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.
Wednesday, June 14, 2006
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!!
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!
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.
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.
Thursday, June 01, 2006
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!
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!
Thursday, May 25, 2006
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!
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!
Sunday, May 21, 2006
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.
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.
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.
Monday, May 08, 2006
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.
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.
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.
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.
Sunday, May 07, 2006
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.
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.
Wednesday, May 03, 2006
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.
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.
Monday, May 01, 2006
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!!!
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 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:
- Dialed, got auto-attendant
- 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
- Six minutes later, I ask for the doctor suggested by my insurance company suggested, who is a pediatric development specialist.
- I'm informed that this doctor hasn't been with the practice for four years, and I'm referred to another doctor.
- Doctor #2 is one I've been asked to avoid by my friend, and anyway, she has no appointments available until AUGUST
- The attendant recommends a pediatric neurologist -- who isn't on my plan
- The attendant recommends another pediatric neurologist -- who *is* on my plan
- I hold for about ten minutes while she finds an available appointment
- I make an appointment for early June
- 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!
Monday, April 24, 2006
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!
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!
Friday, April 21, 2006
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...!
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...!
Tuesday, April 11, 2006
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!
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!
Wednesday, April 05, 2006
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.
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.
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.
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