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Posted

DS has asthma, and is one of those people who doesn't just catch a cold and get over it.  He often becomes very ill.  He has severe allergies, so there are auto-immune issues at play.

 

He currently has bronchitis.  It's been bad.  We are on day 10 or so.  He got onto antibiotics (and his choices are limited, due to those allergies I mentioned before) and got worse and worse.  

 

As of yesterday - he's now on a new type of abx, plus steroids.  Plus, of course, continuing albuterol in the nebulizer every 4 hours, motrin, benadryl, and his normal meds.

 

He is miserable.  His pulse ox readings are staying on the low side for him, but they come up with each neb treatment so we are staying home for now, and not going to the ER.  Last night was better, in the sense that there was less coughing and more sleep, though there was some vomiting (ugh).  His temp seems to down a degree overall, too.  

 

Any tips for helping him through this?  Any experience with how long this will take to beat?  Poor kid.  :(  

 

 

Posted

DS has asthma, and is one of those people who doesn't just catch a cold and get over it.  He often becomes very ill.  He has severe allergies, so there are auto-immune issues at play.

 

He currently has bronchitis.  It's been bad.  We are on day 10 or so.  He got onto antibiotics (and his choices are limited, due to those allergies I mentioned before) and got worse and worse.  

 

As of yesterday - he's now on a new type of abx, plus steroids.  Plus, of course, continuing albuterol in the nebulizer every 4 hours, motrin, benadryl, and his normal meds.

 

He is miserable.  His pulse ox readings are staying on the low side for him, but they come up with each neb treatment so we are staying home for now, and not going to the ER.  Last night was better, in the sense that there was less coughing and more sleep, though there was some vomiting (ugh).  His temp seems to down a degree overall, too.  

 

Any tips for helping him through this?  Any experience with how long this will take to beat?  Poor kid.   :(

 

Bless his heart. :grouphug:

 

I had bronchitis just once. It was dreadful. By the time I got in to see the doctor (walk-in clinic on Monday, diagnosed with sinus infection, antibiotic, my doctor on Friday a.m.), I was also wheezing. She gave me an injection of a steroid and a nebulizer treatment--a new experience for me as I do not have asthma. I went home, and was down for a month.

 

Bronchitis just knocks you down. For myself, I tried to keep up with personal hygiene (tricky...one morning when I took my shower--and I usually took my shower at night, so a morning shower was stretching--I was so weak when I got out that I just lay on the floor and air dried). I was too sick to get dressed, but I wore different jammies each day. :-)

 

Sounds as if you really do have a handle on things (as much as is possible), so I'd just hang in there. It might be a long haul.

  • Like 1
Posted

It takes me 4-6 weeks to fully get over bronchitis.  Saline, suction, nebulizer are must-haves and I usually end up on steroids, antibiotics, and have a pneumonia scare at some point too.

 

My advice: skip the benadryl, double the zyrtec if needed. You want a strong long-lasting antihistamine and benadryl isn't up to the task.  Up the advair or get a longer-lasting albuterol form so you get better control. Antibiotics only help with the secondary infections since most bronchitis infections are viral in nature.  I'd also not do the Motrin unless the fever has him very lethargic or he has a lot of muscle pain. You want the high body temperature to kill the germs.

 

LOTS of clear liquids.

 

Watch for those intercostal retractions or for when wheezing bumps over into stridor. Vomiting for us is one of the things that will push us to the ER as usually that happens just before the sats crash. 

  • Like 2
Posted

Ellie, I'm sorry you've been through this, too.  It's just awful.

 

It takes me 4-6 weeks to fully get over bronchitis.  Saline, suction, nebulizer are must-haves and I usually end up on steroids, antibiotics, and have a pneumonia scare at some point too.

 

My advice: skip the benadryl, double the zyrtec if needed. You want a strong long-lasting antihistamine and benadryl isn't up to the task.  Up the advair or get a longer-lasting albuterol form so you get better control. Antibiotics only help with the secondary infections since most bronchitis infections are viral in nature.  I'd also not do the Motrin unless the fever has him very lethargic or he has a lot of muscle pain. You want the high body temperature to kill the germs.

 

LOTS of clear liquids.

 

Watch for those intercostal retractions or for when wheezing bumps over into stridor. Vomiting for us is one of the things that will push us to the ER as usually that happens just before the sats crash. 

 

Oh goodness, I didn't know that about the vomiting.  Thankfully, his numbers are good today (and I've never been so grateful to have the pulse ox thingy in the house!).  Do you have any tips on when you go in?  We are watching for retractions, obviously anything blue would send us in. The doc wasn't terribly helpful re: which number on the sats would send us to the ER.  She basically said *anything* below his normal baseline.  Is that what you do?  His sats are fluctuating but staying about 98 when things are good.  They were down to 95 when he woke this am and I just about fell over, but a neb treatment got it back up to 98 or we'd have gone in.  Would you have gone in anyway, or just done the neb?  I'm not sure I did the right thing, but felt like the neb treatment would help more immediately than going to the hospital, as we'd have to wait.  And then the number was better.  

Posted (edited)

I'm so sorry :( I have one of those kids too. She has atypical asthma, and every passing cold has a pretty good chance of turning into bronchitis or pneumonia. Her inhaler does very little to help her. After a million doctor visits over the course of 5 years, the last time she was sick, an urgent care ped put her on Flovent (and the usual prednisone and neb treatments). She was better within days (faster than ever before) and hasn't been sick again since. 

 

Has anyone ever mentioned that for him? I'm not sure if it will be any help for him now, but it might be worth asking about for the future. 

 

:grouphug: It so awful watching them be so sick and knowing you're pretty much unable to help them feel better. 

Edited by ILiveInFlipFlops
  • Like 2
Posted

I'm so sorry :( I have one of those kids too. She has atypical asthma, and every passing cold has a pretty good chance of turning into bronchitis or pneumonia. Her inhaler does very little to help her. After a million doctor visits over the course of 5 years, the last time she was sick, an urgent care ped put her on Flovent. She was better within days and hasn't been sick again since. 

 

Has anyone ever mentioned that for him? I'm not sure if it will be any help for him now, but it might be worth asking about for the future. 

 

:grouphug: It so awful watching them be so sick and knowing you're pretty much unable to help them feel better. 

 

I will ask about that at the next visit.  

 

I'm so sorry your kiddo is the same way.  :(

Posted

Our doctors have varying philosophies on this.  I understand their perspective on all of this.

 

Ped pulm says anything that cannot be controlled by 2 puffs of albuterol every 4 hours (for up to 24 hours) is worth going in over.

ER dr says if I can't keep his sats in the 90s after albuterol, come in.

Pediatrician says to trust my gut.  

 

FWIW, pediatrician has been right on. My kids crash fast--we've gone from fine to sats in the 60s in a five minute period of a severe asthma attack.  If kid is blue, you are WAY past the point of when you should be in the ER.

 

I go in to the ER for: retractions, stridor, vomiting (because of coughing) if albuterol has been administered in the last four hours, and any time my momma gut is sending off warning bells.  If you've been at this a while, and it sounds like you have, you just know when it's time.  I go in earlier with babies and toddlers.  I've only had one admittance over my career of mommying for asthma--I had a 4 mo. spend four days on continuous oxygen.  We've had several long nights in ER getting iv steroids, some blow-by, and some nebulizer treatments.

 

Nowadays, I keep a fairly well stocked home pharmacy with my nebulizers. I assume you are already on maintenance meds for the asthma.  I'd be hitting the maintenance meds hard and working on that long-lasting albuterol. I've had a kid go into tachycardia from too much short-term albuterol.

 

I am not a dr, but if he is responding well to nebulizer treatments, I wouldn't freak out. FWIW, I usually ride in the high 80s in my sat levels when I'm sick and due for medicine.  Albuterol will only get me up into the mid-90s. I'm usually 99-100 when well.  I personally only get concerned when my kids fall out of the 90s or when I'm seeing something looking unstable-ish going on.

  • Like 1
Posted

Flovent is a maintenance med--in the same class as pulmicort, qvar, etc. I assume he is already on one of those? You mentioned normal meds above. If he is not on a maintenance asthma med, that is worth a call to the ped over TODAY.

 

Ah, okay.  He's on Advair and Q-Var daily, plus Nasonex.  That combo has kept his asthma well maintained for a long time.  Obviously, he has albuterol for emergencies, and the nebulizer for issues like this.

  • Like 1
Posted

My asthma/allergy kid we were told to go in when he's was needing more than 2 neb treatments in I think 4 hours. We were in the ER last Dec. I just knew of was time. He was this close to being admitted but thankfully steroids and multiple treatments of the nebulizer.

  • Like 1
Posted

Mucinex (not the kind with a decongestant) is an often overlooked help for bronchitis. You might want to run it by the doctor. Some cough meds can be taken together--I think Delsym can be taken with mucinex/guafenisin. You can use a decongestant if the drainage is bad, but don't get an all-in-one med because then you can't stop the decongestant if he's getting too dried up. I'm most likely to get bronchitis when I have tons of drainage, even if it's clear and runny (non-stop drainage means my lungs stop inflating fully and feel very heavy--I don't really wheeze until I'm in seriously bad shape). I realize that is not the case with everyone, so you might ask the doc first. 

 

If he has a dry cough, then that likely won't help. If my lungs are super-reactive (coughing every time I inhale), I usually don't respond unless I've had codeine or something of that nature.

 

If my downward spiral started with an allergy trigger, then steroids are usually required for me, which stinks because they make me feel terrible. 

 

Long-term, I would be asking about things to boost his immune system. When I stopped gluten, that helped a TON (I'm not sure if the allergies in question are food, environmental, or what). I also respond very well (over time, not right away) to fish oil. I haven't had a bronchitis scare in a long time since making those changes. 

 

:grouphug:  :grouphug:  :grouphug:  Bronchitis is awful! I hope he's on the mend very soon.

I would ask why antibiotics--it's rare for bronchitis to be bacterial, and those antibiotics can't be helping his body out if they are not needed.

  • Like 2
Posted

Hang in there!  My mother once had to miss 6 months of school due to bronchitis, before antibiotics had been discovered!  (She is 88.)  I did learn with my daughter who has asthma that you can give two neb treatments back to back if necessary.  Otherwise, keeping the air moist this time of year helps.  We got a humidifier for her room, and long, hot showers helped too.

 

Also, preventative meds like Advair helped a lot during the times of year (fall and winter for my daughter) when asthma was more likely to be a problem.

 

 

  • Like 1
Posted

Hang in there!  My mother once had to miss 6 months of school due to bronchitis, before antibiotics had been discovered!  (She is 88.) 

 

My bronchitis was viral, not bacterial, so antibiotics didn't help. :-(

Posted (edited)

I don't think ds' lasted that long. He has allergies and was using a nebulizer machine. It's been a couple of years now, but I think they gave him antibiotics and told us to do the nebulizer treatments. I don't know if we even used any other medicines. Me, on the other hand, was a miserable mess for MONTHS because I didn't get medicine (I was broke and thought it would pass).

 

ETA: I'm not familiar with pulse ox readings so I didn't have those to go by.

Edited by heartlikealion
  • Like 1
Posted

 

Watch for those intercostal retractions or for when wheezing bumps over into stridor. Vomiting for us is one of the things that will push us to the ER as usually that happens just before the sats crash.

I agree!

  • Like 1
Posted

When we get to this point we use DuoNeb in the nebulizer and find it much more effective than Plain albuterol. We have had sats down to the low 70s before.

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