Wheezing infant

DD has asthma. She's been coughing and wheezing for weeks. This past week,
she's been to see the ped almost everyday because she wheezes despite her
around-the-clock albuterol treatments. They had her on steroid shots
everyday and they've tried cromolyn and Atrovent treatments. The cromolyn
triggers attacks, too irritating to her airways, so we've stopped those.
The ped has given up on her, he's done all he can, so he said to bring her
in only if she's in real distress, and gave me what to look for besides
turning blue. For now, he will accept that she wheezes, because she can
play and doesn't look too distressed and her O2 sat is good. She's seeing
an allergist today.

Just a little vent. As a layman, I find it hard to believe she doesn't feel
a little bit of difficulty breathing with all her wheezing, but I'm told
that's possible because some adults have said they feel fine when wheezing.
Okay, I know that's possible, I'm just a concerned parent. Does anyone else
here have a child who wheezes despite albuterol treatments? She was better
yesterday and today so far. We have an air purifier in her room and the
house has the allergen filters on the air intake of the air conditioning
ducts.

toypup wrote:

DD has asthma. She's been coughing and wheezing for weeks. This past week,
she's been to see the ped almost everyday because she wheezes despite her
around-the-clock albuterol treatments. They had her on steroid shots
everyday and they've tried cromolyn and Atrovent treatments. The cromolyn
triggers attacks, too irritating to her airways, so we've stopped those.
The ped has given up on her, he's done all he can, so he said to bring her
in only if she's in real distress, and gave me what to look for besides
turning blue. For now, he will accept that she wheezes, because she can
play and doesn't look too distressed and her O2 sat is good. She's seeing
an allergist today.

Just a little vent. As a layman, I find it hard to believe she doesn't feel
a little bit of difficulty breathing with all her wheezing, but I'm told
that's possible because some adults have said they feel fine when wheezing.
Okay, I know that's possible, I'm just a concerned parent. Does anyone else
here have a child who wheezes despite albuterol treatments? She was better
yesterday and today so far. We have an air purifier in her room and the
house has the allergen filters on the air intake of the air conditioning
ducts.

Personally, I would find this situation unacceptable.
A pediatric allergist or pulmonologist should be able to do
better. You may also need to do a lot more around the house,
especially in her room, depending on what her triggers are.

Best wishes,
Ericka

My daughter wheezed as an infant too. She was never formally diagnosed with
asthma, but was given albuterol and cromylyn treatments too. She played
fine and was otherwise okay, just had noisy breathing. Even a pediatric
breathing specialist couldn't figure out what was wrong. She eventually
grew out of it around age 2 and is fine now.
~Peggy

"toypup" wrote in message
news:RZRbd.369711$mD.128941@attbi_s02...
DD has asthma. She's been coughing and wheezing for weeks. This past
week,
she's been to see the ped almost everyday because she wheezes despite her
around-the-clock albuterol treatments. They had her on steroid shots
everyday and they've tried cromolyn and Atrovent treatments. The cromolyn
triggers attacks, too irritating to her airways, so we've stopped those.
The ped has given up on her, he's done all he can, so he said to bring her
in only if she's in real distress, and gave me what to look for besides
turning blue. For now, he will accept that she wheezes, because she can
play and doesn't look too distressed and her O2 sat is good. She's seeing
an allergist today.

Just a little vent. As a layman, I find it hard to believe she doesn't
feel
a little bit of difficulty breathing with all her wheezing, but I'm told
that's possible because some adults have said they feel fine when
wheezing.
Okay, I know that's possible, I'm just a concerned parent. Does anyone
else
here have a child who wheezes despite albuterol treatments? She was
better
yesterday and today so far. We have an air purifier in her room and the
house has the allergen filters on the air intake of the air conditioning
ducts.

"toypup" wrote in message news:RZRbd.369711$mD.128941@attbi_s02...
DD has asthma. She's been coughing and wheezing for weeks. This past week,
she's been to see the ped almost everyday because she wheezes despite her
around-the-clock albuterol treatments. They had her on steroid shots
everyday and they've tried cromolyn and Atrovent treatments. The cromolyn
triggers attacks, too irritating to her airways, so we've stopped those.
The ped has given up on her, he's done all he can, so he said to bring her
in only if she's in real distress, and gave me what to look for besides
turning blue. For now, he will accept that she wheezes, because she can
play and doesn't look too distressed and her O2 sat is good. She's seeing
an allergist today.

Just a little vent. As a layman, I find it hard to believe she doesn't feel
a little bit of difficulty breathing with all her wheezing, but I'm told
that's possible because some adults have said they feel fine when wheezing.
Okay, I know that's possible, I'm just a concerned parent. Does anyone else
here have a child who wheezes despite albuterol treatments? She was better
yesterday and today so far. We have an air purifier in her room and the
house has the allergen filters on the air intake of the air conditioning
ducts.



My three year old is severely asthmatic, and is just finishing a
couple of weeks of round the clock breathing treatments
(bronchodilators and steroids)/oral steroids and trips to the doc and
ER. Last word we got from pulmonology was to continue the treatments
at least every 8 hours until she's been 'better' for 2-3 days.

I've been a little fed up lately with the vagueness of the
recommendations we get, and for awhile I was on the phone to the ped.
pulm. on call every night because she'd get worse in the evening and I
wouldn't know what to do. I am *very* cautious; I've read everything
they give me, we're part of an asthma treatment and education group
through our insurance, and I've had sessions with the asthma educator
at the hospital during each of her admissions. This attack has been
particularly worrisome because her heartrate has been up around 160
for most of the time. This bothers her (and me) more than the
breathing issues!

I can tell you that my daughter has been similar to yours, and it's
driven me crazy. Has she ever been admitted? Because whether they're
wheezing or not, they don't do much more in the hospital, in my
experience. Do you keep a stethoscope at home? Sometimes it's
helpful to me to monitor Solana like this, because I've watched the
docs closely, and things like whether the wheeze is on inhaling or
exhaling or both are important, as well as how deep of a breath she's
taking (which you can time with a stopwatch). You can also listen to
different areas within the lungs to see if there's one bad spot, or if
the wheezing is all over.

I'm planning to write down a list next time I see the pulmonologist of
how to determine true respiratory distress, though I think they may
not tell me exactly -- I do have an 'action plan', but it's mostly
useless (it used to be useful, we've outgrown it), and I think they
like us to call whenever she has an attack, because they listen to her
over the phone, and talk to her, and use that as part of their
judgement.

I've gotten a little cavalier lately -- I insisted on going to the ER
one afternoon because I *knew* she was not going to get *better*
overnight, and I didn't want to wait in line, because I also knew she
wasn't doing horribly. Just 'pretty bad'. And a couple of times,
when I've talked to the doctor at night, I wait to take her in until
the morning, because I'm so used to it, I can just have her sleep with
us and listen to her all night. But then I remember Circe's asthma
attack.

You totally need to get a pulmonologist. It's hard in some places, we
couldn't get a referral until her second admission. I think this is
mostly because a lot of kids get wheezy with viral infections, and
then never again, and I was told that insurance companies do not like
asthma diagnoses, so doctors try and wait until they're sure before
sending you. But, you need to go ; )

I also heard from a friend recently that one hospital near us has a
special pediatric asthma urgent care that's been very useful to them.
For example, according to our doctors, we can only give up to 3
(albuterol or xopenex) treatments in an hour (every 20 minutes), at
home, and if the wheezing or shortness of breath doesn't go away, we
need to go to the ER. Once there, they can only give up to 6
treatments (and only 4 if you did 3 at home) before an admission is
necessary if the problem is not solved. At the special asthma care
place, a kid can get 10 treatments, and still not need to be admitted.
And since that's all they do there, there's really no waiting. Maybe
there's a place like this you could use as a resource.

I'd be annoyed with that much wheezing despite the treatments, but it
may not be as horrible as it sounds. When my daughter gets really
bad, she stops wheezing altogether (yeah -- I know that *that's*
serious distress), so wheezing means she's getting at least enough air
to make sounds. When in doubt, call the ER and ask to talk to a
pulmonologist! Or in serious doubt, 911, I guess.

Has she had a chest xray during this illness? It could be pneumonia,
maybe. If it is, certainly it's more serious than an asthma attack by
itself, but as long as you're doing the treatments round the clock,
you might as well stay home as long as you can, because that's pretty
much what they'd do in the hospital.

I hope she's better by the time you read this!

Tina.

P.S. -- I don't want to encourage anyone to adopt my cavalier
attitude. We live under .5 miles from the hospital, and I could run
there with her in my arms if I needed to, so I do get kind of overly
comfortable. And we've been dealing with speicalists for years with
this kid, so I'm kind of used to talking to someone at the hospital
all the time. Anyway, this is just a disclaimer. If you feel like
she can't breathe well enough, call 911 or the emergency room right
away.

Hi --

How old is your baby? What does she eat? Is she nursing, on solids,
drinking formula?

In the absense of other answers, a trip to the allergist is an excellent
step. It sounds as though your ped. is doing the right things, and the
allergist referral is great. (I hope it helps!)

Before you go in to your allergist, start keeping a diary of exactly how
your baby's health is, what she's been eating/drinking and where she's
been spending time. You might try eliminating some of the most common
allergens from her diet (wheat, milk protein, soy...) for several days
to a week and see if the elimination helps. (If you're nursing eliminate
them from YOUR diet as well.)

The information from your daily journal of your child's health, food and
places will be helpful to your allergist, regardless of whether it
helps YOU to find an asthma trigger.

Oh, if your child is oold enough, see about getting her a flu shot.
She's in the at-risk category.

I hope this helps.
--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
b Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

NOTE: No email is read at my MIT address. Use the AOL one if you would
like me to reply.

"toypup" wrote in message news:RZRbd.369711$mD.128941@attbi_s02...
DD has asthma. She's been coughing and wheezing for weeks. This past week,
she's been to see the ped almost everyday because she wheezes despite her
around-the-clock albuterol treatments. They had her on steroid shots
everyday and they've tried cromolyn and Atrovent treatments. The cromolyn
triggers attacks, too irritating to her airways, so we've stopped those.
The ped has given up on her, he's done all he can, so he said to bring her
in only if she's in real distress, and gave me what to look for besides
turning blue. For now, he will accept that she wheezes, because she can
play and doesn't look too distressed and her O2 sat is good. She's seeing
an allergist today.

You mention the albuterol, atrovent, and injectable steroids. Please
do say that if her asthma is that severe (unless this is the first
attack) that she's also on maintenance inhaled steroids whether or not
she's symptomatic.

If her asthma is that bad she'd probably stand to benefit a lot from
going to an asthma clinic or pediatric pulmonologist. It's true,
wheezing is the least significant of asthma symptoms, but it shouldn't
last for weeks. I've known people who's asthma simply can't be fully
controlled despite trying everything, but a general pediatrician isn't
going to know every last thing that could be tried.

Kate
and the Bug, 16 months

"Ericka Kammerer" wrote in message
news
Personally, I would find this situation unacceptable.
A pediatric allergist or pulmonologist should be able to do
better. You may also need to do a lot more around the house,
especially in her room, depending on what her triggers are.

Until today, she's only seen a pediatrician and an generalist. Today, she
saw the allergist (who is also the asthma specialist here) and I feel much
better. He said that he didn't think she was getting her asthma attacks
from allergies, because that wouldn't normally start triggering asthma until
they are about 7 yo, but she clearly has problems with her breathing and it
needs to be better controlled. He put her on inhaled steroids for a few
weeks and he will see her again in 1 1/2 weeks. If she's not better, he
will put her on oral steroids. I can see that he is much more experienced
in this area (as well he should be) and it makes me feel so much more
relieved. At least his advice if she is still wheezing after albuterol is
not to not bring her in unless she's in distress. He wants me to bring her
in or at least call him. Thank goodness.

"Tina" wrote in message
om...
I can tell you that my daughter has been similar to yours, and it's
driven me crazy. Has she ever been admitted?

No.

Because whether they're
wheezing or not, they don't do much more in the hospital, in my
experience.

They said if they admitted her, it would be to give her racemic epi, for
which they would have to closely monitor her.

Do you keep a stethoscope at home? Sometimes it's
helpful to me to monitor Solana like this, because I've watched the
docs closely, and things like whether the wheeze is on inhaling or
exhaling or both are important, as well as how deep of a breath she's
taking (which you can time with a stopwatch). You can also listen to
different areas within the lungs to see if there's one bad spot, or if
the wheezing is all over.

Yes. I finally have one and it's very helpful.

Has she had a chest xray during this illness? It could be pneumonia,
maybe.

Yes. It was clear.

Thanks to you and everyone else for the advice. It helps to know of others
in the same situation and nice to get a different perspective.

"Akuvikate" wrote in message
m...
You mention the albuterol, atrovent, and injectable steroids. Please
do say that if her asthma is that severe (unless this is the first
attack) that she's also on maintenance inhaled steroids whether or not
she's symptomatic.

This all only started about 3 weeks ago.


If her asthma is that bad she'd probably stand to benefit a lot from
going to an asthma clinic or pediatric pulmonologist. It's true,
wheezing is the least significant of asthma symptoms, but it shouldn't
last for weeks. I've known people who's asthma simply can't be fully
controlled despite trying everything, but a general pediatrician isn't
going to know every last thing that could be tried.

Yes, I think the ped was running out of ideas, hence the referral. He did
the right thing and I'm happy about it.

Hi -

I'm glad your allergist is on top of things. he sounds good.

Bear in mind that the rast test is not definitive, and is LESS accruate
for younger children. It can be helpful, but many people have allergies
that don't show on either rast or skin tests. that's why the daily
journal is so useful.

If the wheezing started about three weeks ago, the other thing you can
look at is whether there have been any lifestyle changes, including the
introduction of new foods or a new place that you go to frequently, in
that period. As the weather gets colder, you may be spending more time
inside at some place that you only went to occasionally before. Also,
there are some plant allergens that kick up at this time of year that
could be affecting your baby. (Although it's true that babies are less
prone to asthma than older children, they DO get it. And it's
reasonably common for preschoolers to develop asthma, although it may
take a while to be diagnosed properly.)

Some kids also get cold-induced asthma. My older child has this (and
hence qualified for a flu shot, since getting the flu could easily shut
down his breathing). If your child has this form, she may still have
the tail-end of the virus she had a few weeks ago (if I remember your
post correctly).

In any event, I'm delighted that the allergist is on top of things.
Good luck getting this resolved quickly,
--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

NOTE: No email is read at my MIT address. Use the AOL one if you would
like me to reply.