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Asthma Attacks! (and BF+medication questions) Very long
Hi everyone!
I've just been rereading posts about Barbara's recent severe asthma attack because I googled for 'Advair', and those were apparently the only threads that mentioned it -- so I'm guessing the hazards of taking it while breastfeeding are not as serious as the insert says ("DO NOT BREASTFEED WHILE TAKING THIS MEDICATION") or someone would have posted about it separately...? Anyway, between Barbara's experience and my daughter's recent experience, (much more on that below), I basically rushed to the Dr. and ended up prescribed Advair and Singulair, which are working wonderfully. It's the first couple of weeks in a year that I haven't used my albuterol inhaler at least 5 times a week. But, yesterday I got the Rx filled because the samples I was given are almost gone. And the Advair has the big warnng from the pharmacist. I don't know what to do. My Dr. knows I'm still nursing, and he's out of town, so I can't call him just now, and I want to keep taking this medicine, because it's helping so much. But, I obviously don't want to be hurting my daughter. Does anyone have any info about the safety of taking Advair while nursing? If it makes a difference, my daughter is 27 months old, and nursing no more than 2 times a day. And my prescription is the 100/50 strength. The other thing I wanted to post about was Solana's recent experience that was scarily similar to Barbara's, only I (yeah, the mom with asthma herself) didn't realize it until it was nearly too late. My older daughter Sage has had wheezing episodes a few times, and we were told she had reactive airway disorder. She has an albuterol inhaler with a spacer and the ped told us that if Solana ever wheezed, which she wouldn't be surprised about, just have her use the inhaler. This spring, Solana got bronchiolitis, and she refused to use the inhaler, and we needed to take her to the ER for breathing treatments, which she responded to in a couple of tries. She hadn't been 'sick' with the bronchiolitis prior to the wheezing, but she did have a cold type illness afterward, which we were told was the virus that made her wheeze. We were also given a nebulizer 'just in case'. When I say she refused to use the inhaler, I don't mean she just said no. She was hitting us and fighting and screaming, and in danger, we thought, of injuring herself (she has a bleeding disorder, too, so we have to be very careful when she's fighting us). It took several residents, nurses, and a respiratory therapist to get her to take the treatments in the ER. So, we went home with the nebulizer and some albuterol, and stopped worrying, because they said it was the bronchiolitis. Near the end of June, I was suposed to go boating with my in laws, and Mike was going to have the girls for the day. I ended up calling and cancelling at the last minute because while she wasn't 'sick', Solana seemed very fussy, and I was confused and worried about her (and Mike dealing well all day on his own). She sounded a little bit wheezy, but nothing major, and it was obscured by the crying. I tried to have her take the inhaler, but again, it was impossible. We tried to use the nebulizer but she screamed so much she was getting worse, I thought. So we went about our day, attending a party for her cousin and letting her rest in the bedroom at the party. She kept crying though, so when it was time (4 hours later), we took her home and tried the medicine again. She cried more each time we tried. It was getting to dinner time by then, so she ate, but wouldn't rest anymore, just fussed. It wasn't full out crying, just whiny and annoying, I felt at the time. We thought she might be getting ready to cut her 2 year molars. After dinner, we tried the medicines one more time and she kept the mask on for a few minutes but then continued crying. I called the Ped, to see what I should do medication-wise (time to wait, etc..) and while I was waiting to get a callback, Solana lay down in the living room and went to sleep. It was the quietest she'd been all day, and I had a minute to think, and realized I should count her breaths, and look for retractions (what we'd been told to do with Sage, years ago). Well, she was retracting pretty seriously between her ribs, and she was breathing over 70 times a minute. So then I got scared. The Dr. called back and of course I knew I'd have to go to the ER. So, in probably the dumbest move I made all day, I got bags of toys and books together for the girls and put them in the car, and stopped for snacks on the way to the ER -- I was feeling bad for Sage, because it's no fun going to the ER for your sister all the time! Solana woke up in the car, but wouldn't eat or drink, and just kept whining. We got to the ER and luckily got a great parking spot, so I didn't have far to walk with them, and we came around the corner into the waiting area, walking over to triage, because I know the drill -- we spend a lot of time in the peds ER. I'm carrying a wailing Solana and a dufflebag of amusements, Sage is trailing with her own bag, face covered in chocolate ... The triage nurse comes *running* out of triage, grabs Solana and says 'this baby can't breathe!?' half question, half command. She ran into the triage room, weighed Solana, yelled to a nearby EMT "This baby's going to crash!" and we all ran into the ER. Apparently she hit a button or something because by the time we got to the room (about 20 feet in), there were 2 respiratory therapists, a bunch of nurses, a couple of Dr.s, and some residents, plus the triage nurse and the EMT, and me and Solana. They practically tossed her on the table and started treatments immediately. It took most of those people to hold her down, and Sage and I just stood there, in shock, I think. I had no idea she was in that bad of shape. Obviously -- or I wouldn't have waited so long to bring her in, stopped to pack a bag, or get snacks, etc... I was so frightened. She didn't crash, but I was stunned to find out she was even in danger of doing so. She wasn't even wheezing at all. Apparently, her lungs were so constricted, she didn't even have enough air to wheeze. And the fact that the nurse heard her crying from another room and it sounded bad enough that she ran and grabbed her. Scary. I had no idea what to listen for, even. We ended up in the ER for the 6 allowed treatments, but she didn't need to be ventilated. However, the treatments did improve her, but not enough. She needed to be admitted to the hospital. We ended up there for almost 5 days, I only left for about an hour, twice, when Mike was able to sit with her. It was terrifying, and she had treatments every 2 hours for several days, which was hard. She never improved as much as they'd hoped, so they think/thought she had bronchiolitis again, in addition to asthma. They kept asking me how long she's had asthma, and what her medications were, and I kept saying 'I wasn't aware that she did have asthma!' It's not like I'm some slacker mom who wouldn't give her medicine! I got several lessons on asthma, and she was sent home with 7 meds a day (4 zopenex, 1 pulmicort, 1 prednisone and 1 singulair). The Singulair is the only one we're still doing, and she's fine. After that initial string of meds, she's only needed the nebulizer twice, and both times she asked for it before I noticed she was short of breath, and she takes it without a problem now! While we were in the hospital, Sage stayed with my parents, lucklily my Mom could take off work for 4 days, and Mike ended up needing help from his sister to clean up our house which flooded terribly the second night we were gone. I sure don't want to have to do that again, and I'm glad I know what to look for in the future I think this is the longest post I've ever written, but with all the asthma talk around here, I thought some people might be interested. Turns out having asthma yourself doesn't necessarily mean you can detect an attack in someone else! Tina. |
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Asthma Attacks! (and BF+medication questions) Very long
"Tina" wrote in message om... I think this is the longest post I've ever written, but with all the asthma talk around here, I thought some people might be interested. Turns out having asthma yourself doesn't necessarily mean you can detect an attack in someone else! Oh Tina what a horrible fright! Thanks for sharing. Its always good to hear from you, and I hope you get your med situation straightened out as well. -- Rhiannon Madison Sophia - 9/6/01 Owen Grady - 6/23/03 |
#3
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Asthma Attacks! (and BF+medication questions) Very long
Tina wrote:
Hi everyone! I've just been rereading posts about Barbara's recent severe asthma attack because I googled for 'Advair', and those were apparently the only threads that mentioned it -- so I'm guessing the hazards of taking it while breastfeeding are not as serious as the insert says ("DO NOT BREASTFEED WHILE TAKING THIS MEDICATION") or someone would have posted about it separately...? Advair is fluticasone and salmeterol. Fluticasone is an L3. "When instilled intranasally, the absolute bioavailability is less than 2%, so vitrually none of the dose instilled in absorbed systemically. Oral absorption following inhaled fluticasone is approximately 30%, although amlmost instant first-pass absorption virtually eliminates plasma levels of fluticasone." "With the above oral and systemic bioavailability, and rapid first-pass uptake by the liver, it is not liekly that milk levels will be clinically relevant, even with rather high doses." Salmeterol is an L2. "Maternal plasma levels of salmeterol after inhaled administration are very low or undetectable." No reports of use in lactating women are available, though, so I would guess that's a large part of the reasoning behind the big old CYA on the insert. Does anyone have any info about the safety of taking Advair while nursing? If it makes a difference, my daughter is 27 months old, and nursing no more than 2 times a day. And my prescription is the 100/50 strength. Based on the data from Hale's book that I quoted above, and especially based on Solana being older and nursing infrequently, I'd consider it to be fine. I wouldn't hesitate to use it. I'm glad that Solana's OK. So sorry you all had to go through that scary experience! -- iphigenia www.tristyn.net "i have heard the mermaids singing, each to each. i do not think that they will sing to me." |
#4
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Asthma Attacks! (and BF+medication questions) Very long
"She's A Goddess" wrote in message news:5iO8b.334262$Oz4.123076@rwcrnsc54...
"Tina" wrote in message om... I think this is the longest post I've ever written, but with all the asthma talk around here, I thought some people might be interested. Turns out having asthma yourself doesn't necessarily mean you can detect an attack in someone else! Oh Tina what a horrible fright! Thanks for sharing. Its always good to hear from you, and I hope you get your med situation straightened out as well. Good to hear from you, too! I'm trying to keep up with posts here more, and I hope I'll be catching up even more in the future! Tina. |
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Asthma Attacks! (and BF+medication questions) Very long
I'm glad your daughter is okay!
I wanted to mention that for somewhat older kids (probably ages 5 and older), if you go to: http://www.starbright.org/ you can order a free CDROM game that teaches about asthma. When I first heard about it I expected it wouldn't be a very interesting game but hey, it was free. Our younger daughter has asthma and she was 6 years old when she played it the first time and it *really* went a long way towards changing her attitude about having asthma. Kids play the game to defeat asthma "villians" such as "The Mold Mob" and "Smokita" by identifying asthma triggers and answering asthma questions. She has had a flare-up the past few days so played the game again yesterday and came out and demonstrated how the game says to use the peak flow meter. She gets really tired of checking her peak flow so sometimes she doesn't exactly give it her best effort. BTW, the Starbright also has a free game for kids with diabetes and a comic book for kids with burn injuries. Lynda |
#7
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Asthma Attacks! (and BF+medication questions) Very long
"Circe" wrote in message news:Ksk9b.35831$n94.19656@fed1read04...
"Tina" wrote in message om... I've just been rereading posts about Barbara's recent severe asthma attack because I googled for 'Advair', and those were apparently the only threads that mentioned it -- so I'm guessing the hazards of taking it while breastfeeding are not as serious as the insert says ("DO NOT BREASTFEED WHILE TAKING THIS MEDICATION") or someone would have posted about it separately...? Iphigenia already did a Hale's lookup for you, but I just wanted to say that practically ANY medication has that warning on the insert. Heck, bottles of OTC meds that are perfectly safe for *babies* to take (e.g. Sudafed) often have labels that tell you not to take them without checking with a doctor if you're nursing! All the doctors I've ever had have assured me that inhaled steroids and the like are considerably safer, all things considered, than anything I could take orally, simply because they are delivered right where they're needed and less of them get into the bloodstream as a result. Thanks. I was also guessing that since she was on practically the same thing herself, it would be less of an issue if she got trace amounts than maybe some other kid. I don't know. Anyway, between Barbara's experience and my daughter's recent experience, (much more on that below), I basically rushed to the Dr. and ended up prescribed Advair and Singulair, which are working wonderfully. It's the first couple of weeks in a year that I haven't used my albuterol inhaler at least 5 times a week. Wow, that's great. You were *way* too symptomatic before, that's for certain. The current guidelines are that you shouldn't be symptomatic more than 2-3 times per week with no more than one night waking due to asthma. Glad to hear the Advair/Singulair combo is working for you. So far, it doesn't seem I need Singulair. I have had perfect asthma control since leaving the hospital on Advair alone. That Adviar is great stuff. My sister-in-law reports excellent results, too. I didn't even realize how many problems I was having until Solana was in the hospital, and I mentioned it to one of her Dr.s, and she was appalled. Your experience spurred me to get into the hematologist and then the pulmonologist, too! (And it was hard for me to tell what was a night waking due to asthma, and what was due to kids crying -- I didn't even know that was a symptom until the pulm. asked me!) Does anyone have any info about the safety of taking Advair while nursing? If it makes a difference, my daughter is 27 months old, and nursing no more than 2 times a day. And my prescription is the 100/50 strength. FWIW, Vernon still nurses often at 18 months old (I couldn't tell you exactly how many times a day, but it's *way* more than 2!) and I'm taking 250/50 twice a day (though next time I see the pulmonologist, we'll discuss trying to step down to 100/50). I haven't seen any evidence that it's doing anything weird to him! Thanks. The triage nurse comes *running* out of triage, grabs Solana and says 'this baby can't breathe!?' half question, half command. She ran into the triage room, weighed Solana, yelled to a nearby EMT "This baby's going to crash!" and we all ran into the ER. Apparently she hit a button or something because by the time we got to the room (about 20 feet in), there were 2 respiratory therapists, a bunch of nurses, a couple of Dr.s, and some residents, plus the triage nurse and the EMT, and me and Solana. They practically tossed her on the table and started treatments immediately. It took most of those people to hold her down, and Sage and I just stood there, in shock, I think. I had no idea she was in that bad of shape. Obviously -- or I wouldn't have waited so long to bring her in, stopped to pack a bag, or get snacks, etc... I was so frightened. She didn't crash, but I was stunned to find out she was even in danger of doing so. She wasn't even wheezing at all. Apparently, her lungs were so constricted, she didn't even have enough air to wheeze. And the fact that the nurse heard her crying from another room and it sounded bad enough that she ran and grabbed her. Scary. I had no idea what to listen for, even. Oh, Tina, how frightening! I actually think it would be *worse* to watch your child go through something like this than to go through it yourself. Don't beat yourself up too much over not recognizing how serious it had gotten, though. It can be *very* hard to judge. And I have to tell you I think it's amazing that a child with lung constriction that severe could cry at all; when I had my attack, I could barely speak let alone cry. So I don't find it surprising that you didn't think it was as bad as it was. I don't know if it could be worse. You *were* in arrest! It's amazing (I won't beat myself up), mostly because I always thought wheezing would be the symptom to look for. And even though I've had attacks where I had a hard time speaking, I was too worried about taking my meds to notice that I wasn't wheezing anymore, but I know now I was probably the same way Solana was, beyond wheezing. It is great that she could cry. She's a weird one, she doesn't fuss until things are really bad, most times, but then she's as loud as can be! She and our whole family are lucky she has such lungpower, and can throw such a good tantrum, no matter what! I'm glad she's doing better now, though, and that she's more receptive to the nebulizer treatments. {{{{{Hugs}}}}} all around! -- Thanks so much! Tina. Be well, Barbara (Julian [6], Aurora [4], and Vernon's [18mo] mom) See us at http://photos.yahoo.com/guavaln This week's special at the English Language Butcher Shop: "No parking passed this sign" -- hotel parking lot sign All opinions expressed in this post are well-reasoned and insightful. Needless to say, they are not those of my Internet Service Provider, its other subscribers or lackeys. Anyone who says otherwise is itchin' for a fight. -- with apologies to Michael Feldman |
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Asthma Attacks! (and BF+medication questions) Very long
"Lynda Seehusen" wrote in message ...
I'm glad your daughter is okay! I wanted to mention that for somewhat older kids (probably ages 5 and older), if you go to: http://www.starbright.org/ you can order a free CDROM game that teaches about asthma. When I first heard about it I expected it wouldn't be a very interesting game but hey, it was free. Our younger daughter has asthma and she was 6 years old when she played it the first time and it *really* went a long way towards changing her attitude about having asthma. Kids play the game to defeat asthma "villians" such as "The Mold Mob" and "Smokita" by identifying asthma triggers and answering asthma questions. She has had a flare-up the past few days so played the game again yesterday and came out and demonstrated how the game says to use the peak flow meter. She gets really tired of checking her peak flow so sometimes she doesn't exactly give it her best effort. BTW, the Starbright also has a free game for kids with diabetes and a comic book for kids with burn injuries. Lynda Thanks alot! That sounds neat, and both of my girls would love it, I'm sure! We'll check it out! Tina. |
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Asthma Attacks! (and BF+medication questions) Very long
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Asthma Attacks! (and BF+medication questions) Very long
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