My DD(age 6)whom I have mentioned in previous posts was diagnosed with asthma in March...since then she has been on oral steroids, twice in March, once in April, Once in May, 1 day dose after an ER trip Memorial Weekend, a 3 day dose last weekend.

Her doctor changed her to pulmicort(o.5mg once/day) on Tuesday from Flovent, listened to her lungs, said she sounded great. She had a runny nose at the time and the doctor said this could deveop into wheezing.

On Wed she started having dropping into the yellow, after each neb treatment she would come back to green,
On Thursday she developed a hacky dry cough that went on most of the day. She hovered between high yellow and low green.

Thursday evening she went into the red. We ended up in the ER, before we left she had back to back alb treatments at home. While we were there she went back into the green. They could not hear any wheezing and she didn't need any treatment in the ER. The ER doctor wanted to put her on the oral steroid AGAIN. I told him I really didn't want to and he said her lungs needed time to heal and the pulmicort wouldn't kick in until around Tuesday. He gave me the prescription and said if she didn't get better to give it to her.

On Friday I thought she was getting better, her cough was no longer continuos and she was going 4 hours between treatment. She was staying in the green and high yellow. She had a treatment late last night before bed(back to back) and she slept without coughing for 5 hours then woke up coughing and needing a treatment.

This morning she had a strong wet cough and I ended up giving her back to back treatment.She is in the mid to high yellow.

SO what do I do? Should I go ahead and give her the oral steroid? Is it possible we can ride this thing out without the steroid? Am I causing damage to her lungs by trying o avoid the steroid?

The ER doctor made it sound like her lungs have not had a chance to heal since this all started and that is why she keeps having problems. What he prescribed has been the strongest yet, Two doses twice/day for 4 days. The other times it has been once/day for 5 days.

I hate giving it to her but Iam also afraid I am hurting her by not giving it to her.

What are your opinions on this?

Thanks,
Anna

The ER doc has a point. It takes time for inflamed, twitchy lungs to heal.

As for you, however, I'd suggest keeping her off the oral steroid unless she starts getting REAL close to the red again (or if she hits it again).

Any decent cold will throw me right from personal best to low low yellow and I've never been on oral steroids. THIS IS MY PERSONAL EXPERIENCE. IF YOUR INSTINCTS TELL YOU OTHERWISE, YOU ARE MUM, THIS IS YOUR DAUGHTER, FOLLOW YOUR INSTINCTS.

I do not want my words to deter you if you feel it is necessary.

HOWEVER.

I do believe from the way things sound, since she's bouncing around so much, it may be possible for her to come out of this without going on the pred. Prednisone is more for being in a slump and not being able to get out. If she has a cold, treat the cold, (talk to the dr. if it's safe to give her otc cough syrup so long as it does not contain a cough suppressant or an analgesic. Look for preparations containing ONLY guaifensin, STAY AWAY from dextromerthorpan at ALL COSTS or all preparations marked DM. These will suppress her coughing and make it more difficult to tell if she's getting worse.)

The guaifensin(sp?) will make it easier for her to cough up whatever's in her lungs, in addition to the albuterol, and is relatively harmless in children's doses. To the best of my knowledge, it does not interact with asthma drugs, though it is likely a very good idea for you to talk to your pediatrician about it.

Has anyone told you that lots of stints on pred can make the immune system weakened to infection? I'm betting this cold has something to do with the amount of pred she's been on recently. IN MY OPINION, (insert disclaimer here,) putting her on more pred may help her lungs, but it will also make it harder for her body to fight off the cold, and thus, possibly (POSSIBLY I stress) make it take longer for her to get over.

In the meantime, don't be too afraid to use the ventolin nebs. (edit: WITHIN REASON) It will help her cough up what's in her lungs as well, and the faster she gets that crap out of there, the easier it will be for her lungs to heal.

[This message has been edited by wrin (edited 06-08-2002).]

THANKS Wrin,

I knew I could count on you. :)

In all honesty my gut tells me that this is a chest cold and not an asthma attack. She has mainly stayed in the mid to high yellow but you can hear a lot of junk in there. The most important thing is she is acting fine and she says she feels fine. Whenever she has had an asthma attack in the past she is ASKING for the nebulizer, now she is quite put out by it. She has not gotten anywhere close to seriously wheezing and retracting as before.

I will keep doing what I am doing.

Thanks again!!!


Anna

that's the most excellent sign of all -- if she doesn't feel like she needs her neb, as much as she's young and some young children have trouble realizing exactly how sick they are, if she knows she's not sick, go with her.

Instinct is and always has been the best indication in the medical profession -- As a mum, if you feel like there's something wrong, there probably is. Trust yourself. That's most important.

How did this turn out for you, mum?

Wrinny wants an update! ^.^

FANTASTIC!!!

She rebounded and is doing great. She started creeping back into the green around late Sunday and she has been in the green since Tuesday. :)

We are still using the neb in the morning(right before swimming) and the inhaler/mid afternoon and the neb in the evening before the pulmicort.

The ER doc said to wean her off the alb gradually to make sure she stayed in the green for awhile. This weekend I think we will cut it down to two albuterol treatments(morning and evening) and then when we see the specialist(asthma and allergy) on the 26th maybe he will have more answers for us.

She is really doing well on the pulmicort too.I think it has kicked in because she has been sleeping all night without any coughing.

Thanks so much for your advice and for asking about her, it feels great having handled our first asthma flare WITHOUT the oral steroid. YIPPEE!!!

I LOVE this board, I can always count on someone responding to my concerns.


Anna

YAY! I'm very happy for you -- a problem with the oral steroid is sometimes rebound infection because it weakens the immune system so much; this is what I had suspected.

I am sure you are remembering to wait 2 mins after taking the alb. before giving her the pulmicort right? ;)

I agree with your dr. to cut her down on the albuterol. It isn't good for tiny hearts to beat so fast. that much albuterol will make an adult tachycardic, I hate to imagine what it would do to a child.

Hopefully soon you will only have her on pulmicort and alb. prn :)) no daily treatments

Gosh what would I do without you?

I had no idea you had to wait between treatments. Thanks for telling me, I had been giving her the pulmicort right after the albuterol.

I have read on another board that some doctors give their patients permission to combine the alb and the pulmicort.

Anna

you don't have to, it just increases the effectiveness.

You know that drill. Open up the airways before you put steroid in there, it gets in deeper and into the smallest airways. It's not so necessary with a neb since the neb is so small it gets to the smallest airways anyway, but it's just... not a bad practise.

I've been told that it's inadvisable to mix nebs made by different companies because the preservatives can sometimes make bad things happen.

You can get preservative free albuterol...The DEY brand is I believe.We use the DEY brand Albuterol and mix it with pulmicort for Meredith(1y).
Cassidy

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Cassidy mommy to 5 rugrats and expecting #6
"Theres 2 things I've learned"1.Theres a God and 2 I'm not Him"