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.