Conference moira::parenting

    	I recently went through a severe case of asthmatic bronchitis that
    put me in the emergency room (I am also 7 months pregnant and so it was
    a pretty frightening experience). I suffered horribly for three days
    *until* they got the doses of medication right and then I started
    responding very well and started actually breathing normally again.

    	My son (who is 14 months old) showed signs of asthma when he got
    colds at roughly the same age your child is. We used the ventolin
    (sparingly) and he seemed to respond.

    	There are a few things about your note that are similar, little
    babies do not have the reflexes to "clear their throats" and so what
    may sound like a horrible wheeze to you may not be coming from the
    lungs but from the back of the throat. If this is the case, elevating
    one end of the crib is helpful as it allows the gunk to slide back down
    the throat. You may also want to try a syringe although we never
    resorted to that.

    	If the wheeze is coming from the lungs (you need a Doctor to verify
    this) then the child needs medication (this does not necessarily mean
    that he is an asthmatic, apparently young lungs are prone to wheezing).
    If the medication that is being prescribed is not working then you
    either need to change the medication or change the dosage. Again, you
    need a Doctor to do this.

    	If your child is having so much difficulty breathing that he
    appears to be struggling then you need to notify your Doctor
    immediately. It may be a combination of bronchitis, asthma, and
    something called RSV which is a virus that hits young babies especially
    hard in the lungs. If the diagnosis is RSV, you may have to hospitalize
    your baby (ours was in the hospital at 4 months for similar
    complaints).

    	Lastly, if you *think* that the baby should go to the emergency
    room then you probably should go, moms seem to have a very clear sense
    of when their babies are truly sick. (it took us three days to convince
    the Doctors that our baby was sick and when they finally looked at him,
    he was immediately hospitalized).
    	
    	In any event, it sounds like you should be contacting your Doctor
    again to let her know the status of your baby.

    	Wendy who spent many a night just watching the baby breath while he
    		was sleeping.

    Hi Sherry.
    
    You are definately not the only one out there.  My daughter Alicia (4)
    has recently been diagonsed with Asthma.  When ever she gets a cold it
    immediately turns to bronchitis.   Two weeks ago we had our latest
    case.  I'm amazed at how quickly it crops up.
    
    One day Alicia is fine the next she has a 103 fever and cannot catch
    her breath.  I treat her the same way you have been, humidifer, ceclor,
    proventil (inhaler and liquid).  We have only had to use steroids once.
    I hope she never gets that sick again (but she will unfortunately).
    
    I am learning not to panic when she has an attack. I have to be very 
    firm with her.  Nothing tears your heart apart more then yelling:
    Alicia SIT DOWN, Alicia RELAX, Alicia BREATH IN THE MEDICINE, when all 
    I want to do is throw my arms around her and yell for help.
    
    Does Nicky have asthma or just bronchitis?  Alicia's asthma has a lot
    to do with Allergies.  
    
    Angie

    
    We have two asthmatics at home, Lauren (3) and Randy (1).  Speak to
    your doctor about a nebulizer (sp), that and the ventolin keeps us away
    from the emergency room.  By all means if he has trouble breathing get
    him to the hospital immediately.
    
    
    Mike

    Nicky never wheezed prior to getting his first cold. After he got over
    cold #1 I noticed a slight wheeze or squeaky noise when I held him
    close to me. (BTW I call him squeaker now). The Dr said that it was
    "probably" allergy related such as dust and animals, so he gave me the
    liquid Proventil. Cold #2 started in his head and within 24 hrs it
    went IMMEDIATELY to his chest, which the Drs then put him in the 
    catogory of Asthmatic Bronchitis which truns into an infection.
    Ammoxicillin is a part of his diet.
    Within 10 days after finishing it, he is sick again. Each day it is
    like "Ok Bud, are we going to make it another day"? The wheezing
    gets alittle worse, the congestion thickens and then we start at square
    1. My 13 yr old daughter was diagnosed with asthma due to allergies
    at the age of 3 but has since grown out of most of it. 
    Nickys situation is nothing like hers.
    
    BTW, I am bringing him to the Dr's at 2:30.
    
    Thank you all again for the input.
    
    Sherry

	Do children with asthmatic bronchitis exhibit any other symptoms,
	such as fever ?

	Karen

    If there is an infection, yes. In Nicky's case he has a fever
    everytime.
    
    Sherry

re: .6

>    If there is an infection, yes. In Nicky's case he has a fever
>    everytime.
    
But it is important to note that the fever is related to the infection, not 
the asthma or asthmatic bronchitis.  Many people are prone to asthmatic 
attacks brought on by irritations to the bronchial passages (such as by smoke, 
smog, or very cold air) or by vigorous excercise; others have asthma attacks 
that are triggered by allergies.  In neither of these cases is there a fever 
present.

Clay

    re: .7 
    
    Just to clarify my response in .6, in Nicky's case he has had an
    infection along with the asthmic broncitis. You are right, its the
    infection that causes the fever not the asthma.
    
    Sherry

My son Brad has BPD which is commonly referred to as premature lung disease.
It is treated the same as asthma as I understand a lot of lung diseases are.
He has done the steroid treatment a few times from the heavy duty 3 month
course to the 1-week course.  There are some negatives to the steroid use
like extreme vulnerability to catching other things (chicken pox are a great
concern when he's on the steroids) as the steroids somehow suppress the immune
system, but some children respond quite well to steroid treatment as Brad does.
Whenever he is on the steroid treatment, we also have to give him antibiotics
to build up his immunity, and we tend to keep him isolated from the rest of
the world.  I don't understand your pedi's comments about age and weight of
baby.  My son was around 12 weeks old (adjusted age 0) and 3-4 pounds when
he was put on the long course of steroid treatment.  It's very common to use
that treatment for premature babies as a last-ditch sort of effort to get
them off the breathing machines.  Worked like a charm with Brad, though I
know of some babies who did not respond to the same treatment.

Our pedi noticed that whenever Brad gets a cold, he gets a wheeze, so we
tried the ventolin/preventil route (which makes Brad very hyper and crazy),
but after the 3rd cold/wheeze, the pedi prescribed a nebulizer which was 
mentioned in a previous reply.  Since then, we've used it for maintenance
where if anyone in the house gets sick, we nebulize Brad for a few days
with Intal.  This has prevented the wheeze from returning since we've had
the nebulizer, so seems to be working.  You might want to ask your pedi
about this, especially if it seems to be a chronic condition with your son.
And if you are that concerned about your son's breathing, take him to the
emergency room.  They can give him treatments right there for breathing.  I 
know that Brad once had a slight wheeze we couldn't even hear yet, but the
pedi was so concerned that nebulizer treatments (2) were given right in the
office to make it go away.  He could have sent us to the hospital and had
Brad admitted, but we sort of got medical degrees when the babies were born
so early, so we do a lot of stuff at home that normally would be done under
hospitalization or doctor's direct supervision.

Best of luck.
Cathy

    Please see a discussion of asthma, wheezing, and related allergies in
    note 225.  
    
    Note 405 is for discussions of bronchitis, asthmatic and otherwise.
    
    L
    co-mod
    

    Hi everybody,
    
    Nicky went to the Drs yesterday afternoon, he now has a nebulizer at
    home,(thank God my insurance covers that) and I have to give him a
    treatment before he goes to bed and one in the morning with the Proventil
    syrup in between. He did rest much better last night, but I feel that
    extreme exhaustion from the treatment and then the 1/2 hr coughing 
    fit afterward contributed to that. He also has a appointment with
    an allergist on the 18th. 
    I informed my 2 older children that we are going to have to give away
    the cat and the dog, so that has started yet another thing I have to
    worry about. I explained to them that if that is what it takes to
    make Nicky more comfortable we will have to make the sacrifice.
    Hopefully he will start to improve soon.
    
    Thanks for all of the imput.
    
    Sherry

    I may have missed it in earlier notes but.....  If you haven't brought
    him for allergy testing yet, how can you be sure he is allergic to the
    dog and cat?  It is possible that he does not have a specific allergy
    to them or their dander.  Dust mites (housedust) could be one of the
    culprits as well as 100,000 other allergens - and not necessarily the
    animals.
    
    I guess I would wait for the testing before making a big decision like
    that.  My personal experience was in developing adult allergies.  I
    assumed that I would be allergic to my dogs and would have to get rid
    of them.  I was pleasantly surprised to show no reaction to dogs or
    cats.  I was allergic to tons of other things - but not them.

    re .12
    
    When I went to the allergist with Nicky he told me that he was to 
    young to be ALLERGIC to the animals, but it would not hurt to remove
    as much as possible from his atmosphere during his INTIL/PROVENTIL
    nebulizer treatments to hopefully allow his bronchial tubes and lungs
    to get the best out of these treatments. The INTIL is a long term 
    proventive medication to help stop asthma attacks from happening,
    and the PROVENTIL is for when he is wheezing and coughing.
    I have removed stuffed animals, have cotton curtains in his room,
    and I also damp dust his room every other day. One of the problems
    with the dog is that he has eczema which is very hard to keep
    under wraps, which in turn makes him itch all the time. 
    Right know I am keeping him in the kitchen, and every day I am
    sweeping up dried skin along with much hair.
    My ex said that he will take the dog, and, if at some later date I 
    can take him back I will, but I am still looking for a good home
    for my kitty.
    
    Sherry

    Sherry, (.12)  I've got a real problem not with you personally, but
    with the world's way of thinking that the first thing you MUST do when
    a child wheezes it to get rid of animals.  I've got two cats, and AJ is
    diagnosed with asthma.  My feeling is that if the animal is not the
    reason for the wheezing then why on earth get rid of them.
    
    One very important thing we always watch for is something called
    "retracting".  This is a chest movement that occurs when he is in
    respriatory distress.  If you were to look at his belly it looks like
    it's pulling IN when he breaths, where normaly it should go out in a
    nice even flow.  Usually when I call the pedi either they ask me or I
    offer the information that he is retracting.  This is a very definite
    sign that your child needs to be seen either by your pedi or an ER VERY
    soon!  Also we watch his color, if it's pasty and or his eyes seem
    puffy then we know that we've got a problem.  I've would consider
    calling an ambulance for this if its going to take more than 15 minutes
    to get to help.  (OK that's the EMT in me speaking)
    
    Since AJ has been wheezing since almost birth I feel I've had a lot of
    chances to experiment.  Here's some of the things we've discovered that
    has made living with asthma more tollerable.
    
    We use only the nebulizer machine to give him the ventolin, we also
    administer the mist using a converted (non-rebreather type) oxygen mask, 
    most doctors have them in the office, most of ours came from ER visits 
    The plastic piece from most neb machines fit the lower opening of the
    mask where the plasic bag is generally attached.
    Although the liquid given by mouth will work "in time", the inhaled meds 
    work much quicker as they are going directly into the lungs.  By the
    way this is not only my opinion, but that of many respiratory
    therapists and his pedi-pulmonary specialist.  He has recently been
    placed on inhaled steroids four times a day.  This is in the form of a
    small aerosol pump attached to a plastic chamber that he sucks in like
    you would a straw.  He still takes the steroids by mouth, but again
    they take longer to react (24 hours is what we've been told)  We have 
    also stopped using the oxygen mask only recently, since he is now 6 and 
    old enough to understand what is being asked of him.  We found he still 
    "cheats" a bit so we bought a nose clip designed for swimming so he can 
    only breath through his mouth with the mouth piece.  
    
    When AJ was an infant it became almost a nightly habit to rock him to
    sleep while giving him a breathing treatment.  Maybe he was the
    exception, and more tolerant of the whole thing?  We maintained a very
    matter of fact attitude towards his wheezing, so he knew that this HAD
    to get done like it or not.  
    
    It's not easy being a parent, is it?
    Lyn
    

    RE:.14
    
    You are right! It is not easy being a parent. We all do things that we,
    as parents, feel are for the best for our children. As I stated in note
    13, the Dr. said that the baby was too young to have allergies to the 
    pets, but if they could be put in new homes either for good or just for 
    awhile, that is less hair (and skin, the dog has ecezma) floating
    around in the air for him to breath in. He is constantly on the floor
    playing now and I feel more comfortable that I don't have to worry
    about that. The pets are in wonderful homes now with people I know,
    so it is very easy for me to ask how they are doing and it has been 
    much easier on the two older children that way.
    Also in one of my earlier notes I stated that Nick is on INTIL
    treatments via a nebulizer and mask three times a day. the only time
    I have to put in the PROVENTIL is when he is wheezing or coughing alot
    when he is coming down with a cold. There has been a great improvement
    in the past 7 weeks since this has started.
    
    Sherry

    For your sake I can only hope its a flu. BUT... we had a similar type
    of thing happen when AJ was about the same age, I truly thought he was
    having a seizure!  He stiffend up while his father was holding him and
    let out this animalsounding scream at the same time.  I'm not kidding I
    called 911!  I thought he was having a seizure!
    
    Turns out he was having a bronchitis attack, and because he was hypoxic
    (lack of adequate oxygen) he did this.  Unfortunately the bumble
    brained resident in the ER told us it was from an ear infection,
    prescribed anitbiotic and sent us home.  He was still crying, I still
    can't forget that sound.  We spent the next 4 hours taking turns
    rocking and trying to comfort him, nothing worked.  I finally called
    the pedi somewhere around dawn and begged for something to be done, he
    called in some tylenol with codien.  He too was going on the pretenseof
    an ear ache.  Finally at 9:00 a.m. his visiting nurse came by for her
    usual bi-weekly visit, she listened very briefly and recognized
    difficulty in breathing.  She sent us on to the hosptial, and called to
    say we were coming.  He spent 3 days in a croup tent, and I lodged a
    complaint against the resident, because she really endangered his life,
    he was starving for air and she brushed us off!
    
    I'd say if you still think there's a problem, especially considering
    its the beginning of a weekend, call the doctor and ask to be
    seen-tonight!!
    
    Please keep us posted...
    Lyn

Trust what you know about your child.  Since this is highly unusual behavior,
I suggest you make a doctor's appointment.  In the meantime, use Tylanol or
Panadol (same thing, just different brands).  It can reduce the pain and
help her to start acting more like herself for a little while.  

       Carol

    It doesn't sound unusual behaviour for a child who isn't feeling well.
    Typical short attention span ... self recognized frustration from the
    short attention span and general discomfort.  (How well do any of us
    concentrate when we don't feel well, and scold ourselves for not being
    able to buckle down ... ?)
    
    I would definitely try a bit of acetaminophen (Childrens Tylenol, Tempra
    or Panadol) and see how that goes.  Don't use children's aspirin ...
    especially in case this is the 'flu because there is a link between
    use of aspirin, certain viruses, use of aspirin and Reye's Syndrome
    in children.  If the Tylenol helps, then carry on, but be careful not
    to give so much that you mask other symptoms ...  we generally use
    it on an as needed basis, which we extend out to be longer than the
    recomended dose intervals if possible.
    
    Then talk to your Doctor's office ... even if you don't take your child in
    ... just get their opinions.
    
    Stuar

    I am confused.  My son Paul had his first cold that ended up being a
    five day hospital stay with bronchilitis.  Note the difference in the
    name with bronchities.  According to my pedi, its a virus that strikes
    infants.  I also somewhat remember her telling me that infants do not
    get bronchitis.  We diagnosed that he did not have allergies the second
    day in the hospital (under an oxygen tent) because he spiked at 102
    fever and an ear infection.  It was also then that they said he did not
    have asthma either.  He was 10 weeks old when this happened and when we
    came home we were sent with a 10 day supply of amoxicillin.
    
    The following week after we arrived home my husband got bronchitis.  He
    gets this every year and we wondered if he contracted it from our son,
    and, if my son is going to be prone to bronchitis because my husband
    is.  In any case, after my husband was on amoxicillin for 10 days, 
    we were at a party where my neice and neufew were.  Yesterday, I found
    out they both had two ear infections and bronchitis.  Today, I am not
    feeling well and neither in my son.  I was hoping that the doctors
    office would prescribe amoxicillin to both of us but they said that
    they could for me but would have to see Paul.  He is not that sick
    however and I was hoping to "nip this in the bud" before he became too
    sick that he is unable to breathe.  I guess for someone so young
    however, they want to see him.  My questions you ask?
    
    1.  Why wait until he is so sick that he needs the medicine?  Its
        obvious to me that we are all going to be very sick in 24 hrs if we
        do not get the proper treatment.
    
    2.  Is he going to be prone to this type of bronchitis all his life?
    
    I have a cool air humidifier that we keep running all night next to the
    bed.  We have his crib matress propped up a bit to help him breathe.  I
    have quit smoking.  What else can I do to make his life easier? 
    (besides never taking him to visit his cousins again.. they are
    "always" sick and never tell us until its too late!)
    
    I laughed when I read the noter who said they stayed awake all night
    watching their child breathe and they were sleeping.  Lately, it seems
    that is all I ever do.
    
    Just wondering if anyone can give me some insight...
    
    cj
    

    Our son, Jason, had bronchiolitis as an infant.   As your note points
    out, it is a virus - antibiotics are effective in the treatment of
    bacterial infections, not viruses.   I don't have the memory that
    so many of the noters seem to have 8-) - but I believe bronchiolitis
    is characerized by wheezing while breathing and that there are a
    couple of prescription medicines that can be given to help clear 
    the airways (I don't recall the name, but it wasn't an antibiotic).   
    When Jason had the bronchiolitis as an under-6 month old, you could 
    actually see his chest kind of collapse as he tried to breath.   He 
    continued to have the wheezing with most of the upper respiratory 
    infections he had during his first two years.   We gave him the
    prescription medicine as needed over that two year period (went 
    through three bottles).
    
    RE: your question of why wait until he is sick to give him 
    medicine?   I believe that doctors try to limit the use of
    antibiotics unless a bacterial infection is indicated.  The reason
    being that antibiotics are ineffective for the treatment of
    common viruses and you don't want the child (or adult, for that 
    matter)to build up an immunity to the antibiotics and have them not 
    be effective when they are truly needed.  
    
    RE: Is he going to be prone to bronchiolitis all his life?
    Well, in our son's case, he did seem to be prone to it for
    awhile but then "outgrew" it.  I seem to recall there being some
    increased risk of a child who had bronchiolitis frequently as
    an infant developing asthma as a child...  
    
    One person's experience,
    Carol  

    >    1.  Why wait until he is so sick that he needs the medicine?  Its
    >    obvious to me that we are all going to be very sick in 24 hrs if we
    >    do not get the proper treatment.

What did the doctors office say?    

Don't know, but there may be concerns over allergies to antibiotics.  Also, 
use of antibiotics can lead to some serious gastrointestinal problems.  Some 
of these can be resolved with a few dishes of yogurt, but some can be quite 
serious; my wife had a stomach problem caused by antibiotics that took MONTHS 
to clear up.  Also, there's the problem of developing resistant strains of 
bacteria, so it's good not to overuse them.  And if it's a viral infection, 
antibiotics are useless.
    
>    I have a cool air humidifier that we keep running all night next to the
>    bed.  

Make sure that you clean and disinfect the cool air humidifier.  Because they 
are moist and spew stuff into the air at room temperature (the water never 
boils) they can breed bacteria and spew it into the air.  Quite honestly, I'm 
not sure how to do this properly, but I'm sure some other noters know.  
Bleach perhaps?

And not to be a spelling freak, but I believe the other condition is 
"bronchiolitis".

Clay

	My daughter was just diagnosed with bronciolitis on Monday.  After
	4 days of coughing (periodically, not chronically), I brought
	her to the doctors.  She was also breathing very rapidly.  The
	doctor also told me she was wheezing (I couldn't hear it though).
	So, 2-1/2 hours later after 2 nebulizer treatments and chest
	x-rays for pnemonia, they tell me she has bronciolitis.  She also
	has an ear infection... I had no clue about that.  She had no
	fever and, except for the nasty cough, she was quite happy.  For
	treatment, we were given antibiotics for the ear infection and
	a nebulizer with broncho-saline and proventil 4x/day for a week.
	This nebulizer is supposed to help slow down her breathing.

	I was told by the docutor that the virus that causes bronciolitis
	in babies would just cause a nasty cold in people over the age
	of 2 years.  I'm kind of confused about why a chest cold has
	a different name when a baby has it.  

	I'm also wondering if the treatment is overkill (the nebulizer).
	I'm doing it just as the doctor asked but the doctor said that
	I should do it for a week and a half!  

	For those of you with children who have had bronciolitis, what did 
	your doctors prescribe?

	Karen

    Speaking as the parent of an asthmatic child, who was diagnosed with it
    at only a few months old, the nebulier machine is a minor miracle!  NO
    the machine is not overkill.  The object of the machine is to get the
    child's lungs open as quickly and painlessly as possible. 
    
    Since you said your daughter had two neb treatments, I suspect she was
    to "tight" that the first one didn't open her up completely.  Most
    doctors won't give a second back to back neb unless it is justified.  
    
    FWIW, asthma is diagnosed after three episodes of Bronchiolitits. 
    Whether it is ever officially called asthma or not, the symptoms and
    treatments are just about the same.  
    
    For future reference, even if you can't acutally hear wheezing,
    unfortunately it's the wheezes you can't hear that are the deepest in
    the lungs.  It's the ones that are up high, you can hear that really
    are not a big deal,unless they just sound very high pitched and high
    toned.  Look at the child's bare tummy, if the tummy is being pulled
    *in* with each breath, that's a clear indication you've got a problem. 
    The child is working very hard at each breath, call your doctor and
    take her to be seen immediately!  Retracting is serious.  I've seen it
    all too much!
    
    Lyn 
    (first the mom, then the EMT!)

    She was retracting.  I would have never known it but the doctor
    showed me what signs to look for in the future.  It was scary
    seeing her breathing so fast.... I knew something was wrong but
    I didn't know if it was serious or not.  The doctor told me that
    she is not very serious (otherwise she would be hospitalized).
    She is in daycare today and my daycare provider will do one
    nebulizer treatment for me.  I stayed home yesterday with her
    and kind of felt guilty because she was acting quite normal!  We
    had alot of fun yesterday hanging out together!

    Her breathing has slowed down today.  I hope she doesn't have
    asthma!  The doctor didn't even mention that to me though so
    it probably is not an issue.

    Karen

    My middle son, Ryan (now age 8) had Bronchiolitis + Pnemonia when he
    was 3 months old.  All we had to do at the time was give him an
    antibiotic.  Of course, this was a while ago so procedures probably
    have changed.  Ryan has ALWAYS had some type of respiratory problem. 
    He had his tonsils and adenoids out last summer as they were extremely
    enlarged.  He was also recently diagnosed with Asthma (very mild case
    but still uses a Vanceril inhaler twice a day).

    My daughter has had bronciolitus/broncitus 2 times.  This winter she
    has had nebulizer treatments (1 or 2) at the doctors office for 3
    separate illnesses.  It appears as though when she gets sick, be it ear
    infection, bad cold, etc they tend to settle in her chest and she
    wheezes.  Her pediatrician had prescribed ventilin, which has the same
    basic effect as the nebulizer only it's taken orally.  I agree with
    previous replies that this treatment is not over kill.  It has
    obviously helped her with her breathing.  When I don't give her the
    ventilin, almost immediately her breathing becomes more difficult.

    This is from someone who HAS Asthma, and has had bronchitis at least
    once a year for the last 8 years. )-:
    
    Karen,
    
    First off, it's not just a different name for a child under 2.  I think
    what the doctor was trying to say to you is that a bad cold effects an
    infant much more than it does an older child/adult.  Bronchitis STARTS
    as a cold, and then an infection develops in the lungs, making it
    bronchitis.  
    
    The nebulizer IS a godsend!  Keep using it just as the doctor ordered. 
    It will clear out her lungs considerably, and will help her to breath
    easily.  She may have looked like she wasn't very sick yesterday, but
    she probably wasn't breathing really well.  Her lungs were probably
    still congested, even if you can't hear it.  
    
    Holly
    

    What is a Nebulizer and what is Ventillin?
    My daughter has had bronchitis frequently lately. Here in
    France the doctor has prescribed antibiotics and "clapping".
    "Clapping" = a physical therapists claps with a cupped hand on
    the childs back , loosening up the congestion and making the 
    baby cough the stuff out. 
    I am interested in the difference of treatments. (to find the best)
    Carol

    A nebulizer is a sort of a compressor machine, the best equivalent I
    could give is that it is sort of a small, designed for short term use,
    aquarium air pump.  From this you string oxygen tubing, which has on he
    end a small chamber that hold liquid medications which in many cases is
    Ventolin, mixed with another solution; frequently it is normal saline
    sometimes chromelin or something else. At the top of the chamber for
    the solution is either a face mask, a common oxygen mask usually, or a
    mouth piece which looks like that of a SCUBA diver.  The liquid in the
    chamber becomes a fine aerosol mist which is inhaled into the lungs and
    begins to expand the various parts of the lung (alveoli, etc).
    
    I am familiar with the "clapping".  In the us it is not used as
    frequently, unless you have a known pulmonary disease such as Cystic
    Fibrosis, emphysemia and such.  I have personally only used it a couple
    times on my asthmatic son, only when he was quite small.  It is a
    method of "cupping" your hands and sort of running your hands up and
    down the back, to disloge stuck mucous in the lungs.  
    
    Steroids are also given, either inhaled using a small chamber with a
    steroid containing mist, sometimes the chamber isn't used at all. 
    Steroids in pill form are also used in conjuntion with the Nebulizer or
    chamber broncho dialaters (ventolin).
    
    Hope this helps, not confuses.
    
    Lyn
    

re: .28

In answer to your other question, Ventolin is a trade name for a medication. 
I believe the chemical name is albuterol, but I'm not sure; I'll try to 
remember to check tonight.  It is a bronchodilator -- that means that it 
opens the bronchial tubes to provide a bigger air passage.  It's generally a 
short term fix; in fact one use of it is to open the air passages so that the 
patient is better able to inhale some other medication, such as an inhaled 
steroid as Lyn mentions.

It is most commonly (possibly exclusively) taken as an inhaler.  My son takes 
a couple of puffs before sporting events.

Clay

I was a childhood asthma sufferer.  When I had bronchitis last summer, I had
an asthma attack for the first time in 30-odd years.  I was given an albuterol
inhaler in the emergency room.  It relieved the symptoms, but didn't make the
bronchitis go away.  When I saw my doctor, he prescribed Azmacort, a steroid
inhaler.  This cleared up the bronchitis.

   fyiw, Ventolin IS Albuterol and is used WHEN the person is having
   an attack, used to help open up the airways - Azmacort is a trade
   name for Triamcinolone Acetonide, which is an INHALED STEROID - the
   dr's say (and I will attest it works !) that the steriod helps to
   KEEP the airways open thereby minimizing/preventing attacks.....

   and in case you wonder how I know, I've been asthmatic for YEARS
   but just this year had an episode SO bad I was in the hospital for
   3 days - went to the ER at 2 a.m., had 5 breathing "treatments" in
   3 hours, sent home at 5 a.m. seemingly under control, back to the ER
   at 10:45 by ambulance (wouldn't ya know, we had blizzard conditions
   the same time !!!) and admitted into the ICU at about 3 in the afternoon.
   They started giving me the steriods by needle along with breathing
   treatments every 2 hrs and antibiotics and kept me on oxygen until
   about 2 hours before I was finally allowed to go home - SCARIEST 3 days
   of my life !!!!  But the Azmacort has really helped and, up until this
   episode, the Ventolin ALWAYS did - major difference this time was a
   VERY bad cold/infection on top of a BAD respiratory winter in New England.

    
    Ventolin and Proventil are both brandnames for Albuterol.
    
    It can be had as a liquid, I believe tablets, and most commonly as a
    microcystalline suspension in propellants (Inhaler).
    
    The inhaler can be QUITE helpful.  
    
    Don't know about the nebulizer, but a friend of mine had one for his
    son who had really bad asthma as a child, and they swore by it.
    
    -Patty

    When I first started this note Nick was just a wee one. Now he is
    running around and having a grand time discovering things. Nick will be
    2 on 8/1 and is still using the nebulizer with Intil sometimes mixed
    with proventil as needed. We were to stop treatments for the winter
    season, but he is currently suffering from croop (sp?) which is
    triggering him to start wheezing. Anyway, the nebulizer has been a God
    send. I will tell you now if not for it, my little guy would have 
    been in the hospital more than I would care to think about. Between my
    wonderful daycare provider and my self Nick has been alot healthier.
    Not saying he has not had his share of sickness, he has, but the neb
    has made it alot easier for him AND myself.
    It sometimes is a pain to lug the thing around all the time but it is
    well worth it.  :)
    
    Sherry   

    When my son Paul was sick at 10 weeks old (see note 29ish) I brought
    him to the doctor and the nebulizer was the first thing that they gave
    him.  We were sent home to see how things were.  The second day he
    wasn't better and I brought him back to the pedi.  Another neb
    treatment and a respiratory nurse showed me how to do the clapping.
    She also recommendated to put him in the hospital in a tent.  I
    couldn't bear the thought of the poor thing in the hospital with tubes
    and stuff all over him so I tried again.  I woke up at 4:00 on January
    2nd, in the middle of a great NE blizzard to a blue child.  We ran him
    into the hospital right away and he was in an oxygen tent for five days
    with neb treatments every 4 hours and clapping after every treatment. 
    We didn't bring home any of the neb treatments but had amoxicillin and
    were told to continue the clapping.
    
    He has been fine since, knock on wood.  Take this illness seriously and
    use the neb treatments!
    
    cj

	   Well, Lauren is doing much better!  Her cough is gone
	   and she is back to normal.  Her parents on the other
	   hand... we both have horrible colds!  I felt awful starting
	   last Friday and still feel pretty poor!  Lauren got over
	   it much quicker than I did, thats for sure!  Must have
	   something to do with not being run down.  I'm pooped!

	   I just hope she doesn't catch this cold again from me.
	   I used to think that you can't catch the same virus twice
	   but I was reading an article in Parenting about "how to
	   prevent the 3 month cold" and it implied that the same
	   cold virus can make the rounds in a family several times.
	   I'll have to ask the pedi about this one.  

	   Karen

It is extremely rare to catch the same virus (even colds) ... not impossible
but extremely rare.

BUT the cold virus is very mutagenic... ie it can mutate very easily, which
is why we seem to get cold afer cold.  It would be perfectly possible for
a cold virus to mutate sufficiently after infecting a family to looks
sufficiently different to your white blood cells to be able to reinfect the 
earlier members in the family.

It really depends on how mutagenic the particular virus is ... how much and
how fast it mutates.

Stuart

    I found this in a local Parents' guide and thought it may be of some
    interest.
    
    		Q & A's: BRONCHIOLITIS by Laurie A. Cohen, D.O.
                -----------------------------------------------
    
    
    Q. What is bronchiolitis? 
    
    A. Bronchiolitis is a common infection of the lower respiratory tract
    	that affects young infants up to two years of age. It causes 
    	inflammation of the very tiny airways in the lungs called bronchioles. 
    	Swelling of the airways, along with mucous discharge, leads to 
    	narrowing and blockage of these airways. 
    
    
    Q. How do children get bronchiolitis? 
    
    A. The source is usually a family member or other close contact who has
    	a minor respiratory illness, such as a cold. 
    
    
    Q. Why are infants and toddlers affected, as opposed to older children
    	and adults? 
    
    A. Infants and toddlers have narrow airways and are therefore more
    	sensitive to inflammation and swelling in this area. 
    
    
    Q. What causes bronchiolitis? 
    	
    A. Bronchiolitis is primarily caused by viruses, the most common one
    	being RSV (respiratory syncytial virus). This virus is most active in
    	the winter and early Spring.
    
     
    Q. Can cigarette smoke cause bronchiolitis? 
    
    A. Although cigarette smoke does ott directly cause bronchiolitis, 
    	children whose parents smoke are more likely to develop bronchiolitis, 
    	as well as ear infections. The cigarette smoke tends to aggravate the 
    	symptoms.
    
     
    Q. How do I knowif my child has bronchiolitis? 
    
    A. The first symptoms are those of a common cold - stuffiness, runny
    	nose, mild cough. Then you'll notice that the baby has a tight, hacking
    	cough and is breathing rapidly. These symptoms get worse over a few
    	days, and then gradually improve. You may notice, in addition to the
    	rapid breathing, retractions of the chest and a wheezing or whistling
    	noise when the baby breathes in and/or out. Babies with bronchiolitis
    	can become so breathless that they can't suck well. Most cases of
    	bronchiolitis last about seven days, but children with severe cases can
    	cough for weeks. 
    
    
    Q. Does attending day care increase my childs chances of developing 
    	bronchiolitis? 
    
    A. Yes. The more respiratory illnesses a child is exposed to, the
    	greater the risk of developing bronchiolitis. 
    
    
    Q. Does breastfeeding decrease my childs chances of developing
    	bronchiolitis? 
    
    A. Yes, because breast milk contains antibodies which fight infections. 
    
    
    Q. What is the incubation period of Bronchiolitis? 
    
    A. The incubation period is several days to one week. 
    
    
    Q. When should I call my doctor? 
    
    A. You should call your doctor if your child is: 
    	- taking more than forty breaths per minute.  
    	- wheezing. 
    	- pale or bluish. 
     	- too tired or distressed to drink from the breast or bottle. 
    
    
    Q. What is the treatment for bronchiolitis? 
    
    A. Since bronchiolitis is usually a viral infection, antibiotics are
    	not helpful. There is no specific treatment for bronchiolitis except
    	time. Sometimes bronchodilator medications are helpful, as they help
    	open the airways in the lungs. This type of medication can be given
    	orally or inhaled through a machine called a nebulizer. However, a baby
    	who is so distressed he cannot suck (eat) and breath at the same time
    	may need to be hospitalized to prevent, or treat, dehydration through
    	IV (intravenous) fluids. 
    
    
    Q. How can I help my child with bronchiolitis? 
    
    A. The following suggestions may help your child feel more comfortable. 
    	- Use a cool mist vaporizer to make the air more moist. 
    	- Prop the baby in a sitting position; tilt the mattress up slightly. 
     	- Encourage your baby to take in extra fluids. 
     	- Use any prescribed medications only as directed. 
    
    
    Q. Are there any long term affects of bronchiolitis? 
    
    A. A large number of children who get bronchiolitis later develop
    	asthma. The reason is not known. 
    
    Dr. Laurie A. Cohen is a pediatrician with Children's Healthcare. She is 
    a graduate of New York College of Osteopathic Medicine and did her 
    residency at Hahnemann University Hospital. Dr. Cohen is certified by the 
    American Board of Pediatrics and is a Fellow of the American Academy of 
    Pediatrics. 
    
    Childrens Healthcare is located at the Childrens Healthcare Center,
    1517 Pond Rd., Allentown, PA, and provides care for children from the
    prenatal period through age 18. 610-395-4444. 
    
    

    Interesting...thanks for entering that.  My one son who had
    bronchiolitis as an infant DOES have non-allergenic Asthma.
    
    Linda