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Old 04-05-2012, 03:04 PM   #21
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Re: Any experience with seeing a pulmonologist for asthma??

DFS didn't get bad til he had RSV. Pulminology first did a round of oral steroids to cut the inflammation that was already there, the pulmicort twice daily, and albuterol 4 times a day to start, with an optional 5 in the middle of the night if he was coughing. His take is that every day you have inflammation, you are doing damage, so he brings out the big guns from the start. Then, we gradually weaned off the albuterol. We've tried to wean to one pulmicort a day, but just can't. We also did Zyrtec and Claritin in there with the cocktail to try to help, but it didn't do much. He is also on Prilosec for reflux/to protect the airway since he coughs til he pukes sometimes still, and it sprays out his nose.

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Old 04-05-2012, 08:52 PM   #22
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Originally Posted by luvsviola
DFS didn't get bad til he had RSV. Pulminology first did a round of oral steroids to cut the inflammation that was already there, the pulmicort twice daily, and albuterol 4 times a day to start, with an optional 5 in the middle of the night if he was coughing. His take is that every day you have inflammation, you are doing damage, so he brings out the big guns from the start. Then, we gradually weaned off the albuterol. We've tried to wean to one pulmicort a day, but just can't. We also did Zyrtec and Claritin in there with the cocktail to try to help, but it didn't do much. He is also on Prilosec for reflux/to protect the airway since he coughs til he pukes sometimes still, and it sprays out his nose.
Wow...that seems bad! Thats how we started on the meds when we had rsv and pneumonia. Well, pulm started on pneumonia but the albuterol was every 4 hours, even during the night. My son also has been coughing, but never to the point of throwing up. Poor fellow, i hope you can somehow get that under control..

On a side note, i called the dr today and asked how long its supposed to take for the singulair to start working because he doesnt seem to be any better (but no worse either) and he has had some coughing and greenish snot...so he goes in the morning to see his regular doc again.
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Old 04-06-2012, 08:12 AM   #23
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Re: Any experience with seeing a pulmonologist for asthma??

I see at one point this was an old thread that was revived and can I say - Thank God for reviving threads!

I need some advice.

We have 5 children - youngest was 2 this past October. The main point/question is about her, but I want to give you a brief background first.

#4 - she was 4 in Jan. started coughing mid January. I started her on some Children's musinex. It didn't seem to be helping a whole lot and then #5 started. Neither really had any other symptom other than the cough. We did the musinex a few more days then made an appt. with the ped. #5 had strep and an ear infection (she has had several ear infections during her short 2 years and has was build up terrible). They treated them both with meds due to the close exposure. Meds finished - coughing still there for both - did a recheck and they started both on nasal spray and zyrtec. Thinking it was allergy related because we had an early spring here. It worked wonders for number 4 and we still use it daily as things are in full bloom here. No relief for #5. Again - the only symptom is a cough. No wheezing - cough is horrible (gagging cough) for the first 30 minutes she is up - off and on throughout the day. No coughing at night. They did another round of meds treating for a possible sinus infection. Keep in mind she is 2 - smart little thing but can't communicate everything. For weeks now she has walked around saying - I'm tired. Not normal! We completed that round of antibotics for the possible sinus infection. Took her back for a recheck because the coughing had not changed and was actually getting worse. This was just the middle of last week so how long as this been going one - yes, 2ish months! The coughing was still intense in the morning and the off and on coughing throughout the day was becoming more frequent and was changing from just a cough to a gagging cough. She ordered blood work and chest xray - Dr even said - no hurry. Well obviously it wasn't her child! I took her to the children's hospital for the work. Results were back that afternoon and she called - spoke to my dh - said lab (cbc) was fine but she was taking back by the chest xray - showed she had asthma. She didn't have wheezing so the ped had pretty much ruled it out. Called in a neb and pulmicort to use once a day for 30 days. This was this past Friday. We started it Friday evening. Still coughing over the weekend but the dr said it could take 7 days for some signs of it working. Only thing I noticed was that her nose was running a lot where it hadn't been at all before. Monday her appetite was very low. Tuesday morning she had a coughing fit and I noticed her toe nails and fingernails had a purple color to them and her face was very pale. Dh called dr and they "nurse" said to give her a breathing treatment and someone would call back in a few minutes. We did and she seemed a bit better but not normal. they called back and said to do another one and bring her in. We did. Saw a different dr because that was who was open. He asked for the "story" and I explained. He got stuck on the - she is only on pulmicort part. I said yes - that was what we were told to give her and bring her back in 30 days. He said that the nurse assumed we did albuteral and that is why she said to give a breathing treatment. I said no - pulmicort only. He listed to her and said she doesn't wheeze because there is too much restriction to allow the airflow to cause wheezing. All my trust in the other dr went right out the window. He did an albuteral treatment right there and listened again. He said he could he some airflow now. He sent us home with a prescription of the albuteral to use if she has coughing fits - labored breathing - etc. Rescue medicine. Keep up the pulmicort and schedule a follow up with the other dr in a week. I asked him - if she is just coughing do we give it - he said no - just if she is in distress. This was Tuesday morning - after her not eating hardly anything Tuesday or Wednesday, I called and talked to the regular dr on Wednesday afternoon and she said that she may had picked up something viral affecting her appetite - seriously????? - we have 5 kids and she is the only one who has it and it just so happens to be when all this is going on. Yes I am doubting that! She started coughing pretty intense Wednesday night but did eat fairly well Thursday morning so I didn't call her back. It is Friday morning and her nose runs like a fountain and she is coughing off and on throughout the day. Some intense and some not but it sounds very wet and mucus like. We have a follow up scheduled for next Wednesday. I am at a lose. I don't understand why we aren't doing the albuteral on a regular basis until the initial coughing is better and then put on the pulmicort as a maintenance. How do you do something for maintenance when the initial "problem" still isn't fixed? To beat all - when I talked to her on the phone Wednesday afternoon , about the eating, she says - I didn't put her on albuteral because there wasn't any wheezing and I haven't officially diagnosed her with asthma- WHAT??? She told my dh she had - then why didn't she say that the xray showed asthma like characteristics????? I am not sure what to do now. Throughout the day she has coughing where she gets gagging - like she has mucus that she can't move out of the way. I have thought about contacting a ped. pulm on my own but didn't know for sure. I don't have a whole lot of faith in the peds now that the treatment is so all over the place. She has had 7 treatments of the pulmicort so I guess there is still time according to them but do we chance it? I hate it for her - she is so whiny and says she is tired and I think that is her way of saying something is not right. She is eating some but not normal for her by any means. She is now coughing at night which started about 2 weeks ago. Any advice?
Thank you for reading my novel and thank you in advance for anything you can offer!
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Old 04-06-2012, 12:16 PM   #24
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Wow! Sounds like you have had a rough two months (about like us here in this house. Lol). I would ask your peds office for a referral (unless your insurance allows you to self refer) and say you just feel like with the back and forth and possible asthma that you want to see a ped pulm to be sure. I dont know how much help i can be, as we are just starting this journey ourself but every time he was seen again at the doc for a new illness she gave him oral steroids and pulmicort and albuterol. Our alb was every 4 hours at first, but now its as needed, (well, it changed today, but i'll write about that in a minute). Our pulm is still twice a day (morning and night). Maybe you could call the pharmacist or doc and ask how much albuterol she can have in 24 hours (depends on how strong her script is). Then give the max treatment for a few days? And don't be afraid to ask for a second opinion. I was about to ask for one when my ped said she was sending us to a specialist. So thankful for that because i hate confrontation (asking her for a second opinion would be like telling her i dont trust her....lol, confrontation to me..)


Afm, riley was seen again today. His wheezing wasnt getting better it seemed but it actually has. He went from "expiratory wheezes" to "faint expiratory wheezes" lol. So she gave him a round of orapred (oral steroids) to help get him "over the hump" as she described it, and that way afterwards the nebs will be all that is needed to maintain until the specialist. He also has an ear infection (for like the 8 millionth time this winter) so he is being referred to ENT as well.
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Old 04-06-2012, 12:47 PM   #25
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Oh and i also wanted to say that mine hasnt gained any weight since this all started two months ago. He has been holding steady at 27lb. He barely eats anything but is ALWAYS drinking something.
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Old 04-06-2012, 09:31 PM   #26
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momto2and2...didn't wanna quote you since its so long

your asthma journey isn't uncommon. It's a hard diagnosis and docs don't want to diagnose a kid with asthma. Usually they won't even diagnose til age 3. I wanted to touch on your comment about the maintenance med and albuterol. First off the pulmicort has to get in her system and she has to keep taking it for it to remain affective. If she has asthma and comes off the pulm her symptoms will come back. It will then take another 7 days or so to get back in her system. Pulmicort works by decreasing irritation and swelling in the airways, which helps to control or prevent asthma symptoms. Albuterol is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs. They work in conjunction. I hope I explained why you can't necessarily deal with one problem then the other. If the pulmicort does it's job (aka works for her) then she will stop using the albuterol so often. Right now your just working on getting her lungs opened back up. I've noticed a correlation between major snot noses and asthma...par for the course maybe?
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Old 04-07-2012, 06:34 AM   #27
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Re: Any experience with seeing a pulmonologist for asthma??

Thank you to both mama's for your replies.

Brittni - I went as far a looking up the ped pulm in the area. Our follow up with the regular ped is Wednesday so I hesitated because I thought maybe I should at least give it the "time frame" of a week that the second ped recommended for the follow up.

Anna - Thank you for the clarification. I have had her on the pulmicort since it was called in for her - once a day for 8 days at this point. She has only had one dose of albuterol and that was in the dr's office after she had the episode of purple nails and no color in the face. He did give us a prescription for it and said that we could give it to her up to every 4 hours as needed. I clarified what "as needed" meant and he said that it is a rescue medicine and that we should give it if she is in distress. Difficulty breathing - coughing where she wasn't recovering - wheezing. SO - I haven't given her any. She doesn't wheeze - never has. She does cough off and on all day but not to the point that she doesn't recover on her own - although it is gaggy at times.
Should I be giving it? I honestly am a bit confused - I don't know at this point. I wonder if I should be giving the Albuterol every 4 hours throughout the day until I see a difference with the cough since that is her symptom. I didn't know if I should just ride it out until this Wednesday until our follow up but honestly to see her cough so hard breaks my heart.

Thoughts?

Thanks!
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Old 04-07-2012, 05:38 PM   #28
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Re: Any experience with seeing a pulmonologist for asthma??

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Originally Posted by momto2and2 View Post
Thank you to both mama's for your replies.

Brittni - I went as far a looking up the ped pulm in the area. Our follow up with the regular ped is Wednesday so I hesitated because I thought maybe I should at least give it the "time frame" of a week that the second ped recommended for the follow up.

Anna - Thank you for the clarification. I have had her on the pulmicort since it was called in for her - once a day for 8 days at this point. She has only had one dose of albuterol and that was in the dr's office after she had the episode of purple nails and no color in the face. He did give us a prescription for it and said that we could give it to her up to every 4 hours as needed. I clarified what "as needed" meant and he said that it is a rescue medicine and that we should give it if she is in distress. Difficulty breathing - coughing where she wasn't recovering - wheezing. SO - I haven't given her any. She doesn't wheeze - never has. She does cough off and on all day but not to the point that she doesn't recover on her own - although it is gaggy at times.
Should I be giving it? I honestly am a bit confused - I don't know at this point. I wonder if I should be giving the Albuterol every 4 hours throughout the day until I see a difference with the cough since that is her symptom. I didn't know if I should just ride it out until this Wednesday until our follow up but honestly to see her cough so hard breaks my heart.

Thoughts?

Thanks!
From what I have been taught and from my experience in the hospital 3 times with DD...whenever DD coughed all the time like your experiencing we did albuterol every 4-6 hours around the clock. First sign off a cough..albuterol. And then we would albuterol til the cough subsided..as in the kid wasn't sick anymore. There are multiple mamas on here who take this approach too..I've posted a ton of asthma threads so you may find it beneficial to read through them all
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Old 04-07-2012, 07:37 PM   #29
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Originally Posted by TalkinBoutMyGirl

From what I have been taught and from my experience in the hospital 3 times with DD...whenever DD coughed all the time like your experiencing we did albuterol every 4-6 hours around the clock. First sign off a cough..albuterol. And then we would albuterol til the cough subsided..as in the kid wasn't sick anymore. There are multiple mamas on here who take this approach too..I've posted a ton of asthma threads so you may find it beneficial to read through them all
I agree. I would give it every 4 hours until the cough is gone or at least until it sounds like a normal not so hacky cough. Especially if she is coughing at night.
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Old 04-07-2012, 11:23 PM   #30
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Coughing=distress in my book. I'd give it every 4 as well.
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