Saturday's Attack

Just an update -- after lots o' drugs, the coughing finally subsided by 1:00pm. He coughed a little more before bedtime, but it wasn't bad.

I kept him on the Combivent/DuoNeb through Sunday, and gave him a dose Monday AM, but he's back on Albuterol only now.

Funny story: He was coughing at breakfast this morning, and he looked at me and said, "Mom, I need Al-bu-ter-ol." He's not even four yet. Is that cute -- or just terribly sad??

Anyway, we'll see how long we can go before the next attack. Clearly, I'm not optimistic. We'll see how fast his regular doc puts him back on Flovent 220. She's back from maternity leave in 2 weeks.

Meanwhile, the baby's running 103. Some holiday weekend.

Another Attack

So...while I attempted to steal an extra hour of sleep this morning, I could here little B coughing his head off downstairs. And coughing hard.

His dad tried his best to take care of things - and did a surprisingly adequate job, I have to say. First he tried Albuterol, and when that failed, he whipped out the neb and hooked the little guy up with some DuoNeb.

When that barely changed things, I paged the doctor.

I kinda expected him to tell me to get some Robitussin DM. But no...he prescribed the most hard-core regiment of meds I think we've ever heard of -

• DuoNeb every half-hour - three times.
• Flovent back up to 220 for several days.
• If he's too hyper from the DuoNeb to deal with, hit him with some Dimetapp. (Or take some myself!)
• Also called in some Orapred to the pharmacy, just in case.

This'll be a fun holiday weekend....

More later. Gotta start another neb treatment.

Coughing Again

We were doing so much better for a few days there ... The rash cleared up, the congestion seemed better... All the new meds seemed to kick in and get the job done.

Then, all of a sudden, this morning he let out a brief coughing spell that ended in a gag. Yikes! A few nasty-sounding coughs later, I grabbed the Albuterol.

I called the Respiratory Center this morning and spoke to the nurse practitioner. She said we should probably extend the antibiotics for another week and a half (she's right - we've typically done three weeks for sinus infections in the past) and start doing Combivent/DuoNeb again. (Oh, joy!)

But, she warned, this may not be an attack. There's some kind of viral "syndrome" out there causing kids to cough uncontrollably for up to 5 days. Every asthma mom's dream! She said they're even allowing the kids to take a cough supressant - usually a BIG asthma no-no - for this particular ailment.

Even worse, they're seeing a lot of walking pneumonia this week.

Add to that the fact that the weather here in the Northeast SUCKS this week - loads of pollen and mold in unseasonably cold temperatures - and it really could be anything.

So...bottom line: We're watching and waiting, MDI in hand.

*That was the SECOND Attack of the Blog*

I forgot we'd had one other one in January or February. We had to use the Combivent then - which, thank God, worked really, really well.

Can't imagine why I wouldn't have written about that one, but I'll look for a post....

First Attack Since the Blog Began - And a Small Rant

So I took little B to the pediatrician today.

I don't know why -- they never hear anything, even when he has pneumonia! I love our peds, but with the kid's tiny little bronchioles, it seems to take well-trained peds. pulmonologist to determine how serious the attacks are.

It's stupid, but since our regular (wonderful and stunningly fabulous) pulmonologist is on maternity leave, I feel like I'm bothering the other doctors when I call.

It's the height of parental stupidty, I know. But I think we all do it. Every parent, facing the "great unknown" of children's health, feels vulnerable and intimidated when calling doctors. We're paranoid, they're innundated with the time-consuming calls of hypochondriac moms. They're brusque; we feel foolish, hypersensitive and ever-so-slightly abused. I don't blame the doctors and nurses - although I probably should. They should try to be a little more understanding.

I don't page my physicians very often; I'm not an alarmist. But I'm so often dismissed by the doctors at the respiratory group who don't know me well. They're all wonderful doctors, and I trust all of them. But they don't know me, and they don't know my son.

And that's why I went to the pediatrician first. I knew I wouldn't get exactly the care I needed, but I knew I'd be listened to, that every symptom would be taken into account, and everything treated. And if they felt the asthma was a serious factor, they'd *send* us to the respiratory group.

I was right. They checked for Fifth Disease. They checked his throat, ears, nose. They listened to his chest. They listened to the account of last night's events and a brief history of life after adenoidectomy.

Then they prescribed antibiotics for the sinus infection and nasal steroids for the *chronic nature* of the sinus infection.

THEN I went home and called the respiratory group.

Surprisingly, they weren't even remotely dismissive. In fact, they were far more aggressive than I could have predicted.

For those of you who have experience with this stuff, we're bypassing Albuterol altogether. We're doing Duoneb or Combivent every four. As a trusted asthma parent, I've got permission to do three doses two hours apart (enough medicine to give an elephant a coronary, quite frankly) if necessary.

We're doin' saline spray 10 minutes prior to the Nasonex, and we're definitely not lowering the Flovent this month.

This'll be fun. Nothing like have your preschooler on a rigid schedule of inhaled speed, after all.

Even better, he has to stay home because there's no way in HECK I'm trusting his daycare to administer meds on schedule, much less identify an asthma attack.

Cool. A preschooler. At home. On speed. While I'm trying to work.

Hey, let's just put him on Orapred too, while we're at it.

Rough Night

Preface: The big kid has had a nose full of green gook since November -- despite February's adenoidectomy. Generally we've learned to live with it, and the wet, "junky" cough that accompanies it. But sometimes, like over the last week, it gets pretty bad.

Last night: We've been letting B stay up til 9 since daylight savings time started, since he doesn't like to go to bed while it's light out. I should have put him to bed earlier yesterday, since he seemed a bit overtired and "snakey" - but I didn't.

When I told him it was bed time, he got all teary and said, "But my tummy hurts!" I asked him to show me where it hurt.

He pointed to his chest.

Uh-oh.

So, one Singulair, one puff of Flovent, two puffs of Albuterol, a teaspoon of Dimetapp and two sniffs of saline later, he's off to bed.

Not an hour later, I hear whimpering, so I head upstairs. B's crying. I went to give him a hug and realized he was still sleeping.

Uh-oh again. It's a night terror. God, I hate these things.

And it's a bad one. He's hysterical, screaming and sobbing like an infant. Dad has to take the baby downstairs because he's starting to freak out (that's Dad AND the baby).

Problem is, he's crying and screaming so hard, he's triggered an asthma attack. He's coughing til he gags, and by the time it's all over, he's got petechiae all over his face.

I page the pediatrician, natch, and she tells me to bring him in in the morning -- and to give him another shot of albuterol.

So, I head upstairs, MDI/spacer in hand, and give him another dose. Which arouses him and starts off another night terror. Yea.

When it's all over, he's calms down and goes back to sleep, but he spends the night breathing at 40 resps/minute, and he's moaning a lot in his sleep.

I can't complain too much -- he hasn't had an attack in AGES. We've had a great winter. But I hardly slept last night because I was so worried.

And I can't help but wonder if lowering his Flovent was a baaaaaad move.

Concern over food child marketing -- from the BBC

Another article -- and maybe this is the first I'm posting -- about marketing unhealthy foods to kids and what it can do.

As a marketer and parent, I have a very strong opinion on this, and here it is: As a parent, I am responsible for what my small children see, experience and eat. If you're a parent, you are, too.

Don't go blaming McDonald's for your child's obesity. It's your fault, not theirs. If you're child is eating too much fattening, unhealthy foods which lead to obesity and/or asthma flareups, I fail to see how it's McDonald's fault.

Feed your child wholesome, healthy foods. Don't let your toddler or preschooler watch television with commercials or inappropriate characters. If you choose to let them watch things like Nick or Disney Channel, make sure they know what they're watching. Supervise. Explain why they can't have everything in the commercials and why they can't have milkshakes for dinner.

It's called parenting folks. Our moms and dads did it -- we can to.

You know can't do it? Your TV. And corporate America.

(soapbox down, angryasthmamama quiet.)

But wait, there's more stupid asthma news...!

Steroid use for asthma no more effective than placebo, study finds (So be sure to switch your child to sugar-based inhalers to test for yourself.)

Toxic chemicals in the home cause asthma in children, says study (So make sure you use vinegar and lemon oil only to clean and disenfect your home..._

Asthma inhalers actually worsen asthma; cow's milk and chronic dehyration are the root cause (And we're back to the sugar inhalers.)

But one happy story:

World Asthma Day organizers hope to save lives through education

Damn -- this site's a GOLDMINE!

"Asthma is a false disease caused by chronic dehydration and body's drought management efforts, says doctor"

Believe it. This doctor attributes the asthma epidemic to, among other things, the fact that we let our kids drink too much soda. I'm so not kidding!!! Check this:

Now, children, there are 17 million children in America, probably more because the numbers rise every year, who have asthma, and the reason is, at the same time, children have been consuming more and more sodas. Three year olds to five year olds have been consuming three times as much soda in the last ten years than in the ten years before that. So these people are getting dehydrated, they are consuming more sodas, which doesn't function in the same way as water, and that is why they get asthma. Now, give these children water, and their asthma will disappear very quickly, in a matter of a few hours, completely the breathing becomes normal. The need for these inhalers will disappear.

Sure. That's it. Replace the Coca-Cola with water and your kids will be fine. And sorry, my kid was diagnosed at 18 months. He'd never even HAD soda -- and still gets it pretty darned rarely.

And just to get you a little more ticked off, here's how the article opens:

Mike: I'd like you to elaborate a little more on asthma, and the idea that the body is managing its water supply deliberately in a way that produces symptoms that are called asthma.

Dr. B: Yes, well you see, drought management means that you have to clog the holes where water is lost from the body. Water is the most precious commodity in the interior of your body, and when not enough is coming in and more is being lost, this is a no-no situation for your body. The intelligence behind the design of the body has it such that a drought management program will kick in, and then allergies are a sign of dehydration because the system that regulates water balance of the body suppresses the immune system, because it's an energy-consuming situation. Then you get asthma.

Interest (or bile) piqued? Read the whole thing. It's positively baffling.

Asthma News Aggregator

Check this out: http://www.asthmafactor.org/ -- It's all asthma news!

Stridor and Wheezing - Symptoms, Not Diagnoses

I was just on the BabyCenter boards, and I noticed that someone's doctor had diagnosed their incredibly sick child with Stridor.

A peds ER doctor had diagnosed her child - who had collapsed and turned pale and blue with O2 level of 89 - with severe asthma. The pediatrician had "corrected" the diagnosis and called it Stridor.

Now, I've been an "Asthma Mom" for two years now, and I have never heard of "Stridor."

So, being the research geek I am, I Googled it. Here's the best info I found:

Stridor is the audible symptom produced by the rapid, turbulent flow of air
through a narrowed segment of the respiratory tract, more specifically, the
large airways. It is often the most prominent symptom of airway obstruction
in the pediatric patient. Proper management is possible only after a precise
diagnosis has been established.

Stridor is a symptom and not a diagnosis. It cannot be managed appropriately on
the basis of a presumptive or inferential diagnosis.

Stridor is most often inspiratory. It typically originates from the
larynx, upper trachea, or hypopharynx. The term stertor has been
used to describe the low-pitched inspiratory snoring sound typically
produced by nasal or nasopharyngeal obstruction.

So, basically, stridor is pretty much the sound your wheezing child makes on the inhale. It is *not* a diagnosis. And it seems to occur most often during a case of croup, as far as I can tell.

I have to think that the asthma mom on the babycenter board misunderstood her doctor. Either that, or the guy got his med school degree from IDG ("Pediatrics for Dummies?")

But either way, I hope she takes my advice and finds a peds. pulmonologist!

Bad News: Baby has eczema

So, while I try to be optimistic about #1 son, #2 son seems to hell-bent on raining on my parade!

He was diagnosed with eczema yesterday and put on a steriodal cream. Ah yes, his first (topical) taste of corticosteroids.

It wouldn't be so bad if (1) it had started BEFORE I put him on regular mild; (2) he hadn't had those many, many incidents of coughing til he turned purple and gagged and (3) he hadn't already had bronchiolitis.

Let's tie that in with the fact that (oh, yeah) his big brother's asthmatic.

But really, I'm trying to be optimistic. Really. I am. Seriously.

Thank GOD they're really good kids, right?

Good News: Clear Lungs!

Little B had an appointment at the respiratory center on Tuesday and - lo and behold! - his lungs are clear. At risk of jinxing myself, I can't believe we've gone since LAST JANUARY with no pneumonia and no major attacks.

Things are looking so good, the doctor is talking about lowering him to Flovent 44 for the summer. Considering we were on 440mg this time last year, it's really almost too good to be true.

His regular pediatrician says this is because we treated the asthma so aggressively in the early days.

So I guess all that Orapred has paid off. It's nice to know I didn't spend all the days with a near-psychotic toddler for nothing.

Econests - Safe houses for asthmatics

Check this out : http://www.econest.com/

I read about these in Taunton's Inspired House recently. If I had a lot of money and lived in Arizona or New Mexico, I would totally do this for my kids.

What is an Econest?

For most of us our home is our center. It should be a sanctuary that nurtures body, mind, and spirit. Sadly, standard homes today are built with little regard for our health or the environment. There are better ways to build. The Econest is our simple solution. Health, ecology, and sustainability begin at home in an Econest. Building such a home, with friendly natural materials, fosters the innate builder in all of us. For those of you longing for this true experience of home - we invite you to join us in the creation of our next Econest. Discover for yourself the joys of building a home in harmony with nature.
>> Read more about Econests

Oh, and they're GORGEOUS, too.

Lower Flovent, New Sinus Infection, New Symptoms

What an exciting 10 days since my last post.

On 3/22, we took Bryn to another pulmonologist (at the same practice). His lungs were clear, so the doctor lowered his Flovent from 220 to 110.

This past Monday (three days ago), Bryn woke up for school and begged me to keep him home. That's so unlike him. He loves school. He never wants to stay home.

That night, when I went to run an errand, he threw himself at me and begged me not to go. Again, totally unlike him.

Was it the Flovent reduction?

Besides that, he continues to wake up with blood-streaked mucus clogging up his little nose. He really hasn't had a clear day since the adenoid surgery. His face looks kinda puffy, too.

So...is this pleasant new mood related to what appears to be yet another sinus infection, or is it the Flovent reduction?

Being the mother of an asthmatic preschooler is so cool! (not)

Welsh Kids and Asthma

This is just weird. My husband is of Welsh decent, and both my kids wheeze. So is this environmental or ethnic? -- From BBC

Child Asthma Rates Quadruple
(12/1/04) Asthma rates among children have quadrupled since the 1970s,
according to a major new survey.
More than 2,700 children from schools across south Wales were involved in
the 30-year research project carried out by experts at Cardiff University.
The findings are being published at a meeting of the British Thoracic
Society (BTS) in London on Wednesday.
Dr Michael Burr, who led the survey, said more than 1.4m children across the UK suffered from asthma.
The first study, which was carried out in 1973, diagnosed asthma in 5.5% of the children.
Read the whole article.

And then there was this one:

Wales 'has highest asthma rate'
Asthma causes almost 30% more hospital cases in Wales than anywhere else in
the UK, a new report claims.
Asthma UK Cymru said one in 10 children and one in 12 adults in Wales are being treated for a condition - one of the highest rates in the world.

Read the whole thing.

Hmmmm. Bad genes? Or just coincidence?

New one for me: Xolair Proven Effective in Asthma Treatment

Maybe I'm out of the loop a little bit, but I hadn' heard of Xolair until I saw this article on HealthDay.

SUNDAY, March 20 (HealthDay News) -- Adding the drug Xolair to an asthma
patient's medication regimen helps cut emergency medical visits, new research
confirms.
The research, a pooled analysis of seven prior studies, was
presented Sunday at the annual meeting of the American Academy of Allergy,
Asthma and Immunology in San Antonio.
The fact that the pool analysis
contained more than 4,300 patients, about half of whom were on Xolair, does give
these conclusions more credibility than any single study, said study co-author
Dr. Phillip Korenblat, a professor of clinical medicine at Washington University
School of Medicine in St. Louis.

Let's, of course, keep in mind that the study was conducted by Novartis.

A few more tidbits on the drug:

• It's a once-monthly injection (and the doctor'd better do, cos I won't!!)
• Xolair (generic name omalizumab) is a monoclonal antibody that heads off allergy-triggered asthma
• "Individuals who used Xolair on top of their usual treatment had a 47 percent reduction in total emergency visits. That meant a 52 percent reduction in hospital admission, a 61 percent reduction in trips to the emergency room and a 47 percent reduction in unscheduled doctor visits"

Don't know if it's for pediatric use....and thankfully, I don't even need to ask at this point as the Singulair/Flovent 220 cocktail seems to be doing the job for now.

Study Links Autism and Mercury

...which has nothing to do with asthma, I know. But in a way, it has a lot to do with this blog.

First off, here's the article from the LA Times.

Now, here's the connection. Throughout this blog, I've ranted time and time again about pharmaceutical companies -- how they encourage unnecessary vaccines, etc. It may not seem like a bad thing that they're incouraging vaccinations for things like chicken pox and the flu, but in fact, it may be. Read on.

While this study (funnily enough) doesn't specifiy it, skeptics like me have been questioning the link between autism -- and other disorders (like asthma) -- and vaccines. Both asthma and autism have reached epidemic proportions over the last generation or so, and many blame the last version of the MMR vaccine, which contained a mercury binding called thimerosal. (Thimerasol also binds the flu vaccine)

Since the speculation began, pharmaceutical companies have denied any connection. Which, to me, seems ridiculous. If you're injecting your baby with a known neurotoxin like mercury -- I don't care how small the amount is -- bad things are bound to happen.

Finally, this new study, which links the two. They do chicken out a bit, citing mercury in the air and water, and funnily not in injected vaccines. But at last, a connection. In writing.

And according to the article, autism rates over the last 20 years have jumped from 1 in 2000 to as high as 1 in every 166 children. Terrifying.

I'd love to see where asthma rates are today. And a study brave enough to reveal what's really causing the epidemic. (Vaccines? Latex paint? SUVs?)

Sleep Apnea and Night Terrors?

Because we needed more to worry about...

On Saturday night, I paged the pulmonologist because Bryn was breathing really badly when he went to bed. It was odd, because he was so happy and totally fine before then. ( Okay, he coughed a few times and was a bit congested, but that's it.)

When I gave him his Flovent before bed, I thought I heard something funny, so I asked him to take a deep breath for me. When he did, I was surprised to hear an audible whistle. My husband is *sure* this was due to nasal congestion, but I'm almost positive he was breathing through his mouth.

Anyway, I gave him some albuterol.

When he fell asleep, he breathing was very noisy and he was retracting like mad. I gave him another shot of albuterol less than an hour after the first, which our doc has told me to do if he's unresponsive.

It didn't help, so I paged.

I got the oldest doc in the practice, who asked a battery of questions. He then told me that what I was seeing may be a result of continued swelling from the adenoid removal, but that he was probably suffering from sleep apnea, and that I should consider a sleep study.

(We did a sleep study last year. It sucked harder than anything I've known as a parent.)

But he may have hit on something. The night after the surgery, Bryn had a night terror. He used to get those a lot, but this was the first in well over a year. It was also the most intense, lasting at least 10 minutes.

Funnily, my mother-in-law was convinced it happened because we'd let him watch Shark Tale, which she instead was too scary and too intense for him. And while I'm not a huge fan of the film and won't let him watch it again anytime soon, I know that night terrors aren't caused by external stimuli.

I figured it was from the anesthesia, possible combined with albuterol. But I guess I was wrong too.

Either way, looks like we may have something new and exciting on our hands. Better hit the books (and the Web) again.

Elidel can cause cancer?

This is exactly the kind of news asthma moms have nightmares about. Yikes. Elidel, the non-steroidal eczema medication reportedly carries a cancer risk. (Protopic is at risk of black box, as well.)

I just heard this on the WB 11 News at 10 and I feel like crying. The FDA even says the products should *not* be used on babies at all!

Here's the Reuters Report.

Y'know...you try to do what's best...