Saturday, March 24, 2007

Ear Tubes, All of a Sudden

Quickly, because there's a baby screaming down the hall --

Finally took Ig to the ENT on Wednesday. We had to wait over a month for the appointment. He's had 8 infections since October, including one that resulted in a perforated eardrum. Never mind that he's rarely slept an entire night since birth, instead waking up halfway through and screaming for up to two hours. (Sure, let him "cry it out." HAH!)

So, the ENT said that Ig's ears are so badly infected, he'd like to do the tube surgery the following morning. (This during one of the busiest, hairiest week's I've had at work in a good, long time, I might add. But, priorities...)

The surgery is done on Thursday morning. We're at the surgical center at 6:45, we're home by 9:30. The baby is seranading me over waffles by 10.

And yet, he's still not sleeping. Even as I type this, he's screaming his head off. Are his ears still hurting, or have I just spoiled him, letting him sleep with me every time I knew he was in pain? (He'd literally KEEP crying for HOURS, and the big boys and I have to sleep, too.)

Anyone with advice on this, please post a comment! I need help!

Friday, March 16, 2007

Iggy's Mystery Illness

So, by now you may have noticed (if I've kept up-to-date with my posting, that is) that Iggy gets sick every two weeks. Every other Friday, I work from home because he's running a fever, coughing, has an ear infection, a stomach virus...something exciting like that.

This week's illness is just WEIRD. He has "the cough", but I only hear it a few times a day. Per the doctor, who - by the way - now thinks I'm completely neurotic, his ears are clear, his throat's only a little red, and his chest is clear. And he's negative for Strep. He's had little or no fever in the morning for the past few days, but he's gone up to 102+ at night. His diapers have been nothing short of repulsive -- but normal in number.

During the day, he's irritable and lethargic. My normally sweet, cuddly boy is grumpy and tantrum-prone. He's not eating well, he's not playing...he'd rather snuggle than toddle aorund, but after a while, he'll start crying and writhing -- then he won't let you put him down, or continue to hold him, or put him in his crib. Not without screaming.

So...knowing that there've been cases of mono and flu in the area, I'm wondering if either of these could be a possibility.

Does anyone have any thoughts, ideas, suggestions, experiences to share? I could definitely use some advice, and I don't feel like I have my pediatrician's attention right now.

BTW, we're in the NY Metro area, if that helps.

Wednesday, March 14, 2007

How much time do you spend at the Peds Pulomonologist?

D asked this question in a comment, and I realize that there's enough of an answer here to be a post -- AND a full conversation.

First off, I have to admit (in response to the first part of D's question) I love Denial. I spend a great deal of time there myself! I'm there right now, in fact. Went to the pediatrician instead of the PP today. (I suspect the pediatrician is slightly deaf because she said both little ones were moving air well. That despite tight coughs and Oz complaining that his chest hurt.)

So here's the thing with PPs...the amount of time you spend there is directly proportionate to the amount of time your child is sick. BUT - if you come up with the right combo of meds right away, you may only go a few times a year.

It also depends on how quickly you can be trained as an Asthma Mom. We have a unique skill set and toolbelt. You'll see.

My oldest monkey has not a file, a BINDER at our PPs office. When he first got sick, we were there constantly, and when we weren't there I was on the phone with either the PP or her nurse practioner.

But once we got the right balance of meds (Flovent 220, Singulair, Nasonex) and the right Asthma Action Plan, we were able to manage most illnesses with a phone consultation and called-in prescriptions.

At this point, I have the office on speed dial and a closet full of supplies (nebulizer, cups, tubes and masks for said nebulizer, albuterol, Xopenex, saline, giant bottles of Dimetapp...) Oz and Ig have regular files, and the nurses like me a lot better these days.

Hope this helps. You may want to join the Asthma-Parents email list and see if someone else lives near you and can recommend a good Pediatric Pulmonologist.

Monday, March 12, 2007

Monday Fun: Your Monster Name (not asthma-related)

Yes, all my kids are coughing right now, but I thought I'd shelve that post for a bit, and bring some fun instead.

Check out my Monster Name!


Anthropologist-Injuring Monster from the Enchanted Earth


Get Your Monster Name



How much fun is that?

When to switch to a Peds Pulmonologist and other questions answered!

Got a great comment today with a lot of good questions...some of which I can actually answer!

I'd love to ask you some questions since I feel like I'm kind of a
beginner in this whole thing...like at what point do I take him to a
pulmonologist vs. the regular ped? When and how does he get officially diagnosed
with asthma? What about allergy testing--when is it recommended? I never feel
confident in deciding whether or not to neb...how do you decide? Stuff like
that.


So here's answer #1 -- Take your child to the pulmonologist as soon as you suspect your child is asthmatic. Assuming you have insurance coverage and a pediatic pulmo nearby, GO. Many pediatricians -- even the fantastic ones -- miss the subtleties of peds. asthma. Go to a PP or an Asthma/Allergy specialist as soon as you every think you should.

Answer #2 -- Children often keep the "Reactive Airways" diagnosis until age 5. Asthma is a type of RAD, but doctors seem to be skittish about making the hard diagnosis. I'm not sure why. My PP diagnosed B with asthma at age 2, but other specialists still insist on referring to his condition as "Reactive Airways," even when I correct them. I mean, JEEZ, I think my pediatric pulmonologist may have been qualified to make the diagnosis.

Answer #3 -- With the allergy testing...our PP sent all three of my kids out for blood panels at their first appointments with her. Now that B is 5, he's going to an allergist for more in-depth testing. So it may be another "age 5" thing.

Answer #4 -- As far as nebbing, always call your doctor first...but we prefer to err on the side of caution. When in doubt, neb. At first sign of a cold, neb. Think you hear a wheeze? NEB.

See a pattern?

Bottom line...get a pediatric pulmonologist on your team. It all falls into place from there.

Hope this helps, Miss D!

Thursday, March 08, 2007

New Site for Asthma Parents

I referenced this before, but I think I wasn't so clear --

I started a MySpace for asthma parents... check it out and let me know what you think!

Click here to join Asthma Parents!About Asthma ParentsIf "nebulizer" is part of your every day vocabulary, you know the difference between an MDI and an HFA, and you have a pediatric pulmonologist on speed dial, we're with you.
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Article on Flu Shots for Asthma Kids

This article just caught my eye on Yahoo! Health. It's about how children with asthma should get flu shots, but very few do.

I have a number of thoughts on this, especially since I have an egg-allergic child on the autistic spectrum (the vaccines are grown in fertilized chicken eggs).

  • Thought #1: Perhaps if all flu shots were thimerosal-free, I wouldn't think twice about it. But thimerosal-free vaccines are only an option -- and not all insurance companies cover them.
  • Thought #2: Flu strains mutate over the course of a single season. The vaccines are selected on the assumption that the strains covered will be effective for that season. It's not always accurate. Even if you decide to vaccinate, you're not guaranteed a flu-free season.

Given the risks the flu poses to asthmatic kids, I'm pretty well pro-vaccine if you can go Mercury-free. Just know that it's not a perfect solution.

Now here's article:

Ch

ildren with asthma should get flu shots to protect them, but only 3 in 10 do, U.S. health officials said Thursday.

We were surprised at how low the number was," said Susan Brim of the U.S. Centers for Disease Control and Prevention, lead author of a study that looked at flu shot data from 2005.

The study represents the first national estimates on flu vaccination rates for asthmatic children.

Children with asthma, a chronic lung problem marked by wheezing, coughing and labored breathing, can die from flu complications, such as pneumonia and acute respiratory disease. And they are at higher risk for those problems. Inactivated flu vaccine is recommended for asthmatic children older than six months.

The study's findings came from an analysis of a 2005 national survey of the parents of children ages 2 to 17. About 5,100 kids were represented in the data, and 557 of them had asthma.

Only 29 percent of the asthmatic children had gotten flu shots during the 2004-05 flu season. The lowest vaccination rates were among children ages 5 to 12 who had not had an asthma attack or episode in the previous year.

The survey came after a flu vaccine shortage that caused long waiting lines for shots. Brim said it's not clear what impact that had on the study results: Asthmatic children were prioritized for the scarce shots, so the shortage may not have hurt — and possibly might even have boosted — vaccination rates that year, she said.

The low rates may have to do with family's misperceptions about flu shots, said Dr. Gerald Teague, a pediatric pulmonary specialist at Emory University.

Many patients seem to mistakenly believe flu shots can trigger asthma attacks or flu symptoms, and it's important that doctors talk to families and address such concerns, Teague said.

"Influenza in a child or adult with asthma can be fatal," he said.



...Nothing like ending things on a positive note!

Saturday, March 03, 2007

Asthma Parents on Ning

I started an Asthma Parents Group on Ning.

What's Ning? It's new social networking site where, essentially, you can start your own, focused version of "MySpace."

Here's the invite:

Come join me on Asthma Parents!

Click here to join Asthma Parents!

About Asthma Parents
If "nebulizer" is part of your every day vocabulary, you know the difference between an MDI and an HFA, and you have a pediatric pulmonologist on speed dial, we're with you.

Friday, March 02, 2007

Ig at the Cardiologist

I've mentioned a few times that Ig has gone cyanotic on me -- from turning fully blue to just going blue around the lips. The pulmonologist thinks is probably just reflux triggering a bronchospasm, but she wanted us to see a cardiologist -- just in case.

So we went to the pediatric cardiologist this morning, nearlhy 2 months after getting the appointment. (Guess we're lucky to even have one nearby and under our insurance, right?)

Of course, Ig is sick again, and of COURSE he pooped right through his diaper the minute we were leaving...but beside the point...

The appointment was very long and very thorough, and at times, very unnerving. During the ultrasound, for example, the tech kept zooming in and taking more and more pictures of one area, and all I could think was, "Oh, no. She's found something."

Even worse, at one point, they took his sats and he was only 83. Normally, I would question that, but the cardiologist is actually in the same clinic as our PP and shares the same nurses, so I was fairly certain the nurse how to get a correct pulse-ox on my baby.

But actually, everything was FINE. Not only were his sats perfect, there wasn't really anything wrong with his heart at all. One wall *may* be a little thick, but apparently, that's nothing to worry about, and it may be "a normal variant" for Ig. But we'll check it again next year, just in case.

What a RELIEF.