2 yr old with viral-induced asthma

[q2b]

My 2 yr old daughter was diagnosed with viral-induced asthma about eight months ago. Her only symptom was a persistent cough, which was worse at night (and slightly after exercise).

She was started on salbutamol and flovent, neither of which helped. We saw an allergy/asthma specialist, who gave her Singulair in combination with the salbutamol and flovent. This also didn't work. She was also tested for the "top ten" allergens, and all came back negative.

Finally, she started Ventolin, Singulair, and Qvar a couple months ago. That combination finally started working, and we cut back to just the Qvar (on the doc's rec, of course). Then we all got sick over the holidays, and she started coughing again. So we we started back on all three (again, per doc's rec). It took three weeks for her cough to stop, and we waited another week, and dropped back down to just the Qvar (all part of the plan from the doctor).

Last night she started coughing again, and so we've started using all three again.

I'm concerned that the medications aren't working. Last time we met with the doctor, he said that we had run out of options, and we may just have to "live with it" until she (hopefully) grows out of it.

It's very hard to listen to my daughter cough all night. Because of the coughing, she doesn't sleep well, and is generally miserable.

I'm wondering if there's anything else we can do, and also, am worried that there may be some long term damage from her constant coughing.

This may not be related, but we're unsure whether she is lactose intolerant. I breastfed her until 15 months, and when we started her on whole milk, she had bad diarrhea. This happened several times, and we gave up trying mild for a few months. Lately she will drink a bit of milk, and hasn't had diarrhea, however she drinks no more than 1 cup a day (and not every day). She eats yogurt and cheese without issue.

I appreciate any comments or suggestions. Thank you.

[Bellavita34]

I sympathize for you.. I was looking to get more information myself because my son has been coughing all throughout the night again and  I was amazed to find so many parents in the same situation, it was  like reading about my own experiences with my son's asthma who is also 2 yrs old. Like you,  my son apparantly isn't allergic to anything so I was given a treatment using QVAR  in the morning and at bedtime ;however, when he gets a cold his asthma ALWAYS worstens . His asthma doctor has me do the nebulizer treatments with albuterol every 4 hrs and singulair pills one in the morning and one before bedtime. Once he gets better then it goes back to just the QVAR.  This winter so far has been particularly difficult , he has had a cough , heavy chest congestion for  almost 2 months . Along with the nebulizer treatment during the day at night I leave the humidifier on low setting and keep the door slightly open for ventilation .. you don't want it to get too humid in the room and found that it helps a little to try to alleviate the coughing. I also give him a little lollipop ( you can find over the counter grape flavor ) so he can suck on for a bit to help soothe his  throat or I sometimes I even use a little tea spoon with honey. I can't help but feel so guilty and helpless at times because if you don't recognize when to jump start treatment it can take awhile for the condition to improve.  It has taken me awhile to understand how all this works and yet I still feel clueless about it at times. Trial and error and trying whatever to make them feel better. He does get better eventually but  then as soon as he gets a cold it takes a turn for the worst so I feel and it has been my experience to try and jump start the nebulizer treatments as soon as possible and stay consistent until it is completely gone. So far my son has had this back and forth thing going for two months now. He gets better for a week and then slowly starts to go back to having congestion and that lingering cough. A couple of weeks ago he had a really bad night and was coughing ALL throughout the night so I took him to the dr  the next day and she said he had no infection , no fluid in his lungs but could hear the congestion so she just basically said to do the nebulizer treatments again. This is basically the answer I get every single time , there doesn't seem to be any other way.  I also tend to worry about what side effects this may be causing him. I have read that medication tends to stunt their growth but when I asked his asthma dr he said no.. I can't help but wonder sometimes though because you read about it . He has also already shown to be a bit more aggressive than other 2 yr olds and has mood swings so be aware of your  daughter's behavior aswell to see any changes. I hope this helped you out a bit or atleast know you are not alone. We love our children and it is difficult to see them go thorugh this at such a young age, I know it breaks my heart to hear him coughing and wheezing.

[momtofourboys]

The doctors have put my 4 year old on xopenex and pulmicort via nebulizer. they said that is the best one for him, he has a complicated history. You really need to seek a 2nd opinion, and that is just my opinion. from everything that my little guy has been through I always maek sure that I also have a copy of his medical reports that way there if you go for a second opinion, then you have all of that stuff and you can be prepared. to ask questions or whatever.
good luck
Michelle

[Vickie418]

What a rough start for your poor daughter! My daughter was also diagnosed with asthma before 2 years old. She had chronic pneumonia. Sometimes her pneumonias would be diagnosed as an asthma problem, then they would try antibiotics and she'd clear right up. Once your daughter gets older it's easier to see the signs. My daughter is on Sinulair, Flo-Vent and Xeopenex. My daughters asthma is illness induced and allergy induced. My daughter is very allergic to milk and that is how her problems started. Does your daughter drink a lot of milk?? Maybe it's making her phlemy and that's irritating her asthma?!? My daughter is on rice milk and does very well with it. Hang in there, get a second opinion.

[peanut501]

Have your home checked for molds and randon One of my daughters had a cough that didn't stop until we moved upon selling the home we found there was mold in a room not far from hers and radon in the home Check it out and clear the down, flannel and carpet  any where you can especially her bedroom keep it always free of dust and wash all the bedding frequently with hot water no softners keep scents away also this can cause sensitivity Try these things they really are possibilities

[falcon676]

It's funny because your story along with all the others sounds just like my sons also.  He's 6 1/2 now and has been diagnosed with illness induced asthma also.  One thing I would recommend you do is ask your doctor if they can do a blood test to check your daughters immune system.  The ENT we were sent to, because of all the sinus and ear infections my son was getting from just a basic cold, had us do this when my son was 5 years old.  Turned out that he was deficient in the antibody that fights the pneumiccocal bacteria.  He had the vaccine as a baby but they gave him a booster and the antibody came up to where it should be.  Then at 5 1/2 he had his adonoides removed and has been great for almost a year.  He recently had a bad bout with the flu but is much better.  He used to be on the singular and flovent which are supposed to be preventatives but never stopped him from getting the terrible constant cough.  We'd take the nebulizer with albutoral on family vacations any time of year (including summer) just in case and twice in the past few summers he had terrible flair ups.  They would have him on antibotics, and sometimes pretisone (a steroid) when the coughs got really bad.  When he's healthy he's great, but those little colds would always turn into major issues.  I felt like I was in the doctor's office constantly.  It's like the ENT finally tried to address the fact that if you stop what is getting your child sick, then maybe the asthma flair ups won't occur as much or often.  I wish the pediatricians would've checked his antibodies when he was much littler because that was 1/2 of his problem.  Good luck and hope your daughter gets better!!!!

[VVH]

Thanks for posting the details. I must tell you that my son seems to fit into the problem description of your son.

However, my son had his Pneumococcal Vaccine first time when he was 4. But he still have cough with any common illness such as cold.

[ksmith693]

Hello, my daughter was diagnosed with intrinsic asthma when she was 10 months old; after a couple of hospitalizations and several ER visits... She is also allergic to milk and eggs and you know when they are allergic, they scream and cry intolerably, have bad ezcema (eczema), and/or horrible belly aches, etc. Anyway, her asthma is not related to her allergies - good and bad. She started singulair before bedtime, pulmicort (1mg) per day, and xeopenex when needed for wheezing. She is MUCH better! And, she does have asthma problems with drainage or any sinus issues she starts wheezing every time, so they could be the same... I have never heard of Qvar, but my daughter's symptoms have improved drastically so I would definitely get a 2nd opinion. SHe also takes Orapred when her symptons are bad and we are fighting to get them under control (usually when a viral infection comes along or just a sinus infection or drainage in generl) LOVELY.
Kerry

[tlbeals]

my daughtr has a different dad now that I have been married 6 years. but theStep dad was ordered to pay 80 % of bill and caring insurnce.  My 11 year old daughter has a 800.00 prescription for Pulmincort 1mg.I cannot buy at walmart..I have no insurance on health and prescriptions..I just lost my mothe 1 week ago and I cannot loos my daughter too..She is always caughing but did get 12 hr delsyn and nibulizer but the main meds I cannot get because her real dad said he is broke.   WHAT do u do when ur dauhter is n such need. I am at my last ends...I cannot see her caugh not breath, but he did give her atibiotics which we all know it doen't help.


Teresa

[cmkkllss]

My daughter is now 5 1/2 and was diagnosed with viral induced asthma at about 1 1/2.  We went through years of hell of many different medications, terrifying episodes that ended in the ER for oxygen,etc.  Every cold or virus was horrible.  I think I lost years of life in the stress of that time.

I did so much research and found out that viral induced asthma is a different illness than regular asthma.  If your child only has asthma symptoms in response to illness, you may find that normal asthma treatments do not work or do not work well.

I worked with my ped. Dr. and with a naturopath.  My daughter now has had only one episode in the last 1 1/2 years.  I think the main thing that helped was pycnogenol.  It is a supplement derived from maritime pine trees. plus some other basic things like probiotics and cod liver oil.  

I could go on, but if anyone is interested, email me and I'll give you the info.  The bottom  line is that viral asthma needs to be treated differently, but most Docs have no clue, and just want to drown the child in dangerous meds.

Good luck.

***@****

[viralasthma]

My 2 1/2 year old son was diagnosed with viral-induced asthma a couple weeks ago.  We've already cycled through action plans that included daily Singular, Nasonex, & Pulmicort.  We've used Xopenex and Prednisone (steriod) too.  Nothing (short of the steroid) worked.  The doc thought he was having allergic reactions because he does have allergies to a couple grasses and one tree (skin test).  But the last episode came during very low pollen counts, that's when we finally got the 'viral-induced' diagnosis from our new allergist.  This process took over 1 year and spanned 1 pediatrician, 2 allergists, several sickness episodes, and countless coughs.  Like many of your stories, my son's cough was much worse at night.  If it's really just plain asthma from allergies, you child would cough randomly some time in the middle of the night (because allergic responses vary throughout an episode).  If it's viral-induced, kids will start to cough almost immediately when you lay them down.  This is because (at least in our case) our son's viral-induced asthma was caused by large amount of mucus build up in his sinuses that was draining into his throat and cause him to cough (hence the instant cough when he's horizontal).  He didn't necessarily have a stuffy or running nose, but he always sounded very congested during his episodes.  We just changed his action plan completely from proactive daily allergy type meds, to reactive mucus management types.  He takes nothing daily anymore.  He got sick this past weekend and I put the plan into action.  SUCCESS!  No coughing at night.  Zero.  No coughing that led to gagging, vomiting, and him sleeping in his car seat vertically.  None.  In fact, I stopped the plan on day 3 and he started coughing that night.  Started the plan back up and within an hour put him back to bed and he didn't make a peep.

If your child's cough gets instantly (say 1-5 minutes) worse when they lay down, they are producing a lot of mucus that is irritating their throats and causing the cough.  Ask your doctor about drying agents to manage the mucus.

Our Plan:

1) 0.5mg Pulmicort (1 AM, 1 PM) to manage true viral asthma.  The kind that causes his airways to constrict and make him cough.  In our case this is estimated to be only about 20% of the reason for his cough.
2) Rynatan, 3ML (1 AM if necessary, 1 PM) to manage the mucus orally.
3)Atrovent noise spray (1 spray each nostril 1-3 times/day) to manage the mucus topically.

We back off on the Atrovent first, then the Rynatan AM dose, then the PM dose, then the Pulmicort.

Hope this helps and best regards.