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Posts Tagged ‘albuterol’

I’m leaving off the “Disease” in Reactive Airways Disease (RAD, which, incidentally, is not rad) because it makes it sound so serious. But Mister Finn does have this. RAD. Reactive Airways, as I’ll call it. Reactive Airways is what it sounds like. The lungs’ airways react to something–like a cold–by behaving as though they have asthma. Here is a picture.

As you can see, it sucks.  There is wheezing and difficulty breathing just as with an asthma attack. Treatment is the same as with asthma: albuterol, and if necessary, steroids.

A’s first episode was in Summer of 2009 and he has had about seven episodes since then. They are more or less the same:

1. A. gets a cold.

2. a few days after the cold begins, wheezing or noisy breathing starts, with chest retractions

3. we start giving him albuterol treatments via nebulizer

4. if he can’t make it four hours between breathing treatments we’re supposed to take him to the doctor. If the episode is happening not during the clinic’s open hours, this means the Emergency Room.

5. Emergency Room, because the episode usually happens at night and on weekends. Features major 2 year old anxiety, throwing up, awful tests (such as the test for RSV), a few nebulizer albuterol treatments, chest X-rays, the giving of oral steroids, the throwing up of oral steroids, the manual injection of steroids.

6. We go home with oral steroids.

7. Steroids (crushed prednisone tablets mixed with apple juice concentrate and squirted via syringe into his mouth, followed quickly with chocolate bunny grahams usually intercepts barfing) and nebulizer albuterol treatments work, and A. is fine within a few days.

8. If child is in preschool (or engaged in some similar germfest), repeat from beginning in approximately one month.

The whole thing is hard on him and us. You can die if RAD is left untreated. It feels very wrong and mean for the universe to present me with my child’s mortality every month. It seems that many people go an entire childhood without courting death, save for an averted gumball choking. Why is my child’s life up for negotiation every few weeks? Huh, universe? I want an explanation!

The universe does not give me an explanation, so I turn to google. Also, I ask Mister Finn’s smattering of pediatricians (I really wish we could see the same person every time like the baby books led me to believe we would, but it doesn’t seem to be our luck) the same questions over and over again. The answers I get are mostly reassuring. This is a relatively common childhood “disease” that is often outgrown. It is not a guarantee that A. will have asthma the rest of his life; likely, he won’t.

Because the Albuterol treatments are usually not enough and he needs steroids, his doctor recommended and prescribed Pulmicort (an inhaled steroid) to be given daily via nebulizer. Every day, even if A. has no symptoms. It would be a preventative measure to keep his airways open and make it less likely that he’d have a full blown RAD episode with every single cold. It’s just hard to think of giving him medicine every single day. That makes it seem like he’s sick all the time.  Also, there are side effects, like oral thrush and irritability and the increased susceptibility to respiratory infections.

I need to call a pediatrician to talk about it more. If you’re reading this and you’ve been through this with your child, I welcome any stories you have to share.

 

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It turns out I was especially worried about Mister Finn’s cough for a reason. {How does this parental “intuition” thing work?? What does it mean? How do I keep myself from having false-alarm freak-outs, now that I’m apparently developing a track record of sensing correctly when something is wrong with my baby?}

On Wednesday morning the cough was worse, and about 10 minutes after Wifey left for work I heard him wheezing. He also seemed to be having chest retractions. So I threw some diapers and my wallet in a bag and took him to the emergency room at the hospital where he was born and spent his third trimester. It was terrifying hearing his wheezing from the back seat. Tears were streaming down my face by the time we got to the ER. I called Wifey at work and she took the bus up the hill right away.

The kind yet condescending (or maybe kindly condescending?) pediatrician ordered chest x-rays, albuterol breathing treatments, and steroids to be given orally, which were promptly thrown up all over me. His lungs looked and sounded clear, but because they didn’t know if he was going to get better or worse, the pediatrician wanted him to stay overnight for observation.

We were treated really well, and the whole ER experience was not really too bad until a guy next door arrived thrashing and yelling, strung out on something. Apparently in hospital-speak “code orange” means “uncooperative guest; need police.” My anxiety peaked right around then. It was terrifying overhearing what was going on on the other side of the wall, and I really wanted to grab my baby and run out the door.

Upstairs in the pediatric unit,  A. did great all night (with breathing treatments every 2-3 hours from a Respiratory Therapist) and responded well to the albuterol, which further signaled that this isn’t an infection (other than the common cold, or some strain of it). We took turns sleeping in the crib with him– a sight no one batted an eye at.

The diagnosis was simply a virus that triggered a reflex in A.’s baby lungs to tighten– a very common reflex in babies (?). It was basically an asthma attack, but one that is specific to a virus, not an ongoing condition.

The whole thing was very surreal, like we couldn’t really believe this was happening. All the same sounds and smells and food as our big hospital adventure last year. The lasagna tasted the same. The feeling when the ladies came in to check the trash was the same.

We were discharged Thursday morning with treatments to continue giving A. at home, and we got home around 1pm. It seemed that as soon as we left the hospital he was coughing more and working harder to breathe. It continued after we were home for an hour and a half, so we called the the pediatrician’s office. The nurse there said if he was still having symptoms of difficulty breathing we should take him back to the hospital.

So, back to the ER. (This too felt like a repeat of last year, when I was discharged only to be readmitted two days later when my c-section incision opened.) After more exams by more nurses and doctors, the pediatrician examined him and said that he is fine!  He was still having some difficulty breathing purely because he’s still getting over the virus. The pediatrician also said that there is a wide spectrum of respiratory issues in babies, and A.’s episode was mild. The pediatrician isn’t worried about him at all.

We assumed that this whole ordeal was related to his prematurity, but apparently it isn’t (!?!) and this happens to full-term babies often. They said the best test indicating that A.’s lungs are “good to go” (with no lasting effects of prematurity) is the fact that he didn’t get a single infection –viral or bacterial– his entire first year.

For 2 days we did albuterol treatments via inhaler (which are completely painless, yet totally awful, with him screaming and kicking and it feels like we’re torturing him) and steroids. He hasn’t really been acting that sick; still crawling and laughing and “dancing” to his music.

I managed to write a rather cheery post about all of this on Mister Finn’s blog, for all of his friends and family to read, to let them know he is OK. (I cut and pasted some of that post into this one, which may be why the mood here is rather choppy). I suppose I also managed to be strong through the whole thing. But I’m kind of on the verge of falling apart inside. The whole thing was really scary, and seems to have left a hole in my heart. I thought about Maddie pretty much the entire time all of this was happening, obsessively, repeatedly remembering the details of her last hours.

When I’m living our beautifully chaotic every-day life, I thankfully take it for granted. When we’re thrust for 28 hours into a nightmare, I am reminded that I have no right to take our life for granted. I read people’s blogs –some utterly unimaginably devastating, some seemingly giddy with perfection– and am keenly aware that fankly, there are lives to be lived that are heavenly, and those that are hellish. Who/what puts people on either side of that line?–I have no fucking clue.  I do believe that it’s not black or white; of course there is some good in every bad story and vice versa. But really, people and their luck seem to fall on one side or the other, for no apparent reason. I don’t believe in people “deserving” the things that happen to them. It just happens, and one day you’re in heaven and the next you’re in hell. In the ER, in the hospital overnight, driving back to the ER the next day (and now as a fading haunt), frightening, nagging questions pulled at my insides: Why shouldn’t my family be thrust into hell like some of the other families with their babies in the hospital? Why does someone else’s beautiful child die and mine live? What is keeping us on the “heaven” side of the line, and are we secure in our place there? Why did Maddie’s sickness escalate into a nightmare, while A.’s only peeked in on one? The hospital is the place where my assumptions about life come crashing down all around me. There are no rules there, and no one cares which side of the fence you’re supposed to be on. Superstitions aren’t entertained and prayers are ignored. Any notion of “fairness” is laughed at.

I walked around Target yesterday in a partially celebratory (my baby is fine, right?), partially shell-shocked (my baby is fine, right?) daze, feeling like if I did not buy him this ensemble of board books then all hope might be lost. My past is filled with so many sullen strolls through the aisles of Target’s baby section (longing to be pregnant, then longing to not have a miscarriage… longing for my baby to not have a chromosomal abnormality… longing for him to be a “miracle baby” that survives the NICU without a scrape… longing to take him home… longing to care for him without a cloud of anxiety over my head… ) But here I am now: I have a baby. I have a beautiful boy to read these books to. To not buy them is to give up my place on the heaven side. So, I buy them defiantly, wishing I believed that someone was taking note.

hat1

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