Steroids

2chatter

The ear infection thread has me seeking more input.

DD (she's almost 11) was diagnosed with a chronic sinus infection after we went through a battery of allergy tests and it turned out she is literally allergic to nothing.  She suffers from a sore throat and headaches, and for the most part, I encourage her to drink water, tea and give her Tylenol when it impedes her day to day activities.  So far, the allergist and ped haven't offered any solutions other than Nasonex (which has little impact) and courses of steroids (which we have only done once).  DD is really miserable right now, pale, not really hungry because she cannot taste things properly, short tempered - just really not herself.

I am OK with one more course of steroids (making it a total of two for the year) but don't see this as a long term solution.  Am I being oversensitive to steroids?  Is there another solution?  We have an appointment this afternoon.  DS has a croupy cough and wheezing so I am betting he goes back on breathing treatments....so it's steroids all around.  In his case, the ped is fine with me determining what DS needs after giving me the oxygen stats and his assessment of his lungs, so we keep the steroids to a minimum there.  Any thoughts?

[Deleted User]

I would seek a second opinion (another ENT) before doing long term steroid use.  Another round, sure.  As a permanent solution?  No.

I have chronic sinus issues and had some luck with the balloon sinusplasty but I am not sure if they would do that on a child.

Also, if one medicine isn't making an impact then ask to try a different type medicine, in this case the nose spray.  Sometimes it takes trial and error to find what works.

KayteeGee

I would definitely get another opinion from different specialists maybe? I can't tell if you've just seen a GP, an allergist or an ENT?

FWIW we went to three ENTs before I found one I was comfortable with (chronic ear infections; constant fluid leading to delayed speech).

Have you seen a pulmonologist?  DS was on some inhaled steroids (pulmicort) as well as albuterol after a bout with RSV but the pulmicort was at the instruction of a pediatric pulmonologist and it was not long-term.  If it's long-term steroidal breathing treatments they're suggesting for a sinus infection I would TOTALLY insist on seeing a pulmonologist. 

2chatter

We saw an allergist, ENT and the ped.  We are just going to the ped today because....no one has offered anything different and the ped does refer widely, so I am hoping if he cannot solve it, he can refer us elsewhere (but not to the two above). 

For DS he's an interesting case.  He started breathing treatments after RSV, but his stepbrother, dad, grandfather, uncle and all male cousins all had severe childhood asthma with onset before age 2 in all of their cases (literally all of them had multiple hospitalizations into the teen years).  DS is only wheezy when he is sick, so curious to hear what the ped says because he was curious as to if DS would have issues again this winter.  (I nursed for 17 looong months due to entirely circumstantial "evidence" that BF "might" help with decreasing asthma severity).

[Deleted User]

Do you need a referral for insurance? If not, no need to wait on a pedi referral for a second opinion. You can certainly ask for recommendations on ENTs but don't feel like you have to wait on him to decide he needs to see someone else.

And if you have to get a referral for insurance, point blank ask for one.

The best parenting decision I've made thus far is going around my beloved and trusted pediatrician to see an allergist/asthma doctor.

2chatter

We don't need one for insurance...we need one to get in the door.  The ped knows who is and is not accepting new patients and who is not that his office can call and ask that we be seen.  I tried to find a pediatric allergist with good reviews on my own and they were all 4-6 months out for an initial appointment...ped gave me two and both would have worked us in (one I had already called!).

We got an ENT referral and it's to an ENT this ped has always referred to who moved 30 minutes north of his old office when he moved his family and therefore has openings.  For now, she is on an antibiotic.  ENT over Christmas break, I hope.

DS is on Albuterol and a Zpac.  So a few days (literally) of meds and he should be much improved.  Fingers crossed....we tried a side stream as I need a new mask for the nebulizer and that was a lenthy process that left me unsure how much he really breathed through his mouth (he's pretty congested so I hope a lot).

MommyAtty

Twice a year, I get a nasty sinus infection that will only go away with the use of steroids. When I was little, they were oral. But starting around your daughter's age up to now, they give me a shot and I'm better within hours. If they don't give me the steroids, the sinus infection goes chronic. And I second the "use the Nasonex daily" advice. It doesn't seem to be doing anything in the short term, but over time with consistent use, it has helped me. Though it helps me with allergies, so if she's really allergic to nothing, I'm not sure why they want her to use it. Hmmm. So I change my advice to "ask what the Nasonex is for and if the explanation makes sense, use it every day."