asthma symptoms 2011: Aralık 2010

31 Aralık 2010 Cuma

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.

infertility |chemotherapy |naturopathic medicine |childhood asthma symptoms |asthma info |

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...?

lung cancer |chemotherapy |treating asthma |asthma in infants |pediatric asthma medications |

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?

infertility |asthma treatments |over the counter asthma medicine |asthma information |information about asthma |

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.

allergy relief |occupational asthma |asthma natural |arthritis |information on asthma |

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.

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?

asthma natural |allergy induced asthma |copd symptoms |arthritis |over the counter asthma medication |

'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!)

asthma natural |asthma control test |baby asthma |new asthma treatment |skin allergies |

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.

depression |allergic asthma |allergy asthma |allergy medication |treatments for asthma |

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.

seasonal allergies |emphysema |migraine |food allergies |asthma help |

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.

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!)

lung cancer |pediatric asthma medications |sleep apnea |child asthma |pediatric asthma |

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!

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!

new asthma medications |allergy treatment |asthma education |occupational asthma |allergy symptoms |

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!

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?

treating asthma |allergies |asthma medications |asthma wheezing |allergy asthma |

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 asthmasymptoms2011.blogspot.com/" title="asthma children">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.

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Quick Note: Ig's Pneumonia

Just a quick update: Ig developed pneumonia the day we left Canada for home. (We go to Canada for the holidays every year - in-laws are in Ontario.)

He's fine - didn't even need any nebs. Never mind that his fever hit 104.8 on New Year's Day!

Isn't it ironic? The kid who spent his first day of life in respiratory distress in the NICU is the kid with the strongest lungs! Fever started Thursday, and he'll be back in preschool tomorrow.

For the record, I believe this is pneumonia #6 for the mama.

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And the pneumonia just keeps on comin'!

Update -

Sent Oz back to school yesterday. He'd been fine all weekend, and practically bouncing of the walls. He couldn't wait to get out!

When he came home, he immediately lay down on the sofa and fell asleep.

That is NOT like my Oz.

When I checked, he was running 100.8 and complaining of pain in his chest and a headache.

I put him to bed early, but he woke up shortly after crying hysterically - he was completely incomprehensible. Then he threw up all over my bed. Then he fell asleep again.

Next time he woke up, not an hour later, the screaming resumed. He was in pain, scared - I don't even know what. I started to warm up the car so I could take him to the ER. But by the time I came back in, he was asleep again.

I'd spoken to the doctor twice by this time. She warned me that it could either be an effusion or a mucus plug. (eeeeuwwww.)

He made it through the night after that. He was laboring to breathe a bit, but his respiratory rate was OK.

This morning, we had to go back to the doctor, of course. And of course, we were sent for another chest X-ray.

The results? The Zithromax he'd been taking wasn't working. The pneumonia had actually gotten worse! WTF??!!!

So... while it may actually be a viral pneumonia, we're starting Omnicef tonight.

Wish us luck. We're back to the pulmonologist next week.

mold allergy |herpes |skin allergies |wheezing |information on asthma |

Mom's Peak Flow Meter

OK, so I got my peak flow meter today.

Here are my benchmarks:

I should be around 471 if I'm healthy, according the chart that came with the meter. (It's a PDF)

I'm blowing about 400 right now. Would we make that....yellow?

Admittedly, I was still questioning whether this asthma or chronic post nasal drip (I *love* denial! And I never had reason to believe that I was asthmatic) but I guess daily peak flow tests will make me a believer.

If I'm anywhere near 465 two weeks from now, I'll buy into the diagnosis.

Meanwhile, I'll try to remember to post my scores every day.

allergy medicine |pediatric asthma medications |copd treatment |new asthma treatment |allergy shots |

Update on Mom's Asthma

Two quick things:

First of all, I doubled my Asmanex dose, so now I'm doing two puffs in the AM and in the PM.Within 48 hours of dose-doubling, my cough pretty much stopped completely - despite the fact that I seem to have a head cold. Pretty impressive. Still need albuterol from time to time (like right now, in fact), but sooooo much better!
Secondly, I found this article on cough-variant asthma, and it's seems 100% like what I've got. Cold air and strong smells are definitely among my biggest triggers, and I don't think I've ever wheezed.

The timing for the sudden improvement is pretty fortuitous. I have a singing gig every Friday night in March, and I was in no shape to perform. The big concern: My accompanist has about 5,000 cats, and his whole house does kinda reek of cat pee. Should make for a fun rehearsal. I'll definitely bring the MDI!

eye allergies |asthma supplies |asthma meds |asthma symptoms |asthma symptoms in children |

Mom's Asthma - Symbicort

Another quickie update -

While the Asmanex did stop the coughing, mostly, I had a heavy feeling in my chest and just didn't feel well overall. I almost felt like there was a wet sponge wedged under my sternum, and it sort of pulsated or spasmed before I started coughing. Ick.

I called the doctor's office when I ran out of the Asmanex, and told them I wasn't feeling that much better. They gave me a sample of Symbicort, which I've been on before.

It's only been a few days, and while I'm coughing a bit more, I feel SO much better overall.The only downside is that I keep losing my voice.

For other people, this might not be a big deal but (surprise!) I sing professionally and am booked every Friday this month. I had to cancel last week, because I couldn't get through two songs, and I'm supposed to sing four. During rehearsal, I was so winded after my first number, I could barely get through the less challenging second song. Singing, after all, does rely heavily on breath support.

When I asked the doctor about the laryngitis - which seemed to occur after every presentation I gave, or any time I spoke for 10 minutes at a time or longer - he said it was probably from the Symbicort. So, in addition to rinsing my mouth after taking the stuff (which you should do after taking ANY inhaled steroid), I am now gargling. It's very feminine and appealing, I assure you.

So...hopefully we're on the right path now. I'm looking forward to feeling better soon!

asthma disease |asthma control test |asthma in infants |copd |emphysema |

Please don't let it be pneumonia. Please don't let it be pneumonia. Please...

Home with the two younger boys today. Ig started coughing over the weekend, started running low-grade on Sunday. He's 99.3 now, but his cough is awful. He has to draw in a huge, narrow breath, and then he lets out this long spell of deep, resonant, slightly muffled-sounding coughs. He only weighs about 40 pounds, so they seem to take over his entire little body.

Oz had his usual dry, asthma for a few days, and we were giving him albuterol, but yesterday he really needed a neb before school. At 1:30, he was sent home from school. His teacher said he hadn't been himself all day - too quiet, low on energy. When the nurse called for us to pick him up, she said he was running about 99.

He needed a neb the second he got home, and he was running 99.9. Overnight, he was coughing his head off, of course, and I had to give him albuterol and ibuprofen overnight. He was over 102 at 5:30 this AM.

Ig was up a lot overnight, too. I gave him Dimetapp.

This morning, Oz's cough was soooo bad. I gave him a neb of Xopenex, but less than an hour later his was still coughing violently, so I gave him another neb - DuoNeb this time. The DuoNeb has alwasy worked well for us, but it really hasn't slowed the coughing today.

The sound of the cough is different since that neb - it sounds more resonant. Maybe it's loosened up a bit? I can't say for sure, but it sounds AWFUL. And he's still coughing til he gags, pretty much.

This is NOT going to be a fun day. This seems so similar to what we went through in January with the pneumonias - I'm just praying this isn't the same thing!

I'm calling the doctor as soon as they open at 8:30 ET. I'll let you know how it goes.

toddler asthma symptoms |pediatric asthma guidelines |infant asthma symptoms |allergic asthma |lung cancer |

Kids' Diagnosis and Note on ProAir

We saw my *least* fave pediatrician in the group. She diagnosed both boys with sinus infections, and said their lungs were clear. She said it might be viral, but she wanted to start antibiotics anyway.

I'm going to wait 24 hours before starting.

I'm also going to take Oz to the pulmonologist.

I don't believe in taking antibiotics for everything. If you're not SURE it's bacterial, why do antibiotics? Why risk developing resistance? Although I'd hate to put Oz at risk for another pneumonia...Would I be doing that? And Ig seems to be completely on the mend already. Thoughts?

I did show her our barely functioning ProAir inhaler, too. She said they know it's an issue, and they've got calls into the manufacturer. She said to insist on either Ventolin or Proventil next time, although I'd be just as happy with the Warwick generic. But glad I said something.

I wonder if I can return the two ProAir MDIs I have for another brand...?

****
Update: Went to the pulmonologist, who sent us for a chest X-ray. It was clear! Looks like we're definitely sinus infection/ asthma flare. The PP wants us to start the Biaxin, so I guess we will.

otc asthma medication |living with asthma |asthma in toddlers |asthma control |wheezing |

Mom's Asthma: Question for you guys

Hi, all -

As I enter my first full season as a newly-diagnosed asthmatic, I have a few questions for you. As you know, I took myself off Symbicort this spring - I just felt ill from that stuff. I intend to find a new pulmonologist soon and look at some different meds.

Anyway, this past week, everyone in my office, on the bus, apparently in most of lower Manhattan, has had a violent, horrible-sounding cough. Seriously, I thought my boss was going to break a rib in the office, the way he was coughing.

Yesterday, when I woke up, I felt run down and a little "fluffy-headed." I had a very slight fever. I'd been feeling a little tightness in my chest the day before, but not enough to make me think this was asthma-related.

Today I have the same feelings...fatigue, a little tightness, but no fever. Is this the start of a flare? What should I be doing?

Thanks for your tips!

PS - the kids have been doing well. B's had some bad allergies, but no major flares. Oz has been doing really well...but I'm terrified that I've caught whatever horrible illness the folks around me at work have, and that one of the boys (Oz, particularly) will end up in the ER again.

They're all getting flu shots in the morning!

emphysema |allergy and asthma specialists |asthma medicines |allergy asthma symptoms |allergic asthma |

30 Aralık 2010 Perşembe

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.

allergy medicine |otc asthma medication |antihistamine |asthma research |asthma natural |

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.

'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!)

asthma in toddlers |copd symptoms |information on asthma |asthma meds |asthma natural |

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.

childhood asthma |asthma nebulizer |allergies |allergy asthma |new asthma treatment |

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?

lung cancer |asthma wheezing |infertility |asthma in toddlers |childhood asthma symptoms |

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.

information about asthma |asthma meds |asthma disease |asthma medicines |asthma nebulizer |

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.

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.

allergic asthma |copd definition |herpes |seasonal asthma |asthma medications |

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....

new asthma medications |asthma supplies |asthma air purifier |asthma meds |wheezing |

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

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.

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!)

emphysema |naturopathic medicine |allergies |chemotherapy |occupational asthma |

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?

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!

allergy asthma |asthma information |asthma |allergy and asthma specialists |toddler asthma symptoms |

Utter Madness - But We're All OK

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!

31 Aralık 2010 Cuma

30 Aralık 2010 Perşembe

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