Freaking Out WWYD? (long)

mcdev · March 2010

So yesterday I posted that Keira has bronchitis (most likely pneumonia, but without a chest x-ray, we don't know for certain) and I had a couple of nebulizer questions. How I have escaped breathing problems/treatments for nearly two years with a CLD baby is beyond me, but I feel like we're making it up for it this week. To catch you all up...I ended up bringing Keira in to the pedi yesterday. Only a nurse practitioner was present (one who I've never met), but she seemed thorough enough. She agreed that Keira's lungs sounded horrible, but in true Keira fashion, she was running around, singing "Elmo's World" , and smiling away. Definitely not looking as sick as her lungs sound. The nurse looked in her ears and said there was lots of fluid. She wanted us to do a chest x-ray, but when I questioned her about what we would be looking for (Poor Keria has had sooooooo many x-rays...I only want them now if absolutely necessary) and she said pneumonia. When I asked her how that would be treated, she said with antibiotic...the same antibiotic she would prescribe for an ear infection if the ear progresses to infection. I assure her it WILL become an infection..it always does...and now Keira's fever is back and her nose is green. Nurse agrees to bypass x-ray and go straight to antibiotics. This was at 5pm.

Fast forward to 8pm and Keira's wheezing is loud and crackly like static and squeaky. I give her a breathing treatment. Nothing changes. She starts belly breathing...rapid heartrate (prob treatment, but still), and almost panting. I call the on call dr. She says give another treatment. I do. Symptoms persist. We go to the ER.

Basically the ER did nothing. Her sats were 90. We sat and waited over an hour and a half for a dr. At this point Keira is playing peek-a-boo with other patients, singing, dancing, and again not acting sick. breathing is normal. Fever is gone. They send us home with instructions to do treatments as needed.

So we're home and belly breathing is back...wheezing never left....WWYD? continue treatments and keep an eye on her? Take her back to the ER? Do a damn chest x-ray? Relax, this is all "normal" and the meds will kick in? Crawl in a hole?

Sorry so long!! TIA!!

meldoo2002 · March 2010

I'm so sorry I just wanted to say that I understand how you feel and how scary it is. Did they give her anything other than albuterol at the ER? There are other medications they can use if that's not working at home. I think I'd call the on call pedi again this morning and see their recommendation.

Mrs. Destructo · March 2010

Is she taking an oral steroid (like orapred)? If she isn't, I would call the doc this morning and ask him to call it in. It might take a couple of days, but the oral steroid will really help with the inflammation and wheezing.

If the doc won't call it in, is there a pediatric ER or urgent care near you? It might be worth taking her to one.

Poor girl, I hope she's feeling better soon.

witt0198 · March 2010

I'd probably try the treatments again, but if she still doesn't have improvement and she's belly breathing....if her sats were 90% last night, I'd probably try to get her seen again. Ditto about the comments for steroids. Sats of 90 in a kid that young are just too low, and she can compensate pretty well for awhile, but not forever. Trust your instincts, I'd say if it's freaking you out.....you should go in.

Rachel&Joe · March 2010

I would definitely go in & ask for some liquid steroids (stella was on predisolone this winter & they worked very quickly). Good luck!

mcdev · March 2010

Thank you everyone!

She is on an oral steroid...prednisolone and I think has her last dose today. For her nebulizer, we are using Albuterol. I've been doing every two hours since last night and I think there *may* be a little improvement I'm seeing. I think part of her problem is that she is so so active (even when at her sickest, she doesn't "act" sick) and I'm sure that's not helping her breathing. I just gave her a treatment, a bath, cleaned out her stuffy nose, fed her her very first meal in THREE days, and I'm going to try putting her down for a nap. Hopefully the rest of the day will be this uneventful. If not, it's to the ER I go.

Thank you again. You all really help to calm my nerves and (as always) have great advice that comes from valuable experience.

xoxo,

corey

orangejuice · March 2010

Hopefully you'll see this - - I just went through pneumonia with my 29 weeker two weeks ago. It was incredibly scary because she's had trouble with her airway in the past. Her symptoms were a fever that wouldn't go away but the biggest concern was rapid shallow breathing even when sleeping which is indicative of fluid in the lungs. I called my pedi's on-call doctor at 3am because I was so worried and they agreed then that it sounded like pneumonia.

I'm sure you know but the only way to confirm the pneumonia was a chest xray, which we had done. If you're thinking of having the chest xray done: my pedi told me that the pneumonia may appear better than it really is (i.e., less widespread and severe) if the child is dehydrated. My daughter hadn't been eating or drinking well for several days at that point so we agreed to do the antibiotics regardless (though the chest xray did show pneumonia anyway).

My daughter felt and looked a million times better about 24 hours after we started the antibiotics so I hope you're little girl is on the mend!!

preemieparent · March 2010

It sounds like things are (hopefully) better. A couple of thoughts to throw in the ring in case you need more ideas or for future reference:

1) Antibotic shot - This is a very strong, concentrated dose that goes in the leg. It hurts but it works well. Olivia got it and her pneumonia was a million times better by the next day.

2) Pulmicort - This is a steroid given through the nebulizer (Flovent is another brand). You can do it twice a day on top of everything else - sometimes it helps open up the airways.

3) A fever can cause an increased heartrate and belly breathing. Try alternating Motrin and Tylenol to get rid of the fever. If her breathing/hr get better than you'll at least know if that was part of the problem.

Good luck!

AviatorJJ · March 2010

wow sounds like our two kids have been through almost the same exact thing at the same time! weird. does she do a preventative nebulizer/inhaler? probably not since you said this is the first time you've had trouble with the wheezing. may be something to think about to get her through the winter. the Orapred didn't do anything for Rowen so that's why they gave him the Decadron steriod at the ER. the Urgent care didn't have it and all they did was the same Xopenex that we have at home so it was very frustrating. does she see a Pulmonologist? ours was really helpful in calling in medication and checking up on us. i felt just like you, i didn't know whether to make a big deal about it or not. at one point i called the pulm back and said "ok just to make sure im clear, should i take further action (go back to ER) since we have tried the neb for 12 hours (every 2 hours) and he is still relentlessly coughing?" that's when they told me to go back. he was running around happy as can be too. it's very scary when they can't breath though. i hope she feels better soon!

axh2277 · March 2010

When DS had RSV last year we were doing breathing treatments every 2 hours which ended up helping him so much. My other advice is to see if you can get flovent or pulmocort. I have asthma and everytime I get a cold or bronchitis I have to use flovent on top of my inhaler to help get the inflammation in my airway down so I am not struggling to breath. GL!

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