Reactive Airway vs. Asthma

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

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

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

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

Okay. Off the soapbox..

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

From eMedicine:

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

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

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

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

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

Hah!

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

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

88888888888888888888888888888888888888888

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

"Coughing Syndrome"

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

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

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

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

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

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

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

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

Started albuterol

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

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

Ah, the trials of motherhood.

Stomach Virus Triggering Attack???

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

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

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

Except that he was coughing!

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

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

Guess what? The coughing stopped.

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

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

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

Vent: Fox News on Flu Pandemic

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

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

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

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

Asthma / Reflux Connection Explained

Found a few things already:

A good explanation of the whole deal on InfantRefluxDisease.com

Some interesting info from ClinicalTrial.gov

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

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

It's a start...

Asthma-Reflux Connection

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

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

Hence the quest for research.

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

New Resources: Asthma Action Plans

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

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

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

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

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

Diary of a Paranoid Asthma Mom

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

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

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

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

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

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

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

Separation Anxiety Nightmare

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

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

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

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

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

Aid for Katrina Victims

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

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

Asthma? Or just sinuses?

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

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

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

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

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

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

Asthma-Vaccination Connection?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Congested Again -- Seeing Doctor Thurs.

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

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

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

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

Annual Checkup

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

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

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

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

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

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

Cheryl's Pulmicort Question

From the comments gallery:

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

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

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

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

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

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

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

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

Per Barbara's Comment: On DuoNeb

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

Barbara -- regarding your DuoNeb question...

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

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

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

HUH?

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

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

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

Another Post on the Singulair Debate

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

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

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

The Great Singulair Debate

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

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

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

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

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

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

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

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

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

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

AsthmaFactor.org - A Big Pile of Poop

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

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

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

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

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

He's 4 today.

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

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

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

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

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

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

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

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

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

Asthma News: Advair Stays on Market, Florida Covers Pulmicort

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

FDA panel recommends asthma drugs remain on market

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

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

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

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

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

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

To My Anonymous Commenter - Please Be Careful!

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

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

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

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

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

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

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

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

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

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

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

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

Best of luck to you both.

Update: The Cough Continues

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

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

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

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

When it comes to asthma, Mother knows best

Man, can I call it or what?

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

Same deal Saturday night.

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

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

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

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

Symptoms Again - Waiting it Out

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

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

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

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

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

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

Nasonex - A small miracle

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

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

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

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

Keep your fingers crossed!

Asthma Update

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

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

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

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

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

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

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

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...

RSV- Obsessed

This is what helplessness does. Because we caught the baby's RSV early, I feel like I'm just sitting around, watching him get sicker. Every night, I've been CRANKING the monitor, counting his respirations. I listen carefully to the pitch, tone, and resonance of every cough.

Do sane moms do this, or is it just me?

Honestly, he seems well. He's congested and coughing a bit, but he's happy and eating well. I'm probably making myself crazy for nothing.

Definitive RSV Resource

Alarming but accurate. Big "duh" on my part -- I don't know why I never thought of checking the American Lung Association site for asthma info before. (I was a blonde once...)

Here's the RSV fact sheet.

The Baby Has Bronchiolitis...

...and maybe RSV.

I brought him to the pediatrician (for the second Sunday in a row) because he had a rash. And while he seemed fine and happy, the doc was surprised to hear a wheeze when she listened to his chest. She'd recognized the rash immediately as viral, but she was as shocked as I was to find that he had bronchiolitis.

He's on Albuterol exery 4-6 hours (you can imagine how he loves the nebulizer), and he seems to be okay...but of course I'm checking on him every 45 minutes to make sure he's breathing normally.

Hopefully, it won't get any worse this. He's already high-risk for asthma; I'd rather not have another RSV situation like we had with his older brother.

While I'm sure I could take care of another asthmatic baby...I'd really rather not. One healthy kid would be nice.

My friend, the wise wife of a rabbi, once told me that I shouldn't ask why I was given a little boy who was so sick. She said I should look at it differently. It's a blessing, she said, that God gave us the tools, patience and love to care for a child as special as ours. Imagine if, with all his health problems, he'd been delivered to another family -- one without the caring and (frankly) the insurance coverage to look after him.

She's right, of course, and it is helpful to look at that way. We have wonderful, beautiful, and very special sons. And we'll do absolutely anything we have to to make sure they stay happy and healthy.

Adenoidectomy: The Jury's Out

Sorry I haven't posted in a week -- UNBELIEVABLE, the mess that's been my home!

But to the point: Bryn's doing really well. He can barely move his neck, but he hasn't complained at all. He hasn't developed a major post-op asthma attack or hemorrhaged as I feared (I'm totally paranoid - I admit it) and I still have a full bottle Tylenol with codeine. He's said once that his mouth hurts, and he cried once because he hit his head, which apparently hurts more than it would if he hadn't had the surgery.

But he's coughing like mad and he's *still* breathing through his mouth, so we'll see... I'm just not convinced this was the best (or the only) option.

The real kicker...when we got home from the hospital with Bryn, the baby was running 102. Turns out he had strep...and so did I. We both went on Amoxicillan (so all three of us were on it) and while I got better, his fever continued for days.

Turns out, he's allergic to Amoxicillan. Does this bode well?

Surgery Tomorrow

...so tomorrow's the big day. Adenoids out. We're off to the Children's Hospital of NJ first thing tomorrow morning.

Bryn and I have talked about it, and he seems to understand. ("My add-en-oids are making me sick. The doctor's going to take them out. I won't go to school, but I can watch Thomas videos all day.") He's such a good boy...I hope this doesn't suck too much for him.

I'm nervous as hell. I'm glad we opted to go to the children's hospital, where they have a pediatric anesthesiologist on full-time. We could have donet his outpatient, and a lot closer to home, but we would have been taking a gamble with the anesthesiologist. And, as my dad astutely pointed out, anyone can take out adenoids. It's the anesthesia that's tricky. And, might I add, especially when you're dealing with an asthmatic preschooler.

Really, what's worst for me is the idea of watching him go under. I did this last year, when he had a optical surgery. I walked him to the OR and held his hand as he went under. To see him walk down the hallway in that blue gown (which was too big for him) looking so much like a little angel, and then to watch him so agreeably put on the mask for the anesthesia (this is, after all a kid who's been on nebulizer treatments for two years) then lie there so frighteningly lifeless on the table -- well, it was the most terrifying thing I've ever seen.

The "AngryAsthmaMama" is usually pretty good about handling the illnesses of her children. After all, like all parents, I do what I have to do, particularly when it comes to my kids' health. But that moment in the OR was haunting and terrible. I completely lost it. As I left the OR, leaving Bryn in the hands of relative strangers bearing scalpels, I positively crumbled. I felt so frightened and helpless. I wanted to rip him off the table and take him home.

This is the scariest part for me. Usually, I take the advice of my doctors - about 85% of it - and administer treatments myself. I call for backup when I need it; I offer all the hugs and kisses and positive reinforcement I have to in order keep my kid as healthy and wonderful as he is.

But in the OR, I leave Bryn (and myself) prone and vulnerable and in the hands of a doctor I suddenly don't know enough about. It's not a control thing - it's a protection thing. I want to be there, not running the surgery, but holding my son's hand throughout his ordeal.

God, I just love that little boy more than words can ever express.

Say a little prayer; pray that everything goes well tomorrow.

Adenoidectomy Scheduled

So...we're doin' it. Surgery's scheduled for Tuesday the 22nd. I'm not freaking out yet. But I am totally loathing seeing my baby under anesthesia. Did it last year when he had eye surgery, and it was just about the scariest damned thing I've ever seen. I don't recommend it.

Ideally, this surgery will mean fewer upper respiratory infections and hence, fewer asthma attacks (since Bryn's asthma is triggered almost exclusively by upper respiratory infections). My peds pulmologist admires my optimism.

I've read message board posts going both ways -- some have called the surgery a bona fide miracle, others have said it was a waste of a copay. I have to hope for the best. I don't take putting my son into surgery lightly.

We did find a doc who seems to be a highly regarded peds ENT. And he's doing the surgery at NJ Beth Israel, where he's head of Pediatrics (or just Peds Otolaryngology -- I forget) and where they have a peds. anesthesiologist on staff full time.

Y'know what? Maybe I am freaking out a little bit.

Anyway...they say he'll recover in 3-5 days, but he'll be home for two weeks. He's not allowed to run around at all, so I guess we'll be watching a lot of Thomas videos.

Poor kid. I just want to hear him pronounce his "m" and "n" sounds properly again. I've been "Bob" (instead of "Mom") since before Thanksgiving.

Update on the Boy: THIRD antibiotic for the sinus infection

That's right. Now we're on Biaxin, a completely evil and side-effect riddled antibiotic. Allow me to quote the sheet that came in the bag:

SIDE EFFECTS: Diarrhea, nausea, vomiting, stomach upset, changes in taste, and headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects...

Oh my God! What am I doing to my baby?

I have to keep reminding myself that he's (a) had this infection since at least November and (b) has had two back-to-back, 3-week courses of progressively stronger antibiotics. He still sounds terrible, and I'm scared to death that the infection will trigger a major asthma attack or - since it's defying antibiotics anyway - spread to his lungs.

But there does come a point where you start wondering if the treatment really isn't worth than the illness itself.

....more after we see the ENT on Weds.

Another New Asthma Resource

About.com has a great Asthma resource center, and an even better forum. (People actually post replies on this one! Maybe they just hate me on the Parents' Center one. Let's face it -- I'm not exactly reserved with my opinions, am I?)

What did asthma Moms like me do before the Internet?

Best Asthma News Resource Yet - Breatherville.org

Although I've never mentioned it before, I've relied on Breatherville, the official site of the Asthma and Allergy Network/Mothers of Asthmatics, for everything from basic asthma info to discount spacers and nebulizers.

Now I find that they have the most current news on asthma -- complete with little analyses detailing how it affects you as the parent of an asthmatic child.

While the marketplace is still lacking in certain respects, this is definitely the best resource on the web for parents of the "respiratory-challenged."

Thanks to Blogwise

....for the listing!

Tailor Asthma Treatment for Kids

Yesterday's HealthDay snippet is a handy reminder that all treatments don't necessarily work for all kids. In other words, just because your neighbor's kid is thriving on Advair, don't think your kid can drop his Pulmicort/Singulair routine. Asthma triggers are different, as are symptoms -- so the effectiveness of treatments will vary, too.

TUESDAY, Feb. 1 (HealthDayNews) -- Specific asthma characteristics in children may help doctors determine the most effective treatment for each child, according to researchers at the National Heart, Lung, and Blood Institute's (NHLBI) Childhood Asthma Research and Education Network.

Read the whole article.

(Omnicef) Two weeks down, one to go...

We've finished two weeks on Omnicef for Bryn's sinus infection, and honestly, I'm not seeing much improvement. His nose isn't running anymore, to be fair, but he's still got a wet cough and he doesn't look great. He's also a little lethargic, which also isn't like him.

We see the doctor next week....

Vitamin C can cause asthma?

From HealthDay: Vitamin Intake During Pregnancy May Affect Respiratory Health of Kids

But the shock came when they looked at vitamin C intake.

"Much to our surprise and consternation, we also demonstrated that a high
maternal intake of vitamin C was associated with increased wheeze in the second
year of life," said researcher Dr. Graham Devereux, a consultant respiratory
physician at the Aberdeen Royal Infirmary.

Now I'm trying to remember how many grapefruits I ate during my first pregnancy....

Magnesium Infusion Helps Kids with Asthma Attacks

I don't know how I missed this!

NEW YORK (Reuters Health) - For children who need to go to the ER because of a severe asthma attack, giving them an intravenous infusion of magnesium sulphate along with conventional medications provides an additional benefit, Hong Kong doctors report. (Click here to read the whole article)

Carmen wrote in to let me know about this, as it was reported on HealthDay on January 7. According to her, "the last time my daughter had an asthma attack I gave her 1 - 2 tsp (5 - 10 ml) milk of magnesia every day and could decrease her breathing treatments by about 75% !!!!!! she just didn't wheeze as much, period!"

Note that this was administered *in addition to* regular asthma meds.

Love to hear from anyone else who's tried this!

Combo Therapy Gives Asthma Relief

From HealthDay News:

Combining an inhaled corticosteroid and a long-lasting beta2-agonist seems to provide consistent relief for people with asthma, says a study in the January issue of the American Journal of Respiratory and Critical Care Medicine.

I think a lot of us knew this already, but confirmation's always good!

New Resource - ParentCenter's Asthma Board

Look -- I'm not the only parent in the world with an asthmatic preschooler! ParentCenter's got a whole message board dedicated to the topic.

Hallelujah! (You'd think someone who's been on the Web as long as I have would have found this sooner...)

Omnicef and Adenoids

Poor Bryn. At 3-and-a-half, he's been on countless courses of antibiotics, he's been in the emergency room 5 or 6 times had RSV, occular (is that right?) surgery, and a six-day hospitalization. In the past year alone, he's switched schools, moved, and had to adjust to a new baby brother. And now this.

His sinus infection was kind enough to return after a 20-day course of amoxicillan. Nice, right. So we went to a pediatric otolaryngologist (ENT) on Saturday. Now he's on a 21-day course of Ominicef (broad-spectrum, super-strength antibiotic) and if that doesn't work, the doctor recommends having his adenoids removed.

Oh, yea. Another hospitalization.

The poor kid. He's obviously not feeling well, although he says he's fine. (He's 3.) He's lethargic, coughing his cute little head off, and wiping his nose every 5 minutes. I so want him to get better, but the thought of another surgery.... He's really brave and *such* a good sport about all this stuff, but I hate to do it to him.

I really need to read up on this. I mean, if the tonsils and adenoids are filters, wouldn't removing them mean that the bacteria/allergens/viruses (whatever the hell they're filtering!) would go right to his lungs? Wouldn't that make his asthma worse, potentially?

I'm not sure I understand this.

I know I'm jumping the gun here -- I'll just pray the Omnicef works. I don't need to worry about the adenoid removal -- yet.

All Asthma Meds Created Equally

Here's a really, really useful article for a change:

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A67463

I wonder how true this is when you're talking about children. I'm willing to wager that a mask-on nebulizer treatment is WAYYYY more effective than an MDI w/spacer when you're talking about peds.

Protein Can Protect the Lungs from Damage. (Will Tofu Work?)

A protein believed to cause lung problems may actually help protect the lungs
against damage caused by asthma and other chronic respiratory diseases, says
a University of Texas Medical School at Houston study.

This from HealthDay. Read it for yourself.

There aren't enough screams in the world...!

So we have - what? - two, maybe three days left of antibiotics left for the sinus infection(s). He sounded GREAT for over a week, and now, suddenly, he sounds all congested and has begun coughing again.

Not enough screams in the world to vent my utter frustration.

Whistle Watch, part II

Neglected to mention -- when I spoke to the pulmonologist (in a harried panic the night before we left for holiday) I asked her about the Whistle Watch.

Her take: it's a piece of crap. (She was a bit more diplomatic.) There's a reason they don't trust kids younger than 8 with peak flow meters -- and the fact that this one has a whistle doesn't make it anymore reliable.

So there you have it.

Holiday Update

So, while other families are sending out their annual Yuletide Newsletter, I'm sending you, my dear readers (and it actually looks like I have some!) my AngryAsthmaMama Holiday Rant -- er, Update:

1. Number One Son has a sinus infection "everywhere." That is, every sinus in his tiny three-year-old head in infected. So we've extended his current course of Amoxicillan (prescribed for the Strep) from 10 days to 20. Then, he'll probably get another CAT scan. If things haven't cleared up, he'll go onto a course of Clindamycin (yes, the same stuff they use topically to treat acne). Can't wait to see what that does to his bum.

2. Number Two Son finished his antibiotics just before New Year's. All seemed to be well, but once we got home from our holiday trip to Canada, he got all "snuffly" again. And he seems to only have congestion and coughing at night. Go figure.

3. Number One Son was looking so well -- until New Year's Eve, when he suddenly went all flushed. His cheeks developed these queer little red circles, almost like a cartoon elf or something. This freaked me out mightily, as the *only* other time I've seen those weird Raggedy-Andy cheeks was when he had pneumonia last year. While he felt a little warm that evening, he doesn't seem to be running a fever. But he hasn't looked well since. He's been looking very pale and wan, and he went all flushed again last night.

In a typical maternal fashion, I blame myself for the kids being less than 100% right now. We spent the week with the in-laws, just outside of Toronto. It should have been a fun, relaxing week with their grandparents. And mostly, it was. But of course, we had to drag them out 1. for lunch Tuesday *and* Wednesday; 2. for dinner at a cousin's house Thursday (late!) 3. for a New Year's party on Friday (another late night!). Gosh, I feel like a terrible parent just typing all that out. Especially when you add the 9-hour drive home on Saturday.

Way to go, running the kids down during flu season. Why don't I just let them hang out in wet clothes in the freezing cold, while I'm at it?

They both have strep...

...and Bryn, the older one, is going for a CAT scan of his sinuses today.

Golly, this is going to be the best Christmas ever!

Quick update on the baby....

Okay, with respect to last week's post, the baby has....Acid Reflux. That right. Baby Awstin has joined the masses of infants on a daily dose of Zantac. Is that bizarre, or what?

In conjunction with his new meds, he's now being fed smaller meals more frequently. And, since I'm still nursing, I've had to go on a low-acid diet, complete with (GASP) reduced coffee intake. I was at two cups, maybe three a day max - perfectly within the limits recommended by La Leche League, mind you - but I've cut it down to one small cup a day. Barely enough to satisfy my cravings for my dark aromatic lover, yet still enough to keep the withdrawal migraines at bay.

While the Zantac will take another week or so to kick in, the baby has been vomiting less. He's still coughing a lot at night, though...so, in my eyes, it remains to be seen whether or not this is really Reactive Airway.

But I'll give it the full two weeks. I may be paranoid, but at least I'm patient. Occasionally rational, even.

Whistle Watch?

I was in CVS the other day and I saw this thing -- the Whistle Watch -- which, basically, is a peak-flow meter for preschoolers.

For $15, I'm going to give it a shot. I'll post the results. And if any of you, my dear readers, have tried this thing, please let me know your thoughts!

Steroids Key in Avoiding Hospitalization

Here's Health Day's latest yeah-we-knew-that news flash:

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A66489

According to the article, kids who miss one in four doses of their inhaled steroids are WAYYY more likely to end up in hospital.

And parents who let their kids miss one in four of their inhaled steroid doses deserve every last penny of those hospital bills.

A moment to bitch and moan...

...after all, that's why I started blogging, right?

My infant, now nearly 8 months old, has been suffering from something asthma-like for the past month or so. Snurfling through the night, coughing until he vomits, etc.

And while I'm unbelievably concerned for him - his long-term health *and* his comfort - my rant has to focus on this: I haven't had a full-night's sleep in at LEAST six weeks. I feel like utter poo. My sleep sensor is set to "light" since I need to be prepared to race in and rescue the baby the moment he starts couging. So I'm up at least once or twice a night, usually more frequently, for an hour or more.

So while the baby is wonderfully happy, sweet and peaceful throughout the day, I now feel (and look) a little bit like the Grinch Who Stole Christmas.

To the guys I work with: Good luck.

Helpful Asthma Info

This may seem really obvious, but those parents out there with asthmatic kids know how nebulous the definition of pediatric asthma can be.

Here's a helpful article straight from the CDC:

http://www.cdc.gov/asthma/faqs.htm

It's surprisingly clear and useful.

Tips for Breathing Through the Holidays

And so with probably TWO asthmatic children, I'll take these common sense tips to heart:

Breathing Easier Through the Holidays

Because once is never enough

Strike that last post about the poultry. When the baby puked up peaches and rice cereal, we realized poultry probably *wasn't* the problem. And when he spent the rest of the night coughing until the gagged, it seemed that something strangely familiar was happening.

A trip to the doctor Saturday morning left us with a prescription for Amoxicillan and the suggestion that it was probably a sinus infection...but it could be Reactive Airway. (Newbies: "Reactive Airway Disease" is the new noncommittal language pediatricians use to tell you your baby or toddler probably has asthma.)

As I've said: Strangely familiar.

After another Exorcist-esque episode and the realization that I had nothing on hand to relieve this violent cough, I paged the pediatrician again (I'm pretty fearless with the paging) to find out what the hell I should do until the Amox kicks in.

And she suggested my old friend, the nebulizer and some Albuterol.~ My turn to pull an Exorcist moment.

The good news/bad news finale to my story? The Albuterol (actually, Xopenex) worked like a dream. Fabulous that it worked so well -- he's a million times better.

And horrible that it worked so well. What we've basically got is a diagnostic test with positive results: the baby probably has asthma.

I'll be seeing my buddy the pulmonologist tomorrow to find out how dramatically I'm jumping to conclusions. But I think it's that mother's intuition. Sometimes we just know.

We'll see...

Happy Thanksgiving: Allergic to poultry?!

Yes, believe it or not -- My three-year-old is allergic to eggs, and we've just learned that our 8-month-old is allergic to poultry. Okay, it's not for sure that he's allergic, but he does seem to have an unnatural tendency to vomit an entire day's worth of food when he has it...so odds are....

We'll be taking him to an allergist next week to be sure.

Way to start the holidays, right? Ho, ho, *HACK!*

What every 3-year-old asthmatic wants to hear

Apparently, chocolate is the new codeine:

http://story.news.yahoo.com/news?tmpl=story&u=/nm/20041122/hl_nm/health_britain_chocolate_dc

(When it comes to coughing, that is. When it comes to numbing pain...I think most women already knew this.)

Worry more about colds than pollution.

Rabinovitch said the study findings offer good news for parents of children with asthma.
"Instead of worrying about air pollution, they can focus their efforts on preventing and treating the real wintertime threat to their children's health -- colds and other respiratory infections," Rabinovitch said.

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A65309

...but the fact is, with pre-schoolers, it's probably easier to protect them from pollution than it is to protect them from colds!

More good news for us regular folks....

If you're like me and more or less forced to mail order your kid's maintenance meds, here's some great news:

Extreme Heat Can Degrade Mail-Order Drugs

It's so reassuring to know that, not only is it next-to-impossible to know whether or not you have any medication left in the MDI, now you can't even be sure if the stuff's any good!

Another (yawn!) New Study

Yes, it's all very important and it appears in the current edition of The New England Journal of Medicine, but how can it help my three-year-old this winter?

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A64346

Honestly, I'm glad that big pharma's actually allocated funds to something other than arthritis medications that cause heart attacks; I'm just too tired and cranky to even read the whole article tonight.

File THAT under obvious...

Okay, the methodology is cool, but did it take a study to tell us that pollution and second hand smoke can lead to asthma?

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A63964

And, hey, can someone get me a subscription to Chest magazine for the holidays?

Demand MDI Reform Now!

Anyone reading this blog on a regular basis knows that I am, shall we say, disenchanted with pharmaceutical companies on the whole. Here's just another twig to add to the fire:

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A63909

This health day article focuses on how most families make errors when administering medication via MDIs -- largely (and most seriously) because, as we parents of asthmatics know, there's no accurate way to tell how much is left in the damned canister!!

It's one thing with Flovent -- four puffs a day from a 120-dose MDI is easy enough to estimate. But with Albuterol, which is given only as needed, and for which I have several MDIs.... well, unless I take a razor-pointed Sharpie and make a little checkmark on the case every time I use it, I'll never know how much is left.

I've been using the flotation method (mentioned in above article) to determine whether the MDIs are empty, but apparently that's both inactive AND dangerous. Who knew?

So - my point (and yes, I do have one) is that big pharma should really stop putting up funds for high-tech gas treatments (I mean, what the hell is GERD, anyway? And aren't Gaviscon and Mylanta good enough for most people?) and come up with an MDI that actually tells you that it's empty. That way asthmatics can either stop wasting money by throwing away still-useful MDIs (and for those of you who don't know, Flovent costs about $200/month) or putting themselves at risk by sucking on empty canisters -- and not getting the medication they need.

Sibling Study is CONFUSING

Have a look at this: Having Siblings Cuts Asthma Risk

There are a few things I'm not understanding: If asthma risk is greater in kids born July-December than in kids born January-March, how does the risk for kids born March-July measure up?

If the risk is reduced for children who have siblings, why is the risk increased if a sibling is already asthmatic? Is the risk only reduced for multiples or people who *didn't* already have asthma in their families? Wasn't the latter group already at a reduced risk?

The study also puts at higher risk "if their primary-care provider was a pediatrician." Ummm....who should the primary-care provider for my preschoolers be? A pulmonologist?

AsthmaMoms.com

Hooray! I've found a new resource -- and it's LOCAL! Check it out: http://www.asthmamoms.com.

Yo, don't believe the hype.

Okay - has the wold gone nuts? Why is everyone freaking out about the flu vaccine shortage? I can't believe this has actually become a campaign issue now. Can you not see how strong the pharma lobbies have gotten?

Seriously, I have *never* gotten a flu vaccine. First off, it wasn't even offered to me until a few years ago. Secondly, when it was, it was understood that the vaccine couldn't and wouldn't cover all strains and mutations of the virus. With so many strains of flu every year, why bother? And won't a vaccine just cause a resiliant virus to mutate further?

Which brings me to why I won't get the vaccine -- or give it to my kids. The number one reason? It's made with thimerosal, a mercury-based binding. (See Wikipedia on this: http://en.wikipedia.org/wiki/Thimerosal) Thimerosal has been linked in some studies the enormous surge in autisim over the past few years.

Another reason, Asthmatic Bryn (who, by the way, can't get the shot because he's allergic to eggs) got the flu last year. And it developed into pneumonia (natch). And guess what? The nasty strain he got would not have been covered by the vaccine.

So, by giving him the shot, I would have put him at risk by taking him unnecessarily to the doctors office where, undoubtedly other sick kids would be running around, and at risk(small risk, granted) for autism. And he would have gotten the flu/pneumonia anyay.

But to my original point, when did the flu become so incredibly dangerous that we all need an annual vaccination? Isn't this just pharmaceutical companies capitalizing on the SARS scare?

Or am I just a paranoid, fanatical lunatic?

If you're living under a rock....

...you might not know that there will probably be a flu shot shortage:

http://story.news.yahoo.com/news?tmpl=story&cid=514&e=5&u=/ap/20041005/ap_on_he_me/flu_vaccine_suspension

So, if you're up for a thimerasol fix, better get a move on.

What the heck is a TREG?

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A63315

Apparently, we've found the cause of Asthma. And it's got a really funny name.

Peds Asthma NOT Caused by Allergens

But we knew this, right? There was that study -- I think it was Australian? -- that showed that kids who grew up on farms and/or around dander-producing animals actually had a lower instance of asthma.

Anyway, here's the link: http://health.yahoo.com/search/healthnews?lb=s&p=id%3A63466

Whew. What a month.

So, naughty me...too long a lapse between posts again.

Meanwhile, Bryn's just (hopefully) recovering from what's essentially been a six-week long attack. Brutal. It started with mild cold symptoms that persisted for about two weeks. Dr. W and assumed this was another sinus infection, so we did another course of Augmentin.

...and no recovery. The slight cough he'd had became a bad cough, and his teachers reported coughing fits after exercise at school. That was new -- we'd never seen exercise-induced asthma before.

The cold symptoms disappeared, but the cough got worse during weeks 4-5, and he was often so short of breath, he couldn't get through a short sentence without 3-4 breaths.

So, we started doing DuoNeb or Combivent every eight hours, alternating with Albuterol. And when that didn't help too much, we started doing it twice as often.

Man! Can I tell you what it's like having a 3-year-old pumped up on Albuterol and Combivent? I should have just handed him a large (Venti, whatever...) Starbucks French Roast. The results probably would have been similar. The poor kid was so wired, he couldn't sit still. His teacher at preschool didn't know what to do with him. I just kept him as busy and active as I could.

Today, he's finally seeming a bit better, so I took him off the Combivent. That stuff's just EVIL. I know it works, but Lord Almighty -- I hope I never have to use it again (but I know I will). And Lord help us all if he's got to be on that and Orapred at the same time. It will be like living with the Tasmanian Devil!