Neb Woes
Almost two years ago I spent nearly four days in the hospital with Ryan as he was in respiratory distress and they couldn't get his oxygen levels back to a sufficient level to release him.
After that incident we were sent home with a nebulizer and an Rx for Albuterol, which we use from time to time when Ryan has an episode. These events typically start with a small dry barking cough, which can turn into a non-stop 24/7 cough accompanied by wheezing as his airways become restricted. We've only had one trip back to the hospital (thank goodness) and that time he was treated and released, so it has been pretty manageable. Ryan hasn't been diagnosed with asthma, and our pediatrician said that he very well could just grow out of this, which is what I keep hoping for. For now we know he has "reactive airways" and where the rest of us might just have a cold or cough, for him a normal illness can take a turn of events that impacts his breathing.
This past winter went pretty well in this respect - while Ryan had a few colds, not all of them turned into "episodes" which was an improvement and I hoped he was growing out of this. But last month he had a really bad episode. He was on an every-4-hours cycle with the nebulizer for at least 4 days, when normally we are only in that acute stage for a day after which we taper down before stopping. I was really worried and was considering further discussions with the pediatrician, but as soon as Ryan started getting better Colin got it, nearly as bad as Ryan, so I wrote it off as a particularly bad illness and not something specific to Ryan.
I was wrong.
On Monday we got home from school, and Ryan was coughing. A lot. He'd been fine that morning, and coughed just a bit the night before, but nothing major. This was different. As soon as we walked in the door he told me, "Mommy, I need my medicine. I need my ne-boo-lizer." I texted Hari, and warned him that this was probably going to be a bad night, because I could already see that he was breathing hard. We did a neb treatment, and another 4 hours later, but he was clearly still in distress. I tried giving him saline neb treatments to hold him over until the 4-hour mark, but it just wasn't enough and he was miserable. He couldn't sleep, couldn't breathe well, and just kept crying. I think I got maybe an hour of sleep all night, and Ryan was little better.
I ended up having to WFH on Tuesday, and called the doctor to try and get him in but as fate would have it their first available appointment was at 3:45PM. I kept a close eye on him, as he wasn't looking good, but we made it through the day. When we got to the doctor's office his breathing was labored, you could hear him wheezing with every breath, and I was worried. I showed the doctor a video from that morning so he could see how things had been. The doctor listened to Ryan, then took his oxygen level - it was down to 92.
At that moment I felt like an awful mother, thinking that I should have had him in the ER, but our doctor was calm and didn't say anything along those lines. He just said that he was going to give Ryan an immediate neb treatment and then recheck his levels. After the treatment, however, it was only up to 94. Not good enough. They did a second immediate treatment and thankfully his oxygen levels went up to 99 and you could see an immediate change in Ryan. He suddenly wanted to run around the room, asked if we could go home, and started playing with Colin.
Then came the treatment discussion. The first step was immediate - a 5-day course of steroids, along with continued use of the nebulizer. Then the conversation I dreaded. Our pediatrician had offered the possibility of putting Ryan on daily steroids before, but I always declined because I really didn't want to have him on any daily medication, especially at his age. Now I had to reconsider because... well... the kid needs to breathe. Our doctor first talked again about the daily steroids. The good news is that they would be inhaled (either neb, or eventually via an inhaler), so they would be restricted to his lungs which would help minimize any side effects, and then eventually over time we could work to wean him off them and see how he does. The other option was to put him on a medication to try and control the inflammatory response from his lungs ( Leukotriene inhibitor). This option supposedly may or may not be sufficient to address the concern, but has virtually no side effects so I went that route. If it doesn't work we can always revisit and talk again about steroids, but for now we're giving this a shot.
The drama of course didn't end there. I hit horrible traffic coming home (a 30 minute drive took over an hour and a half) so I gave up before picking up the meds, and Hari offered to get them. I remembered that the steroids taste awful from our last round, so I asked Hari to get them flavored (the pharmacy does this for a couple of bucks extra). He came home with strawberry flavored meds. I got the first teaspoon in Ryan and he clamped his hands over his mouth crying and saying that it was TOO SOUR and that was that. I tried again but he spit it all out. We tried bribery (lollipop), forcing (he spit it out), badgering him... nothing worked. He wouldn't take it, and kept getting more and more worked up about the whole situation. Hari gave up and went upstairs to spend some time with Colin (who had been an angel all night!) and I tried to continue the negotiations. Ryan got himself so worked up he started coughing again, got up off the sofa, and... BLEEEEH! He threw up all over himself and the floor.
My day was now complete.
I took the sobbing boy, planted him in front of the toilet, and went to clean up the mess. When I was sure the bout had passed I then showered Ryan, set him up with the nebulizer and iPad (he was due for his next treatment), and called the pharmacy. I begged them, explaining the situation, and asked if they could possibly re-make the prescription using bubble-gum flavor instead. Thankfully they took mercy on me, and at 9:20PM I was out the door to get the new meds. I got home and offered them to Ryan, hoping against hope that the bubble gum flavor would work.
Ryan: "Is it blue bubble-gum, Mommy?"
I quickly and covertly added a couple of drops of blue food coloring to the clear medicine... Yes, Ryan, look. Blue bubble gum!
In my head I just kept praying, Please-please-please-please-please let this work.
He tried it and gave me his most winning smile - I like it!
I thought I was out of the woods, but this morning the chewable daily medicine was a bust as well. He touched it with his tongue, declared "YUCK" and was done. I was freaking out. I'm supposed to give this medicine to my kid every freaking day and I can't get him to take even ONE DAMN PILL?!?!? Poor Hari had no idea what was going on, and was trying to tell me about the All-star (baseball) game from the night before, and I very unkindly informed him that I had no interest whatsoever in that game, Derek Jeter, or who got a lead-off double. AAAAUUUUGGHH!
Then I had a moment of clarity. It works for dogs and cats, maybe it will work for me. PLEASE, PLEASE let this work.
I cut a slice into Ryan's chewable vitamin and stuck the tablet in there. He looked at it for a moment, then happily took the medicine. SWEET MERCY, IT WORKED!!!
So, I now have a child on daily asthma medication. It makes me want to cry, but if this little pink pill makes it so my little guy can breathe then I'm going to suck it up and be grateful that we live in a time where he doesn't have to suffer once a month with days of being unable to get a full breath. And hopefully sometime in the not-too-distant future we'll wean him off the meds and he'll have grown out of it, and he can just go be a little boy without any further issues.
After that incident we were sent home with a nebulizer and an Rx for Albuterol, which we use from time to time when Ryan has an episode. These events typically start with a small dry barking cough, which can turn into a non-stop 24/7 cough accompanied by wheezing as his airways become restricted. We've only had one trip back to the hospital (thank goodness) and that time he was treated and released, so it has been pretty manageable. Ryan hasn't been diagnosed with asthma, and our pediatrician said that he very well could just grow out of this, which is what I keep hoping for. For now we know he has "reactive airways" and where the rest of us might just have a cold or cough, for him a normal illness can take a turn of events that impacts his breathing.
This past winter went pretty well in this respect - while Ryan had a few colds, not all of them turned into "episodes" which was an improvement and I hoped he was growing out of this. But last month he had a really bad episode. He was on an every-4-hours cycle with the nebulizer for at least 4 days, when normally we are only in that acute stage for a day after which we taper down before stopping. I was really worried and was considering further discussions with the pediatrician, but as soon as Ryan started getting better Colin got it, nearly as bad as Ryan, so I wrote it off as a particularly bad illness and not something specific to Ryan.
I was wrong.
On Monday we got home from school, and Ryan was coughing. A lot. He'd been fine that morning, and coughed just a bit the night before, but nothing major. This was different. As soon as we walked in the door he told me, "Mommy, I need my medicine. I need my ne-boo-lizer." I texted Hari, and warned him that this was probably going to be a bad night, because I could already see that he was breathing hard. We did a neb treatment, and another 4 hours later, but he was clearly still in distress. I tried giving him saline neb treatments to hold him over until the 4-hour mark, but it just wasn't enough and he was miserable. He couldn't sleep, couldn't breathe well, and just kept crying. I think I got maybe an hour of sleep all night, and Ryan was little better.
I ended up having to WFH on Tuesday, and called the doctor to try and get him in but as fate would have it their first available appointment was at 3:45PM. I kept a close eye on him, as he wasn't looking good, but we made it through the day. When we got to the doctor's office his breathing was labored, you could hear him wheezing with every breath, and I was worried. I showed the doctor a video from that morning so he could see how things had been. The doctor listened to Ryan, then took his oxygen level - it was down to 92.
At that moment I felt like an awful mother, thinking that I should have had him in the ER, but our doctor was calm and didn't say anything along those lines. He just said that he was going to give Ryan an immediate neb treatment and then recheck his levels. After the treatment, however, it was only up to 94. Not good enough. They did a second immediate treatment and thankfully his oxygen levels went up to 99 and you could see an immediate change in Ryan. He suddenly wanted to run around the room, asked if we could go home, and started playing with Colin.
Then came the treatment discussion. The first step was immediate - a 5-day course of steroids, along with continued use of the nebulizer. Then the conversation I dreaded. Our pediatrician had offered the possibility of putting Ryan on daily steroids before, but I always declined because I really didn't want to have him on any daily medication, especially at his age. Now I had to reconsider because... well... the kid needs to breathe. Our doctor first talked again about the daily steroids. The good news is that they would be inhaled (either neb, or eventually via an inhaler), so they would be restricted to his lungs which would help minimize any side effects, and then eventually over time we could work to wean him off them and see how he does. The other option was to put him on a medication to try and control the inflammatory response from his lungs ( Leukotriene inhibitor). This option supposedly may or may not be sufficient to address the concern, but has virtually no side effects so I went that route. If it doesn't work we can always revisit and talk again about steroids, but for now we're giving this a shot.
The drama of course didn't end there. I hit horrible traffic coming home (a 30 minute drive took over an hour and a half) so I gave up before picking up the meds, and Hari offered to get them. I remembered that the steroids taste awful from our last round, so I asked Hari to get them flavored (the pharmacy does this for a couple of bucks extra). He came home with strawberry flavored meds. I got the first teaspoon in Ryan and he clamped his hands over his mouth crying and saying that it was TOO SOUR and that was that. I tried again but he spit it all out. We tried bribery (lollipop), forcing (he spit it out), badgering him... nothing worked. He wouldn't take it, and kept getting more and more worked up about the whole situation. Hari gave up and went upstairs to spend some time with Colin (who had been an angel all night!) and I tried to continue the negotiations. Ryan got himself so worked up he started coughing again, got up off the sofa, and... BLEEEEH! He threw up all over himself and the floor.
My day was now complete.
I took the sobbing boy, planted him in front of the toilet, and went to clean up the mess. When I was sure the bout had passed I then showered Ryan, set him up with the nebulizer and iPad (he was due for his next treatment), and called the pharmacy. I begged them, explaining the situation, and asked if they could possibly re-make the prescription using bubble-gum flavor instead. Thankfully they took mercy on me, and at 9:20PM I was out the door to get the new meds. I got home and offered them to Ryan, hoping against hope that the bubble gum flavor would work.
Ryan: "Is it blue bubble-gum, Mommy?"
I quickly and covertly added a couple of drops of blue food coloring to the clear medicine... Yes, Ryan, look. Blue bubble gum!
In my head I just kept praying, Please-please-please-please-please let this work.
He tried it and gave me his most winning smile - I like it!
I thought I was out of the woods, but this morning the chewable daily medicine was a bust as well. He touched it with his tongue, declared "YUCK" and was done. I was freaking out. I'm supposed to give this medicine to my kid every freaking day and I can't get him to take even ONE DAMN PILL?!?!? Poor Hari had no idea what was going on, and was trying to tell me about the All-star (baseball) game from the night before, and I very unkindly informed him that I had no interest whatsoever in that game, Derek Jeter, or who got a lead-off double. AAAAUUUUGGHH!
Then I had a moment of clarity. It works for dogs and cats, maybe it will work for me. PLEASE, PLEASE let this work.
I cut a slice into Ryan's chewable vitamin and stuck the tablet in there. He looked at it for a moment, then happily took the medicine. SWEET MERCY, IT WORKED!!!
So, I now have a child on daily asthma medication. It makes me want to cry, but if this little pink pill makes it so my little guy can breathe then I'm going to suck it up and be grateful that we live in a time where he doesn't have to suffer once a month with days of being unable to get a full breath. And hopefully sometime in the not-too-distant future we'll wean him off the meds and he'll have grown out of it, and he can just go be a little boy without any further issues.
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