The pulmicort push

  1. [font=Comic Sans MS]Help me please! I have a 14 month old son who has been plagued with poor health since birth. Born full term and over 9 pounds you'd think he'd be healthy, not so. He's had pneumonia 4 times, recurrent bronchitis, over 8 ear infections, which led to tubes, eczema, asthma, tonsil infections, food allergies and now seasonal allergies. His ped. has had him on .5mg's of pulmicort 2 times daily for months now. She now wants to up his dosage to 3 times a day and to start the albuterol again as well. How harmful can these dosages be to my son? He wont sit any more to use the neb, and we still have 4 months until he can start a chewable. Any advice?
    [font=Comic Sans MS]~mom/nursing student in need of advice~
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  2. 7 Comments

  3. by   traumaRUs
    Not to scare you, but has he had a sweat test for cystic fibrosis? I would want to investigate why he is so ill. Exposure to smokers? I would also recommend getting a referral to a peds pulmonologist. Good luck...
  4. by   colleen10
    Not that I have much experience but I agree with Trauma.

    I'd seak a specialist to see if there is an underlying cause to all of these resp. problems, ie. CF, asthma, severe environmental allergies, genetically immunocompromised, COPD, environmental factors such as pollution, smoke, day care, etc.

    Good luck and hope you can find some answers.
  5. by   flowerchild
    I think you should look at getting him tested (again?) for his allergies. What exactly is he allergic to? Find out, avoid the allergens, and ask the doc about allergy shots (probably too young though) or allergy meds.
    The pneumonia, tonsilitis, ear infections, bronchitis, could ALL be caused by the allergy. Wet ears, lungs, sinus', increase the risk of infection.
    My approach, as usual, find the causitive factor and remove it if possible, if not then treat the symptoms to avoid complications.
    BTW, my kids have allergies, RAD/asthma, sinus allergies, rashes too. I try hard to keep them "dry" via use of anti allergy meds, which I have noticed fewer infections in thier ears and airways.
    I understand your frustration. It's so hard to watch them suffer. So many children have these allergies. More than ever before. I've thought long and hard as well as researched for info. I can only sumise that it is environmental. Our air quality where I live is 83%, our food ? I don't even like to think of pesticides, ab, weird chemicals, etc that are used to produce our food supply.
    One problem I have found is that only male plants are patented. In turn, when you buy a plant or tree from a store, it's usually male. Cities, counties, and other municipalities, as well as many homeowners, avoid or cut down the female plants b/c they are messy. They flower, fruit, and leave a mess to clean up. So all these male plants putting off pollen and no females to take up the pollen, it stays in the air for us to breath. There are now a couple of cities in America that have outlawed the planting of male trees. One is in N.M.
    I'm checking out or IN as many would say, leaving the city behind, to grow my OWN vegetables, raise or hunt my own meat, milk from MY cow and goats, eggs from my chickens, and best of all, I'll have an unlimited water supply of the very best around. Same water that I now buy in the store in a bottle and pay too much for. There are plenty of natural forests all around. The air quality where I am moving is 98%. I have yet to see an asthma attack at our new place. They run through hay fields, play outside all day having fun, and I don't have to give Albuterol. I can't wait to get out of the city! I'm outa here!
  6. by   MayBaby
    I agree with "flowerchild" and a possible environmental link. However, I also have a family history of asthma, eczema, hayfever, and bronchitis. You did not say if you have a family history of allergies to food, medicine or the environment. That would explain alot. If you don't have a familial link, then I agree, further testing is a definate. These signs and symptoms typically don't just happen for the sake of happening.

    Here are some other possible causes and tips that might help you environmentally. Do you have new or really old carpeting? The glue, backing or carpet material can be a trigger. Do you have gas appliances? The gas fumes and exhaust from them can pollute the air in your home. I open a window in my home once a day for a little while no matter how cold it is outside. The air in your home is more polluted than the air outside. Do you have pets? Pet dander or flea treatments can be a trigger especially if the pet likes sleeping with your child. Do you use candles? The different natural materials used to make them and give them their scents can be triggers. Do you spray air deodorizers around the house, especially after a diaper change? Items like Lysol, Oust, Glade, etc can be triggers. Is there a bookshelf near where your child sleeps? Bookshelves encourage dust mites which are triggers. Stuffed animals are in the same category as bookshelves, dust mites love living in them and are triggers.

    Try to learn his triggers. Look for patterns in the environment and your child's health. Is he worse or better at home, in the car, at daycare, at Grandma's, outside. Just something to think about.

    I don't know how other nurses feel about chewable/oral respiratory treatments but from what I have seen on my pediatric floor and with my nephew, a nebulizer is the best route. He can be expected to protest because that is what toddlers do best. Maybe he can see you get a neb with normal saline, then let him get a neb with the real med. Maybe you can let him help you hold it. Maybe you can decorate the tubing and chamber with stickers. Maybe you can try to do an activity with him like read a book or fingerpaint while getiing a neb. Try to be creative, not upset, because they will push your buttons and love you anyway!
  7. by   karenG
    its probably worth pointing out that most inhalers dont work in the under 2's.

    he may just be a normal child who is lurching from chesty cough to chesty cough- they are designed to do that and just sometimes thats the way it goes! do you use oral steroids in children in the states?? we have the SIGN asthma guidelines which are excellent.

    oh you always seem to look for zebras in the states... copd in a child?? sorry but not diagnosed in the under 35!! (at least over here!)

    Karen
  8. by   ferfer
    I know where you are coming from, my 3 year old daughter has struggled with the same since birth. It is unfortunate but these things seem to all go together, allergies, asthma, imunnosuppressed children. Keep in mind that the prednisone has its good and bad points. It may help to control the asthma and chronic inflammation in the airways, but it suppresses your child's natural immunity and makes him more susceptible to infection (bronchitis, pneumonia). Is he in daycare at all? That makes things 10 times worse. Increasing the meds can help and often times specialists can prescribe doses that are not recommended by the manufacturer out of liability, but in honesty are safe for a child to take when there are no other alternatives. My little one hates the neb. When she got a bit older we switched to using a spacing device with her inhalers. It allows to her breathe it in naturally and as she has gotten even older she now understands that she has to breathe it in DEEP. But, if your child is to young to understand these concepts you have to go with the neb, even when he hates it.I do recommend you see a specialist. My daughter sees an pediatric immunologist that specializes in the testing and treatment of asthma and allergies. It has helped immensely. I also had a tiny spot of black mold in my bathroom at one point. It seemed to get bigger and my daughter was very ill. After I did research I realized we had to move and have had minimal problems since. Plus, furnaces irritate children with asthma/allergies as it just blows dust around. Get it cleaned, change the filter bi-weekly. If you have carpets, consider getting hardwood. If this is not an option, get a vacuum with a hepa-filter on it and use it DAILY. Its a pain in the rear but makes a difference. Also you can buy air filters that help, as well as certain types of humidifiers. Don't be afraid to increase the meds if your child needs it! But if you are very uncomfortable with it you can always seek another opinion! Good luck!
  9. by   mom-student
    thank you all for your advice! i will call his ped. tomorrow and ask for that referal!
    in response to a few questions neither my family, nor my husbands, have a history of allergies. i am still holding on to the hope that he'll outgrow some of his symptoms, if not all of them. we also have no pets, he's not in day care, and we have recently remodeled our older home. however, we have not taken out the older carpet in his room, which i am now thinking will be our next step! i hope that our ped. will give me the referal! a few months ago i had wanted her to do some testing on his immune system, and she just talked us out of the idea. thank you all again! i cant wait until i finish my bsn and am able to give out such helpful advice!

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