bull and a couple of Hersey bars....)

Levalbuterol Is No More Effective Than Older, Cheaper Asthma Drugs and Should Not Be Used, Public Citizen Advises on WorstPills.org
“Worst Pills, Best Pills” Subscribers Receive Life-Saving Warnings About Dangerous Drugs Before They Are Removed From the Market

WASHINGTON, D.C. –Levalbuterol HFA (Xopenex HFA) inhalers are no more effective than older, less expensive drugs used to treat asthma and other diseases and should not be used by consumers, Public Citizen writes in a new February posting on its WorstPills.org Web site. The consumer advocacy organization cited information published in the March 2006 issue of Medical Letter on Drugs and Therapeutics.

In 2005, Americans filled more than 2.2 million prescriptions for levalbuterol at a cost of more than $293 million. Marketed by Sepracor Inc., levalbuterol has the same atomic components as the asthma drug albuterol, which has been on the market longer and costs less. The difference is that, while albuterol has both of the two mirror images of the molecule, levalbuterol has only one. Levalbuterol is available in two forms, Xenopex [SIC]HFA, a pocket-sized inhaler approved by the Food and Drug Administration (FDA) in March 2005, and Xenopex, a liquid drug approved in 1999 that is converted to a fine mist when passed through a device called a nebulizer. Levalbuterol is short-acting and is used to relieve symptoms experienced during an asthma attack. In 1999, Public Citizen placed levalbuterol on its “Do Not Use” list of drugs because there was – and still is not – any compelling evidence that levalbuterol is safer or more effective than albuterol.

“Creating a drug that is nearly identical in nature to a drug that is already in existence and then marketing it as a ‘new’ or ‘breakthrough’ drug is a strategy that neither helps consumers nor produces better drugs,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group. “In marketing levalbuterol as such, the manufacturer is manipulating patients into unnecessarily paying hefty prices.”...

Again, I say the value of Xopenex is not the effectiveness of the drug -- we know it's equal to the cheaper, generic albuterol in that way. But the side effects...where albuterol has the kids bouncing off the walls (especially lovely if they're already on oral steroids) levalbuterol yields negligible negative effects.

To be able to give your asthmatic child a neb at 2:00 AM and know that they'll actually be able to sleep after that is worth the higher copay.

Asthma - Not a disease, a collection of symptoms

Just found this article on NewsTarget, which seems to be an aggregator of highly biased, self-serving news with a decidedly non-medical bent. But this one may have some merit. Here's a pretty comprehensive excerpt:

(NewsTarget) The medical journal The Lancet is appealing to the medical
community to stop using the term "asthma" as it misleads people to believe it is
a disease rather than a group of symptoms with various origins and
characteristics.

Symptoms of asthma include wheezing, coughing and breathing difficulties,
and it is generally accepted that attacks are brought on by inflamed airways,
but the actual spark for the inflammation is not known, nor is the reason why
some people contract asthma while others do not.

"Perhaps asthma as
a symptom is really only the clinical manifestation of several distinct
diseases," said The
Lancet article. "Rather than confusing scientists, doctors and patients even
further, is it not time to step out of the straight jacket of a seemingly
unifying name that has outlived its usefulness?"

The article went on to explain that asthma can have a multitude of
triggers, symptoms and treatments, providing more evidence that it is
inappropriate to label it as a single disease.
"The Lancet article raises
some interesting points; asthma is indeed a complex ailment," said Dr. Andrew
Miller, a spokesman for the British Lung Foundation. "But whether this is a good
enough reason to abandon a useful name which encompasses a range of symptoms
treated in a similar way is not yet clear."

...Currently, experts claim that approximately 300 million people have
asthma worldwide -- a number expected to reach 400 million by 2025. One in 250
deaths is caused by it, and children with allergies are more likely to
develop the condition. The Lancet noted that there has been an increase in
childhood allergies across the globe.

"Until the 19th century fever was regarded as a disease and maybe in
20, 30 or 50 years' time we will look back at asthma in the same way," said the
editorial.

Ig has Croup - allegedly

Saw the peds today -- Ig was up last night coughing so badly, B and I were both freaking out a little. We finally woke him up at around midnight to give him a neb of Xopenex.

This morning I brought him in. It's Saturday, and we were probably among the last patients on what seemed like a very busy day, so she did seem like she was rushing a bit. And I'll confess upfront (and I've said this MANY times before on this blog) while I love my peds, I don't trust them when it comes to determining the clarity of my kids' lungs during the infant/toddler years.

Anyway, she listened to my concerns (low-grade fever, cough, ear pain, etc.), and checked the baby out. She said his ear looked better, so she thought the Omnicef was working -- but based on what I told her, she suspected croup. Now, she didn't hear him cough. And - shocker - she said his chest sounded good.

She wants me to keep up the nebs, and she gave me a box of Pulmicort. I reminded her that he was on Flovent already (fair enough, the pulmo prescribed that), and she said we might want to replace the Flovent with the Pulmicort for now.

Ummm...will one Respule be the same as his regular dose of Flovent 110? She didn't say... I'll cut her some slack. Just this once. I'm a frequent flyer, and she was in a hurry.

She did point out that he'd been in for an ear infection once monthly for the last five months, and that we should follow up with the ENT.

Great. So in the next month, Ig will be visiting the Pediatric Pulmonologist, a Pediatric Cardiologist, and a Pediatric Otolaryngologist. Thank God for health insurance.

No Flu (I don't think) and Iggy's Ear

So, I'm feeling a lot better today, and while I haven't taken my temperature since I woke up, I don't think I have a fever. So...phew.

Ig, on the other hand...not so good. I took him to the peds for his millionth ear infection on Tuesday and we started him on Omnicef. The deal was, if the Omnicef didn't work, we'd have to talk to an ENT about treatment. (read: TUBES)

So we're on the fourth day of treatment, and I've finally brought him back to daycare, and they call me less than two hours after dropoff to tell me that he's running 100.5. Yes, that's a low-grade fever, but four days into an broad-spectrum antibiotic, should there be ANY fever? I think not.

He's also had two rough nights in a row. Wednesday he was up screaming bloody murder every two hours. Last night, he was up at about 1:00 screaming. I gave him some Dimetapp (mostly because he was coughing -- and I couldn't remember when I'd given him Motrin) and a cup of water -- which he sucked back like he hadn't seen fluids in a year.

Both nights were better than Tuesday when he spiked up to 104.9.

Spoke to the peds today, and they said that the antibiotic could take another day or two to kick in (yeah, right...) but that if he had another rough night, they'd see him tomorrow morning.

Ah, nothing like the pediatrician's office on a Saturday!

(Did I mention the hideous cough, by the way? We'll be talking about that with the doc, too. I've been giving him albuterol twice a day.)

Do I have the flu?

Ugh -- Ig's just getting over his 3 millionth ear infection, Ozzy's coughing his head off in bed, and I think I've got the flu.

I've just got that achey feeling in my back and the chills right now -- along with a goopy throat and slight cough. My temp is a little over 99.

Here's how I know I'm the mother of asthmatic children: I'm relatively unphased by the fact that I'll be sick through the holiday weekend. I'm FAR more concerned that I may have already exposed my three asthmatic kids to the flu.

(Oh, for a plastic bubble!)

I'm a super-affectionate parent, so I've been all over the kids all week, just like always.

Please, please...just let this be a little cold. Or some freaky thing that only grown-ups can get!

Long overdue update - asthma attacks, RSV, cyanosis and more fun!

Wow -- I can't believe how long it's been since my last post! Rather than blather on, I'm going to cut to the chase and just bullet out what's been going on:

• B - #1 son has been doing great! He's still on Singulair and Flovent 44, but he's had a GREAT winter so far. He had one asthma attack, just last Sunday - stupidly, we let him sleep in his room the night after we'd painted. But honestly, I'd have to check the blog to see when his last flare up was prior to that.
• Oz - it hasn't been as rosy for this guy. Ozzy developed a nasty case of RSV on 12/15. When I took him to the doctor on 12/18, I asked if he was wheezing, and she said no -- because he couldn't even get a deep enough breath to wheeze. We went for a chest Xray and an RSV test, and we ended up doing nebs every three hours for TEN DAYS. It was rough -- and honestly, he didn't have his color back until about two weeks ago. And now he's coughing again. He's currently on Flovent 110.
• Ig - Also coughing again. He had mild RSV at the same time Oz had it. At around that time, he started going cyanotic. His lips go blue nearly every morning, and we're not sure why. We're going to the cardiologist next month. He's also on Flovent 110.
• Me -- Finally taking off the baby weight! Or inches, anyway. Somehow, I've found the time to join Curves (30 minutes x 3 times per week is about all I can manage with a family and full-time job!) I've lost 2 inches off my waist since December -- If I can lose 10 lb. and another 3-5 inches of Iggy weight, I'll be happy!

More soon ... I wont' have this long a lapse again!

Iggy is a NIGHTMARE on Flovent

11-month-old Ig is a demon on Flovent. Man, I thought that kid was a bad sleeper before...on Flovent, he has learned how to scream. So now, when he wakes up at 3:00AM, he doesn't just cry....he shrieks for more than an hour.

He was tenacious before, now he's downright impossible when he gets his mind set on something. (For example, he started self-feeding on Thursday...now I'm not even "allowed" to feed him.)

Good thing he's still so snuggly and cute!!

And yes, I can bitch and moan about it til the cows come home, but ultimately, I'm happy the medication exists that can help my child BREATHE.

Oz is OK

The pediatric pulmonologist tells me I'm as good as an ER. When Oz was having a flare this morning -- so much coughing he couldn't even speak -- I started doing nebs every two hours. I alternated Xopenex and DuoNeb and called her office for backup.

By the time we got to her office at 2:30, he was hardly coughing anymore. By the time we left, he was singing in the car all the way home.

Still doing nebs every 2-3 hours today, and we'll reduce to every 3-4 tomorrow.

But first, we'll see how tonight goes.

BTW, did I mention I've barely seen my office in the last week? I've been working from home since Iggy got sick last Monday. Only *slightly* stir crazy. :-)

Iggy's on Flovent

Forgot to mention this in the last post...but yes, my 11-month-old is now on Flovent 44. Not surprising considering:

• He was born in respiratory distress and spent his first 24 hours in the NICU
• He turned blue when he was about 4 months old (he was fine)
• He has had three illnesses involving serious coughs in the last 9 months, including the one last week

And to my friend who was asking about an alternative to Pulmicort, ask your doctor about Flovent and QVar, which are both in metered-dose inhalers (MDIs) rather than administered via nebulizer. Much faster, easier, and child-friendlier.

Giving thanks...for Flovent and Nebulizers

Thanksgiving's almost here, and - like last year - Oz has RSV again. At least I'm pretty sure it's RSV. We're leaving for the peds. pulmo. in 20 minutes, so I'll know for sure later.

So...yea. Once again, I'll be rushing home from my plate of side dishes (hi, lifelong veg) to administer nebulizer treatments every 3 hours around the clock.

But really, I am thankful. I'm thankful that after over four years of dealing with asthmatic babies, I finally feel like I know what I'm doing. I fearlessly administer Xopenex at the first sign of a cough, and add DuoNeb every 3 hours if things start going south. I no longer feel compelled to go to the ER every time someone's cough spirals out of control. I don't even need to see the PP *every* time one of the boys is sick.

Don't get me wrong -- I still go when we need to. I just don't PANIC anymore.

I'm also thankful that not one of my boys has required hospitalization since 2002. Let's hope I can be thankful for that again next year. :-)

...one final note: Apologies for the two month hiatus. So busy with work and three kids, and big B's Asperger's Syndrome has consumed a good deal of my maternal concern. There may be another blog in that one.

Status Check: The boys this week

B -- fine, but due for allergy tests. He's had intermittent congestion (the nasty, green kind) and is breathing noisily at night, but nothing alarming. We're going to do the "real" allergy tests this time -- not just blood work. (Damn, gotta schedule that...) He's 5 now. It's time.

Oz -- He's 2-1/2 now, can you believe it? GORGEOUS, too. Anyway, he's coughing at night and has been for a few weeks. He's had a goopy, green nose on and off for 2-3 weeks now. He's also been up 2-3 times per night pretty much all summer. Now that I'm typing this out, I'm feeling pretty idiotic for not having taken him to the peds. pulmo already. I'll get right on that.

Iggy -- 9 months next week. He's getting so big so fast! (SOB!) He's had a cold or two, but overall, he's been doing great. I've stayed off shellfish and kept him off dairy, and we haven't seen hives since. We'll do allergy tests at his next checkup.

In other Iggy news -- still not sleeping through the night, so I'm up with him at 2, Oz at 4, and dragging through my days. It's painful. He is babbling like mad, sitting up on his own, and ready to crawl. He's very cute!!!

My predictions for our next PP visit: Bryn and Oz both go on Flovent 44. I'm also guessing that Bryn will, once again, not successfully complete a PFT.

We'll see, soon enough!!

Aspbergers: The Beginning of a New and Very Different Year

As usual, summer flew. Here it is September again, the start of a new school year, and always for me, the most stressful time. I love fall, but loathe the change -- shorter, colder days, the end of the lighter traffic and lighter moods of summer.

This year's just a difficult to kick off for me. I resolved (yes, I actually make resolutions at the beginning of the *school* year) to get up earlier, work out for 20 minutes, and then get the kids off to daycare before 9:00. But with Iggy still not sleeping through the night, and Oz suddenly waking up with him, it's hard to face the still-dark morning. And with the boys adjusting to their new teachers and curricula, plus my biggest work project due in less than two weeks...I'm cutting myself some slack.

There's a new hurtle, too. It's the reason I haven't blogged in over a month. If you've been with me for the last 2-1/2 years, you know I don't usually stay away from the blog for that long. If you something was wrong, you guessed right.

Not long after #1 son's 5th birthday, we managed to get in with the developmental pediatrician. She was a terrific doctor -- wonderful with little B, and wonderful with me, as well. Our appointment lasted more than three hours, during which time I was interviewed about little B, and he was given a bunch of activities to perform -- drawing, writing, building with blocks -- and interviewed, as well.

The school district's preschool disabled program and B's child study team had arranged the appointment, and they were paying for it. They wanted a diagnosis so that they could provide additional services for him. I questioned whether he needed anything more than the great services he already had, which included PT and OT, but was happy to schedule the evaluation.

In terms of a diagnosis, I expected to hear that he was dyspraxic, or that he just had poor gross motor skills, and he'd outgrow this. Or that somehow, as a result of his asthma or years of inhaled steroids, he'd developed some unusual sensory issues, but that he'd outgrow them.

What I wasn't expecting was a diagnosis of Aspergers Syndrome.

Children don't outgrow Aspergers. In fact, Aspergers becomes harder to manage as they get older, becuase that's when they begin to realize that they're not like other kids. Or at least, that they're not treated like other kids.

It had been suggested years before that little B had Aspergers. When he was 2 and obsessively opening and closing cupboard doors, even we thought he might have it. But every doctor under the sun ensured us that he would be fine, he made great eye contact, he was very social, there was no way he was on the autistic spectrum.

So I was pretty well blindsided on August 10.

Aspergers is not a death sentence. Even in my horrified state, I was fully aware that nothing had changed. B was still B -- the same wonderful little boy he'd been five minutes before his diagnosis. Still gregarious, sweet and smart as ever.

The drive home was a challenge -- I had to quickly convince myself that the diagnosis was a positive. It was a tool that would both help us understand B's "quirks" and enable him to receive more services through the school district.

Why the rush? Because my husband would be a lot slower to take on this viewpoint. He would need the time to grieve the loss of his perfect goalie, his future Toronto Maple Leaf. I had to be the pillar. I had to be positive or he'd pull me into the sorrow with him -- and for B's sake, I wasn't going.

So, here we are, a month later. We decided to keep B out of Kindergarten this year, at the suggestion of the Child Study Team. He'll stay in daycare (yes, I really do have three kids in daycare) and continue to do the preschool disabled program 4 half-days per week through June. We'll take things one day at a time and see where we go from there.

It's a sad September, partially because he's NOT in Kindergarten, and in my eyes, he's ready. But I recognize that have to trust the doctors and the CST better than my eyes.

It's also sad because now, I've got to keep a secret from his new friends, and that's just not in my nature. But it's important that his friends - and their parents - see him as an equal and don't treat him any differently.

For now, his social skills are pretty normal. He makes friends easily, and even though his teachers a daycare (who, by and large, are not in the know) feel there's something special and different about him, it's something they see as a positive -- a sweetness and naivete that sets him apart from the other children.

My eyes are on the future. My feeling is that for B, is as bright and as promising as ever. I just have to keep everyone around me believe that -- B, most of all.

Baby Iggy's Food Allergy

Ig woke up with hives onthe outside of his buttocks on Sunday.

We started solids at six months, introducing a new food every week. First rice cereal, then bananas, then apples, pears, peas, yogurt and carrots. Couldn't tell if it was the carrots or the yogurt, but naturally, assumed it was the yogurt.

The peds agreed it was probably the yogurt, but I put him on a reduction diet anyway. Bananas and rice cereal only since Sunday. (Poor guy's probably going HATE bananas.)

But the hives were back this morning, so I took him to the peds.

Thank God I'd put him on the reduction diet...I suddenly realized (DUH) that it was something I was eating, what with me nursing and all.

I had lobster on Saturday night, and then again for lunch on Wednesday. Pretty crazy...I'm a 20+ year vegetarian, but I occasionally weaken and indulge in crustaceons. It's a rare week that I have lobster twice!

So...it seems Iain might be allergic to shellfish.

(And that'll teach me to stray form the course of vegetarianism, right? Is this some conspiracy by Peta? Do they do this to all offending veggies?)

Could be worse -- I have a girlfriend whose son breaks out in a rash every time she eats peanut butter. I can't imagine life without peanut butter. I'm far too lazy a vegetarian to live without it.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

B looks worse -- getting really concerned!

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

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

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

So, add guilt to my concern now.

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

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

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

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

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

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

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

Good News -- We're off Flovent!

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

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

Long Overdue Post on "Deadly Asthma Inhalers"

I've been meaning to post this for a week! From HealthDay, June 8:

THURSDAY, June 8 (HealthDay News) -- Adding to the ongoing controversy over a popular class of asthma inhaler medications, a new data review suggests the drugs may be dangerous.
Compared to placebo, the "long-acting beta-agonist bronchodilator" inhalers (which include Serevent and Advair) more than tripled users' risk of asthma-linked death, according to the report. Risks of hospitalization and life-threatening complications also went up.

"These agents should not be used," concluded lead author Dr. Shelley Salpeter, a clinical professor of medicine at Stanford University and a physician at Santa Clara Valley Medical Center in San Jose, Calif.

However, another doctor said the drugs are still safe enough to use -- although they should be prescribed carefully.

Long-acting beta-agonist bronchodilators are designed to help relax airway muscles and improve breathing. They include popular medications such as Serevent (salmeterol) and Advair (which combines salmeterol with a steroid). The drugs are reportedly expected to gross nearly $7 billion in sales to consumers this year.

Another family of bronchodilators, called inhaled anticholinergics, are "very safe and effective," Salpeter said. But long-acting beta-agonist drugs have been controversial. Last year, the U.S.
Food and Drug Administration issued a warning that the drugs could worsen symptoms and even lead to death.

In the new report, Salpeter and colleagues launched a broad review, or "meta-analysis," examining the results of 19 asthma drug studies involving nearly 34,000 participants.
The findings are expected to appear in the July 4 issue of the Annals of Internal Medicine.
The experts found that, compared to placebo, long-acting beta-agonists boosted the risk of asthma-related hospitalization by 2.6 times and the risk of life-threatening complications by 1.8 times.

The risk of death rose by 3.5 times, although the researchers caution that the very small number of deaths recorded in the studies limits the "reliability" of that number. Even so, the findings suggest that salmeterol could be responsible for 4,000 of the annual 5,000 asthma deaths in the United States, the study authors said.
"The take-home message is that long-acting beta-agonists worsen asthma control and increase the risk for moderate asthma exacerbations, life-threatening asthma exacerbations and asthma deaths," Salpeter said. "These can occur without any warning from increased symptoms, which make them especially dangerous," he added.

Not so fast, said the author of a commentary accompanying the report findings.
While they have dangers, the drugs can still "be helpful to some people," said Dr. Jeffrey Glassroth, professor of medicine at Tufts University in Boston.

If the drugs weren't used, "we might prevent some adverse reactions, but we might create as many, or even more, problems in our asthmatic population," Glassroth said. "What I would like to see is more rigorous adherence to the current guidelines that suggest they aren't first-line therapy. There are other things to be used first, and, for many patients, that may be all they need," he said.

Meanwhile, research findings suggest that some groups -- such as African-Americans -- might be at especially higher risk if they use the drugs, he said.

It's unclear how the drugs work, and it's not known why they can be dangerous for some people and not others, Glassroth added, although genetic factors may play a role.

Little B Goes to the Peds Neurologist

Just another quickie: We took #1 son per his Child Study Team, who suspected he might be on the autistic spectrum because of his arm-flapping and toe-walking.

The brief summary: The neurologist thinks they're all nuts. Apparently these things are "soft markers" for autism, he's completely fine, and the regimen of Physical and Occupational therapy he's currently getting through the school system is sufficient.

I think she was just glad we weren't looking for a prescription for Concerta or Ritalin! I think the docs around here are pretty sick of prescribing that stuff...

Anyway, we're still going to have to take him to another Neurologist, as the school system will be sending him to theirs, but needless to say...we're relieved and pretty optimistic!!

Pediatric Asthma is Just Weird Sometimes

Quick Update: Oz began a flare on Saturday -- just cranky and a little "off." He started coughing Sunday, and was coughing a lot on Monday. Monday night was a misery -- he woke up screaming because he couldn't stop coughing. Thank God we'd just gotten a lifetime supply of Xopenex from the mail-order Rx, and I'd already started DuoNeb.

I called and checked on him in daycare yesterday repeatedly, even though he'd been okay during the day -- just rough from late afternoon through early AM. But I was ready to pick him up if need be, and I'd left instructions to give him albuterol twice during the day.

I called the peds. pulmonologist yesterday just to give them a "heads up" and make sure I was taking action appropriately. I was sure I'd have to rush him over there this morning.

But, in typical asthma flare fashion, he was completely fine by the time I picked him up yesterday. Not a single cough the entire evening.

How weird is that? Monday night, he's coughing his head off. Tuesday night, nothing.

I'll taper off the rescue meds gradually, just to be safe!

Scary Headline in Fox News: Survey: 1 in 3 Fatal Asthma Attacks Involves a Child With Mild Form

Here's a terrifying news story to share with all you moms who are just getting comfortable with your kids' asthma. As if worrying about terrorists bombing your local shopping mall wasn't enough to give you nightmares. Or the fact that some inhalers might be "deadly." (Whoops. Forgot to post that. Coming up.) Anyway, the story is reprinted in full below:

Survey: 1 in 3 Fatal Asthma Attacks Involves a Child With Mild Form

VIENNA, Austria — One in three fatal asthma attacks worldwide involves a child with a mild form of the disease, and nearly half of all parents are unaware of the death risk, according to a new global survey presented Wednesday.

The European Academy of Allergology and Clinical Immunology said the findings exposed a critical information gap between doctors who treat asthma and the parents of youngsters diagnosed with it.

"Many patients with asthma underestimate their disease severity and overestimate their degree of asthma control," the academy warned in the report issued at its annual conference, held this year in Vienna.

Dr. G. Walter Canonica, of the University of Genoa in Italy, said the survey underscored how effective treatment "is a shared responsibility requiring continuous communication among physicians and children with asthma and their parents."

"One place to start is in the area of treatment side effects ... in many cases, parents are not able to identify these side effects," he said.

Experts said that with each decade, the prevalence of asthma increased 50 percent. Worldwide, more than 300 million people are afflicted and more than 180,000 die of the disease each year, the Global Initiative for Asthma says.

Asthma is a chronic lung disease caused by airway inflammation, and certain stimuli cause the windpipe to become obstructed. Symptoms include wheezing, coughing and a tightened airway that causes shortness of breath and can be life-threatening. Allergies are responsible for more than 50 percent of asthma in adults.

Treatment for the condition costs society more than tuberculosis and HIV/AIDS combined, the European Academy said.

Its survey of 5,482 asthma patients, their doctors and the parents of young sufferers focused on cases in Britain, Canada, France, Germany, Italy, Japan, Spain, Switzerland and the United States. The academy called it the first sweeping global study of what parents do and don't know about the hazards of asthma.

Many parents cut back on treatments such as the use of drug inhalers when their children suffer side effects, the study found. Others switch asthma medications or discontinue treatment altogether, it said, cautioning that doing so "can be dangerous and greatly impact health outcomes."

Reducing or stopping treatment usually means a child's condition worsens, the report warned.
"More than three-fourths of children who are not compliant with their asthma treatment all the time experience at least one of the following: increased symptoms (66 percent), limited physical activity (48 percent), nighttime awakenings (46 percent) and more frequent asthma attacks or exacerbations (40 percent)," it said.

Those who don't follow doctors' orders end up with 38 percent more visits to physicians and are 14 percent more likely to wind up in an emergency room or hospitalized, the survey said.
Experts said that although 59 percent of parents say they comply with their doctors' instructions all the time, only 9 percent of physicians believe it because the child's symptoms are not controlled. And parents and doctors both complain that the other side doesn't initiate discussions about treatment and side effects.

"Patients with asthma, parents, and the physicians who treat them should pay close attention to the findings from this survey, which show that the way we currently treat asthma is unsatisfactory," said Dr. Erkka Valovirta, a pediatrics specialist at Finland's Turku Allergy Center.

New Resource: RemedyFind

Just a quick one: Not sure how good this is, but it was posted to the Asthma-Parents email list --

RemedyFind

Let me know what you think. I'm hoping it's not another scam site selling liquid oxygen or something ridiculous like that. It would be cool to have another useful, unbiased asthma site in the universe!

Fumes in the Daycare Center? Only in My World...

Tuesday: I go to pick up the big boys at their daycare center, only to find that they're in a completely different part of the building. (The company that owns the center also owns a Gymboree-like business, housed in the same building. That's where they were.)

When I asked why, I was told that in the roof repairs currently underway, they were using a glue that produced an odor that "smells really bad."

It wasn't until I went to get the boys' things that I realized the place smelled like it had been freshly spraypainted from floor to ceiling! "Smells bad" was the understatement of the decade.

And of course it triggered the boys' asthma, only a little. I felt badly -- they'd been really, really cranky that night, and I'd assumed it was because they'd missed a snack in all the hubbub. When I realized they were both working pretty hard at breathing in their sleep, I felt really bad! I 'd been a little short with them (three cranky kids under the age of five...you tend to be a little short occasionally!). I hadn't even thought it could have been their asthma/RAD acting up. Duh.

Wednesday: I have to say, I'm pretty psyched to finally be in the office three days a week. My plan is to go in Monday, Weds., Thurs, but I have an out-of-town, work-related party today, so I worked from home with Iggy, then dropped him with my Dad at 3:00 so I could make the 4:000 event. I'm happy. It's a gorgeous day, and I'm meeting my CEOs and some co-workers for dinner on the porch of a Victorian hotel. I'm wearing a long flowy skirt and dreaming of lemonade.

I'm about 25% of the way there when my mobile phone rings. It's the daycare. They're closing early because of the fumes. Can I please come get my kids?

I pull over and try to call my husband, because I *really* don't want to miss this event. I *really* don't want to turn the car around and pick up the kids instead of sitting in the sun with my coworkers.

And I'm EXTRA pissed off, because I'd specifically mentioned to the director that I was concerned about the odor because of the kids' asthma, and she assured me all was well. (I also told #1 son that he should ask for his albuterol if his chest hurt or if he was coughing. He's pretty reliable with stuff like this, despite his young age.) I had also spoken to the area director that morning, who neglected to mention the persistence of the fumes.

So I eventually get B on the phone, and he does leave early to get the kids, and MAN is he mad! He's especially mad because he's found out that the center was supposed to close at 3:00 -- and we didn't get called til 3:40!

Do you think they should have called the asthmatic kids' parents first? There definitely are enough of us!

And while I did make it to my event (yea!) I did arrive home to the terrible news that center would be closed today and Friday. :-(

So much for three days in the office THIS week.

The daycare did call the Department of Health, and apparently everything is safe, but they felt better airing out the fumes.

And PS, Little B is coughing tonight.

Do you believe this nonsens. I swear, Icouldn't make this stuff up if I tried!

B not starting Kindergarten.

Almost forgot. We had a meeting with B's Child Study Team (CST) at his elementary school on Friday. Looks like we'll be waiting to start Kindergarten.

Can't say I'm happy about that. On the most superficial level, I never would have (a) had another baby or (b) bought a new house if I EVER thought I was going to have three kids in daycare at the same time.

On a slightly deeper level, I'm sad because he's SO bright, I really believe he's intellectually ready for school. But his CST is so concerned about his arm-flapping, toe-walking, and impulsivity, they really think we should wait.

What helped us make the decision to wait (we were so against it!) was talking to other parents. Since we are in one of the nation's top school districts, it seems things have gotten very competitive around here. Lots of parents whose kids were born in the summer (like B, an August baby) wait until the following year to start their kids in school. Which means that not only might B be the youngest if he starts next year, he'll be the youngest by FAR. And apparently, kids around here are dating and fooling around by the sixth grade (was that vomit I just tasted?) and the age/maturity difference between B and the others might be so profound, that the social damage could be irreparable.

And nevermind that in this town full of over-achievers, being 10-11 months younger means he'd have to work that much harder to keep up academically, too.

Seems parents of kids without learning disabilities make the decision to wait - sometimes at birth!- so we'll do it while we can. Once we start public kindergarten, there's no going back. At this stage, he won't realize what we're doing, and he's happy to stay at his daycare another year with Oz. (Iggy will be there too in the winter.) If we held him back once he was in the public school system, he'd realize it -- and so would the other kids.

The plan for next year is to put him the Kindergarten class at his daycare (it's certified, but I doubt it's as good as the public school) but send him to the preschool disabled program he's currently attending. Right now, a mini bus picks him up at daycare and takes him to and from the program in the afternoons. Next year, it will be the same.

The CST said he had really made improvements since starting the preschool disabled program in January. Their feeling was that he should have all or nearly all of his problems ironed out by next year.

Their also sending him for a full development evaluation at the great hospital nearby. They're concerned about the physcality of his issues -- the arm flapping, toe walking and head shaking, which all look like autism. He's clearly not autistic, but they'd like him to have an eval. just in case.

Fine by me. I've been trying to get an appointment for an evaluation there for MONTHS and I can't even get a return phone call! I'm taking him to a pediatric neurologist next month at the other nearby hospital...but I'm really glad they're getting us in with other doctors.

I absolutely don't think B is "on the spectrum," but we'll see.

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....