Conference moira::parenting

    
    
    Here we go again...
    
    My 2 1/2 year old goes through weeks of sleepless nights where it seems
    that she has a hard time breathing.  I have suspected all along that
    she has allergies, as it gets bad for weeks at a time.  She is fine
    during the day and shows no signs of cold or sickness.  However at
    night she moans and is very restless.  
    
    In the past we have given her doses of Sudafed during the night, which 
    seems to help a little bit.  However, last night we gave her some
    Benedryl, which didn't seem to help at all!  We ended up bringing her
    into our bed, since she shares a room with her sister and was waking
    her too.  Needless to say, I didn't get any sleep since she was crying
    and kicking me most of the night.
    
    We ask her what the problem is but she just moans and cries.  However,
    you can hear that she is having a hard time breathing, and when she
    finally falls asleep her mouth closes and she wakes up crying.  I am
    not ready to go through several weeks of this again...so I am going to
    talk to her doctor.  Has anyone experienced this with their kids?  What
    did you do to help them?
    
    Carol 

    
    
    	*Sounds* like it could be asthma. I know that when I'm having an
    asthma attack, lying down sometimes makes it worse and without
    medication, I have a horrible time sleeping (I've even awaken from
    dreams thinking that I was being sufficated when in actuality I was not
    getting eonough air because of the asthma.) There are times when my
    asthma acts up more then other times but on the other hand, I can 
    go months without having any asthma symptoms at all.
    
    	To check for asthma, you must go to a Doctor who will measure lung
    capacity using an instrument that you blow into, they will also listen
    to the noises you make when you breath (does your daughter "wheeze" at
    night?). Doses of the proper medication for asthma almost seems like a
    miracle cure, it works that quickly. (I was recently in urgent care
    for a bronchitis induced asthma attack and although I arrived in the
    office feeling like I could not get a gasp of air, I left feeling
    immensely better, they gave me treatment (vaporized medication) right
    there and it really made a difference - I ended up needing the
    medication for about 5 days and then it all went away and I haven't
    used it since).
    
    			Wendy
                                                                          

    
     If she has blanket on her bed put a quilt on it,She could be allergic
    to dust mites or to dust it's self.My mother had a hell of a time
    trying to keep our house as dust free as posaable as I was allergic to
    both.Two "old house wife"treatments are,1 to put mustard in a bason of
    steaming water and put a towel over her head and breath in the fumes.
    Another is a mouth full of treacle.Both worked for me.
    
    SCott

    
    I too have more of a problem with my asthma at night...
    
    Worth checking out...
    
    
    Chris
    

     Thought of this once I got home last night..don't have a feather quilt
    or pillow as the dust content will really irritate there lungs.
    
    
      SCott

    re: .26
    
    It sounds like your daughter may have allergy induced asthma.  My
    daughter has it too.  There are a number of things that can help and
    hurt.  We were told that decongestants and anti-histamines can actually
    worsten the condition.  We have a machine called a nebulizer which can
    be used when the breathing gets difficult.  This machine is actually
    just a small compressor which forces air through a tube into a small
    cup-like-thing (technical term!!!).  Inside this cup is a combination
    of PROVENTIL and INTAL.  The Proventil is a bronchial dilator which is
    used to prevent wheezing.  (I don't recall details about the Intal. 
    I'll look them up tonight and reply again.)  The air through the
    medication resulting in a fine mist which is inhaled using either a
    breathing mask or a mouth tube.  This method brings the medication
    right to the problem area.  
    
    Proventil is also available as a syrup which can be taken when wheezing
    begins.
    
    Dan

My son, Brad, has a fairly severe case of BPD (premature lung disease), and
just got a nebulizer last week because he keeps getting a wheeze.  According
to the doctor, they tend to treat BPD and other lung problems like asthma. 
To expand on what the previous noter said, the INTAL stimulates the cells in
the lungs that produce the hormones to stop the wheeze.  Brad is on a 
maintenance program where he gets nebulized with INTAL twice a day to prevent
the wheeze from coming back, and to help his lungs to mature and develop.  He
was also on the PREVENTIL in the nebulizer, but that was just until the 
wheezing stopped.  He has previously been on the PREVENTIL syrup also.

One thing you should know about the PREVENTIL if you end up needing to use it
is that it makes the kid crazy.  Brad goes from a normally laid-back kind of
guy to climbing the walls.  He gets irritable and cranky which I guess is a
very common side effect to this particular drug.

    
    Thanks for the suggestions.  I was going to take her to the doctor
    today if she had another bad night, but last night she actually slept a
    little.  She woke up moaning a couple of times, but nothing like the
    previous nights.  It also did not seem as humid last night as the
    previous nights, thus she could probably breathe easier.
    
    I will take her to the doctors this week though and have her checked. 
    The fact that it comes and goes sounds like it may be asthma.  Is it
    true that asthma is worse during certain weather conditions, like humid
    rainy days (like we just had)?  Also I have noticed that she gets very
    tired and red in the face after exerting herself lately.  On Monday she
    was running around with a bunch of kids, and she got real red in the
    face.  As soon as the kids left, she asked to take a nap (before she
    even had lunch)...very unusual for this 2 1/2 year old!!  I hope it is
    just the heat and fact that she is running around so much, but the
    other kids didn't look as hot and tired as she did.
    
    Regarding the Preventil, if it wires the kids, what do you use if they
    have a hard time sleeping?
    
    Carol

    	I grew up in a family of severe asthmatics (I didn't show any signs
    until I was 25). I do have memories of my sisters always being rushed
    to the emergency rooms and being administered oxygen and medication. 

    	Times have really changed since then and asthma in children is far
    more manageable. As asthma also runs on my husband's side we are
    constantly on the lookout for asthma symptoms in our 9 month old.                              

    	To answer some of your questions:

    	Yes, Yes, Yes, weather conditions most definitely affect asthma
    especially high humidity and extreme cold weather. Sometimes
    airconditioning may help when it is very humid.

    	Yes, asthma can come and go (which is why your daughter may have
    had a better night last night)

    	Yes, what you described with her activity could be something called
    "exercise-induced asthma" when you turn red, it means that your body is
    in the first stages of oxygen deprivation (blue is obviously the last
    stage).

    	Although Ventolin (or Proventil) tends to wire you up, the effect
    does decrease over time (time being several doses) and doses can be
    decreased to get the most efficient and comfortable levels.

    	I'm glad that you are taking her to see a Doctor, although asthma
    can be controlled quite well with the proper medication, asthma
    uncontrolled can be a nightmare. (One of my sister's asthma is so sever
    that she is on an experimental program down in Tenn. and is trying all
    kinds of medications. She's suffering a lot from some of the side
    effects but during the "good" seasons, she is able to participate in
    Triathalons (something I can't even do!) She and her Doctor are working
    on achieving a maintenance dose so that she can try to conceive - she
    is a very, very strong and brave woman)

    			Wendy

    The next string of notes are copied from note 27, "Sleep Problems".
    

    Well, it must be in season...We started Shannon on the nebulizer again
    last night!  She doesn't seem to get too wired from the Ventolin, but I
    try to administer it while she sleeps.  (She fights the tube in front
    of her face.)  From what I can remember, the "wireness" is due to the
    ingredient used to open the airsacs in the lungs to make them more
    capable of taking in air.  
    
    I am entering this note to suggest the purchase of the nebulizer if it
    is prescribed by your doctor.  I'm glad I did not opt to rent it when
    she got sick in March, it was real convenient to have it last night and
    not have to call anyone to get it!
    
    

Regarding renting vs. buying the nebulizer.  My pediatrician ordered it via
prescription, and it was delivered to our house by the medical equipment folks.
My medical plan bought it because it's cheaper than renting it since you'll
probably need it for quite a while if that's the chosen route.  Mine was in the
neighborhood of $250, so they're not cheap, but I expect your health insurance
may cover it.  At least mine did, but I sort of expected it as they had
previously covered his other medical equipment.

    My son Cameron (21 months) also as allergy induced asthma.  He is also
    on Intal and Proventil via a nebulizer 3-4 times per day.  He is on
    this year round.  Every time we take him off he ends up in the hospital
    with an asthma attack.  I also found that when Cameron took the
    Proventil syrup ... he would get extremely wired.  But, when we give it
    to him via the nebulizer there doesn't seem to be any problem.  I can
    give him a breathing treatment right before bed and he has no problem
    sleeping.  Cameron was diagnosed at a very early age (9 months).  He 
    was given a chest X-ray (I believe to rule out pneumonia) and also they
    did oxygen level tests on him quite frequently.  He also responded to 
    the normal asthma treatments (i.e., shot of epinephrine, nebulizer 
    treatments of Proventil, and the last time also an oxygen tent).
    Cameron has done very well with having the breathing treatments 3-4
    times per day as a preventive measures.  No episodes of wheezing and no
    hospitalizations.
    
    Also, if she only seems to be having a problem in her own room, you may
    want to take some dust proofing precautions.  Encase her mattress in a
    vinyl cover and tape the zipper shut.  Do the same with the pillow. 
    Wash curtains frequently.  Replace mini-blinds with shades.  Vaccuum
    or damp mop daily.  Remove wall to wall carpeting if possible.  Damp 
    mop furniture.  No open shelves or toy boxes.  Comforters should be 
    thrown in the dryer weekly and fluffed. Bedding  changed weekly.  No 
    stuffed animals on bed, preferrably not in the room at all.  Walls 
    should be damp mopped periodically with no dust collectors on walls.  
    This was the allergists recommendation.  I have done some of these and 
    when I am consistent, they really do seem to help.
    
    I also agree that you should have her seen as soon as possible.  Asthma
    is not something to fool around with.  It is very treatable.
    
    Good luck,
    
    Joyce

    Since I don't see any one mentioning the use of steroids, may I?
    
    Ventolin mixed with Cromolin (intal?) in the nebulizer might cut the
    wheezing, however with 5+ years of experience behind us, and probably
    more to come, we discovered the steroids (usually pediapred liquid) is
    what makes it all come together and work.  Usually we do a 5 day
    routine, and taper it off for another 3 to 5 days if it hasn't fully
    stopped the wheezing.  We find AJ's athma is triggered by pollen, and
    the grass being cut.
    
    He started wheezing a couple nights ago, and I quickly recognized that
    the air was "thick".  We were about to have a humdinger of a thunder
    storm, with tornado watch in effect.  The air was very heavy, still and
    damp.  I was just sort of seeing the potential for a problem.  Even I,
    who have no breathing problems, found the air very hard to breath. 
    Fortunately the storm passed before we had a problem.
    
    By the way, I take exception to get rid of the cat, curtains, bedspread
    and rug rule.  We have all of the above!  He is really only affected by
    things that grow outside, which includes the fact we can't burn wood
    inthe wood stove during the winter.  I can always tell when the pollen
    is high.
    
    lyn
    

     Does anyone else's child have trouble with Cromolyn (Intal)?  Gary has
no trouble taking Ventolin or Vanceril (inhaler).  But when he takes the
Cromolyn, he complains of dizziness.  I'm not sure whether it's the Intal
itself or the propellant.  The propellant doesn't make sense to me, because
I assume that Ventolin and Vanceril both use the same propellant.  But
dizziness is not a "normal" side effect of Intal.

re: .14

>    By the way, I take exception to get rid of the cat, curtains, bedspread
>    and rug rule.  We have all of the above!  He is really only affected by
>    things that grow outside

Unfortunately, allergies to dust, dust mites, and animal dander can develop
later.  That's what happened to me.  And that's why our allergist recommended
those same precautions to us.  For example, keeping the cat out of AJ's
bedroom imo, would be a good idea.  Talk to your pedi or allergist.

Clay  

>
>
>re: .14
>
>>    By the way, I take exception to get rid of the cat, curtains, bedspread
>>    and rug rule.  We have all of the above!  He is really only affected by
>>    things that grow outside
>
>Unfortunately, allergies to dust, dust mites, and animal dander can develop
>later.  That's what happened to me.  And that's why our allergist recommended
>those same precautions to us.  For example, keeping the cat out of AJ's
>bedroom imo, would be a good idea.  Talk to your pedi or allergist.

I guess it depends what you're allergic to.  If AJ is allergic to pollen and
grass and someone else is allergic to dust then what works in AJs case will
be different to what works in another.

A friend of mine whose son is very allergic to dust and household dirt was
also advised to remove the carpet, etc.  They did and put down parquet in his
room in addition to the plastic envelop, etc.  He is much better now.  He also
has no problem with animal hair.

Cheryl

    I haven't been following this note too closely so I'm not sure if
    this has been mentioned in detail...
    
    Three years ago I developed *severe* allergies (at age 36). Symptoms
    included: coughing (sometimes violent), running/stuffy nose, red,
    swollen, itchy/irritated, watery eyes (the worst) and wheezing (asthma
    symptoms).  I ran, not walked to the best allergist I could find and
    had testing done. The scratch test done on my arms showed no allergies.
    They repeated the tests on my back and found I was allergic to about
    80% of the 160+ allergins they had injected.
    
    I was then schooled on the best approach to allergy management,
    this is what I have done to make my work and home environment
    a healthy place to be:
    
    1. Covered every pillow and mattress in either vinyl or 
       rubber-backed cotton zippered covers.
    
    2. Removed all houseplants (the soil produces mold spores that
       could cause me problems).
    
    3. Removed all vines and ivy from the outside of the house.
       Vines can trap moisture in the walls which could produce
       mold and mildew.
    
    4. Replaced carpet in high-traffic areas like bathroom and
       dining room.  High traffic areas need to be cleaned more often.
       Cleaning usually means water that often doesn't dry completely
       causing mildew to form lavishly under the carpet.
    
    5. Wash bedding (comforters, blankets, sheets) at least every other week.
    
    6. Installed a Honeywell Electrostatic Air Cleaner. (Big Bucks!)
     
    7. Moved LN03 (or any laser printer) printer away from my face.
       I discovered that the LN02 caused me months (7.5) of violent 
       coughing. One week after I moved my printer, all coughing ceased.
    
    I'm sure there are other things I did but these were the big ones.
    In addition, (in the beginning) I received 8 allergy shots a week 
    and took Seldane twice a day. Inhalers and decongentants when needed.
    The shots are now down to 4, every other week and I haven't been on 
    Seldane in about a month. Life for me with severe allergies was non-
    productive and miserable. I was very motivated to do something. 
    
    Hope this list helps someone with allergies.
    
    Jodi- 

    One thing I noticed in all of the replies - you mention to wash the
    sheets and blankets at least once a week, but forgot to mention that it
    should be done in HOT water to get rid of the dust mites.  My son (3)
    has asthma, and that is what our allergist told us to do.  He gave us
    a sheet for a place to get allergy supplies at a discount - I'll bring
    the information in tomorrow and post it.  I know we didn't pay anywhere
    near $200 for his nebulizer, and luckily our insurance covered it.  We
    also purchased the mattress and pillow covers from this place.  They
    were very quick about shipping the stuff out to us too.
    
    Last summer I was also diagnosed with asthma (at 31.)  I hate this time
    of year - this is when it's the worst for me.  I'm glad I went to the
    doctor and found out though - I'm breathing a lot easier this summer
    than last!  It's no fun not being able to breathe!
    
    Good Luck!

    
    Another thing to do is to remove bookshelves with books from the room.
    These collect dust also.  Also collections of stuffed animals.
    
    It makes for a stark room but better sleeping.

    Kat's shown symptoms of exercise-induced asthma, but the lung
    capacity test came out normal.  
    
    Is this a definitive diagnosis for exercise-induced asthma, or
    should she consider pursuing it?
    
    --bonnie

    
    
    	But what is normal for her may not be normal for someone else.
    
    	If you even suspect asthma or an asthmatic condition, you should
    take Kat to be evaluated by an allergist (usually) or someone who has
    experience in treating and diagnosing asthma.
    
    	You have nothing to lose and everything (including peace of mind)
    to gain.
    
    				Wendy

    Since Kat's 18 now, I can't do much more than advise her -- she
    wants to know whether there are problems (such as the famous AFP
    test false positives) with the asthma tests themselves to help her
    judge what to do next.  She does have low blood pressure and two
    different doctors think this is enough to account for the
    symptoms.  
    
    --bonnie

    
    ah, that's right, I forgot about her age.
    
    If it were *me*, I would buy (or borrow) one of the few good books
    that are out on the market about asthma. She could read about the
    symptoms and see if they fit.
    

    As far as false positives, who knows, she would have to have several
    readings over several days instead of just one data point to see if the
    "normal" range is really normal for her. Also, you indicated that she
    has difficulty with exercise, when she was tested was it while she was
    exercising or while she was at rest?
    
    Lastly, without trying to scare her or you, I would try to impress upon
    her that asthma is a real problem and in some severe cases has led to
    death in both adults and children (if you can't breath...) I've just
    heard too many stories of people with mild asthma who tried to ignore
    it only to have a full blown asthma attack and barely make it to an ER
    in time. She may not have asthma (and if two Doctors think that the
    breathing is related to something else then it probably is), it's just
    better to find out. (does she wheeze at all after exercise - that is
    one of the most tell tale signs of exercise induced asthma - although
    in some cases, you can be having an asthma attack with no wheezing but
    that is usually with an illness like bronchitis)
    
    Other than that, if she is being seen by a Doctor, and they are aware
    of the situation, then it sounds like you can't do much more.
    
    			Wendy

    Just as an FYI, Umass Medical has an *excellent* "pedi" pulmonary
    doctor team, that deal exclusively in pulmonary ailments.  We
    have been dealing with them since AJ was only a few months old.  They
    are also doing some very extensive research in Cystic Fibrosis, and
    have come up with some real notable things from genetics, causes,
    cures, treatments. (I was told by some of the staff on the pedi floor
    that this particular specialty has only a few hundred doctors
    worldwide.) 
    
    Part of the team are some very knowledgeable nurse practicioners, who
    are very able and willing to advise you over the phone for most
    questions.
    
    They have also given me the names of a couple very well written books
    to read on Pulmonary disorders.
    
    I can give you names, and phone numbers off line if anyone is
    interested.
    
               Lyn

    re: .23
    
    Thanks for all the good pointers, Wendy.  
    
    She says she gets short of breath to the point of whiting out, but
    she has never wheezed.  
    
    She's going to keep an eye on it, and if it keeps happening while
    she's away at college, she'll pursue it. 
    
    --bonnie

    In .18 I said I would post the number of the place we got the allergy
    stuff at a discount - so here is the information:
    
    National Allergy Supply Inc.
    1-800-522-1448
    (In Georgia call (404)623-8077.)  FAX (404)623-5568
    4579 Ga. Hwy. 120
    Duluth, GA  30136
    
    Just an example of their prices - a Nebulizer through them was only
    $109.00.  Their prices may have gone up since we got our stuff last
    summer, but I'm sure they haven't gone up much.  We got great service
    through them - I would highly recommend them!  If anyone wants a copy
    of the sheet that I have with their products, send me a note off-line
    at OBSESS::MACARTHUR, and I'd be happy to send you a copy through
    interoffice mail.
    
    
    Barbara

    Charlotte (17 months) has been wheezing and coughing for over a 
    week. We took her to the backup doctor on Saturday and he said
    he thinks she has "associated airway syndrome" or something like
    that, and put her on Ventolin liquid three times a day. This seems
    to be helping; she has slept better but is still coughing some and
    wheezing some. She had bronchitis earlier this fall.
    
    Has anyone heard of this? I am going to discuss it with our regular
    doctor, but wonder if this is common, and what it may imply for the
    future.
    
    Lucy

    It turns out that the right name is "reactive airway disease" (or
    "condition", either one). It's what the doctor calls it when your kid
    has asthma-like symptoms, but he's unwilling to diagnose her as
    officially having asthma. It can occur with every cold, some colds, or
    only once. It can happen a lot and be outgrown; it can turn out to be
    "real" asthma. 
    
    The doctor's main point was that there is such a broad spectrum of
    asthma-like conditions that they are reluctant to call this asthma
    until she shows that tendency over a period of time. For now we are
    just treating the symptoms and waiting to see what happens.
    
    Lucy

    Chelsea (22 months) has been showing some signs of breathing difficulty
    at night.  After bath and p.j.'s, we snuggle up together on my bed for
    a before bedtime dose of Barney.  Chelsea will be kinda restless and
    her breathing seems labored.  No wheezing, it's like she takes in a
    deep breath, holds it and then lets it out with a loud sigh.  This will
    go on for about 30 minutes, if she falls asleep, her breathing then
    goes back to a normal pattern.
    
    I took her to the doctor's a month ago when this started happening.  My
    pedi checked ears, nose, chest, heart, lungs and said everything looks/
    sounds great.  She asked if she had been congested and she has not
    been.  She explained that sometimes even though toddlers noses might
    not be running or showing other signs of congestion, sometimes they are
    congested very high (deep) in the nose.  This can cause some difficulty
    with their swallows and breathing.  Her suggestion was to try some
    Pedicare an hour before bedtime and see if that helped...before running
    a ton of tests.  Well it did help.  I kept her on the Pedicare (just a
    night dose) for seven days and each night her breathing stayed normal.
    
    It's been about three weeks and she has only done it a couple of times
    during that period, but for the last five nights she started doing it
    again.  I suggested to my pedi that we videotape her and she could watch
    it in her office and she thought this was a great idea...surely would
    get our mileage out of the tape in helping diagnose her.
    
    Well like Murphy's law she did not do it last night, even though Dad
    was prepared with recorder in hand.  He did tape her normal breathing
    pattern, so we could show the doctor the difference.
    
    Has anybody ever experienced this type of labored breathing (no
    wheezing or rattling in the chest) with their children?  I'm really
    stumped and it's starting to wear on my emotional bank wondering what
    this breathing problem is related to.
    
    ..Lori
    

    My niece has had difficulty breathing due to swollen lymph nodes in the
    throat. My sister, a nurse, noticed that her nostrils were flaring when
    she tried to breathe. When she brought her outside, she bagan a croupy
    cough. It took two trips to the major medical center to get a good test
    (xray, mri, I'm not sure) that showed the swelling in the glands. I
    think the treatment was to put her on antibiotics whenever she came
    down with a cold in order to prevent an infection that would swell
    those glands. I believe the original diagnosis was croup, even though
    damp, cold night air should stop a croup-y cough, not inspire it.
    
    Sue 

    
    It is difficult to compare breathing patterns just from a written
    description, but I think Chloe does a similar thing to Chelsea. Before
    falling asleep or while watching TV, she takes a slow, long breath in,
    pauses, makes the same type of noise a child would while, let's say,
    straining to go potty, and then lets all the air out. She breathes like
    this for about five minutes, and then resumes normal breathing.
    
    Maybe I am silly, but I have not associated this to breathing
    difficulties, because 1) she does not seem to be in discomfort, and 2)
    it seems to be associated to a certain type of activity rather than a
    specific time of day. It has puzzled my husband and me for a while, but
    we have come to the conclusion that it is just some sort of
    idiosynchrasy (sp.) on her part. Maybe we're wrong? 
    
    She has often been at the doctor's in the past, and whenever I have
    mentioned it, the doctor has listened to her lungs and then shrugged it
    off.
    
    Let us know what the doctor decides.
    
    Patricia.

    I might have missed this in your description.
    
    Is she a mouth breather?  Does she seem tired even when she gets
    an adequated number of hours of sleep?  It might be apnea (a sleep
    disorder).
    
    My son Brian just had his tonsils and adenoids out because they were
    enlarged to the point he had difficulty breathing at night.  It was
    worse whenever he had a cold.  Interestingly enough, he never had
    strep, tonsillitus (sp) or ear infections which sometime indicate a
    problem.  His tonsils were just huge (the ENT doctor said that they
    probably could be entered into the Guinness' Book of World Records).
    
    By the way, if the above symtoms are not apparent, most doctors say to
    wait it out until it becomes obvious that something is wrong. :*(
    

    My son, Ryan (age 8.5), was just diagnosed with Non-Allergenic Asthma,
    Cough Variant (WHAT a title!).  He needs to take Provantil (sp?) daily
    with Ventolin on an "as needed" basis and Bromfed (capsules) when he's
    congested.
    
    The allergist went over all the stuff we need to avoid and we have no
    problem with any of it except.....one of our cats, Dude, sleeps with
    Ryan every night.  The dr. wants all animals removed from him room. 
    Well, we took the Guinea Pig out but getting Dude out is another story. 
    Yes, we could just close the door but the kids hate sleeping with the
    door shut and Dude will just scratch at the door to be let in.  So,
    what we thought we could try is:
    
    		Keep the door closed at all times except when Ryan is
    		sleeping.
    
    		Use an Air filter at night.
    
    		Wash ALL his bedding (mattress pad, blankets, quilt,
    		pillow(?) on a weekly basis.
    
    Does this sound ok?  
    
    Thanks, Linda

    Linda,
    
    Also, wash the CAT.  Most people who are allergic to cats are actually
    allergic to their dander.  Washing the cat about once a month will cut
    down on the dander severely.  If you'd like some directions on how to
    bathe the cat, send me mail.
    
    Holly (who has asthma, and has four cats!)
    

    Linda,
    
    You might also want to give a product, such as allerpet a try.  It is
    supposed to really reduce the allergens in dander.  You can buy it at
    pet supply shops, or your vet may have it.  
    
    My father had asthma, but he and mom agreed that giving up the cats and
    dogs was not an option.  (neither was moving to a "safer" altitude) 
    They did keep the pets out of the bedroom, changed the furnace filters
    every month, and ran the fan on the forced air full-time so that they
    could pull more dust out of the air, and also minimize any mold growth
    in the basement from stale, damp air.  Dad also washed his hands after
    playing with any of the pets.
    
    Meg   

    
    	you probably don't want to hear this but it is not ok. You are
    going to have to remove the cat from the bed at night. cats are not
    stupid, after one or two nights of being locked out they get the
    picture.
    
    	When I was diagnosed with asthma, my Dr. wanted me to get rid of my
    cats (who both slept on my bed) simply removing them from my bedroom
    (with lots of complaining) made the situation so tolerable that I did
    not have to get rid of them (in fact I still have them).
    
	cats close up continue to be a real problem for me but I seem to
    tolerate them well at a relative distance.
    
    				Wendy

    Linda,
    
    My kids' dad has to try to keep the cats out of the dining room, and
    what he found that worked just fine was to put up a child safety gate
    in the doorway.  The cat never figured to jump over it, and it's low
    enough that they can still get around it.  There aren't any doors on
    the doorways, so closing the door wasn't an option.
    
    (-:  Or you could shave the cat (-:  (JOKING!)
    
    Patty

    Chelsea seems to alternate between mouth and nose breathing, probably
    favors nose most of the time.
    
    Well we did tape her Friday night while she was doing her irregular
    breathing.  We took the tape in Saturday morning to let her pedi
    view it.  The doctor felt it could just be activity related, Chelsea's
    way of winding down after bath and before bedtime.  She is only holding
    her breath for 4-5 seconds and then letting out a loud sigh.  Our pedi
    said that even adults sometimes will take a deep breath in, hold it
    and exhale with more vocal sounds then a normal breath.  She felt that
    as long as Chelsea wasn't holding her breath for 20 seconds or more...
    or turning blue (a good indicator!), that there was nothing to worry
    about at this time.
    
    Chelsea had her ears, nose, throat, lungs, chest all checked out and
    she was in top shape.  So the visit ended with pretty much of a "don't
    worry about it"..., although a small part of me still does.  It's just
    when they start doing anything out of their normal pattern, especially
    with breathing, it certainly catches your attention.
    
    We do have two cats and Chelsea has never shown any allergy related
    symptoms since birth.  The cats don't sleep in her room, they are
    indoor and get brushed and bathed regularly.  
    
    The pedi mentioned some of the tests they could do, but really felt
    they were not necessary at this time.  So I guess we just keep and
    eye on it and I hope nothing serious is related to it.
    
    Add another notch in the mommy worry belt!
    
    Thanks for your notes!
    
    ...Lori

    re .33
    Does your son wheeze? How did the allergist determine that he has
    cough-variant asthma?  My family practitioner believes it is likely
    that my 5 1/2 yr. old son has cough variant asthma because of his
    recurrences of bronchitis each winter, which is then aggravated by
    cold/dry winter as we had around Christmas this year. (My husband had
    asthma as a child too).
    
    Anyway, my son takes Ventalin or Proventil as needed when he gets the
    bronchitis but that's it.... I was of the impression that Ventalin and
    Proventil are the same thing - that one is just a name variation?
    
    Regards,
    

>    My son, Ryan (age 8.5), was just diagnosed with Non-Allergenic Asthma,
>    Cough Variant (WHAT a title!). 
    
>    The allergist went over all the stuff we need to avoid and we have no

I guess I don't understand.  If it's non-allergenic, I don't understand why 
it's necessary to get rid of the cat.  As another noter pointed out, the 
problem with dogs and cats is that many people are allergic to the dander.  
Have you asked the doctor what induces the asthma if it's not allergies?

Just for example, I have infection induced asthma.  I get a cold and some 
sort of upper respiratory infection, I start coughing, which irritates my 
bronchial tubes, which kicks off an asthma attack.  I do have allergies, but 
they don't kick off the asthma.  My son has asthma, induced by exercise and 
cold air.  It's easily controllable by an inhaler.  He has some mild 
allergies, but they have nothing to do with his asthma.

Still, the story amuses me and reminds me of a little interchange between my 
allergist and me many years ago.

Allergist:  Here's what you have to do.  .... and no pets.

Me:         Uh, we have a dog, and don't want to get rid of it.

Allergist:  Well, OK, but make sure it's a short haired dog.

Me:         Uhhh, unfortunately, it's a long haired dog.

Allergist:  Well, OK, but keep it out of the bedroom.

Me:         Uhhhh.  OK.  (I didn't have the heart to tell him that the
	    dog was sleeping on our bed).

Clay

    Thanks for all the replies so far....
    
    Ryan was tested for allergies to pollen, animals, molds, dust, etc. and
    all showed up as negative.  When he breathed into a machine (he had to
    "blow the smog away from a city) it showed his large bronchial tube at
    77% capacity and his small BT at 52%.  After he inhaled some Ventolin
    it showed as 88% for his large BT (still 52 for the small but the dr.
    said that takes longer to clear up).  So, the dr. said he had "Reactive
    Airways" which also means mild asthma.  For whatever reason his airways
    overreact to certain "triggers".  I know infection is one of his
    triggers - he always would need at least 3-4 months to get over an
    illness completely.  Weather changes also seem to be a trigger because
    he was doing pretty well this winter until that one warm weekend in
    February.
    
    I don't think he wheezes.  He DOES have the most awful sounding cough
    whenever he gets sick.  
    
    the dr. didn't say we had to get rid of the cat.  She just doesn't want
    it to be in Ryans room.  I know that SOUNDS like a no-brainer but Ryan
    and this cat have a real bond and we (as a family) have been through
    ALOT lately (death of our dog, youngest son developed diabetes, etc.)
    so to also have to break the bond he has with the cat could be just too
    much for him.  
    
    I just called an 800 # for info on an air filter called Enviracaire. 
    It is supposed to be 99.97% efficient at removing all sorts of stuff
    including animal dander.  Has anyone used this type of filter?  The
    mfg. is Honeywell.
    
    Again, thanks for all the responses.  It really helps to have
    knowledgable people give their opinions and experiences.
    
    Linda

    linda,
    
    I have an envirocare filter on my furnace, as that was what was
    available at the lumber company the last time I was there.  My house is
    a construction zone, however, so I can't say anything about the
    effectiveness.  there is no way to reduce dust when you are remodeling
    to the extent we are.
    
    Meg
    

Not sure if this is the right place for this note..

My 2yr old daugher Shruthi has been getting a cold very frequently for the past
eight months or so.  When she does get one, her nose is very runny..we run
through boxes of tissues!  The cold normally lasts for about 10 days-2
weeks..although there was one that lasted for a whole month!  No medication
seems to help...it helps her for a little while...but that's about it.  She has
been getting these colds so often that it very often looks like there's hardly a
gap between the end of one and the beginning of the other.

My daycare lady feels that this may be due to allergies.  I had asked her pedi
about it sometime back..he was rather flippant about the whole thing..said that
I shouldn't worry too much about colds..they will get them...his excuse was that
she is in a daycare...so likely to catch colds more often...when I said that she
was the only one in the daycare with a cold that often, his response was that it
could be the carpeting in her room...

Opinions anyone?  Could this be some kind of allergy ?  If so, how would one go
about detecting what she is allergic to?  I feel really bad to see her suffer
from colds so often..earlier, she seemed to have trouble sleeping when she had a
cold..but now, she seems to take it in her stride!  She does have a couple of
restless nights though....

One other thing I should mention ...we originally linked her colds to
teething...but for the past three colds..we have been saying ' It must be her
molars'!!

--CR.

    You need to see an allergist for testing and that will tell you what
    she is allergic to.  The most accurate test is the skin testing, not
    the blood test (Consumer Report ran an excellent article on how
    inaccurate the blood testing is about 3 years ago).
    
    If someone keeps saying it's the carpet, and the carpet truly bothers
    her, it is probably dust mites in the carpet that are actually
    bothering her.
    
    Then, to desensitize a person from the allergies, you get shots from
    your allergist.
    
    I've been having allergy shots now for years (my frequency for shots
    has decreased to 1 series a month), and it has made a tremendous
    difference.  I no longer get colds "all the time."
    
    Tina

    RE. 43
    
    You know, I've mentioned allergies to my pedi a couple of times
    too, and she was kind of flippant about them also.  Why is that?
    Angeline is almost 9 months and I beleive I'm seeing evidence of
    them (I am so totally allergic to the atmosphere altogether :-( ).
    
    She's really been scrubbing at her eyes and nose, but not a lot of
    congestion.  But the pedi just says, "oh yeah" and goes on to other
    things.
    
    Is it because there isn't much they can do at this age?  Without the
    congestion, at this point, I'm not overly concerned myself...but she's
    always digging at her ears and I suspect their itchy too.  Her last 
    check up, last week, showed clear ears but she's in there up to her
    elbow most of the time.
    
    I think I'll ask *again* next time we go.
    
    						cj *->

>>    You know, I've mentioned allergies to my pedi a couple of times
>>    too, and she was kind of flippant about them also.  Why is that?

Mine, too; and the allergist seems at the other extreme sometimes...

    According to my kids pedi, they usually don't do allergy testing until
    the child is about 7 yrs. old.  He explained that most of the allergies
    in younger children go away on their own and the testing is more
    traumatic than the allergy itself.  I know when my son was tested at
    the age of eight, he had to sit COMPLETELY still for about 10-15
    minutes while the allergens were working on his arms.  I can't imagine
    a child younger than 6 being able to sit still that long.
    
    My son ended up with a diagnoses of Non-Allegenic Asthma - Cough
    Variant (talk about a mouthful!).  
    
    I would ask your pedi specifically why she doesn't seem concerned about
    allergies.
    
    Linda

    
    Well, when we went through the thought of some allergies with Jonathan,
    we received the same sort of response.  First we were ignored, but hey,
    I'm persistent (ok, stubborn), and finally got some answers;
    
    o Food allergies don't tend to show as 'congestive' until after the age
      of two.  Usually.  But there's always some exceptions.
    o Most children outgrow allergies, so "let's wait and see"
    o They were more willing to listen to allergies that other people in
      the family are known to have, before suspecting them in a small
      child.  (ie I get 'hayfever' sometimes, so they were more inclined to
      listen to me complain about that and believe it, in Jason, than if NO 
      ONE had those type of allergies at all).
    o The process for pinpointing a particular allergy is drawn out over
      such a length of time, and a small child is going through so many 
      OTHER changes during that time, that it's incredibly difficult to
      really determine the allergy (without the skin tests).
    o The skin tests are much too painful/uncomfortable to do on a child
      unless there seems to be a severe or life-threatening allergy.
    
    For Jonathan, I gathered all the information myself, and presented it
    to the Drs.  THEN they listened, and agreed with what I'd found.  And
    even then, it was no big deal;
    
    He seems to be allergic to tomatoes and milk, or at least sensitive to
    it.
    
    Why do you say that?
    
    Well, whenever he has a lot of milk and/or tomatoes, he ends up with an
    ear infection, and the tomatoes make his face break out in a bright red
    rash that lasts a day or so.
    
    You're sure it isn't something else?  It's not very common in a child
    this young to have "congestive" allergies.
    
    It's the only thing that I can see that's "in common" with his
    infections, and for every single infection he's had (except for 1 when
    he had a bad cold), I can definitely pinpoint that the week previous to
    diagnosing the infection, he'd been fed a lot of milk and/or tomato.
    
    Oh.  Well, then you're probably right.  Just don't give it to him, ok?
    
    Next.
    
    So, after all that narrowing down, it was more for my own peace of mind
    anyway ... you're the one that's with them ALL the time, every day -
    you need to build your own case, and it seems that THEN they'll listen.
    And actually, with Jonathan, it was the ENT who bought into the allergy
    thing more than his (former!) regular pedi.  His new pedi
    wholeheartedly agrees ... but only said "Well, I don't think that a
    child his age needs a lot of tomatoes or milk - you can certainly
    eliminate it from his diet easy enough"
    
    Phew! That got long ....  Hope it helps!
    
    patty

re:  child under 6 sitting still 
re:  test much to painful/uncomfortable 

Our 30 month old God-daughter had the testing a couple of weeks ago.   They 
put the drops on her skin, did a double pin-prick over each drop, and she had 
to hold her arm completely still for 15 mintues.    Her mom said it was easy 
enough to do by explaining and then reading to / singing with her.    Also, 
she said it was not painful, no struggle, not a huge big deal.  

She has had severe eczema all her life, and they waited till now to test, I'm 
not sure if it was resistance of her primary care dr., or because they get a 
better reading after 2 yrs.   

Sure beats the "injecting the serum under the skin for each allergen" then did 
when I was a kid...   

    My son has had both eczema and psoriasis for most of his life...  plus,
    he snores due to nighttime congestion.  We have had both types of allergy 
    test done.  At six months, they did a basic set of blood allergy tests, 
    and found that he didn't have any of the common food allergies (eggs, 
    milk, soy, etc).

    At about two years, we had the pin-prick tests.  He actually did pretty
    well.  They had about sixteen pins.  I think that fourteen were for the
    tests, and two were some sort of calibrators.  The test itself wasn't
    such a big deal.  They popped them all against his back, and we waited
    for about fifteen minutes to see how his skin reacted.

    However...  In our case, it made only a minor difference in his life. 
    He was found to be allergic to peanuts (he already refused to eat
    peanut butter), to cats (we already figured that out), and minor
    allergies to a couple of other things.  

    He was ALSO supposed to have a strong reaction to wheat.  However, when 
    we completely cut it out of his diet (had a few days of rice cakes,
    plain hamburgs, and rice crispies only), there was NO DIFFERENCE in his
    skin.  When we reintroduced, still no difference.  

    One thing we have concluded (after seeing an allergist, three
    dermatologists, and a nutritionist) is that it is hard to tell exactly
    how an allergy might effect you.  For example, my son reacted as being
    allergic to wheat.  However, eating it seems to have no bad affect on
    him.  But, playing with it (helping mom to knead bread, for example) 
    makes his hands break out.  We have also found that it seems to be
    easier to test for an environmental (smelling, touching) reaction than
    for food allergies (i.e. from eating).  Trial-and-error seems to be
    your best bet for that.

    About the only big difference that we were able to make as a result of
    the allergy tests was to reduce dust mites.  After we removed the carpet 
    and a fold-out cushion chair from his room, bought new pillows, and got 
    new mattress and pillow covers his nighttime congestion lessened.
    
    One last thing...  I believe that another reason that they generally
    wait until seven to do the testing is because that's about the safest
    age to start allergy treatments (such as shots).  I'm not sure that is
    a route that we will take, since our experience didn not convince me
    that allergy testing is sufficiently conclusive.
    
    Peggy

My son Joel has colds a lot also.  It could be from daycare.  We also suspect
allergies since we have them.  The colds don't seem to bother him, and now
that he has tubes, he doesn't get ear infections.

We had him skin tested at 15 mths (he is allergic to milk and some antibiotics
also) and they were no big deal.  You should probably see an alergist. (although
mine didn't realy do much for him)  If she is alergic to dust mites, there is
stuff you can treat her carpet with (don't know the name).  You can also
cover her mattress and wash all her bedding (including stuffed animals) in
hot water.

Lori

    To begin a new string along the same lines...
    
    My little Jake, who will be 4 mos. this week, caught a rotten cold
    shortly before Xmas, and developed a very phlegmy noise in his chest,
    but a dry cough that just wouldn't stop.  Watching him cough until his
    face turned deep red and his breathing stopped looked very familiar,
    both to me and to my mom, because I have chronic asthmatic bronchitis
    (let's call it C.A.B. for short, okay?!).  I was diagnosed with this at
    about 3 months, just like Jake.  
    
    I took him to the pedi's office, where they use CNPs as Physician's
    Assistants.  Mrs. Olson, whom Jake had seen before, became immediately
    concerned when she saw his puffy undereye area, his very pale face and
    the slight tinge of gray around his lips.  She *immediately* got
    out a nebulizer and some ventolin drops and had me treat him.  This was
    a new one for me, since they didn't make these machines when I was a
    small one, and my older boy (Joe, 7), takes ventolin syrup for the mild
    C.A.B. he developed last year.  Anyway, making a long story short,
    after hearing my history and that my older boy take ventolin with his
    occasional colds, etc., Mrs. Olson recommended that I buy the
    nebulizer, and prescribed the ventolin with saline treatments 4 times
    daily, plus amoxicillin for a mild ear infection and what she called
    "bronchiolitis"; she told me to bring him back in two days for a
    re-check.  I had never heard of this bronchiolitis before, but got a
    sense that it was pretty serious, considering the nurses' demeanor.
    
    Well, I did, and he wasn't significantly better, and Mrs. Olson called
    in one of the 9 staff doctors.  By lucky happenstance, it was the one
    who had examined Jake in the hospital, a good Jewish doctor named
    Schwartz, with grandkids, a fast-talking approach and a passion for
    detail.  He got the basics from the nurse and immediately increased the
    frequency to every 3-4 hours around the clock (!? I just got him
    sleeping through the night 4 weeks ago, and you want me to wake him up
    for medicine????  Are you NUTS???!!!).  They also changed his anti-b' 
    to Pediazole, one of the many "-mycin" forms.  
    
    Anyway, I did give him 4 hour treatments, but skipped the middle of 
    the night; I figured if the baby was sleeping through, he mustn't need 
    it that badly then.  The Pediazole was *great* - absolutely beat the
    stuffings out the ear infection, with the ear redness and the pulling
    disappearing in less than 36 hours.  When I brought Jake back for a
    recheck 10 days later (last Fri.), I also had a 1/2 hour consultation
    with the Dr. Schwartz, who has made a note that all of Jake's future
    appointments must be with him.  We went over my history, Jake's, Joe's,
    my hubby's.  We checked Jake from head to foot, talked about feedings
    (Jake's on dreadfully-expensive-but-highly-effective Nutramigen
    formula, with the hydrolized protien and no lactose for tender
    tummies), etc.
    
    Upshots:  *now* the ventolin is being mixed with Intal three times a
    day, and with just saline any other times.  I'm back to doing the
    treatments 4x daily, which seems to be working well enough.  Jake is
    such a happy baby now that his digestive problems are solved that he
    didn't even get fussy before we started the treatments, so I can't get
    a sense of whether he is "in distress" until his lips start turning
    gray!  Lo and behold, he did get to start rice cereal and applesauce
    and apple juice last week, per Dr. (2 month check said no food till 6
    months!!!)  He seems to be doing really well, except that the Intal is
    making him more wakeful.
    
    Anyone else ever hear of/experience this bronchiolitis?  Dr. Spock 
    lists it as a virus that can have lasting effects on a child's lung 
    capacity, etc.  The pedi told me to slowly eliminate the ventolin over
    the next few weeks, but said that I would continue to give him Intal
    for ???? who knows how long!?  Yikes!  So young to have such problems,
    huh?  The good news is that (a) we caught is nice and early, which is
    best with breathing disorders, and (b) he's taking to juice and cereal
    much more readily than I could have dreamed!  The bad news is that in
    the midst of all this bronchilitis madness, Joe got the
    honest-to-goodness Type A Flu, with the attending 105 fevers, vomiting,
    "sleeping sickness", etc.  He also got a nasty cough along the way, for
    which the Xmas-coverage pedi prescribed Promathezene (which we've both
    taken before) with Codeine (which Joe's never had).  The codeine made
    Joe even more ill, with no appetite, further vomiting, total
    listlessness.  
    
    What a Christmas, huh?!
    
    M.

    We experienced a very similar situation with our daughter last year.  
    She had bronchiolitis at 4 months, bronchitis at 10 months, some sort
    of a blockage in her lung at 11 months that caused it to partially 
    deflate (with a 104 degree fever and gray coloring), and then a dust 
    allergy at 12 months.
    
    Anyway, we learned that Taylor has asthmatic tendencies when she gets
    a cold or allergy.  The pediatrician warned us when Taylor had
    bronchiolitis that we should "beware" of possible problems (like
    bronchitis) in the future.  Sure enough, last winter she got
    bronchitis, a mucous blockage in her lung, a dust allergy, and was on
    both ventolin and intol(?) for quite a while.  What we found was that the 
    ventolin was the cause of the hyperactivity (it is well known for this, 
    ask the pharmacist or the pedi for a list of side affects) and caused her 
    a great deal of difficulty when sleeping.  As soon as she stopped the 
    ventolin, within a couple of days, she started sleeping much better.  She
    stayed on the intol from February until July with no problems.
    
    This year she has had no problems with her lungs and bronchi (knock on
    wood!).  I would have no problem, if the need arose, to put her back on
    the intol as it worked wonders for her allergy (we started with 4 times
    a day for 3 weeks, then 3 times a day for 2 weeks, until we got down to
    twice day).  At night, we did the nebulizer treatments while Taylor slept. 
    We just put the little breathing hose in front of her mouth and nose and
    turned on the nebulizer.  If she turned her head, we just followed her. 
    She never woke up.
    
    By the way, our insurance company paid for the nebulizer and all of the
    supplies that go with it.  When we re-order the kits, we just give them
    our insurance number.  They also pay for nebulizer repairs.  You might
    want to check with your insurance company.  A woman also came and trained my
    husband and I on how to use it, clean it etc.
    
    As for the Ventolin, it does its job but it really makes both of my
    children hyper and I like to get them off of it as soon as possible.
    
    Hope that this helps. 
    
    Lauren
          

    
    If I remember right (I know it's in this notesfile somewhere),
    bronchiolitis is a child's form of bronchitis.
    
    Your description of Jake's coughing sounds JUST like when Jonathan had
    pertussis (whooping cough) .... for which he was also given pediazole.
    Either way, there's not much different for treatment.
    
    Good luck with your family!  I hope that everyone's feeling better
    soon!!!
    
    Patty

re: .54   <<< Note 225.54 by OOYES::WEIER "Patty, DTN 381-0877" >>>
    
>>    If I remember right (I know it's in this notesfile somewhere),
>>    bronchiolitis is a child's form of bronchitis.
      ^^^^^^^^^                          ^^^^^^    

   Given the words themselves, I would have suspected that the difference
   was _where_ in the lungs the problem showed up.  Which may very well
   be related to the different sized lungs between kids and adults...
   
   fwiw,

   - Tom

    As I said before, Doc Spock lists bronchiolitis as a *virus*, which
    must simply run its course; bronchitis is generally bacterial, and can
    be treated with an anti-biotic.
    
    As for insurance, the Digital HMO out here in AZ has a $200 deductible
    for durable medical equipment.  The nebulizer costs $99, and I haven't
    gotten the refill kit yet, but I think it will be a while before I
    exceed that $200 annual deductible.  (I could say a few words about my
    feelings on an HMO having a deductible for medical equipment, but the
    Mods would be forced to delete this reply, and my fingers might blush
    just typing them!!)  BTW, my premium for the HMO increased by 75% (!!)
    this year, so I'm really quite peeved about the lack of coverage on
    medical equipment!!
    
    Jake seems quite a lot better today, and has been very wakeful since we
    put him on the ventolin, yes, but even *more* so since we began mixing
    the ventolin with the intal.  Funny, it actually *calms* my 7 year old.
    
    Regards,
    
    M.

    Not to minimize the seriousness of these illnesses, but to rathole
    for a moment (I'm a Virgo, I have to do this :-} ) doesn't "-itis" mean
    merely "an inflammation of", or "an irritation of"?  Maybe the most
    common bronchitis is bacterial, but IMO the name itself just means
    irritation of the bronchi (and similarly, bronchiolitis would be 
    irritation of the bronchioles).
    
    I'm sensitive to this because of the widespread belief that
    "conjunctivitis" is *always* *HIGHLY* infectious, although you can 
    irritate the lining of the eyes by swimming in an overchlorinated pool....
    
    Leslie

    M,
    
    I can whole heartedly relate. We went through your exact experience a
    little over 1 1/2 years ago w/ Nicholas who was then just 6 months.
    
    
    We made constant trips to the ER, Dr's office, chronic Viral Infections
    and Bronchilitas! After a long time, and a lot of stress, we saw a
    specialist to rule out Cystic Fibrosis. The Dr at UMASS told us we had
    a normal case of Infant/child Asthma.
    
    We Last January we started on the same treatments... Pedizole (which is
    a steroid) orally for about 1 month, w/the dosages decreasing over
    time. Ventolin every 3-4 hours as needed and Albuterol as needed when
    things got real bad. 
    
    Over time (1 month) we really got to know the signs of when it was
    going to act up, and excatally what to do.
    
    I would like to  make some suggestions..(these are just my personal
    opinion...)
    
    1) There is a book, Your Child and Asthma. Read it! It was a life
    saver. It went over the Meds, the effects etc. It also went into detail
    about how to tell the if an episode was coming on, and to have a plan
    in place on what to do.
    
    2) Talk w/Other Care givers and relatives re: the Asthma. They should
    be aware of it, know the signs and what to do. (really helps when you
    want to get out for a night)
    
    3) As for the night treatment.... You DON'T need to wake the little one
    to give them the treatment. When using the Nebulizer, you do a
    "blow-by" on someone that little. If you think the child is in distress
    or hear a little wheezing, give the treatment while they are sleeping.
    Its the time that they get the most meds in them, and its probably the
    easiest one to give. 
    
    4) Keep a daily journal. (this is explained in the book) It has columns
    w/times, meds given, comments about daily acitivites etc. 
    
    *This really helped us to determine that Nicholas only had a problem
    when he had an ear infection, or was coming down w/a  cold. 
    By keeping the daily record, we were able to tell when we could cut
    down on the meds, and when they had to be upped to help him through
    ailments.
    
    Its been over 1 year now, and we have been completely off meds (all of
    them) for about 3 months!!! Yeah! We do know that if he gets a bad cold
    or catches something, we will have to start up again, but being an
    active participant in this treatment has really helped us and Nicholas.
    
    If you have any questions, or want to talk, feel free to drop a line,
    or give me a call..
    
    Anne Marie
    

   FYI, 
   
   I have created a Word6 .DOC file that emulates the chart in that
   asthma book.  If there's some interest, I can post the .PS file here,
   or mail it (and/or the .DOC file) to a few folks if there's only
   limited interest.  Let me know if anybody wants it.  
   
   - Tom
   
   (PCBUOA::PEACOCK) or
   (ENGLES::PEACOCK)

    My son has just been diagnosed with Asthma.
    
    Paul had bronchilitis when he was 10 weeks old and was hospitalized for
    6 days, of which he spent in an oxygen tank and at that time, we were
    told he could develop breathing problems later but it was too early to
    tell.
    
    Over the past year, he has been having problems coughing alot, mostly
    at night.  As most of you know, its difficult in an HMO to get your own
    Dr. when you get last minute appointments so he was put on a cough
    medicine with codiene to help him sleep.  It didn't really help alot
    and I started to get concerned but most doctors didn't seem to think
    much of it.  A few weeks ago I got a call from his main sitter who told
    me that he couldn't drink or eat because he was continuing to cough so
    much.  The next day my mother phoned me and told me that he couldn't
    play with the child next door because he was out of breath.  At this
    time I got an appointment with his primary care doctor and told her my
    concerns.  Paul has had a ventilator prescribed to him for over a year
    but it does little so she prescribed a nebulizer and it was delivered
    last week.
    
    She told me that its probably just allergy induced asthma and wants me
    to use this nebulizer three times a day for a month and continue until
    a month passes with no symptoms at all.  She took blood for testing and
    x-ray which came out fine but the blood tests haven't come back yet. 
    Just how did she know that he has asthma?  
    
    I believe she also told me that it would take a week or two for the
    nebulizer to start working at his cough.  Is this right?  He is up for
    at least an hour twice a night with a cough that keeps him up because
    he can't breath and I'm at a loss as to what to do.  
    
    Thanks...
    cj

    I can't answer your questions specifically but I can sympathize. When
    my older son was four, and then again at five, he went through a spell
    of coughing fits once the weather turned cold. The fits were when he
    first went outside, or when he laid down to sleep, or nap. I noticed
    them the first year, but didn't do anything about it until February
    or so when he got sick, and told the doctor of the long-running cough.
    He couldn't hear anything, but put him on antibiotics anyway, and
    eventually the cough stopped. It started again that October. I called
    my pedi (when his school complained of the cough) and was referred to
    another, as mine was on vacation. I talked to that pedi, who diagnosed
    asthma and prescribed liquid ventolin -- over the phone!!! We never
    saw her in person. I followed up with my pedi who said the ventolin
    probably wouldn't help, but it wouldn't hurt either. Happily, the cough
    didn't return last fall. 
    Good luck with this,
    Sue

    
    	My son saw the doctor last fall for congestion in his
    	lungs.  At the time, they weren't sure if he had pneumonia
    	or asthma.  Due to the fact that he tends to develop a
    	hearty wheeze with his coughs, they said they assume
    	asthma, but wouldn't know until he came back again with	
    	the same symptoms.  He had been prescribed ventolin before
    	(albuterol syrup - albuterol is also in Proventil inhalers).
    
    	A week later, my daughter was diagnosed with walking pneumonia.
    	The doctor then said that's probably what Andrew had had, but
    	they'd continue to keep an eye on him.
    
    	He did not develop the lung congestion again, but they gave
    	us a refillable prescription for the Ventolin, and told me
    	that whenever he gets a cough with a wheeze, start up the
    	Ventolin for two to three days, and bring him in if he
    	got a fever (to indicate something other than asthma).
    
    	I'm not sure if there is a specific test for asthma, or
    	if it's a diagnosis that gets made based on symptoms and
    	the child's reaction to treatments.
    
    	I know that the ventolin has helped Andrew every time, such
    	that he sleeps through the night after one day of the syrup.
    
    	I'm fairly certain he has allergies - his symptoms seem to
    	start right when his dad's do.  My husband has allergy induced
    	asthma, so I'm keeping a close eye on Andrew this spring.
    
    	Karen
    

    re: .60
    
    You don't say what is being used in the nebulizer.  In my own
    experience (3 of 4 have asthma), the nebulizer treatment offers
    immediate relief.
    There are usually two different treatment philosophies when treating
    asthma; preventative and active.  We have used both Ventolin (Albuterol
    Sulphate solution) and Intol.  Albuteral (Ventolin, Proventil, etc)
    opens up the bronchial tubes and treats the spasms within the lungs.
    Intol is more of a preventative medication which should reduce the
    severity of the spasms.
    
    If the medication prescribed is Intol, then it will take a few days
    before any change is seen.  If you are using Albuterol, there should be
    immediate relief from the symptoms.  Note: This does not mean that
    coughing will stop.  If anything, the Albuterol will cause a little
    more coughing initially as the tubes open up.  Perhaps the most
    striking change will be that wheezing will stop.
    
    Dan

    
    Thursday night Alyssa had quite a bit of congestion and couldn't sleep
    at all.  She was coughing and kept saying she couldn't breathe.  Friday
    she was congested but I though nothing of it - just a cold. 
    Saturday morning she was coughing and wheezing and saying she couldn't 
    breathe.
    I got an appointment immediately with her pedi - a nurse practitioner
    was filling in - but it turns out her specialty was pulmonary (I lucked
    out!).
    Alyssa had Alboterol via a nebulizer and was feeling much better - the
    wheezing and coughing stopped.
    We were given a nebulizer, a prescription for Albuterol for the neb and
    a prescription for some steroids (I can't remember the name of them).
    We are to give Alyssa a neb treatment every four hours if needed -
    steroids only if the condition worsened.
    We used the nebulizer 2 more times Saturday, once Sunday and once this
    morning.  She is doing better - still not herself.  She has been
    running a fever through all this so they think it might be a virus in
    her lungs.  I am worried because she has very severe food allergies and
    if this is asthma - this could mean serious trouble.
    If another episode occurs, I will be taking her to a specialist.
    
    It is really frustrating for me to be so helpless when she cries that
    she can't breathe.
    
    I have not yet read many replies in this note - so I have some reading
    to get caught up.  I'd welcome comments from parents of kids with
    asthma.
    
    Nancy                                                   
    

While my kids don't have asthma (thank goodness!), I do have it.

Basically, as Dan said, there are two different types of treatment, reactive
and preventative.  The reactive use bronchio dialators.  Albuterol (ventolin, 
proventil) are these.  The inhaled varieties of these work VERY quickly.  These
also come in pill form and can take an hour or two to work.  There is also in
inhaled version of epenephrine (probably spelled wrong), which is sort of a 
synthetic adrenaline.  This tends to only be used in severe cases which are 
viewed as more of an emergency (believe me, an adrenaline high is no fun!).

The preventative drugs that I'm aware of are Theopholine (in pill form) and 
various inhalers which tend to be steroid based.  First, don't panic at the idea
of using steroids.  These are very specific steroids targeted at the problematic
area.  Very little of the steroid every makes it to the blood stream.  These do
take a bit longer to deliver any results.

First, I'd find out from the doctor exactly what your child is being treated
with.  Question what side effects to look out for (some asthma drugs have nasty
side effects) and how long does she see the treatment as being needed.  Also,
I'd question what she is looking for on the various tests.  

I've heard of some doctors now using blood tests to determine allergies.
However, the couple of board certified allergists that I've talked to have said
that trying to determine allergies through blood tests is not very accurate.  If
I remember correctly, they can determine if an allergy is present, but not what
the allergant is.

Good luck,


Irene

    Good questions.  I know that the two prescriptions that are put into
    the nebulizer are not steriods.  I knew enough to ask that question. 
    One solution is in a clear plastic little bottle.  We got a box of them
    which are to used one little bottle three times a day.  My husband said
    its salt of some sort because the box said Sodium something.  I'll
    check tonight.  The other came in a little glass bottle and we put .5ml
    into the nebulizer every 4 to 8 hours if needed.  I tend to think its
    intol because I remember his doctor mentioning this.
    
    The ventolin that Paul had before is in a grey spray pump and it never
    worked well on him although I had the same thing when I had pneumonia
    and it worked great at my coughing bouts.
    
    FWIW,
    cj

    RE: .66
    
    From your description of the containers, I'd guess that you are being
    asked to use Intol (small plastic ampules) with Albuterol (.25 or .5ml
    drops) with the nebulizer.  Intol being the preventative portion.  If
    you use Albuterol alone, you add bronchial saline correct?
    
    A word of caution:  Albuterol has a nasty side effect... hyperactivity!!!
    
    Dan

    I have not seen any hyperactivity in Paul but was advised to it.
    
    You are correct -1.  The prescriptions that Paul was given is Albuterol
    for every four to eight hours for wheezing combined with Cromolyn
    Solutiondey.
    
    Unfortunately, it has not helped but actually worsened his cough.  We
    used it twice yesterday and two hours after his second treatment, he
    was coughing so bad it made his nose bleed.  I checked possible side
    effects and it said to report coughing so I'm calling the doctor today. 
    To make matters worse, his chest seems really congested so I'm not sure
    if its just a virus/cold/allery or a reaction to the nebulizer.  Even
    my husband was very concerned about his coughing last night to the
    point where we considered calling the doctor late last night.  It was
    much worse then his usually cough at night.
    
    cj

    CJ, anytime I was worried about Aaron late at night I'd call the
    pediatric department in the hospital.  The nurses have to be there all
    night and told us many times that they don't mind the calls.
    
    sandy

    One thing a friend ran into with her asthmatic som, and what I ran into
    with dad, was a heightened risk of pnuemonia.  Something about
    compromised airways being less able to get all the gunk out of the
    bottom of the lungs.  Call the doc.
    
    Good luck,
    
    meg

    
    	I was told to expect the coughing to get worse before
    	it got better, but Andrew was never as bad as your son
    	seems to be.
    
    

    I just got off the phone with Paul's doctor.  She prescribed a syrup
    called "Prelone?" that will be given for 5 days once a day.  This *is*
    a steriod and will supposedly give him a jump start to help clear his
    lungs.
    
    She also said that although he isn't supposed to get worse that its
    going to take some time for things to start working.
    
    Someday, he will sleep again..  someday.
    
    cj

    
    C.J.
    
    My daughter allways got bad stomach aches and the shakes while on
    Albuterol.  The side effects do lessen with every dose.
    
    Good Luck - Hope Paul is feeling better soon.
    
    Kirsten
    

    
    
    One note from my experiences with child w/ asthma (all 3 boys).  We
    are a two neb. family.  I was not suppossed to give the Intol more than
    3 times a day, so if the asthma spells required treatments more than 3
    times a day, I had to mix the arbuterol (sp) w/ the saline.  All the
    vials mixes and regular medicines and doasage info gets really
    confusing, so if you are using intol more than 3 times a day, I might
    confirm the amounts per day with your doctor or pharmacist.  Maybe the
    3 times a day is just my doctor's rule, but I did hear from 2 different
    doctors.
    
    Beth

    Paul is currently supposed to be taking the intol three times a day but
    we have yet to get him to stand it the third time.  Once when he gets
    up, again when he gets home and then before bed but by then, he is too
    cranky to want to sit and endure this.
    
    Our video said that the procedure for them breathing the medication in
    was 3-4 minutes but the pamphlet said 7-8 minutes.  So far I have tried
    both but still end up with medication leftover in the nozel when I go
    to clean it.  
    
    How long should a typical treatment last?
    
    Last night was the first time I noticed Paul getting wound up after his
    treatment.  He was not unmanagement but really hyper.  I was not sure
    if its just taken a few days of the nebulizer to take effect or the
    Prolene? that he started yesterday morning (and boy he hates the taste
    of that stuff).
    
    Last night was alittle better, he only awoke once but I'm finding I
    still have to give him a cough medicine and benedryl to keep his nose
    and cough to a minimum.
    
    cj

    
    
    All my children (3) have received neb treatments.  They all range
    around 5 to 10 minutes, less if they are cranky, 10 minutes on my
    eldest, as he 's used to it (5 yrs.)  My recommendation is either to
    arrange the times a little earlier if you can so that you get the
    treatment in before the cranky time.  I also put in a favorite tape in
    and administer it them.  If they get pre-occupied by the tape, the time
    flies by.  I have also given treatments to my children in their sleep
    (not recommended if they are a light sleeper) and at times I have given
    treatments to screaming toddlers.  5-10 minutes is a lifetime when they
    are crying, but on the good side of things, when they cry they take in
    more of  the medicine deeper into their lungs.
    
    Re; What medicine is left over?  There's always some.  I just try to
    tape the fluid down from the sides of the container a few times during
    the treatment and if I've gotten in a "good" 5 minutes of "good"
    breating in the medicine, it seems to work.
    
    Good luck!  Beth

    RE: -1
    
    
    I mean tap the fluid down the sides of the container.  Sorry

    I heard an interesting note on NPR yesterday regarding study of
    asthma in children. They tested a large number of children, known
    asthmatics and non-asthmatics, and monitored their oxygen and heart 
    rates when emotionally upset. They showed the movie ET, and focused 
    on the scene where ET 'dies'. The asthmatic children had a measureable
    restriction in airways. When showing happy scene, the asthmatics were
    fine. I believe Stamford is funding additional studies into the
    relationship of emotions and asthma attacks. 
    Sarah
                                                        

    Well, I have begun to sleep again.  After three continuous days of
    giving Paul the Prelone Syrup in the morning he began to stop coughing
    at night and as continued to do with Sunday being his last treatment.
    
    Side effects were irritability and emotional the first two days and
    eating up a storm but we quickly adjusted his routine in order to
    survive.  Heck, we were sleeping and Paul was breathing again!
    
    We have not used the nebulizer at all this week.  Should we maintain
    even though the coughing has stopped completely?
    
    Thanks for all your help!  This file is heaven sent!
    
    cj