Asthma Strikes Again

It was just over a year ago that Jack had his first wheezing episode.  We were quickly introduced to the world of nebulizers and breathing treatments.  Over the next eight months, Jack would often wind up wheezing when he would get a cold with a bad cough.  I lost track of how often it happen, but it’s fair to say that it was at least 4 times in that 8 months.  Then in March, a bad cough hit him hard and he was hospitalized.

It was during that hospital stay that Jack was formally diagnosed with asthma.  The wonderful doctors and respiratory therapists at Children’s Hospital of Pittsburgh developed a treatment plan for him.  Since Jack’s asthma episodes are brought on by colds, the plan was to aggressively treat his colds. At the first sign of a cough, we were to give Albuterol.  Instructions were to give it as often as every 2 hours to try and keep his lungs open and prevent the wheezing.

Since Jack’s hospitalization in March, he has had three episodes of wheezing. The latest two episodes occurred just three weeks apart.  I don’t know about you, but to me, that is far too often.  I knew what needed to happen.  I knew that Jack needed to be put on a daily maintenance asthma medicine, so I called up the pediatrician’s office to make an appointment to talk to the doctor about it.

As soon as I mentioned the word “asthma” to the receptionist, she transferred me to the nurse.  As I quickly explained the situation, the nurse immediately declared that Jack needed to be seen that day.  I explained that we were following his treatment plan and she kept insisting that if he needed his inhaler every 2 hours then he needed to be seen.  I tried to explain that he didn’t *need* the inhaler every 2 hours but it was part of his aggressive treatment plan.  She refused to make  any appointment other than one for that day and I argued that I didn’t understand why she was giving me a hard time regarding a treatment plan in his file.  I agreed to an appointment and angrily slammed down the phone.

Now with hindsight, I know that my reaction was a bit strong.  My husband and sister-in-law talked be off the ledge.  I was just extremely frustrated that we were following an agreed up treatment plan and she was making it seem like I wasn’t taking care of my kid properly.

We met with the doctor that afternoon and he felt that Jack needed to be on an oral steroid to clear up his existing cough which had turned into a bit of wheezing.  He agreed that since it was the 2nd time since his hospitalization in March that Jack needed oral steroids, a daily maintenance drug was necessary.  Scripts were sent to our pharmacy and all was well.

At some point it hit me that what the doctor prescribed was a nebulizer treatment and that meant a 10 minute treatment every single day for the foreseeable future.  I don’t know why it didn’t occur to me at the doctor’s office, but it is just  not feasible to ask a very active 3 1/2 year old to take a 10 minute treatment EVERY.SINGLE.DAY.

I decided to call the doctor and have the meds switched to something that can be used with an inhaler and a spacer.  But of course given my prior interaction with the nurse, I was chicken.  I posted as much on Twitter and my husband offered to call.  Of course when he called, the nurse, she was just fine and had the doctor call him back.  The doctor was agreeable to switching to a new med and yesterday Jack started his new meds.

We go back for a follow up in a few weeks to see how he is doing.  We again have a plan with regards to treatment and what will happen if this med doesn’t do the trick.  In the meantime, Jack and I are well on our way to establishing a new morning routing consisting of Jack sitting on the bathroom counter and singing me a song as I hold up his spacer to his face and he breathes in the medicine that will hopefully stop him from having wheezing episodes.

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