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    Old 12-22-2006, 08:27 AM   #1
    rbryant
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    Persistent Cough/Wheeze..Need Help

    Gosh, I don't know where to start as my wife and I are at wit's end here.
    Our 5 month old daugher has had a persisent cough (alternating between a dry cough and productive) and wheezing for five to six weeks. It seems like we are in the pediatrician's office every week. She was hospitalized for two days last week, given periodic breathing treatments, placed under a croup tent. Tests for RSV and Influenza were both negative. Chest X ray did not show anything as well. As of now, she is taking Xopenex and Pulmicort (steroid) through her nebulizer everyday. We just started the Pulmicort last night, so it's a little early to see any results I guess. Her pediatrician is going to refer her to a pulmonary specialist in the next couple of weeks. We are getting concerned that this is not going to resolve itself anytime soon, or worse it's something serious. Does anyone here have any experience with this? Any ideas/suggestions/stories would be greatly appreciated

     
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    Old 12-22-2006, 08:58 AM   #2
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    Re: Persistent Cough/Wheeze..Need Help

    RB-
    Hey, First let me say that I am so sorry your little one is sick. I know how terrible it is when your infant is having breathing problems. My son had severe croup, sometimes two or three times each winter from the time he was born until he was almost 8. There were many ambulance trips to the ER, breathing treatments, steroids- you name it. I feel for you and your wife.

    My first thought was RSV, but you mentioned she had tested negative for it. I'm sure if it was somtething serious like CF, they would have seen soemthing on the X-rays, so for right now, try (I know it's almost impossible) not to worry about serious things.

    Do you and your wife have animals of any kind? Dogs, cats, etc? Also, is her crib under an air vent or directly above an air vent in her room? I ask because my son, although never truly diagnosed with asthma was diagnosed with "reactive airway disease", and he would get flare ups from things like this.

    I think it's a good idea to have a pumonary doctor take a closer look at your daughter. I would say that 5 weeks is long enough being treated by pediatritians and getting little or no results. In the mean time, start a list. On that list, make sure you reference all of her symptoms, when they seem worse, and when they seem better and also write any questions you might have. You can add to the list each day, or even as you think of things so when you see the new doctor, nothing will be forgotten.

    Oh- is there a possiblility she is allergic to her formula, or any other things such as laundry detergent, baby bath soap, etc.? THey might need to check for allergies too.

    I hope your little begins to show marked improvement soon. Good luck!

    Last edited by ozzybug; 12-22-2006 at 09:00 AM.

     
    Old 12-22-2006, 09:07 AM   #3
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    Re: Persistent Cough/Wheeze..Need Help

    Thank you for your help. I can't tell you how many times I obsess and think the worst scenarios possible, I even think CF at times. She is growing well, and I know there is no issue with failure to thrive...so that's a very positive sign that CF may not be an issue. Still, I'm sure if things continue a sweat test may be in order..if for nothing else to rule things out. I would hope they would consider testing her for allergies, although they claim that classsic allergies dont start until ages 2 or 3.

     
    Old 12-22-2006, 09:09 AM   #4
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    Re: Persistent Cough/Wheeze..Need Help

    Also wanted to add that we don't own any dogs,cats, etc. Neither my wife or I smoke. I've noticed our house is very dry in the winter..maybe because our heating system runs on natural gas. We use a cool mist humidifier in her room, but the effects seem to be minimal.

     
    Old 12-22-2006, 09:21 AM   #5
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    Re: Persistent Cough/Wheeze..Need Help

    Why not try one of those air purifiers in her room as well, like the hepa-filters? I know a family who has to do that with their little girl, and have had to do it since she was an infant. She has always had terrible repiratory problems and this seems to help. She has fewer "attacks" which is a huge plus.

    I know what they say about allergies, but my son proved them wrong. He was allergic to his formula and once we changed him to the soy formula, his breathing episodes did become less frequent. He still got the croup every winter like mentioned before though. That had lots to do with the heat I think.

    I do know they don't do "formal" allergy tests until a child is like 6 or 7. I think at this point, you seem to be doing your best not to over-worry. I know it's hard not to think about the worst case scenario because I always did. Again, try not to go to the worst case scenario in your mind. Try and pay very close attention to any triggers that might cause her symptoms to become worse.

    You know, my son is now 12 years old and we still have an albuterol inhaler around along with several different allergy type medications such as Flo Nase, Claritin, Sudafed.....it's awful when your child has difficulty breathing. Now that he's older, he seems to have less problems, but I've learned to start treating symptoms as soon as I see them.

     
    Old 12-22-2006, 09:51 AM   #6
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    Re: Persistent Cough/Wheeze..Need Help

    If it were periodic episodes of wheezing, I wouldn't worry as much or overthink things. The problem is the wheezing is nonstop, or so it seems. Overall, she has noisy breathing..anything from wheezing to a rattly chest. I can't remember the last time she sounded clear..maybe october?

     
    Old 12-25-2006, 04:51 PM   #7
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    Re: Persistent Cough/Wheeze..Need Help

    Hello rbryant, your story is my story. I will try to make this as short as i can my son is a year old and he had a cough and cold for MONTHS i took him to the doctor at least once a week because i knew as a mother this was not normal for a baby, every visit i got the same story, "your son sounds fine and there is nothing wrong with him" but i knew they were wrong. Right after his first bday everything went downhill, but first let me just say i did take him to the emergency room one night because his wheezing was so bad when he was sleeping you could hear it throughout the entire house, i said THATS IT he is going to the hospital. I took him there and what did i get nothing the emergency room doctor told me he sounded fine and the whistling and wheezing sound was coming from his nose. After his first bday, literally one day after, me and my husband heard him having an especially hard time breathing through his nose which was constantly conjested but again this was not normal, we rushed him to the hospital and it was just in time because he went into respiratory distress. I still cant talk about it without crying. Here is the thing the test for RSV Is not 100% accurate my son's test came back negative but the doc said he definitely had RSV but because he was older the docs at my doctors office didnt consider that, but thats why he was sick for so long and RSV turns into BRONCHIOLITIS not BRONCHITIS the two are different. If you do a search under the American Academy of Pediatrics under Bronchiolitis it explains it all.

    We were giving him the Pulmocort and Accumed 2x a day it helped tremendously except he had major insomnia which any steroid will do. My son is alot better but of course he got another bad cold so now i started the treatments again to make sure it doesn't turn into Bronchiolitis again. I hope any of this helps you.

     
    Old 12-27-2006, 06:05 AM   #8
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    Re: Persistent Cough/Wheeze..Need Help

    Thanks, the story sounds familiar. We took her to the Dr again yesterday, he said the congestion was coming from her nose and throat. Also said our daughter was very healthy, and not likely to have CF, or some other congential abnormality. Having said that, we have a appt with a pulmonologist in two weeks to rule anything out. If that does not turn anything up, we will be sent to an allergist. The Xopenex and Pulmicort does nothing to alleviate the rattling sound we hear. So apparently the Dr was right about the source of congestion being nasal/pharnyx, as both drugs are effective in relieving problems in the smaller airways (bronchioles) of the lungs. Still, it's very upsetting to hear your daughter rattle/sneeze/cough for weeks on end. We are so much at wit's end that we are contemplating the idea of my wife taking a long leave of absence from work to stay home with her. One other thing, you would think there is something (steroid based) that can be used to alleviate mucus production in the nasal passages. Sorry to ramble so much, I'm glad you found some resolution to your son. Hopefully this latest bout will be temporary.

     
    Old 12-27-2006, 06:17 AM   #9
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    Re: Persistent Cough/Wheeze..Need Help

    R-
    I'm so glad you dropped in. I've been wondering how things are going. I know you are at your wits end, because like you said, it's very upsetting when your child (especially an infant) has any kind of respiratory condition affecting their breathing.

    You and your wife sound like wonderful, caring and loving parents and I totally understand why you feel the need for your wife to take a leave of absence to be with your little one.

    There are medications like Pediacare, musinex and such which can help with the nasal congestion, but I'm not sure that they make infant formulas. I know they make them for children who are a bit older. My son uses FloNase which helps with keeping the nasal passages from being inflamed, but again, that is for older kids.

    When he was an infant, my pediatritian told me that dropping a tiny amount of saline solution into his nostrils would help keep things moist, but I just could not bring myself to do it. You are doing the right thing with the cool mist humidifier. I ended up having to set my son's humidifier just outside of his bedroom door because his room was a bit too small for the humidfier and it could have caused more problems had I left it inside the room.

    I do wish you all the best of luck. Please continue to keep us informed. We are here for you!

     
    Old 12-27-2006, 12:16 PM   #10
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    Re: Persistent Cough/Wheeze..Need Help

    Thanks Ozzy for your concern, it's nice to be able to relate. I was wondering why you would remove the humidifier outside the room. Our daughter's room is quite small, and I have sometimes wondered if too much moisture is a bad thing. Also, after speaking with others who have had similar problems, I'm really starting to think she has allergies (maybe dust mites). I'm hoping that we can see an allergist and get her started on Singulair.

     
    Old 12-27-2006, 03:28 PM   #11
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    Re: Persistent Cough/Wheeze..Need Help

    R-
    I had to take the humidifier and set it just outside of her door because after reading the information booklet, it has instructions/information about the size of the room that this model should be used for. After reading that information, I spoke with the pediatrition and he confirmed that it should be just outside my son's room so that not all of the mist would be inside his room. He said setting it just outside the door would allow enough of the mist to enter his room, and the rest to distribute into the hallway. His room was really tiny.

    I do hope you can find the answers needed to help treat your baby girl. I know how helpless a parent feels in a situation such as this. It hurts to the core of your very being when you just can't make it "right". I actually used to pray that God would take the breathing problems away from my son and make me be sick so he would be healthy. Even as my son got older, if he had any kind of respiratory problem going on, I had the monitor in his room and in my room during the night. If he was really sick, like with croup, my husband and I would take turns sleeping on his floor because I worried so much. I know it might sound silly to others, but I just can't help it.

    Take care! Please let us know what the doctors say. I am sending positive thoughts that the doctors can pinpoint the cause of this and be able to help you to treat your daughter!

     
    Old 12-29-2006, 07:43 AM   #12
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    Re: Persistent Cough/Wheeze..Need Help

    Hi rbryant, all four of the doctors at my son's doctors office told us not to use the cool mist humidifier. Maybe you could take a break from it for a little while.

     
    Old 12-29-2006, 01:46 PM   #13
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    Re: Persistent Cough/Wheeze..Need Help

    FYI, when I got my new HVAC system this past spring, I asked about a humidifier on the unit since I have allergies and asthma. My service tech told me that they really don't work all that well unless you get the very expensive ones. He told me for a house my size (1100 SF) I could put a large pot of water to simmer on the stove and get more humidity in the air than the built in one would do and it wouldn't cost as much! And it works!

     
    Old 01-01-2007, 07:46 AM   #14
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    Re: Persistent Cough/Wheeze..Need Help

    Quote:
    Originally Posted by rbryant
    Gosh, I don't know where to start as my wife and I are at wit's end here.
    Our 5 month old daugher has had a persisent cough (alternating between a dry cough and productive) and wheezing for five to six weeks. It seems like we are in the pediatrician's office every week. She was hospitalized for two days last week, given periodic breathing treatments, placed under a croup tent. Tests for RSV and Influenza were both negative. Chest X ray did not show anything as well. As of now, she is taking Xopenex and Pulmicort (steroid) through her nebulizer everyday. We just started the Pulmicort last night, so it's a little early to see any results I guess. Her pediatrician is going to refer her to a pulmonary specialist in the next couple of weeks. We are getting concerned that this is not going to resolve itself anytime soon, or worse it's something serious. Does anyone here have any experience with this? Any ideas/suggestions/stories would be greatly appreciated
    Hi,
    I am so sorry your daughter has been ill for all this time. I do have some questions though. What is the dose of the Pulmicort and Xopenex and how often are you giving the neb treatments? Are you holding the nebulizer against her face for the entire treatment? (The meds do not work correctly if you are not holding the mask on her face.) Has your PMD tried giving her oral steroids as well? (Orapred or Prelone?) Is the specialist you will be seeing a pediatric pulmonologist? If your PMD calls the pulmonary office, rather than just having his staff call, he may be able to get the apt moved up. (Often the physicians are able to talk Dr. To Dr. and get apts moved up.)The best thing for your daughter would be for her to be evaluated ASAP by a pediatric pulmonologist. (And just so you know, it is vital that if they do order a sweat test, it is only done at a CF approved center.) Is the pulmonologist that you will be seeing affiliated with a Children's Hospital? The symptoms you are describing do not sound like they are just coming from the nasal cavity.
    The portable humidifier is not a good idea. They often are a source of contamination, and I would suggest taking it away.
    Best of luck to you. Please let us know what happens.

    Last edited by SofteeatHeart; 01-01-2007 at 07:47 AM.

     
    Old 01-29-2007, 05:21 AM   #15
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    Re: Persistent Cough/Wheeze..Need Help

    HI..need to update a few things. First, the dose we are giving is .25 mg Pulmicort twice daily. Xopenex as needed (.63 mg). Fortunately, things are finally looking up. We went to the pulmonologist at University of Kentucky last week, he felt that there was a 99.99 % chance that this is not related to CF. He cited excellent growth, family history of allergies/asthma. He also felt that the source of the problem was nasal congestion, although she did has some very minor inflammation of the bronchi as noted on chest xray. He put her on Singulair and extended the Pulmicort therapy. We are still having a time with keeping her nose clear (and this is with Singulair, Saline drops, cool mist humidfier). Her congestion is most noted in the morning, with a stuffy nose and a little rattle in her upper airway. He did mention the possibilty of adding a nasal steroid to her treatment.

     
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