Even more nerve-wracking is this was the week I needed to have my D&C (read my blog post "Miscarriage") and so he was left with his baby-sitters. I hated leaving him. I knew I needed to take care of myself, but I wanted to watch him, make sure he was breathing okay. What really made me nervous was that he would have an attack. One of the big problems he was having was that his cough would make him cry; once he started crying, he couldn't catch his breath, which made him cough and cry more; he was having retractions that pulled at his collarbone. He wasn't eating or napping. He would sit in my lap and wheeze. My heart broke leaving him on Wednesday to go to the hospital. Logically, I felt good knowing that he had already had two days of Orapred and that he needed less Albuterol on Tuesday than he did on Monday. Emotionally, I thought of him sitting in my lap wheezing, knowing how quickly things can change, from my own experience with asthma and from what the doctors have told me about reactive airways in toddlers. I don't think I could have left him with the sitter, if not for the fact that our baby-sitters also have asthma. They are comfortable taking care of him and know what to watch for. I had my phone with me as long as I could; my husband had his phone on him the whole time. We got home from the hospital around noon and O was doing great.
On day #5 of the Orapred, I brought O in for a follow-up on his breathing. His oxygen levels were awesome and his lungs sounded great. We had a trip planned (ready my blog post "Let it be") and she asked if we wanted inhalers too, for travelling. So now he has Pulmicort in nebulizer and inhaler form. He already had Albuterol in nebulizer and inhaler form; we keep an Albuterol inhaler and aero chamber in our diaper bag along with his Asthma management plan. This works out great because mornings are a little difficult for us. This morning we had a lot going on and used the Pulmicort inhaler with the aero chamber. Occasionally we miss the morning Pulmicort because it is so hard to get D to preschool, get the boys dressed, and do the nebulizer. We don't miss it very often because O does well sitting with it on his face if I am in the room with him, telling him "sit" or "hold still" if he starts knocking his mask off. But now with the inhaler, we won't ever miss it.
On most days, I do the first Pulmicort nebulizer treatment after dropping D off at school. Some days we have to do it before D goes to school; those days are rough. We do the second treatment at night, before bed. We try to have it finished 10-15 minutes before they go to bed so we have time for teeth brushing at prayers. During the nightly Pulmicort we read stories and watch Jeopardy or Wheel of Fortune. The days that he needs Albuterol, I do my best to time the treatments. They make him jittery, wired. I try to do them 45 minutes before he goes to sleep or eat. Sometimes he will still nap immediately after doing an Albuterol treatment. Some days he will still eat after doing a treatment. Most of the time, he just wants to run in circles or rock back and forth in his high chair after doing Albuterol. I try to give him some time to get the "sillies" out, as we call them. The bad times are when the Albuterol doesn't affect him much and he still wants to sit afterwards. That is when he is really struggling, like this last time he went on Orapred. He still just wanted to sit in my lap after the Albuterol. The Orapred can upset his stomach. I try to give that to him an hour or so after he's eaten, so he has a full tummy and it has had time to settle. I don't know how much this all helps. I don't know if I time things in a way that helps him. Maybe it makes me feel that I'm helping.
Since the first time he went on Orapred was right when he started his daily regulator, Pulmicort, and he only had to go on Orapred once after that, our doctor wants to keep him on the Pulmicort. She says if he has another episode like this, we may need to think of changing his medications. Obviously we are praying that doesn't happen, not now. But, for now, we are doing well.
Previous blog posts about O's reactive airways: