I just got off the phone with Pat, the head nurse for our pulmonologist. As I was talking to her, it occured to me -- Bryn (thank goodness) hasn't really been sick since he had pneumonia this winter. I haven't had to treat a serious attack since then.
But since the winter, he's become a different boy. Suddenly, he can articulate his thoughts and feelings (to some extent, anyway), he's potty-trained, he's just more mature.
So a lot of the signs I associate with his attacks aren't necessarily valid anymore. He may not open and close doors the way he used to. He never did wheeze. He may not even act as cranky as he did with previous attacks. So how will I know when an attack is brewing?
Pat recommends plotting things on a calendar: he was pale today; he coughed three times; he didn't eat; he was cranky. Next day: Ate breakfast; cranky before bed; coughed once.
Etc., Etc.
Not a bad idea. It does all sort of go mish-mashy in my brain after a while. I know he's had mild cold symptoms since last Wednesday, but was he cranky? I remember that he barely ate all weekend, but I can't remember how his cough sounded.
So...plotting it on a calendar seems the way to go. Guess I'll have to start acting a little more "Type A" now.
Thursday, August 26, 2004
Tuesday, August 24, 2004
More specifically...
Check out this article on how stupid parents like me waste money on pointless attempts to relieve our kids' asthma: http://www.healthdiaries.com/2004/08/nose-cream-for-allergies-parents.htm
What's a Buteyko?
Check this out: http://asthmajournal.blogspot.com/.
Apparently, there are these breathing exercises you can do that seem to strengthen the lungs and bronchial system. Pretty wild.
I won't be taking Bryn off his steroids in favor of this -- yet! Until he can tell me how he's feeling and/or use a peak flow meter so we can actually see how well he's breathing, we'll probably keep him where he is. After all, he's been doing pretty well on the reduced dosage of Flovent.
Maybe we'll even be able to take him off it next summer. Keep your fingers crossed.
Apparently, there are these breathing exercises you can do that seem to strengthen the lungs and bronchial system. Pretty wild.
I won't be taking Bryn off his steroids in favor of this -- yet! Until he can tell me how he's feeling and/or use a peak flow meter so we can actually see how well he's breathing, we'll probably keep him where he is. After all, he's been doing pretty well on the reduced dosage of Flovent.
Maybe we'll even be able to take him off it next summer. Keep your fingers crossed.
Friday, August 20, 2004
This is so sad...
...and so frightening: Tragedy: Asthma Kills Girl, 12
I didn't think I'd see stories like this. I have a million questions: Was she in treatment? Did they try a rescue inhaler? Did she have allergies, as well, or was her asthma triggered by viruses? Or aerosols?
Obviously, it doesn't get worse than this. My heart goes out to that poor girl's family.
I didn't think I'd see stories like this. I have a million questions: Was she in treatment? Did they try a rescue inhaler? Did she have allergies, as well, or was her asthma triggered by viruses? Or aerosols?
Obviously, it doesn't get worse than this. My heart goes out to that poor girl's family.
Tuesday, August 17, 2004
Arrrggh! Stale again!
Good God! I've let this thing sit again! Bad blogger. Bad, Bad, Bad!
In truth, no news is good news. If I'm not posting, you can pretty safely assume that asthma issues are the furthest thing from my mind.
Which means there's a healthy, happy three-year-old boy running riot somewhere in New Jersey.
In truth, no news is good news. If I'm not posting, you can pretty safely assume that asthma issues are the furthest thing from my mind.
Which means there's a healthy, happy three-year-old boy running riot somewhere in New Jersey.
Wednesday, August 04, 2004
But wait -- there's more!
My RSV theory is confirmed in that article I just linked to. Look:
A major branch of the study has shown that children with a small difference in their lungs caused by something before or just after birth makes them more susceptible to asthma.
Dr. Martinez has found that children that develop respiratory infections such as bronchialitis and pneumonia at a very young age or before birth started life with lungs that were different, and they are predisposed to develop asthma.
He said that if mothers smoke or the child is born prematurely, they are at a greater risk of developing these infections. Preventing these infections early in life is easier than trying to erase the asthma.
So it WAS the RSV, most likely. In most other kids, it would have just presented as a cold. But for some reason, although he wasn't born prematurely, Bryn was susceptible to bronchial ailments. (He'd had a mishandled bronchiolitis just after his first birthday.)
Right. More research to be done, Mama.
A major branch of the study has shown that children with a small difference in their lungs caused by something before or just after birth makes them more susceptible to asthma.
Dr. Martinez has found that children that develop respiratory infections such as bronchialitis and pneumonia at a very young age or before birth started life with lungs that were different, and they are predisposed to develop asthma.
He said that if mothers smoke or the child is born prematurely, they are at a greater risk of developing these infections. Preventing these infections early in life is easier than trying to erase the asthma.
So it WAS the RSV, most likely. In most other kids, it would have just presented as a cold. But for some reason, although he wasn't born prematurely, Bryn was susceptible to bronchial ailments. (He'd had a mishandled bronchiolitis just after his first birthday.)
Right. More research to be done, Mama.
I'm right AGAIN
Somehow, it's made the news again today that kids *usually* don't outgrow asthma --
http://wildcat.arizona.edu/papers/97/159/01_2.html
...but we already knew that, didn't we?
http://wildcat.arizona.edu/papers/97/159/01_2.html
...but we already knew that, didn't we?
Thursday, July 15, 2004
Told ya so...
Asthma Needs Right Treatment
...and here's my thought on this: not only must you have a great relationship with your doctor, you also have to read everything. You can't only trust your doctor - s/he's not going to know everything. Take responsibility for taking care of yourself and/or your child and your treatment.
...and here's my thought on this: not only must you have a great relationship with your doctor, you also have to read everything. You can't only trust your doctor - s/he's not going to know everything. Take responsibility for taking care of yourself and/or your child and your treatment.
Here's today's biggie...
The Asthma-Obesity Connection
Could Link Explain Why Some Kids Don't Outgrow Asthma as Previously Believed?
Could Link Explain Why Some Kids Don't Outgrow Asthma as Previously Believed?
Monday, July 12, 2004
Glad it works on mice, but....
Singapore scientists develop asthma vaccine
Gotta hear Allison's comments on this one. (For those of you visiting, Allison is my best friend and a Chiropractor -- therefore, notoriously anti-vaccine. But considering her love for Bryn, her thoughts on the subject will be pretty intriguing!)
My thoughts -- can we test it on something larger than a mouse before hailing it as a cure? (Although the thought of animal testing turns my stomach...)
And: Using a dust mite gene? How does that affect kids like Bryn who developed asthma after two bouts of bronchiolitis? His asthma isn't necessarily dust or allergy related.
Do we need a more comprehensive definition of asthma here?
Gotta hear Allison's comments on this one. (For those of you visiting, Allison is my best friend and a Chiropractor -- therefore, notoriously anti-vaccine. But considering her love for Bryn, her thoughts on the subject will be pretty intriguing!)
My thoughts -- can we test it on something larger than a mouse before hailing it as a cure? (Although the thought of animal testing turns my stomach...)
And: Using a dust mite gene? How does that affect kids like Bryn who developed asthma after two bouts of bronchiolitis? His asthma isn't necessarily dust or allergy related.
Do we need a more comprehensive definition of asthma here?
Hah!!!
Asthma Often Does Not Go Away as Kids Get Older
I know everyone just thinks I'm being horribly negative when I say, "Actually, he probably won't outgrow his asthma..." but see? See? It's true!!!
Our pulmonologist has told me this a thousand times, and even my own husband doesn't believe it. The truth is, when you have a "tricky" respiratory system, it just stays tricky. But treating asthma aggressively within the first few years of diagnosis can really help the resp sys grow healthier over time. Which means that Bryn probably won't be on Flovent forever. By the time he's a teenager, he'll probably just need to carry Albuterol around, "just in case."
So while this headline isn't the best news in the world -- I would rather have seen a headline saying, "Asthma DOES Go Away as Kids Get Older" -- it's nice to have some substantiation for my comments.
I know everyone just thinks I'm being horribly negative when I say, "Actually, he probably won't outgrow his asthma..." but see? See? It's true!!!
Our pulmonologist has told me this a thousand times, and even my own husband doesn't believe it. The truth is, when you have a "tricky" respiratory system, it just stays tricky. But treating asthma aggressively within the first few years of diagnosis can really help the resp sys grow healthier over time. Which means that Bryn probably won't be on Flovent forever. By the time he's a teenager, he'll probably just need to carry Albuterol around, "just in case."
So while this headline isn't the best news in the world -- I would rather have seen a headline saying, "Asthma DOES Go Away as Kids Get Older" -- it's nice to have some substantiation for my comments.
Thursday, July 08, 2004
Bad, bad blogger!
A full week gone by, and not a single post! Blame it on the holiday...
News for today, we're lowering Bryn's Flovent dose to 1 puff of 220, twice a day. That's half his usual dose.
We tried this last month, and he developed a cough within a week. Hopefully, we'll have better luck this time.
I'll post some *real* news tomorrow...
News for today, we're lowering Bryn's Flovent dose to 1 puff of 220, twice a day. That's half his usual dose.
We tried this last month, and he developed a cough within a week. Hopefully, we'll have better luck this time.
I'll post some *real* news tomorrow...
Thursday, July 01, 2004
Big Duhs for the Day
Child Asthma Link to Passive Smoking
Study: RSV can increase risk of asthma
Study Links Gas Fumes and Incidence of Asthma Attacks
And this is news. Glad I'm on vacation.
Study: RSV can increase risk of asthma
Study Links Gas Fumes and Incidence of Asthma Attacks
And this is news. Glad I'm on vacation.
Sunday, June 27, 2004
The culture of daycare -- my newest scapegoat!
Just a thought -- I was going to dig a little into RSV as a possible cause of the Asthma outbreak. I mean, what the hell is RSV, anyway? Where was it when WE were kids? Was it just called "pneumonia" or "bronchitis" or "chest cold" then? Is it a new virus, or just a newly analyzed-and-renamed virus?
...but then it occurs to me that its this new culture of sticking your kids in daycare at 6 weeks of age that's probably to blame. (Yes, I know about the Australian study that showed lower incidence of asthma in daycare kids. But, hello, that's the other side of the freaking planet from here!)
Seriously, babies are meant to be with their mothers (or fathers)for the first few years. I'm a total feminist, but I absolutely believe that's true. They should be home -- not in virtual petrie dishes brimming with bacteria from other kids' snot. That's probably why so many kids are getting RSV (which, most of the time, presents like a cold) and why so many are, consequently, developing asthma.
Think about it -- most of us parents didn't leave home without our folks until age 3 or 4 for nursery school. How many of us have asthma? I knew one kid. That's it. Heck, I hadn't even heard of a nebulizer until my son got RSV.
Okay -- so that's it. I'm crucifying American culture now. It's not the daycare centers. It's US for creating the demand for them.
...but then it occurs to me that its this new culture of sticking your kids in daycare at 6 weeks of age that's probably to blame. (Yes, I know about the Australian study that showed lower incidence of asthma in daycare kids. But, hello, that's the other side of the freaking planet from here!)
Seriously, babies are meant to be with their mothers (or fathers)for the first few years. I'm a total feminist, but I absolutely believe that's true. They should be home -- not in virtual petrie dishes brimming with bacteria from other kids' snot. That's probably why so many kids are getting RSV (which, most of the time, presents like a cold) and why so many are, consequently, developing asthma.
Think about it -- most of us parents didn't leave home without our folks until age 3 or 4 for nursery school. How many of us have asthma? I knew one kid. That's it. Heck, I hadn't even heard of a nebulizer until my son got RSV.
Okay -- so that's it. I'm crucifying American culture now. It's not the daycare centers. It's US for creating the demand for them.
How does this explain the epidemic? (Today's Asthma News)
Asthma Emerging as Genetic Disorder
I'll skip the first few paragraphs, which outline the general background info -- asthma responsible for 14 million missed school days, growing epidemic, yada, yada, yada.
Here's the meat-and-potatoes (or TVP and cous-cous, in my case!):
Dr. Deborah Gentile, an asthma specialist at Allegheny General Hospital, in Pittsburgh, said immunologists are increasingly coming to understand asthma as a genetic disorder -- at least, in its beginnings. "We're thinking that there are different types of asthma driven by different genes."
A child with one parent who has asthma has a 30 percent chance of developing the airway condition herself. If both parents have it, her odds of getting it approach 70 percent -- not a given but a stacked deck.
Gentile said there are three factors that contribute to a person's risk of asthma. The first is the genetic legacy from parents; the second is exposure to infections and irritants that "program" the immune system and make it sensitive. The third is timing: It seems that the immune system is particularly sensitive during the first two years of life, Gentile said, so children with the right combination of genes and the right mix of exposures early in life are at the greatest risk of developing asthma.
skipping irrelevant stuff...."It's important to distinguish exposures that cause asthma versus those that exacerbate existing asthma," Camargo said. "Although these are, at times, the same, there are also factors that worsen existing asthma but are unlikely to cause disease," such as strong odors like perfumes, he said.
And you can find the whole article here: http://www.healthcentral.com/news/NewsFullText.cfm?id=519749
My thoughts: If I'm understanding the research correctly, this reinforces the theory that the bronchiolitis and RSV Bryn had suffered by 18 months probably DID cause his asthma -- in conjunction with his dad's history of severe allergies.
What it doesn't explain in the least is why asthma is reaching epidemic proportions...
I'll skip the first few paragraphs, which outline the general background info -- asthma responsible for 14 million missed school days, growing epidemic, yada, yada, yada.
Here's the meat-and-potatoes (or TVP and cous-cous, in my case!):
Dr. Deborah Gentile, an asthma specialist at Allegheny General Hospital, in Pittsburgh, said immunologists are increasingly coming to understand asthma as a genetic disorder -- at least, in its beginnings. "We're thinking that there are different types of asthma driven by different genes."
A child with one parent who has asthma has a 30 percent chance of developing the airway condition herself. If both parents have it, her odds of getting it approach 70 percent -- not a given but a stacked deck.
Gentile said there are three factors that contribute to a person's risk of asthma. The first is the genetic legacy from parents; the second is exposure to infections and irritants that "program" the immune system and make it sensitive. The third is timing: It seems that the immune system is particularly sensitive during the first two years of life, Gentile said, so children with the right combination of genes and the right mix of exposures early in life are at the greatest risk of developing asthma.
skipping irrelevant stuff...."It's important to distinguish exposures that cause asthma versus those that exacerbate existing asthma," Camargo said. "Although these are, at times, the same, there are also factors that worsen existing asthma but are unlikely to cause disease," such as strong odors like perfumes, he said.
And you can find the whole article here: http://www.healthcentral.com/news/NewsFullText.cfm?id=519749
My thoughts: If I'm understanding the research correctly, this reinforces the theory that the bronchiolitis and RSV Bryn had suffered by 18 months probably DID cause his asthma -- in conjunction with his dad's history of severe allergies.
What it doesn't explain in the least is why asthma is reaching epidemic proportions...
Thursday, June 24, 2004
This one's for Allison --
Oh, Al, PLEASE post a comment after reading this. It's going to piss you off so profoundly, you'll be shooting steam out of your ears for DAYS!!
A thought on pediatricians --
Anyone who knows me personally has heard me say this:
There have been days when I've taken Bryn to his regular pediatrician, she's listened to his chest and back and told me he sounds fine.
The same afternoon, I'll take the boy to his pulmonologist, she'll listen to him, and she'll tell me that he's *not* moving air well, and put him on either Duoneb or Orapred.
She tells me that there are subtleties to pediatric asthma that you have to really be trained to here. I've heard this from respiratory therapists in the Peds ER, too.
So, while I love, love, love our pediatrician, when it comes to Bryn's breathing, I always call the pulmonologist first.
After reading the "Camp Super Lungs" article, I wonder how many people just trust their pediatricians and *never* see a pulmonologist. Case in point: the kids photographed for the article, a brother and sister, are, well, pretty darned overweight. While I know this can happen when you spend a lot of time on steroids, obesity is probably a little bit of a hindrance when you're already having a hard time breathing. I imagine there are plenty of parents out there who are scared to let their kids run around if they're asthmatic -- but you should probably find out if that's one of your kid's triggers before condemning them to life as a couch potato. (I'm NOT saying that's the case with the kids in the photo.)
Another example -- we have friends whose pediatrician put their kid on Flovent, but only when he's having an attack. Now, I could be wrong, but I'm pretty sure inhaled corticosteroids are intended for LONG term use. I mean, do they even work in the short term? Our doc recently said something along the lines of, "a year of Flovent is like 5 days of Orapred." So I can't see that short-term use of Flovent does much good.
...So my thought to all the pediatricians out there: If you think a young patient of yours has asthma, PLEASE -- send them to a pulmonologist! I'm sure most insurance companies would cover a few visits.
There have been days when I've taken Bryn to his regular pediatrician, she's listened to his chest and back and told me he sounds fine.
The same afternoon, I'll take the boy to his pulmonologist, she'll listen to him, and she'll tell me that he's *not* moving air well, and put him on either Duoneb or Orapred.
She tells me that there are subtleties to pediatric asthma that you have to really be trained to here. I've heard this from respiratory therapists in the Peds ER, too.
So, while I love, love, love our pediatrician, when it comes to Bryn's breathing, I always call the pulmonologist first.
After reading the "Camp Super Lungs" article, I wonder how many people just trust their pediatricians and *never* see a pulmonologist. Case in point: the kids photographed for the article, a brother and sister, are, well, pretty darned overweight. While I know this can happen when you spend a lot of time on steroids, obesity is probably a little bit of a hindrance when you're already having a hard time breathing. I imagine there are plenty of parents out there who are scared to let their kids run around if they're asthmatic -- but you should probably find out if that's one of your kid's triggers before condemning them to life as a couch potato. (I'm NOT saying that's the case with the kids in the photo.)
Another example -- we have friends whose pediatrician put their kid on Flovent, but only when he's having an attack. Now, I could be wrong, but I'm pretty sure inhaled corticosteroids are intended for LONG term use. I mean, do they even work in the short term? Our doc recently said something along the lines of, "a year of Flovent is like 5 days of Orapred." So I can't see that short-term use of Flovent does much good.
...So my thought to all the pediatricians out there: If you think a young patient of yours has asthma, PLEASE -- send them to a pulmonologist! I'm sure most insurance companies would cover a few visits.
Camp Super Lungs
Here's the headline: "Asthma camp teaches kids to manage illness." And it's called Camp Super Lungs. I'm kind of torn between wanting to send Bryn and being moderately disgusted by the whole idea of it.
The camp is sponsored by Summit Health, and it's intended to teach kids about their asthma. But I mean, if you have serious enough asthma to actually go to camp for it, shouldn't you also have a doctor who educates and supports you and your family?
The camp is sponsored by Summit Health, and it's intended to teach kids about their asthma. But I mean, if you have serious enough asthma to actually go to camp for it, shouldn't you also have a doctor who educates and supports you and your family?
Wednesday, June 23, 2004
Actually, it appears I *will* be ranting after all...
Check this out: Asthma drug may boost risk of deadly asthma attacks
That's the headline for another one of today's stories. "One of the most commonly prescribed medicines to treat America's 16 million asthmatics may actually make asthma worse and contribute to heart problems, two studies find."
When I first read this, I was (as you can imagine) a little upset. But then I read on: "Salpeter and her team reviewed studies conducted from 1966 to 2003 of asthmatics taking beta-agonists. They found that patients who took the drug daily developed a tolerance and had more inflammation in their lungs than those not taking the drug at all, making them more susceptible to a potentially deadly attack."
...which led me to ask, why would any asthmatic take Albuterol every day? Isn't it just for treatment during an attack? That's how it's been prescribed to us.
And then I remembered: Advair. The wonder drug that toddlers cannot take because it doesn't work with a spacer. Advair is a combination of Serevent (fast-acting bronchiodialator) and Flovent (corticosteroid).
So if you're taking Advair every day -- and you would do -- I'm guessing that you may be doing more harm than good? I haven't found any articles specifically implicating Advair, but, hey, this is just today's news.
That might be fodder for tomorrow's post.
That's the headline for another one of today's stories. "One of the most commonly prescribed medicines to treat America's 16 million asthmatics may actually make asthma worse and contribute to heart problems, two studies find."
When I first read this, I was (as you can imagine) a little upset. But then I read on: "Salpeter and her team reviewed studies conducted from 1966 to 2003 of asthmatics taking beta-agonists. They found that patients who took the drug daily developed a tolerance and had more inflammation in their lungs than those not taking the drug at all, making them more susceptible to a potentially deadly attack."
...which led me to ask, why would any asthmatic take Albuterol every day? Isn't it just for treatment during an attack? That's how it's been prescribed to us.
And then I remembered: Advair. The wonder drug that toddlers cannot take because it doesn't work with a spacer. Advair is a combination of Serevent (fast-acting bronchiodialator) and Flovent (corticosteroid).
So if you're taking Advair every day -- and you would do -- I'm guessing that you may be doing more harm than good? I haven't found any articles specifically implicating Advair, but, hey, this is just today's news.
That might be fodder for tomorrow's post.
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