Oral Steroids to the Rescue Again

I heard her sniffle.

"Mom, my eyes are watering, and my throat hurts."

Another sniffle, and a little cough, not a concerning cough, but then, when your child has asthma, isn't every cough concerning? They have become so, at least with this child. When she coughs, I listen, with my ear on her chest and back, and often with a stethoscope.

Sometimes it's nothing, and sometimes it's asthma. Sometimes there's a whistly wheeze, sometimes there's a crackle, often there is noise other than the simple rush of air I wish to hear.

The runny nose and watery eyes called for some Benedryl. At the first sign of the tickly cough, the Albuterol came out. Every 4 hrs is the standard protocol.

9 am on Sunday morning, she 'had a neb' before we left for church. Her next one was at 1pm, and all seemed relatively ok, except for the cough, it sounded more productive. By 3 (only 2 hrs) she needed another breathing treatment, as her coughing increased and her O2 level began dropping through the 90's. Below 95 is not-so-hot, below 92 for any length of time is not good, that has been the benchmark stat that her docs have told us is when she needs to get in on O2.

By 5 she was at 90%, another neb. She dipped to 89%, and got a second one, back-to-back. She lingered around 91-92%, borderline, but it was early, we've seen her drop her stats at night so many times.

More meds at 7 and again at 9, then she fell asleep on the couch, and dipped to 87%.

It was time to go in.

And it was snowing.

It ended up ok, one of those runs where the very act of getting up and walking out in that cold air actually helped her O2 stat come up a bit by the time we got there. She dipped some after relaxing, but only to 91%, so the doc ordered yet another breathing treatment. She had also developed a fever over the course of Sunday evening, which could have meant virus (as opposed to just a typical asthma/allergy type of event) or that she was already developing pneumonia, which she has done rapidly so many times.

Thankfully, her x-ray was clear! Beautiful lungs, and no antibiotics. She is, however, on yet another oral steroid 'burst', never my favorite, but, as I've grown rather fond of saying "a girl's gotta breathe"...

She was not admitted that night (thank you, Lord!), instead I drove home on a snowy night, oh so tired and barely able to see the road in front of me. The snow stuck to the road and I could see no lane markings. My only landmark on that pavement was the little bumpy grooves in the center that make your car rattle when you drift across the lanes... I was thankful it was after 1am and there were few cars on that rural highway that night.

Monday was an ok day, with breathing treatment interruptions every 4 hrs, long nebs with 2 meds, and the steroid behaviors kicking in along with the desired respiratory effects. Tuesday was even better, though she had a few coughing fits that gave me pause...

Tuesday was busy, though we had to get those breathing treatments in between the work and play. Our oldest started a speech class with other homeschoolers, which looks like it will be an excellent addition to our lifestyle of learning. We also made a Target run to pick out a birthday gift or two or three for our 4 yr old who is about to turn 5. There was an abbreviated afternoon of school work before the cake baking, and then the cake eating began. Games were played (the classic Operation- love that game!) and new puppy toy was played with. Pictures were taken and a couple short videos captured. Bedtimes were pushed back for a night while busy children laughed extra long, extra hard, and extra loud- we can never leave out the loud part around here.

It never ceases to hit me, when the asthma rears its head, how blessed we are. We have meds, we have good hospitals, we have good doctors. It wasn't that long ago that a child with chronic breathing issues wouldn't have made it long. We are so lucky to have her, except that I don't really believe in luck. She is a gift from God, and every day with her is a gift from Him. One more reason to keep on keepin' on, to do my best by my children, and not take them for granted.

Today is day 4 of the oral steroid (that started Sunday night) and I do think we have this round under control. She will stay on her inhaled steroid for some time after the oral dose taper, probably until we have our next visit with her pulmonologist. Which reminds me, I need to schedule that for sometime in March, which seemed much further away back in the first week of December...

Mr. Extraordinary scored some tickets to a local event tonight and will be out on a free date night, enjoying a night on the town, while my youngest sister is in the throes of labor (unless it goes fast! pray for fast!) as she is scheduled to be induced to deliver their 2nd son later this morning. If any of you praying Mommas out there would take a moment to offer up a prayer on behalf of my baby sister and her baby, please know you're appreciated! If we time things right, or if she times things right, or if baby times things right, we won't be all that far from the hospital in the evening... maybe we can sneak in for a peak and some pics!

Asthma Again

Dazzle started to cough a bit Saturday morning. That cough. Not the little tickle in the throat cough that comes with a bit of a 'common cold' or a touch of hayfever. She started coughing the cough of another asthma flare-up. It began mild and infrequent, yet she got a neb treatment with albuterol, rather than a quick puff on the inhaler. I just knew. Sure enough, she continued to cough over the course of the afternoon, and the cough grew rather reminiscent of the times she has developed pneumonia in a matter of hours. The nebs came every 2 hrs and pulmicort was added before bed, and again Sunday morning (and will be added morning and evening until this flare-up is good and passed).

We stayed home from church Sunday morning. Her O2 level had dropped down to around 89-91% in the night, but came up to a nice 96-97% after a neb, so she was able to avoid a hospital visit*. She perked up a bit through the afternoon, even tolerating 3-4 hrs between nebs, so I'm hoping we caught this one in time and the frequent nebs have kept the airways open enough for her to cough it up and out and keep things clear. I've actually lost track of how many times she's developed pneumonia, crazy, huh?

*below 92% means in the hospital on oxygen for her...

Her overnight O2 didn't seem to dip as low, when she came down this morning and we checked first thing, she was at 94%, so she seemed to have had a much better night than the previous one, though she told me that she had woken up coughing and then heard herself wheezing in the night. I reminded her to please come down and tell me when she's wheezing in the night, so she can use the inhaler or get a neb treatment in the night. I don't dare just leave the inhaler in her room for her to grab when she needs it, as she shares the room with her 8 yr old and 4 yr old sisters, the 4 yr old obviously more of a concern. She's a curious one, and a quiet sneaky one at times, and I just cannot bring myself to leave strong meds around where she could get into them. Dazzle just needs to learn to come down and get meds when she needs them. The coughing I can hear sometimes (I am a very heavy sleeper, but you know how you just wake up when the baby cries or a kid is sick...?) but the quiet wheezing at night, it scares me that I cannot hear that.

She's playing pretty normally today, though she continues to cough. At least her energy levels seem good. If she is developing another pneumonia, it looks like a mild case. I'm hoping and praying that keeping up with frequent meds another few days will keep this one at bay and that we can make it through without any doctor visits this week or next.

Here's hoping the rest of the week only gets better!

Oh, and PS- my husband and I met the MckFamily last Friday night! They don't live very far from us and they opened their beautiful home for a lovely party. I just have to say that they are genuinely warm and open people and their children are just as special and cute up close and in person! Thanks again, Jennifer and Isreal!

Another Bug So Soon

Big J (10), Baby J (just turned 1!) and Little M (2) seem to have picked up a bit of a 'common cold' bug- very runny nose, watery eyes, a bit of a cough, thankfully no fevers, so no, I do not think this is the flu, seasonal or swine, excuse me, H1N1. I know some people with little ones battling some pretty bad ear infections, so I'm on the lookout for signs of such, but other than that, I'm not really worried, not really.

That being said, when Hope (4 yrs) began coughing Saturday morning, my Asthma Mom radar went off. Both she and Grace (6 yrs) have been consistently taking a controller med ever since the last (and worst ever, for us) flare-up, and have had no asthma symptoms since coming home from the Children's Hospital. That cough meant time to move to the 'Yellow Zone' on the asthma action plan- which for them means increasing to using controller meds twice per day and adding in albuterol nebs or inhaler every 4 hrs or as needed.

Grace doesn't have any cold symptoms, but she is the one who has been the sickest the most often, the one who's given us the most sleepless nights and brought out in us the most earnest prayers of parents truly concerned about the health of a child. Having a virus moving through the house, this soon after being in the hospital puts Grace in the Yellow Zone too, asthma symptoms or no asthma symptoms. If you know me at all, you know that I do not like to over medicate, that I do not like to throw a bunch of meds at a body 'just in case', but I am learning to deal with the current fact that our daughters' asthma isn't like my 'touch of asthma' or 'reactive airway disorder', which from what I can gather is like being diagnosed with asthma-light. Theirs is the scary kind.

Watching a child continue to get worse after having IV steroids and antibiotics pumping through her little veins for days, not understanding why all those meds, in addition to all of the rescue inhaled meds, aren't helping her lung function improve faster, is heartbreaking, confusing, and terrifying, all at the same time. I don't want to watch that again, none of us do. I'm pretty sure neither Grace, nor Hope, want to experience that again. Our hope and prayer this week is that we've started the extra meds early enough, and that we won't even hear a wheeze, but that this cold bug would pass through and be gone with no Dr. visits to speak of.

So, with 4 out of 7 coughing and runny-nosed, again, the extra sunshine (when we can get it!), extra fluids, extra vitamins, and on the days I really get my act together, some extra good food, are not really extras, but so very important parts of our attempts at a healthy lifestyle. There will be chicken tonight, and broccoli- have I mentioned how much I love that my kids all eat their broccoli?!

Last October, Hope had a wheezy cough for 3 weeks straight, but never had any issues with her O2 level, never even needed to see a doc, we just monitored her closely and kept giving her meds 'til it passed. I truly didn't worry. She had never (since a baby) really given us a reason to really worry. After last month, this year's coughing has me a bit more concerned. The pulmonologists stressed, before we left the hospital, that after such an extreme flare-up, the lungs will be extra-sensitive for a while, another minor thing could turn major fast- so we watch and pray, and try to do that thing that can be so hard for us as parents- to trust, trust that our daughter's health, more than that, her very life, is in His hands, and His hands are far greater, far more capable, than ours.

Enjoying them,

because of Him-

ali

A Girl's Gotta Breathe

The sniffling started on Monday, if I remember right, and it wasn't much, just enough to alert my asthma mom sensors, and start dosing with benedryl every 4 hrs. Little Miss H started to cough a wee little cough by Tuesday evening, and with both she and Miss G still sporting runny noses, they both got a preventative couple 'puffs' on the inhaler before bed. At least, I was hoping they would be preventative. Little Miss H coughed herself to sleep, finally settling in pretty good, only to wake up on Wednesday with a much deeper and more concerning wheezy cough. Out came the albuterol nebs (breathing treatments) and she got a good dose before we headed out for Teenager's violin lesson.

While he has his lessons, I usually take the rest of the children to a nearby park, which we have had mostly to ourselves since the rest of the kids went back to school. The running around was too much, and Miss G needed to come sit still and use the inhaler again. When Miss G starts wheezing, alarms start going off in my head. Little Miss H can cough and wheeze for days, even go through a bout of pneumonia, and keep her stats up like the hearty little trooper that she has always been. Miss G, on the other hand, can start a slight wheeze, that most people wouldn't even notice, drop her O2 level and progress to a wheeze that most people couldn't miss, in the blink of an eye. Ok, not quite that fast, but in a matter of a few hours.

After we got home, both girls started getting nebs every 2 hrs, rather than waiting the prescribed 4. The benedryl dosing continued, the garlic consuming started, and I went ahead and started Miss G on another steroid burst- my least favorite thing about life with asthma, but a girl's gotta breathe, and so a mom's gotta do what a mom's gotta do.

After falling asleep, both girls dropped their O2 stats into the 80s, so I headed to the ER, this time with 2 girls, around 10 pm. After 2 more nebs, only a few minutes apart, they were deemed to have opened up and were moving air well, so we were sent home, with orders to start Little Miss H on a steroid burst as well, as her lungs were making much more 'noise'.

After getting home around 12:30 am, I collapsed into bed with a sudden severe headache and started vomiting, seriously, that's how behind in sleep I have been this week. My body canNOT handle that much sleep deprivation, so Darling Husband had to take over. He got up to watch the girls get settled into sleep, to give another neb in the middle of the night, and to take Miss G back in after her O2 level dipped to a way-too-low 70%, along with some retracting. Those of you that have experienced respiratory crud, know about retracting, and that it's not good. She's using auxillary muscles to help expand and contract her lungs, which mean she's working extra hard to breathe. That's taxing on a little body.

This time they x-rayed and confirmed she had already progressed to pneumonia, barely more than 12 hours from the time I noticed she had started wheezing. They gave her a shot of antibiotics and sent her home with oral antibiotics to add to the steroid burst and frequent nebs, with directions to bring her back (again) is she worsens. Well, by 7 am, her O2 was back down to 81% and she was still wheezy and retracting some more, so Darling Husband took her back, again, for the 3 time in 9 hrs...

This time her O2 had only come back up to 85% with all the waking activity and 'excitement' that comes with running to the ER (which will often result in a higher O2 stat long enough to be sent home, only to drop again when she falls asleep). This time she's staying, she's on oxygen, and she's needing a good sleep just as much as her Dad and I.

Most activity around here has come to a screeching halt, with videos being watched by the youngers, chores and extra helping out being done by the olders, so hopefully Mom can get another nap. I'll update as I hear more from Darling Husband.

Enjoying them,

because of Him,

ali

When Pollen Counts Merge

This past week our local grass pollen count was still in the 'high' range, as the weed pollen count shot up to join it up there in the spotlight. Combine that with the heat wave and accompanying humidity (it's not the heat, it's the humidity, I'm from Minnesota, I have to say that) and throw in a couple allergic & asthmatic little girls and you get lots of coughing and an increasingly uncomfortable amount of wheezing, oh and don't forget the snot- out the nose, out the eyes, sometimes even out the ears, stuff running everywhere. We should've invested in Benedryl, that and Albuterol, ugh.

I'm home from church today with the younger 5, as too many girls have been coughing too much. My husband brought the 2 oldest down with him for the day. I hope (and pray, always pray, it's more effective than simply hoping) that they will get something good, from the Lord, from today's messages, and that they will bring some of it back home to share with the rest of us!

In the meantime, in between time, it's time for another round of meds.

Enjoying them,

because of Him,

ali