Spring Asthma Update

Hey, all - just checking in. It's been quiet on the blog, I know, but believe me...not so much at home!

While we've kept the asthma at bay well enough, sons #1 and #3 have had horrible allergies this season (ironic, since #2 is the only one with diagnosed allergies).  I really need to get them both to the peds - runny noses, wet coughs, all kinds of icky booger nastiness. #1 is 7 now and really uncomfortable. He's getting a little relief with Zyrtec, but not nearly enough.

More time consuming and concerning has been the story of #3, our little Ig, now 3.5 years old. As my longtime readers know, #1 son has Aspergers Syndrome, a mild form of autism. (He's 100% mainstreamed at school, doing beautifully and has absolutely no disciplinary issues.  He's a gift and a blessing in every way.) So we have some experience with developmental concerns. And we think Ig has some kind of developmental delay. We're not sure what, but we're trying to get answers.

The last few months of my life have been spent (apart from changing jobs and restarting my singing career at night - another story!) trying to get help for Ig. This has involved a long process with the school district's Child Study Team, several unreturned calls to the nearest Child Development Center (finally got an appointment - in August) and a visit with a family therapist...along with many tears and a lot of shouting.

Ig is a beautiful little soul, but so difficult that he's thrown off the balance we had as a family. He obstinate, combative, and prone to tantrums. He has no impulse control whatsoever, which concerns me every single waking moment (he WILL run out the door of the daycare center and into the driveway. He WILL leave the house while I shower) and he is immune to discipline. What concerns me most though are his communication skills.  He's not capable of any kind of meaningful conversation - only  brief, immediate chats about what we're doing in that moment. And I'm concerned that a lot of what he does say is echolalia.

Because I can't modify his behavior, I've modified mine. When I shower, I put on his favorite TV  show and bolt the doors.  (I plan to put a latch up high on the door, as well.) I park at the back of the daycare center, so the car can butt up to the sidewalk, instead of having to cross the parking lot and driveway to get to the door. I choose weekend activities for which he doesn't necessarily have to stay put or stay quiet - like going to our local zoo. (We went twice this weekend!)  He needs to have his own story at bed time, so I have to read twice as much (one story for B and Oz, one for Ig) so I can keep the routine we've had for him since infancy.  

And I've given up on getting him to sit and eat at dinner time. We try to eat as a family as much as possible, but Ig won't sit  (or eat) for more than a few minutes, so I just have a safe activity lined up for him when he leaves the table.

It's exhausting. And it's not fair to B and Oz. Ig requires so much of my time and attention that I worry that the two older boys are missing out - or worse, feeling like I love Ig more than them. I'm desperate to find out what's going on with him so he can get the help he needs - and so I can pull my family back together.

So...at least the asthma's been under control, right?

Civilization as the Cause of Asthma - Amazing Article

I just happened across this astounding article on the Atlantic Online - absolutely had to share it with you! It's from 2000, but still incredibly relevant and eye-opening. Here's a quote:

Martinez, who came to the United States after launching his career in asthma research, is one of a number of specialists who believe that modern life may be responsible for the developed world's asthma rates -- but in a very unexpected
way. It is not tobacco smoke or pollution that is at the heart of the problem, these specialists believe, but modern hygiene practices and antibiotics that foreclose the need for the young immune system to tackle microbial and parasitic challenges. "Just as you need to use your eyes to develop sight and your legs to develop the muscles to walk," Martinez said, "your immune system develops through its experience. By legitimately protecting our kids from dangerous infections we may have kept parts of their immune systems from maturing."

This could explain why children in the developing world, who are repeatedly infected by bacteria and parasites, are unlikely to contract asthma, whereas children in the developed world, who are inoculated against infectious diseases and frequently given antibiotics, are contracting asthma in ever greater numbers. (Martinez quoted estimates that an astonishing 40 percent of children in the United States are given antibiotics for a period of a month or more in their first year of life.)

Read on. Have your thoughts provoked.

Special AccuClean Air Filtration Offer from Mom Central

So...I got a call from Mom Central last week. While I'm a marketer by trade, I don't typically use this blog to promote stuff, but the material they asked me to post is 100% relevant and helpful. And admittedly, I'm kinda flattered to be on their radar!

They're working with American Standard (yes, the toilet people) to share info about allergy and flu prevention - and to give you a chance to win their AccuClean whole home air filtration system.

Since allergy season is pretty much here (at least in NJ. Does it ever LEAVE NJ?) But yeah - we're just about reaching those days when our cars are blanketed in a fine layer of yellow dust. (Pollen, people. I'm talking about pollen!)

Staying in doesn't help much either. According to Mom Central, it turns out that indoor air is four to five times more polluted than outdoor air, of particular concern because most of us spend as much as 90% of our time indoors (and we wonder why obesity's a problem? Sheesh!), according to the U.S. Environmental Protection Agency. So keeping our home’s indoor air quality high ensures that our kids (and even we) will be able to breathe more easily and suffer fewer symptoms during allergy and flu season.

American Standard's Heating & Air Conditioning’s AccuClean™ whole home air filtration system can makethe air in your house virtually pollution-free. (It attaches to your existing furnace or air handler, so there's no major renovation required to install it.) AccuClean removes allergens from the air in every room of the house, not like plug-in air cleaners that work in only one room. It removes 99.98% of all allergens in your house. It also removes more than 99% of the common flu virus, which I didn't honestly know air filters could even do. And apparently, it's pretty easy to clean, too. You just vaccuum it.

Hannah Keeley, one of Mom Central's consulting principals and founder of www.TotalMom.com, has been working closely with American Standard Heating & Air Conditioning over the past two years and has met with moms who have experienced, firsthand, the difference AccuClean can make in families’ homes and lives. Hannah shared this with us:

Keeping the dirt and dust out of your house is easier said than done, and cleaning every day is simply not an option for today’s busy families. AccuClean prevents unwanted dust and dander from continually circulating in your home, ensuring the indoor air your family breathes is cleaner and healthier.

Mom Central asked me to post this special offer for Kansas City, MO and Charlotte, NC families. Click the links below for more information and a chance to win a system for your home.

• Kansas City link
• Charlotte, NC link

I'm actually going to look into this too -- our pulmonologist won't let us use humidifiers, so maybe this is a good option for us to have more breathable air in our house.

Everyday Health on Inhaled Steroids

Since posts on this topic are always catalysts for comments and lively discussion, I thought I'd share this one. Everyday Health answers this question:

"My son has been on steroids for asthma since he was 18 months old. He has been on Flovent since March 2006, one puff twice a day, 110 mg. He turned three on June 9, 2006. I have two questions: Are there any studies that show long-term effects of taking this steroid other than affecting growth? Could Flovent be causing him to be hyper? He is a very busy, active boy."

The answer, by an asthma specialist, might make you feel a little better about keeping your kids on Flovent or Pulmicort.

My take (as always): I hate the stuff as much as the rest of you, but it does tend to keep my kids out of the hospital. If helping them breathe means their a little more active and a little shorter...I'll take it!

Chest tightness? S**t, maybe I DO have asthma!

So...I think I've mentioned this in previous posts, but I've been sick since before Thanksgiving. I've had a dry, chesty-cough, and I had a pretty crazy flue-like thing just before Christmas.

Turns out I've had a very persistent sinus infection, which has triggered reactive airways. The cough is really only present at night, or when I hit a blast of cold air. Or eat/drink something really cold. Or encounter a strong scent or fumes.

I'm on my second course of antibiotics (had to cut the first short when I had an allergic reaction!) and albuterol as needed.

But here's the thing: I've seen what albuterol can do to my kids, so I use it pretty conservatively. I have to be coughing a lot to take out the MDI (ProAir HFA).

But right now, I'm coughing less, but my chest feels really tight. I was trying to determine earlier if it was from the pec workout I did yesterday, heartburn, or actual tightness in my airways.

I think it is actually respiratory - and it's kinda creeping me out!! I'm going to buckle down and take some albuterol. We'll see if it helps!

Tracy's Question: When the Asthma Action Plan Needs Revision

Tracy posted this question to a post, and I thought it was worth adressing front and center:

"I am new, but desperate to find some advice. My 4 year old has asthma and has been on albuterol, pulmicort, singulair, and prednisone for a few years on and off. His 6 year old sister brought a cough/cold home from school last week and now he is battling it. All of the parents of asthma children know that when they get a cold/cough...it's SOO much worse for them over other children. I'm at my wits end, he is coughing and coughing for days now. The doctor told me to do the regular routine...albuterol/pulmicort in his machine. It doesn't seem to be helping, he has made himself vomit 2 times from his coughing attacks. It's now Saturday night, 6:30 pm and he's coughing nonstop. He isn't wheezing, but his breathing is fast. The cough is the worst, and I don't seem to be getting much help from his doctor.

Any advice on how to help the cough even a little bit other than his albuterol/ pulmicort/ prednisone. I feel like I'm overmedicating him today. I'm so stressed, he can't stop coughing. I'm not sure if it's time for a trip to the ER, but not sure what else they can do for him, we have all the meds right here, it just doesn't seem to be helping. "

I don't know if it's documented anywhere, but I swear some kids develop a resistance to albuterol.

So here are my questions for Tracy, right off the bat: Are you seeing a regular pediatrician, or do you see a pediatric pulmonologist or asthma/allergy specialist? If you read this blog regularly (and considering you came in via a post from 2005, I'm guessing you might!) you know how important I believe this is: Pediatric pulmonologist just "get" pediatric asthma better than pediatricians do. We have seen our pediatrician and been told our child was "moving air well," then seen the PP a few hours later - only to be promptly sent for a chest x-ray!

Question 2 for Tracy: When did you last have your action plan updated? It may be that your son has outgrown his current dosages, or needs stronger meds. Our middle guy is fine on Flovent 44 for the summer, but needs to be on Flovent 110 this time of year. Last year, we bumped him to the 220 for the winter months.

When it comes to the emergency meds, I always have albuterol and Xopenex stockpiled, but have found that when things get really dire, we need DuoNeb and Combivent, as well, which are stronger. (I don't know if they're typically prescribed for kids, as they seem to be COPD meds, but they definitely take care of those evil coughing fits.)

I've also been lucky enough to have a great PP with a great staff. They know I've learned to treat mountains as mountains and molehills as molehills (it took a few years...), so they've empowered me to take certain measures at home. If things are really bad, I'm allowed to administer three doses of albuterol 30 minutes apart. If there's no relief from that, we either go straight into the office, or straight to the emergency room. Note - DO NOT do this without the permission of your own doctor. I will only take these measures after calling the office and checking in first!

One more trick we keep up our sleeve: Dimetapp. If your doctor allows it, we find that this alleviates coughing caused by upper respiratory symptoms. It's not a cough supressant, so it's OK for asthmatic kids to take. Bonus: Helps them sleep, too!

So, Tracy, I hope this is helpful. I'm frequently in your shoes, and I know what you're going through. Of my three boys, Oz, my 4 YO, is currently the worst asthmatic. He will cough until he gags. Sometimes, he can't get through a sentence without coughing. It's awful, and I will do whatever I can to make it stop.

We've had a good winter so far, but he has started coughing today - and I'm visiting my in-laws in Canada without the nebulizer, so I hope I didn't just jinx myself.

Please feel free to respond via comments or email.

Do I have asthma, too?

I've had a cough for about 3.5 weeks now, and I went to the Minute Clinic (LOVE the Minute Clinic!) for a second time. The cough had gone from clearly a "tickle" to something that sounds a little more dry and chest-y.

In a nutshell, the nurse practictioner at the clinic said that the only reason anyone would have a cough that long would be either chronic sinusitis or exercise-induced asthma. So I plan to follow up with my doctor this week. (OK, I plan to find a *new* doctor and then follow up.) The NP can't really treat asthma, so she just continued the treatment for acute bronchitis, which was my previous dx.

I did a little research, and it really sounds like I have cough-variant asthma. I wake up fine, but after walking from my car to my office in the cold air, alongside a major highway, I'm hacking up a lung by the time I get to my desk. Seems like cold air and fumes are my big triggers.

I got my very own albuterol HFA. Pretty crazy.

Truthfully, I'm a little skeptical about the diagnosis. But on the other hand, I grew up in a house with two smokers - my mom smoked a pack a day in our broadloom-covered house for the 21 years I lived at home. My brother was just diagnosed with asthma. And let's not forget that I live in New Jersey!!!

Funny PS - my mom was far more skeptical about the dx. She gets coughs all the time, she tells me. Coughs that are triggered by cold, and coughs that make her cough til she gags, like I do. But it's just a cough, she says. It's not asthma!!

...this from the woman who STILL smokes a pack a day and NEVER goes to the doctor for anything!!!

Health Day: Acetaminophen Linked to Childhood Asthma

I have to laugh when I think about all the things linked to pediatric asthma. Seems like we moms can't do ANYTHING right! Now even Tylenol is a culprit in the pediatric asthma epidemic!!

According to Health Day:

Children given acetaminophen during the first year of life to reduce fever are more likely to develop asthma later on, a new study finds....

"If this association is causative, it would suggest that acetaminophen use is a risk factor for asthma and may explain the asthma has become more common," said lead researcher Dr. Richard Beasley, from the Medical Research Institute of New Zealand in Wellington.

Since this study can't definitively say that acetaminophen is a cause of asthma, its use for children shouldn't be changed, Beasley added. "Acetaminophen is the preferred drug for relief of pain and fever in childhood," he said.

Just remember, Moms: Everything you do is wrong.

Sigh.

Asthma in Children and the Fear of Pulmicort

New Question - Just In:

HELP!!!!! My son is 7, was dx w/ asthma this past winter after a lifetime of treating what different ped's "thought" were simply nasal infections with antibiotics. We have recently went from zyrtec, to oral steroids, now on to pulmicort, albuterol and Singulair. I am VERY afraid as my son is already a sensitive and emotional boy. It sounds like the pulmicort is simply a BAD med??? Does anyone have any homeopathic advice on treating asthma? My mom is permanently disabled from medications that were not properly tested and monitored...I am in search of help, not more hurt!!! - Tammy

Tammy, I'm *not* a doctor, but I have a few insights I can share from experience:

First of all, many of us who have used Pulmicort and Flovent (same med essentially, delivered differently) have found that Flovent may tend to have less "roid rage"-type side effects.

Personally - and I do have sensitive boys - I haven't seen any negative behavioral effects from the steroids. (At least not that I remember!) Certainly albuterol has them bouncing off the walls, but I give Xopenex as often as I can to aovid that.

I can tell you that it works - WELL. For children with asthma acute enough to require daily inhaled steroids, there aren't many alternatives. None of us likes the fact that our kids are taking steroids every day, but it certainly beats the alternative of not being able to breathe!!

The best recommendation I can give you, though, is SEE A SPECIALIST. If you've read this blog at all, you'll know that I love my pediatricians. But when it comes to asthma-related issues, I call the pulmonologist first, then make a courtesy call to the regular peds to keep them in the loop. Pediatric pulmonologists know more about asthma than general pediatricians do, and understand the subtleties, the latest meds, and so much more than any other doctor.

If there are no pediatric pulmos in your area, look for an allergy and asthma specialist.

On the holistic side, I know many parents who have seen benefit from taking their kids off dairy. Others have seen a lot of success with sinus washes (now sold as "netti pots" at your local CVS) particularly if their kids' asthma is typically triggered by upper respiratory infections.

Again, I'm not a doctor or medical professional of any kind, but this is my best mom-to-mom advice.

I would also refer you to the Asthma-Parents group on Yahoo, which has been a great resource for me over the years. Two other sites:

• http://www.breatherville.org/ - the site of Mothers of Asthmatics, which also provides discounts on nebulizers and other equipment, among many other resources; and
• http://www.lungusa.org/ - the American Lung Association, which has great newsletters.

Hope this is helpful. Best of luck, Tammy!

Speaking of working mothers' guilt...Daycare Drama

I'm switching the little boys' daycare this week. The one they've been in was B's third, but he's in 1st grade now -- and this is the only daycare the two little guys have ever known. So you can imagine how grueling a decision this has been.

The place was really nice for the first few months we were there. I should have known, when the director who showed me the place departed on our first day there, (departed *for good*, I should add) that the outlook might not have been good. And now, four directors later, I can say that it was, at times, very good. But right now, it sucks.

After the last director left, the new one, Miss R. came in very quickly. Rob and I call her "Miss America" because she literally comes to work with pageant hair and full makeup - including eyelashes. She's built like a beauty queen, too, and loves to wear tasteful, expensive-looking, very fitted clothing to show it off.

Miss R looks very professional, but she - like the rest of the staff - is very young, with no children of her own. She's concerned with things like ratios, and classroom supplies. She loves the cute kids, but hasn't an inkling what it's like to leave your children with strangers every day.

So, needless to say, she's part of the problem. She hires young staff, doesn't announce when they leave, doesn't announce when new staff joins, and doesn't communicate well with parents. When I talk to her about concerns I have, I often feel like there's a language barrier or something. I can practically see everything I say fly right over her perfectly styled head.

Turnover is a problem, too. Half the time, someone I've never met is handing my kids to me at the end of the day. There's only one teacher who's been there as long as we have.

That's the background. Here are the actuals:

1. Frequently, when I drop Ig off, his room is over ratio. Now, if this place didn't already push state limits, it probably wouldn't be such a big deal. But on a GOOD day, there are two very young women with 14 2.5 year old. I can barely manage 1 two-year old. But seven? So if there are 16 kids in there, I will wait until kids and teachers are shuffled appropriately and I can feel safe leaving my son. The waiting makes Ig uneasy and me late for work. And it's an ongoing issue.

2. When I pick up, the boys will sometimes be together in one room, with a teacher I barely know watching tiny little Ig with a bunch of older 4YOs. Which wouldn't be so bad if the teacher was actually watching and if Ig weren't so tiny and immature for his age.

3. On 3 separate occasions, Ig has come home with no pullup and no undies. Funny the first time, downright concerning by the third. He doesn't have tear-away pullup. He has to take offf his pants and undies to do this. Which means he's got to be alone in the bathroom for close to five minutes to accomplish this task. And did I mention that he slipped in the bathroom and had to get stitches a few months ago?

4. Ozzy had an asthma flare last week. I would have kept him home if I had any flexibility at work, but I coudln't. So I nebbed him up and sent him to daycare with an alubterol MDI. I filled out all the forms for him to get the meds....and he didn't. They forgot to give him his 4 o'clock dose. They. Forgot. To. Give. Him. Asthma. Meds.

...and that was the final straw.

So I'm moving them away from their friends to a nearby center. The new place is about half the size and family-owned. It's clean. And Ig's room has 8 boys and two *mature* caregivers. Ozzy's room has three teachers; one of them is the owner.

I feel good about the move, but it's a LOT more money...at a time when no one has a LOT more money for everything. And it's disruptive to all of us.

I wish this wasn't a necessary step, but I don't think our current childcare situation is repairable. Miss America takes responsibilty for nothing. She blamed Ig for the diaper removal. While her business manager admitted to forgetting Ozzy's medicine, she lied to corporate -- and essentially blamed Ozzy for lying about the missed dosed! She blamed the teachers for Ig's stitches and the business manager for the ratio issues. I can't work with someone who can't own their mistakes. Doesn't she realize that her staff is reflection of herself? That if she were on "The Apprentice," the Donald would have sacked her ass?

Hopefully, the kids and I will be happier at the new center. Ig's been very clingy at drop-off lately - a new behavior for him, probably sympomatic of the chaos he has to deal with once I leave.

As my co-worker so aptly put it, "It's OK to *miss* your kids while you're at work, but you can't *worry* about them."

Ain't it the truth?

Working Mothers of Asthmatic Children - Time to Lose the Guilt!

A sigh of relief, courtesty of our friends at the American Lung Association. Got this from their excellent email, The Weekly Breather (which I wish I had more time to read):

Day Care May Cut Kids' Asthma Risk...WebMD reported on September 9 that infants and toddlers who attend day care are less likely than other children to develop asthma symptoms by age 5, a new study shows. The research adds support to the so-called "hygiene hypothesis" -- the idea that early exposure to infections and germs helps protect against allergies and asthma.For the full story: click here

See? You're not such a bad mom after all. Don't you feel better now?

Place Blame for Asthma Here: Stomach Germs and Peanut Butter Sandwiches

Yesterday, my co-worker shared with me an article that stated that eating too much peanut butter during pregnancy may increase the likelihood that your child will develop asthma.

Now I know that I craved - and indulged in - many peanut butter sandwiches during one of my pregnancies...but was it child one, child two, or the miscarriage before both? (I know it wasn't child three - I was too busy to EAT during that one!)

It's a theory I can get behind because, having the traditional "mother's guilt", it puts the blame on me. I can take responsibility for my kids' asthma once and for all. Pretty messed up, huh?

But another theory that seems a little sane is this one: A study at the NYU Langone Medical Center found that H pylori, a bacterium that used to be common in the human stomach, seems to prevent pediatric asthma, allergies and hayfever. Prior to WWII, this was a familiar germ, but with the advent of antibiotics and antibacterials, resulting in cleaner homes and schools, it's become pretty rare. Here are some stats and quotes from the study worth sharing:

"In our study we asked the question, is there any relationship between having H. pylori in the stomach and having asthma and other allergic disorders," said lead researcher Dr. Martin J. Blaser, the Frederick H. King Professor of Internal Medicine and chairman of the department of medicine at the New York University Langone Medical Center in New York City.

"We found a strong inverse association between H. pylori and childhood asthma, childhood hay fever and childhood allergies," added Blaser, who's also a professor of microbiology and has studied H. pylori for more than two decades.

Blaser thinks that H. pylori may protect the body against asthma. "When children have H. pylori in their stomach, their immune system is different than if they don't have H. pylori," he said.

...

Among children in the survey, just 5.4 percent born in the 1990s tested positive for H. pylori. In addition, 11.3 percent of the children under 10 had taken antibiotics in the month before the survey.

Blaser and Chen found that among children 3 to 13 years of age, those who carried the stomach bug were 59 percent less likely to develop asthma than children without H. pylori. These children were also 40 percent less likely to suffer from hay fever and other allergies, such as eczema or rash.

Among children aged 3 to 19, the researchers found that those who harbored H. pylori reduced their risk of asthma by 25 percent.

OK...if there's an experiment related to this study, can I bring my kids?

Unhappy Mothers Day

Where to start, with everything going on around here?

B is having an "off" day - getting frustrated easily, getting stuck in grooves that we can't quite pull him out of. There are days when the characteristic autistic behaviors are more apparent. This is definitely one of them.

Ozzy started Mother's Day with a time out -- how many time do I need to ask the kid to get dressed? How many???

(B is like a little timebomb at the dining room table right now. He's working on one of his mysterious projects, and he's either going to throw it down and rip it to shreds - or burst into tears. I keep hearing say, "I hate paper. I hate it!" I'm watching him, ready to help or hug when needed.)

Ozzy, by the way, had a BRUTAL asthma attack last Sunday. DuoNeb was only holding him for an hour at a time, and when it wore off, he'd cough until he gagged or vomited. It was horrible, and we had to put him on orals for two days.

Ig, last but not least, was diagnosed with his 50,000th ear infection, we had to put him on Omnicef and schedule surgery for new tubes and adenoid removal.

Within two days of starting the antibioitics, he broke out in a flat, lacy rash for which I promptly called the peds. After three days on Omnicef, they told me his ears were clear and took him off the stuff. That was Tuesday.

Today, he's pulling at his ears and running a low-grade fever. Are you surprised?

...so needless to say, it's been a rough couple of weeks. All I wanted for Mother's Day was a nice diner breakfast and a trip to the zoo. I wanted to see my kids having fun, and I didn't want to have to yell at anyone. Not so much to ask, right.

Apparently it was. I had three out of four boys seriously grumpy. Dad, B and Ozzy were all cranky today. What a bummer! Thank goodness Iain was happy.

It's still early, so hopefully we'll make up for it on the playground later. I just want to have some fun with everyone before Ig's surgery on Thursday.

I'm going to take a little nap now - my Mother's Day present to me.

To the rest of you SuperMoms -- enjoy your day!

Utter Madness - But We're All OK

I've been the absentee blogger lately, I know...

In a nutshell, I left the job I've loved for four years and started someplace new. That was about 7 weeks ago now.

The new job is fine -- I have a decent life/work balance, which is critical for me. Obviously.

It is taking a long time to get ramped up though, which is frustrating. I don't really have a budget for my online marketing programs, and the two guys I work with, who have complimentary positions, are very, very smart, and very, very busy. So I feel kind of stupid and lazy right now. It's a little challenging.

At home, I'm still getting used to the routine of the new job. Different commute. Different stress level...scared to be late or to ask to work from home...but I do both anyway...

The kids are doing well regardless. I'm definitely yelling at them a little less. The stress of the new job is a heck of a lot lower than the stress of the old job as it was petering out.

The old job was so wonderful...loved every minute of it until the company was acquired. Then it was something like watching a beloved grandparent succumb to Alzheimers. Everything you love, all the memories just dying away, until you don't recognize each other anymore. I'm writing in a rush right now...but you get the idea. It was painful and horrible, but I know the company I loved really doesn't exist anymore. And I don't recognize -or trust - what's grown in its place.

So those last few weeks, with a new boss and a new CEO, were VERY stressful, and I felt like I was losing patience with the boys a lot in the morning. I'm not, by nature, a yeller, so it was weird for all of us to have me screaming at them (especially Ozzy, who's just going through a PHASE right now).

Things are quieter now, but it's still challenging. And I dont' feel like I have time for anything at all these days. By the time I've gotten those three guys off to bed, I want to go lie down myself!!

Anyway...enough about me! Here's the deal with the guys:

• Ozzy: Coughing. I went to on my first business trip in a while - and my first plane ride in 8 years! - this past week, and of course he had a flare. I got called on my cell phone mid-meeting in Atlanta...he was being sent home from daycare because he was coughing so much! I called the husband and made sure he understood the action plan. Then called every two hours to check in. Sounds like it was a rough day or two, and he's still coughing at night, but he's doing OK overall. He was dropped from Flovent 110 to 44 about two weeks ago, and taken off Singular, so we'll evaluate the meds situation if he's not better in a few days.
• B: Still coughing a bit. It's been about three weeks now, and he's doing MUCH better. Oddly, he's on Augmentin right now for (of all things) a severely infected hangnail. (So gross...) I suspect the cough is from a lingering sinus infection, so the Augementin would clear that up, if I'm right.
• Ig: Bad diapers, a few sleepless nights, and digging in the right ear. Could we be en route to another ear infection? If so, we're down for new tubes AND an adenoidectomy. We'll see...

I *may* have heard a cough from Ig this morning, and he did insist on taking his blankee to daycare today. Never a good sign.

Sorry for the very long and poorly (quickly!) written post, but gosh it feels good to bring you up to speed!

Oz is FOUR today!

Happy Birthday, Monkey! I wish you a year free of flares and Orapred.

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Singulair: Believe the hype!

I hope by now you know me well enough to know that I'm no alarmist. I report, I offer my opinion, but I generally don't freak out over things.

So with the news of Singular and possible suicide ideation, along with other emotional symptoms, I followed the news, but I didn't react much. My kids are so young...is there really any risk or suicide, even of depression, in a six-year-old?

Apparently, there is. We went to the pediatric pulmonologist on Thursday, and she's taking all kids off Singulair over the next month.

Now, this is a woman who is against anti-bacterial hand soaps, who aggressively prescribes inhaled steroids...and someone I tend to think of as reasonable and level-headed.

For her to take B and Oz off of Singulair so abruptly was a bit disconcerting. The office is taking the new - and still unconfirmed - research very seriously. They even sent an email to their patient base about it.

B's been on Singulair since he was 26- or 27-months old, way before his ASD diagnosis. We never considered that the night terrors he suffered might be from Singulair. Nor did we consider that the lack of mirth we've seen in him since September might be related to the drug. There's been so much ELSE going on...Kindergarten, for starters! New friends, my husband's new job and new schedule....MY new job...so much. It would be hard to trace the changes in him back to just the Singulair.

But we'll see. He's got a cough right now - first one since the early fall - so he's on the stuff through May 8.

Ozzy's already off, and all I can say is that I'm HOPING for an improvement in behavior!! He's been on Singulair for as long as I can remember.

Lately, his behavior has been horrible. He's been tuning us out, talking back - he even HIT me yesterday. (He was tired, so I'll cut him some slack...but really, that's unacceptable!)

Maybe there's some small chance that the Singulair is behind that nasty attitude.

Maybe I'm totally dreaming.

Ig's Ears

As good as my pediatricians are, sometimes they're in a rush. They've got a busy practice.

Today, I got one of the docs to slow down and read the file.

Ig, as it turns out, DOES have another ear infection. Dr. G listened to my reports about Ig's two weeks of low-grade fever and persistent cough (upper respiratory, thankfully). She flipped through his file and noted that we'd had a rough time pretty much since New Year's. Lots of coughing, fevers, plenty of ear infections. I'm not exaggerating when I tell you the kid was there every two weeks.

She prescribed a 10-day course of Omnicef, but recommended we keep him on for two full weeks if he's not completely symptom-free.

She also recommended that we see the ENT again, since he's had so many ear infections. Hopefully we won't need tubes again. Although, we all slept a lot better when he had them!

Mostly Quiet

It's been a little quieter around here as allergy season looms ahead!

Ig is still coughing a bit, and I do believe he has an ear infection...but overall, not so bad.

The big headache is that we've changed insurance, and the new company - ExpressScripts - is giving us a hard time filling B's Singular Rx. Shocker, right?

Anyway, taking Ig to the peds AGAIN this afternoon for the ear, so I'll keep y'all posted.

New Study -- Aspirin Reduces Asthma Risk Among Older Women

From the Washington Post:

Taking a small dose of aspirin every other day seems to reduce the risk of developing asthma among older women.

The study, appearing in the online issue of Thorax, essentially mirrors a similar study in which men taking aspirin saw the same
reduced risk.

Interesting, right? But check THIS out...

The incidence of asthma is on the increase, possibly due to obesity, dietary factors, exposure to antigens and environmental factors. But the trend also coincides with a decreased use of aspirin as people have switched to other over-the-counter pain relievers, or have avoided aspirin use in children due to concerns about Reyes syndrome.

That led some researchers to wonder whether the reduction in aspirin use was contributing to the rise of asthma.

Discuss amongst yourselves...

Oz Is Better; Ig Is Coughing

It just never ends!

We finally managed to get Ozzy's cough under control Friday afternoon, after about 36 hours of DuoNeb treatments. It was pretty scary for a while there -- we were prepped and ready to take him to the ER if needed. And I'm amazed that we made it through that one without orals!

...but then, he's still coughing a little, so I should probably refrain lest I jinx myself.

His fever, by the way, hovered over 102 for a full three days, but then just broke out of nowhere Saturday afternoon.

Meanwhile, it's been two weeks since Ig was sick, so I guess we're due there. I heard him cough once or twice yesterday, and then at dinner tonight he let out a few seriously croupy barks.

So...I'm going to bed now. Since I probably won't sleep. Again.

Holy Virus!!!

I just heard from the PP ... based on my description and the peds assessment, they think it's a virus that they're seeing a lot of. Here's the skinny on the virus --

• Fever of up to 105 lasting 5-7 days.
• Cough is so acute, they're recommending DuoNeb every 4 hours
• They are hospitalizing kids with this

If I can be selfis and even sacreligous for a second here: 5-7 days?? God, did you plan this because I was starting a new job? Is this a sign that I shouldn't have left the old one? I mean, my new boss is a mom, too...but a whole WEEK???

Secondly, how scary and POOR OZ! I've never heard my PP, as aggressive as she is, prescribe DuoNeb only every four hours. She usually has us alternate between DuoNeb and albuterol.

I just pray that 1) Oz gets well quickly and without a trip to the ER and 2) that the others don't get this.

Think of me at 4:00 AM while your sleeping and I'm nebbing away. I hope they have Law & Order reruns on then.

Oz is sick - not strep, not flu

Terrible day! I started a new job last week, and while I *will* have flexibility ultimately, I do need to put on a good show and be at my desk for now.

But Oz let out a few croupy coughs overnight Tuesday, and had a moderate cough yesterday. I started albuterol, just to be safe.

Last night, he woke up with a fever, and my husband ("B") stayed home with him today. I gave him some ibuprofen a neb before I left for work, and told B to call me if he had any concerns.

B called at 11:30 - Oz was coughing uncontrollably, until he gagged. He'd already had a second neb, and I told B it was OK to give him Dimetapp. (Yes, I know about the warnings. Please don't call family services on me. The stuff WORKS, and the situation was dire!)

Dimetapp didn't work, so B gave him DuoNeb, which helped a little, but I was already paging the peds and the pediatric pulmonologist from my cube!! The peds were able to see him immediately.

Of course, B's car is in the shop and I have the (hideous, horrible) minivan, but thank goodness our neighbor was home and willing to loan us their car. I'm sure Oz will love sitting in their daughter's Disney Princess car seat.

They tested for strep and flu (both negative) and chalked it up to something viral. They said his chest sounded clear. Unsurprised sinced the kid had three nebs in less than four hours.

I'm waiting for a call back from the PP.

Keep y'all posted --

Pulmicort 'Roid Rage - response to question in comments

This came in today via comments:

I'm not sure I'm typing in the correct spot... I'm new at this. I was hoping to find some answers to a question I had concerning my son. I was wondering if you have heard of any children becoming aggressive or violent from the medicine Pulmicort? My son just turned 3 and since on Pulmicort has been exhibiting some very violent behaviors. Maybe just hit at the same time???? who knows? Do you have any advice or help?

I've been fortunate to have never experienced this, but I've definitely heard about it before.

Pulmicort is a steroid, and sometimes kids will react to it the same way grownups react to, say, anabolic steroids.

While some parents are OK if their kids "occasionally kick the dog," as one mom so quaintly put it, so long as they can breathe, sometimes the behaviors are a lot more extreme and hard to live with.

I've heard, on the Asthma-Parents Yahoo group, that other parents have seen better results simply by switching steroids. So ask your doctor if Flovent or Qvar is an option for child. Ad there's an added bonus: Being a "Flovent Mom" myself, I can assure you that administering a metered-dose inhaler (or MDI) twice a day is a LOT easier than holding a three-year-old down for a nebulizer treatment every single day.

Singular is another commonly-used maintenance med for preschoolers. I've rarely heard of adverse reactions from it, but it does work differently than inhaled corticosteroids like Pulmicort and Flovent, so it may not be right for your son's needs. In fact, my kids have needed to be on both Flovent AND Singular during peak season.

So...I hope this helps. Definitely talk to your doctor about alternatives. You shouldn't have to live with a psychotic preschooler when there are other options available.

Other parents, please feel free to share your experiences and wisdom!

Hark! I hear a cough!

Just heard a NASTY cough from down the hall...think it was Ig.

No surprise. He was wiping his nose on his hand (love that) and digging his finger way, way into his ear while I was reading to him tonight.

Might I just add that the timing is ideal, since I started a new job on Monday. I absolutely need to tell them I need to work from home ALREADY because one of the boys is sick. Nothing like showing the new boss what a liability you are early on.

At least she's got kids, too.

New Vaccine Risk from Merck

Y'all k now how much I love Big Pharma and unnecessary vaccines... (Polio=necessary, chicken pox=unnecessary.)

Here's some exciting news from our friends at Merck!

Ig Again

On 1/21, I posted that Ig had Scarlet Fever.

On 2/7, he was diagnosed with Strep AGAIN! And he ruptured his eardrum - AGAIN. What kind of luck do this boy and I have? And is it luck, or is it just daycare?

He's been on antibiotics since Thursday, and I started nebs on Saturday because his cough just had that edge to it. It only took two nebs for the cough to all but disappear, but I'm keeping him on albuterol for a few more days to be safe.

On another, sunnier note....posted a new link in the side bar to The Shortest Blog in the World. If you need a good laugh (like I frequently do) check it out!

Jennifer's Question on RSV/Asthma

Had to post this one -- probably a lot of this, now that it's Flu/RSV season:

Hello,
I came across you blog by searching google for asthma treatments. My son 8 months tomorrow has had RSV once and now pneumonia twice. This since early December.My head is spinning thinking that this is potentially a lifetime problem. He is on Orapred now with albuterol Not to mention Amox. for an EI. He was on singulair after the first bout with pneumonia. I thought it was working, but then he came down with a cold and within a day it was in his lungs. The dr. is going to switch him to pulmicort now I just have so many questions. I was wondering if you could perhaps help me or just talk me through it

OK...so the best advice any parent of an asthmatic child can give you is find a pediatric pulmonologist or asthma/allergy specialist, if you haven't already. Pediatricians are generally wonderful, but because asthma - particularly in a child as young as yours - can be VERY subtle, a specialist (if you have access to one) is the way to go.

I've found that finding the right combination of meds is an exercise in trial and error, even with the best doctor. I admit surprise that your son wasn't put on Flovent or Pulmicort from the start, but all docs have their own preferences.

It could be that your son will be what seems like a LOT of medication for a while. My oldest was best on Flovent 220, Singular and Nasonex when he was 2-4 years old. I've never met a mom who was happy about all this maintenance medication, but the good news is, it typically is NOT a permanent situation.

B was on a ton of medication for a year or so before we were able to lower the Flovent and phase out the Nasonex. And once we took his adenoids out (sinus infections were his biggest trigger) we were able to phase out the Flovent as well.

Now he's just on Singular, and has maybe two asthma flares a year -- and they've been mild ones, too.

My other guys are still on Flovent, but comparatively low doses, and they're doing well so far.

I do think that our PP is more aggressive with medication than others, but it seems to have worked will for my boys.

One resource I highly recommend is the Allergy and Asthma Network. You can call them directly with your questions and concerns. (They also offer discounts on medical equipment - definitely a bonus!)

Probably Parvo

Doc just called...probably Fifth Disease, but if he has a fever in the AM, we'll take him in for a Strep test.

Awesome. I'll bet the other two have it, too. That would explain why Ozzy's been such a whiney little cranky-pants all day -- and why he was running 100.2 yesterday.

B has a weird rash...

...on his chin, cheeks and the insides of his forearms. I'm thinking it might be Fifth Disease(Parvo) since it itches. But I've already called the doctor, since Ig had Scarlet Fever last week.

He's been really off behaviorally this week, and Fifth would explain it...but I'm bummed that we might have to cancel his playdate tomorrow. We had to cancel one last week because of Ig's little plague, and B will be devastated if he has to miss another. :-(

Oh, and he coughed once, so I've got the albuterol primed and ready for action.

Cold Meds and Toddlers

I would be remiss if I didn't mention the latest warnings for cold medications....

From EverydayHealth....

..."We strongly recommend that over-the-counter cough and cold products should not be used in young children under 2, because serious and potentially life-threatening side effects can occur from use of these products," Dr. Charles Ganley, director of the FDA's Office of Nonprescription Products, said during a morning news conference. "We have not come to a final decision on the use of cough and cold products in children aged 2 to 11 and continue to work within [the] FDA to arrive at a decision."

"We were concerned that parents would continue to use these products in children under 2, even with all the publicity," Ganley added.

Glad Ig's two now, because I don't know what I would do without my industrial-sized bottle of Dimetapp. And just in case the FDA bans it for kids up to 11, I'm going to stockpile the stuff. Please don't report me to DYFS.

I have bronchitis, Ig has Scarlet Fever

What a fun weekend. We had big plans for the holiday, including a big playdate (2 kids at our house) and a trip to the big science museum....but unfortunately, we've had to work in shifts this weekend, and I stayed with Ig most of the time.

Ig started spiking fevers on Friday night, and developed a funny rash on his chest, tummy and back by Saturday afternoon. I called the peds, and they told me that they'd see him Sunday morning if he was still sick. (LOVE my peds!)

He spiked up somewhere near 105 on Saturday night, so we were in on Sunday. Turns out he has Scarlet Fever -- and an ear infection. The tubes he got in March are pretty much out, so I guess we can expect more infections from now on. Poor kid, he was up screaming because of the "boo boo in the ear!"

Here's the funny part...while we were waiting for the doctor, I had a little coughing fit - not uncommon for me over the last month. When she came in, she listened to his chest, said it was clear, but noted that his cough sounded pretty croup-y.

"Ummm..."I smiled sheepishly, "He doesn't have a cough. That was me." She made me open MY mouth, checked MY throat, and told me to back to my doctor and tell him that my son has strep (even though my throat looked fine).

I hadn't actually seen a doctor. I'd gone to the new Minute Clinic at our local CVS. What a great thing that is for adults! It's a nurse-practitioner who works 8-8, and you don't need an appointment. AND they take my insurance. Mind you, I wouldn't take the kids there, but for me, it's fine.

I've had this cough for a month or so. No other symptoms, no chest tightness or anything -- just a tickle in my throat that makes me cough until I gag or cry. I actually didn't think much of it (despite my husband's complaints that I was keeping him up at night...pretty funny that he should complain considering I've been living with his snoring for 15 years!)... until my assistant was diagnosed with bronchitis. She was prescribed antibiotics.

The N-P at the clinic told me I had bronchitis, but that it was probably viral. Apparently it's a crapshoot - 50/50 whether it's bacterial or viral. She gave me a prescription, non-narcotic cough suppressant and told me to call my doctor if it wasn't better within a week or so...but that bronchitis can last up to 6 weeks.

I've never had bronchitis before - or at least, I've never been diagnosed with it before - but I can tell you that this cough, while it isn't as frequent, definitely sounds chestier. I still don't feel it anywhere but my throat, though.

Regardless, I'll try to get in with the GP today or tomorrow, and I'll keep an eye on the kids, too.

Wouldn't it be ironic if the GP put me on albuterol?

Alternative Asthma Treatments (Psych!)

I love this article from Everyday Health. It lists all these great alternative treatments for asthma, like herbs, acupuncture, chiropractic...then explains why they don't work. Way to be open-minded!

Osgood File on Autism: "Defect"? Really?

I hope this rant gets me some big links, because this one REALLY pissed me off.

Yesterday, I was listening to a local news radio station on my way into work, as I normally do. And as usual, I listened to "The Osgood File," which I usually find pretty fun and educational. (And no, I don't listen to NPR in the morning...sorry to disappoint.)

The "File" this morning was on a new genetic link to autism, so, naturally, I cranked it.

Interesting enough story, but the doctor, a Dr. Jon LaPook, continually referred to autism as a "defect." Seriously.

Here are some quotes from the actual transcript on the Westwood One site:

SOT - Dr. Jon LaPook "This problem accounts for about one percent of the cases of autism. So, if you're a child who happens to have this defect, this will help you get an early diagnosis. And we know the earlier you get the diagnosis, the earlier you get treatment, and the better the outcome." So, Dr. LaPook says it makes sense for some parents to take advantage of the genetic testing now available, if they can afford it. SOT - Dr. Jon LaPook "It's an expensive test right now. It costs two-to-three thousand dollars. It's available in large medical centers, research labs. But if you're a family who happens to have a child who has this defect, it can be terrific because not only can you get a diagnosis --- and therefore get treatment --- but you can start maybe making plans in terms of other children, figuring out what are the risks that my other children are gonna have this problem."

Defect? Really? Why don't you just call it an "abnormality?" How about a "retardation?"

Are you saying my son, who has Aspergers Syndrome, is DEFECTIVE? He's a CHILD, not a can of peas, people.

Let's substitute the words "defect" and "problem" with kinder terms like "difference." Again, we're talking about PEOPLE here.

Equally, and perhaps more offensive, is this suggestion:

"...but you can start maybe making plans in terms of other children, figuring out what are the risks that my other children are gonna have this problem."

Awesome. Gotta weed out those defective kids. Got one child with an autistic spectrum disorder? Please refrain from any further breeding.

I'm so disappointed by CBS radio, Osgood and this Dr. LaPook.

Seriously, WTF???

Oz is out of control

Quick one since I'm at work --

Oz's asthma is a little out of control. I feel like he's been gray and coughing for the last four weeks. He's certainly had a runny nose, so I would say -at the very least- that he has a sinus infection.

He thew up after his first swimming lesson yesterday, and has been coughing ever since. This morning, he was coughing until he gagged, and it took a dose of Claritin and a double-dose of Combivent to alleviate the cough.

He's also been waking up and coming into our room every night for the last week. Twice a night, at least. Seriously annoying, especially since Ig, who was sick last week (virus - not asthma-related) has been up, as well. I suspect it's because he's not satting well overnight.

Calling the PP today for a checkup. Don't know if we need to adjust meds, or if it's even just upper-respiratory, but poor Ozzy really is a mess!

Happy holidays and quick update

First off - Happy Holidays to everyone! Hope you've all enjoyed whichever of the many December holidays you celebrate, and (if I don't post before then) that you have a wonderful and HEALTHY New Year!

Just a quick update on the boys --

B didn't have the flu after all. Typical of me to panic like that, right? He was fine the next day, but he has developed kind of a nasty cough over the last few days. I have him on Combivent for the first time since September. Funny how he only develops coughs like that when we come to Canada. Must be something with this fresh Ontario air...

Oz didn't get the stomach virus, but did develop 102 fever and a lovely grayish skin tone as soon as we arrived in the Great White North. He's still not looking all that well, but he isn't coughing, either. He's just congested, puffy-eyed and pale, and he does seem to be retracting a bit. So he's on Dimetapp and albuterol for the time being. We'll see the peds when we get back.

Ig (who turned two last week - did I post that?) is doing well, but is a total toddler. Little tyrant!! Good thing he's so cute... He has a bit of a runny nose and loose cough, but he looks really good. Just keeping an eye on things, but he really seems OK. His lips have been blue a few times, but I think it might just be because my in-laws have cold floors. (Albuterol's always handy, though!)

That's about it. I'm happy to be away from work and focusing on the kids...and actually READING a BOOK. Fiction. Nothing on asthma, Aspergers or business - just pure entertainment.

Now THAT's a vacation!

Could B have the flu?

It's a little early in the season, but I was reading this article on the CDC site...and it could be.

Should probably check with the peds before taking him over the border. It would SUCK to make the news because we started an international flu epidemic, y'know?

Too Sick for the Road Trip

B woke up this morning complaining of a stomach ache. I knew he was serious - he never complains about his health. Ever.

And we were supposed to leave to see the in-laws in Canada this morning. Not only was he incredibly psyched to see his grandparents, he was even psyched for the DRIVE. Seriously -he was all about watching DVDs in the car, stopping at Dunkin' Donuts and McDonald's....I guess I never realized how cool road trips are when you're 6.

Anyway, he threw up his whole breakfast, so we didn't leave today. Rob took him to the peds because B will occasionally vomit when he has strep, and we definitely needed to start antibiotics right away if he had that.

But while the strep test was negative - at least the rapid strep was - he did start running a fever later on in the day.

We'll keep an eye on him tomorrow, and we'll see what his temp is, etc. before we leave. (This will be very had for Rob who would have us loaded in the car at 7:00AM regardless. I totally don't get men and their arbitrary schedules. Is there a hockey game or something tomorrow night?)

Meanwhile, Oz is looking poorly and has a funny rash around his nose and mouth (please let it not be perioral dermatitis again...) and Ig's been breathing noisily and coughing a bit.

We'll see. Hopefully, we'll make it to Canada before Christmas Eve. It would suck if the kids couldn't spend the holiday with the grandparents. Especially since they've got all the presents!!

Keep ya posted...

WEGO Health Recommends....Me!!

Just a little gloating...my blog's currently recommended on WEGO Health.

Let's hear it for the Mama!

NJ's New Mandatory Vaccine: Mama's Angry All Over Again

It's not that I'm against vaccines...I'm not. I think a lot of vaccines are necessary. Polio, for example. Mumps. Measles.

What I have a problem with is vaccinating kids for EVERYTHING. And worse yet, FORCING me to have my kids vaccinated for everything.

Let's give this some context. I'm the mother of a child on the autistic spectrum, as well as three asthmatic boys.

While there's no 100% ideal link between vaccines and autism, there is enough circumstantial evidence - and enough questions have arisen - to give me pause. For one thing, look at the rise in autism diagnoses in recent years. (And sorry - no, I don't believe it's all because of the new diagnostic criteria.)

First of all, why in the world was anything even remotely related to mercury used to bind any vaccines? And no, it's not in the MMR anymore - but is still in the flu vaccines. Seriously.

We'll recall any toy with lead-based paint on the outside chance our kid might chew on it, but we'll inject thimerosal directly into our kids' bloodstreams.

Can someone explain this to me?

Secondly, have you looked at the American vaccine schedule lately? 10 different vaccines before a child's first birthday. Does that seem a little extreme? The UK requires THREE.

But who has the bigger pharma lobby, I wonder?

This just drives me CRAZY.

Now New Jersey, my lovely home state, is requiring me to vaccinate my kids against the flu, as well other illnesses including whooping cough and meningitis.

But let's think back to last year. Anyone remember flu vaccine recalls? How abou the the year before. And hey - didn't Merck just recall the Hib vaccine?

At the end of the day, here's how I feel.

• I will absolutely vaccinate my kids for diseases that pose a dire risk to them and to the public -- Measles, Polio, etc.
• I will not vaccinate my children with predictive vaccines that may or may not be safe or carefully tested.
• I will not allow my children to be injected with vaccines bound with thimerasol.
• I do not think it's necessary to vaccinate my children for non-life-threatening illnesses they're perfectly capable of fighting on their own, like chicken pox.
• I protest the compulsory vaccination of 9-year-old girls for sexually transmitted diseases.
• I DEMAND that vaccinations not be mandatory because pharmaceutical companies have enough money and power to lobby to make it so.

I'm tired, and this may or may not make sense...honestly, I'm not a freak, I'm not a conspiracy theorist. I'm the mom of a child with an autistic spectrum disorder, of three asthmatic boys, who has a LOT of dangerous questions.

Oz & Ig - still not better

So...Ig's being treated for for a double ear infection. FUN - it take two full-grown adults to administer the antibiotic drops for my 23-month old. And he's still got a tight, nasty-sounding cough in the early AM and at night.

Oz has a much looser cough, but he's got enough goop around his nose for me to think he may have a sinus infection. I don't think it's cleared up since he had that flare a few weeks back.

So I think we may end up at the peds tomorrow morning.

In other news, I've got a call into the developmental pediatrician because B, whose asthma is 100% under control with just Singular these days, is exhibiting some odd behaviors. No time to get into right now, but we think it's Aspergers-related stuff.

I'll try to post again after I talk to the doctors...

No RSV but...

We have a double ear infection!

Here's how it played out:

1. Ig was fine by the time we go to the PP on Thursday.
2. Oz was coughing like mad on Friday, so both of them were home and on nebs.
3. Ig was tapered down and went back to just the albuterol MDI on Saturday.
4. Oz was tapered down and went back to just the albuterol MDI on sunday.
5. They both went back to daycare today, but both were meant to get albuterol at 12 and 4.
6. Ig was SO happy to see me when I picked him up today, but then wouldn't stop crying when we got home...and wouldn't eat, either.
7. I noticed fluid draining from BOTH ears (remember how he has tubes now?)
8. I gave him Motrin and Floxin after paging the peds, and then I put him to bed.

Fortunately, Dad can work from home tomorrow. (I was home Thursday and Friday.)

Ig & Oz Update

If was up to 40 breaths per minute this morning (despite a greatly reduced fever), so I took him to the peds. pulomonolgist this afternoon.

Spent the whole day wiping blood-streaked mucus off that kid --his nose was like a little, hideously disgusting faucet. And we went through two shirts because he kept wiping his nose on his sleeves. Really GROSS.

But of course, by the time we got to the PP, he was fine! No wheezing, moving air well, normal resp rate satting at 97%. Not that I'm not happy that he's better, but the kid pulled a total Michigan J. Frog on me.

Nonetheless, she tested him for RSV, and while we haven't gotten the results yet, the respiratory therapist was pretty sure he had it. So I'm not ruling out an overnight nosedive, and I'm definitely keeping Ig home again tomorrow for a rigid neb schedule!

Oz, on the other hand, woke up congested and coughing - just a bit - this AM. I started him on nebs, too, and given the liklihood that Ig has RSV, I'm glad I did.

We'll see how he is in the AM, but I'm not optimistic. But am I ever, when it comes to RSV?

Read this blog and tell me if that's unreasonable.

Ig May Have RSV

Ig was up the last two nights, fussing and congested. He started coughing last night, and sound pretty bad this morning.

I brought him to daycare this morning, knowing that he probably wouldn't make it the whole day. He had no fever, but the cough was a little rough and
he just wasn't himself. He didn't eat breakfast, but he wasn't as congested as he'd been either. I really didn't know what to make of his state, but I had that feeling that he really was getting sick.

Last night, btw, he had me cracking up . He woke up at 3:00 AM (!) crying, calling for me to come get him. I didn't get him right away (3:00 AM, I remind you) so he came up with some GREAT lines to lure me in. Mind you, he's 23 months old now. Here's what I heard:

• "Mom? Want up-up."
• "Mom? Want up-up. 'Kay? Kay."
• "Mom? Want juice."
• "Mom? Want cheerios."
• "Dad? Want juice."
• "Mommy? I smell poopies."

That one got me.

Back to today...he woke up from nap at daycare with 101.9. I went and got him, and he looked SO BAD and sounded so awful that I took him straight to the peds.

The peds noticed he was retracting, but didn't hear anything concerning beyond his cough, which she called a "typical asthma cough." Ears were fine, throat was fine, etc.

She did mention that they've already seen some RSV, and recommended we keep the nebs up and DuoNeb if necessary. I told her we'd watch his resps, too, and she reminded me about hospitalization for RSV. (As if I'd forget staying at the peds hospital with #1 son for five days!)

Keep y'all posted....

Asthma, the kids, and the past few weeks

In a nutshell...'tis the season for peds asthma!

Oz: Had a bad cough the weekend before T-day, as well as a horribly runny, icky nose. He actually had to miss a birthday party because he was such a mess that Saturday. Many nebs later, he's much better and finally off albuterol.

Ig: Just getting sick now. Lots of yellow ick all over his face, but no cough yet. Also just found out that the always-sick (and constantly dosed-and-dropped) kid at daycare just had croup and coxsackie (and probably STILL DOES even though he's there today) so the future's looking a little gray on that front. He was also up SCREAMING last night, and I thought he sounded a bit wheezy. No cough (yet), though.

B: Told me he had a cold this morning. Sigh.

We'll see how it goes over the next few days.

Rethink your Tamiflu Stockpile...

Someone just emailed this to everyone at work in response to an invitation for everyone to get free flu shots:

F.D.A. Staff Recommends a Warning on Flu Drugs

By BLOOMBERG NEWS

Published: November 24, 2007

Makers of the two most common drugs used to treat and prevent flu should add warnings that they may cause psychiatric side effects, federal regulators have recommended.

The report, by staff members of the Food and Drug Administration, was posted yesterday in advance of an advisory panel meeting scheduled for Tuesday to review use of the antiviral medications Tamiflu, made by Roche Holding, and Relenza, from GlaxoSmithKline.

Five Japanese children who took Tamiflu and became delirious died, and there were reports of abnormal behavior among some children using Relenza, mainly in Japan, where the drug is widely used to treat flu, the documents noted.

There have been no fatalities in the United States, the F.D.A. report said.

Regulators are not sure if the deaths and abnormal behavior were caused by the drugs, the flu virus or a combination of both, the F.D.A. staff members said in a memorandum written Nov. 9. They did not propose any new limits on use of the drugs. While governments worldwide have been stockpiling the drugs in case of an influenza epidemic, sales have slipped in recent months amid concerns about the safety of Tamiflu.

Tamiflu generated $257 million for Roche in the third quarter. Sales were down 62 percent from a year earlier. Relenza generated $58 million for Glaxo in the third quarter, down 7 percent.

Roche, based in Basel, Switzerland, says studies show the flu, not the drug, causes the reported side effects, but a company spokesman, Terry Hurley, said yesterday, “If the F.D.A. concludes that it is valuable to place additional details on the label with regard to specific adverse event reports, then Roche is open to that consideration.”

Officials for Glaxo did not immediately respond to a request for comment.

Tamiflu’s prescribing information was updated last year to tell doctors they should monitor patients for signs of abnormal behavior. The label should be revised again, the F.D.A. staff members said in the Nov. 9 memorandum, to alert doctors and family members that psychotic side effects may happen quickly and can be fatal.

Everyone's Coughing

...it's the "in" thing to do!

Ig's been coughing for days, a croupy sounding number that rips through my heart every time I hear it. (He actually asks for his medicine. He's 22 months old, and he asks me for "ap-icine." How sad is that?)

Oz is doing better, but still coughing at night. Looser than it was, thank goodness.

I'll be unreachable, working a trade show Monday and Tuesday, so I hope they're OK by the time the weekend's over.

Combivent and Nighttime Fears?

Granted, we may start watching Ghost Hunters too early some nights, but since we started the Combivent, B seems to have some odd night time phobias. The past three nights, he's begged us to leave the light on his room.

Has anyone else seen this with fast-acting inhalers at bedtime?

Over Albuterol - We're Reaching Straight for the Combivent

B started coughing slightly a few nights ago...so slightly that I (bad mommy!) didn't bother starting albuterol.

Well, ha-ha and me (and pity on him!) he was coughing so badly last night that he was begging me for Dimetapp! I had given him 2 puffs of albuterol, and then 30 minutes later, another 2 puffs, but it hadn't worked. He was coughing his head of most of the night.

Today, when I picked him up from school, he was coughing a bit. It wasn't alarming in frequency, but it sounded SO BAD.

When we got home, I couldn't find the nebulizer, so I gave him two puffs of Combivent.

I swear, he's coughed maybe twice since then.

I'll look back, and I'm willing to bet I've written this before, but giving this kid albuterol is a waste of a perfectly good pharmaceutical. It just doesn't work on him anymore.

I called the PP for a refill, but I'm not sure if they were able to get it to the pharmacy because I called late...I probably have enough to get through the weekend. Just.

'Roid Rage in Your Asthmatic Child

Every now and then, I get a comment like the one I just got from Tami. She's got a son with severe asthma who needs to be on Pulmicort or Flovent, but goes a little psycho when he's on the stuff.

It's a horrible situation to be in. Unfortunately, steroids are considered the strongest weapon in our anti-asthma arsenals. And as a message board buddy once put it, she'd rather have a kids who "kicks the dog" but can breathe than one who's in the ER every other week.

I think we'd all have HAPPY kids who can breathe.

At the end of the day, when we're not happy with the results we're getting from our doctors, the first checkpoint should be other doctors. I realize that some of my friends here don't have the luxury of being in major metro areas like me, but if you can find another pediatric pulmonologist or asthma/allergy specialist, get there. If you've only been dealing with your regular peds -- take the 2 hour drive to see the specialist. You'll never regret it.

Tami, I don't know what other meds your son is on, but you sound smart and I imagine you've been asking all the right questions and tried lots of different things. We're doing well with Flovent, but I know others who've seen positive changes by switching to Qvar and other brands of similar steroids. Maybe your son can do Singulair instead of steroids? Worth asking...

We've got lots of smart moms around here -- I'm sure someone can offer grounded, sensible advice. (Ahem!)

One note on the eczema -- there's a boy in my kids' daycare who had THE WORST eczema I've ever seen. He was constantly scabbed and bleeding. So sad! Recently, I noticed a drastic improvement, and I asked his parents about it. Would you believe their miracle cure was VASELINE? That's right -- they switched dermatologists, and the new doctor recommended that they bathe him every day (seriously!) and coat him with Vaseline within 2 minutes of getting out of the tub (and barely drying him off) to seal in the moisture.

Worth a shot, right? (With your doctor's permission, natch!)

Loving the Autism Diva

This woman is SO on my blog roll! (Some of you may know that my oldest son is on the autistic spectrum - so this is always something we're looking to learn more about.)

Anyway, here's a bit of the Diva's take on the recent hullaballoo over Jenny McCarthy's possibly "cured" autistic son:

Evan went from being a 2-year old (diagnosed) autistic boy (with seizures)to a 5 year old autistic boy apparently still on meds to prevent seizures, in 3 years. This is supposed to be an amazing thing. It's not. Not unless we are to believe that all autistic children stagnate at their two year old level and can never learn anything or develop skills beyond that. Jenny doesn't attribute his
development to, uh, development, but to her magical mystery cures that she got by way of quack dox and quackery promoting autism websites which of course, she discovered by doing "Google research." Oh, but she's a heroine for saving her son, from... what? From being a 2-year old, low functioning, psychic with a few too many autistic traits? Jenny seems to have a hard time keeping her story straight.

This woman is FIERCE and FEARLESS. I love it!!

All of us asthma/autism moms have tried something crazy at some point - the smartest women I know give their kids fish oils, have them on gluten-free diets, have given chelation a shot...I have hand the Autism Diva the feather boa for being the voice of reason in this clearly insane world of parenting special-needs kids.

Stay tuned for a rant on RSV awareness...!

Oz - a little better

Oz is a little better today -- just doesn't seem as...sick. Still whiney, still *definitely* has a cold, but seems improved overall.

Called the PP's office and spoke to the nurse-practioner, who I love. But sometimes I feel like they believe I'm such an "old pro" that it's just not helpful. "There's a virus, low-grade fever, dry cough or really chesty, congested cough. Some kids it lasts 2-3 days, other kids are sick for up to 10 days. You know what you're doing though...just keep up the Xopenex. If he's not coughing a lot, you can drop it down to 1-3 times a day. You'll be fine"

Is that REALLY helpful? And TEN DAYS? Are you freaking kidding me? Ugh.

Up with Oz

I've got a feverish, wheezing little Oz at my side as I type. Poor guy. We'll be at the peds tomorrow morning for sure. :-(

Some quick updates -- if I haven't posted in a while, there are two good reasons. First, we were on vacation the last week in August. Second, B's started Kindergarten at the elementary school, and I am/we are all adjusting to the new routine.

By new routine, I'm referring to getting up at 5:45 AM, getting myself ready for work, getting B ready for school, Oz and Ig ready for daycare and getting everyone out the door by 7:40 every day. Then it's two drop-offs before work, a full day of marketing for four companies, two pickups, dinner (at the table, with everyone) baths, making lunch, and then maybe, if I'm lucky, 30 minutes on the treadmill before washing or folding laundry and going to bed.

Aren't you SO jealous of me???

As for that vacation, let's just say it was everyone ELSE'S vacation, because for me, it was just like every other day, only touger. We rented a cottage on a lake in northern Ontario. My husband found it online, and failed to notice that a) it had steps (and we had no gate) and b) the walk down to the lake was pretty steep!

Ig was a bear....I was carrying him around every second, pretty much. Between the steps everywhere and his seemingly unthwartable desire to walk into the *middle* of the lake, it didn't seem safe to put him down! He didn't sleep well, and when he finally went down for a nap every day, I took a well-needed break by running 2 miles down a secluded dirt road. Believe me, it was my only alternative to running into the woods and screaming!!! I love that baby, but MAN was he tough.

In his defense, it turned out he had Fifth Disease (Parvo virus) but honestly, I still think I had it rougher than he did!

One more thing about that cottage -- every square inch was either carpeted or upholstered. EVERYONE was coughing. B develped a phlegm-y, resonant cough before we left for vacation, and it only got worse while we were there. It didn't go away for weeks, and we finally had to put him on Singular again. :-( Anyway, at least he's still off the Flovent, right?

Anyway, enough feeling sorry for myself -- back to poor Ozzy. He needs some snuggles, and isn't that what moms are for?

FDA Warning on Cold Meds for Babies

I heard this on the radio yesterday AM, and my cousin just sent me a link to the FDA Public Health Advisory (thanks, Sam!). And while I'll freely admit my parental dependency on Dimetapp (stops non-asthma-related coughing, promotes sleep) I doubt I'll give the stuff to Ig anymore.

Honestly, I find that Dimetapp is the only thing that works. Pediacare, Benadryl and Claritin have all been pretty useless for us. And of course, I can't ever give them cough supressants...

Anyway, here are a few highlights from the FDA Advisory:

FDA announced today that, in October, the Nonprescription Drugs Advisory Committee will discuss the safety and effectiveness of cough and cold drug product use in children. Questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under 2 years of age. In preparation for the meeting, FDA is reviewing safety and efficacy data for the ingredients of these products...

What should parents know about using cough and cold products in children?

• Do not use cough and cold products in children under 2 years of age UNLESS given specific directions to do so by a healthcare provider.
• Do not give children medicine that is packaged and made for adults. Use only products marked for use in babies, infants or children (sometimes called “pediatric” use).

Read the entire Public Health Advisory from the FDA site.

Thursday Night at the Pulmonologist

So... here's the quick roundup:

• B - Doing GREAT! He actually completed the Peak Flow Test (PFT) and did great! Dr. W said she would have been happy if he'd been over 80% -- and he actually surpassed 100% (He still improved after abuterol, but whatever.) He is not going back on Flovent this fall, at least not at this point. :-)
• Oz - Doing well, but staying on Flovent 110 and Singulair. We'll keep watching him.
• Ig - With the cyanotic episodes and overall dodgy health, we're starting Flovent 44 again now.

For a change, BETTER than I'd anticipated. I'm so excited about B!! No meds!!! Whoopeee!!!
Now all I have to pay for (for B) are the $500 orthotics, which our insurance wont' cover.

Quick Monkey Update

We seem to have beaten Oz's cough from earlier this week...but Ig had a blue-lip episode at daycare today. Two puffs of albuterol and he pinked right back up.

The blue-lip episode happened during a rather important meeting today, and made for a funny overheard conversation. The daycare admin called on my mobile, and I always take their calls, natch. Here's what the CEO, President and other around me probably heard:

"He's blue? Again?....Is he happy, or does he seem like he's in distress?...Okay. Did you give him albuterol?...Yes, two puffs. I'll sign the form when I pick him up. Okay. Thanks for calling! Bye!"

Ah, the life of a working mom of asthmatic kids. Don't you wish you were me?

Pulmo Tomorrow

Supermom is taking her three monkeys to the pediatric pulmonologist - single-handedly! - after work tomorrow.

Wish me luck!!!

...anyone feel like placing bets on the prescriptions I leave with? Do I hear two Flovents? Three? 44 or 110? Any 220s? How about Xopenex? Do I hear a Xopenex...?

Ozzy Coughing

Quick note: Oz was coughing this morning, so I gave him some albuterol. Hopefully, we can head this off.

B looked puffy and said his nose felt funny...guess I'll be keeping an eye on that two. Sounds sinus-related to me.

All this on the day Rob starts a new job in NYC - an hour commute each way. Once again, he's out the door before the kids are out of bed, so the mornings are all on Mom.

Sigh.

Avon Walk for Breast Cancer

Because we all know someone who has (or had) breast cancer, I'm doing the Avon Walk to raise much-needed funds to combat this evil disease and to help those who are already fighting it.

Please support me! I need to raise $1800 to walk, but I'd like to raise a whole lot more.

I know I've already got asthma and autism to worry about in my world, but I had my first breast cancer scare this year (I'm fine) and it made me think of all the moms out there who are dealing with this illness while trying to raise their kids to be healthy and strong -- and of all the moms who lost their battles. I want to save those moms!!!

Thanks for your help!

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

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

CPSC, Tiffany and Company Announce Recall of Farm Teether Rattles

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

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

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

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

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

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

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

Manufactured In: United States

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

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

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

Only in America, folks. Only in America.

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

Albuterol Test, part deux

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

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

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

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

Iggy's Sick

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

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

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

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

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

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

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

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

Happy Birthday, B!

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

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

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

Happy Birthday, B! I love you!!

Albuterol Test Results

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

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

The Albuterol Test.. and Yea, ME!

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

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

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

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

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

Duh.

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

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

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

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

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

Adopt the Sky

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