Bronchiolitis vs. Asthma...

[saearl]

Bronchiolitis vs. Asthma...
by saearl, 1 hour ago
My now 7 month old baby girl has had coughing and respitory issues for the last few months. She got a cold when she was 3 months old (we have a 4 year old in preschool who has had a terrible year with colds), with a small cough and runny nose back in October. I had her chest listened to every 2 weeks and was told that she was all clear. She is very snuffly and stuffy and snorty sounding so I was doing steams, cool mist humidifier, and saline drops up the nose to try to relieve this. She started sleeping horribly. In early December, she had an Xray that showed inflammation in the lung tubes and she was diagnosed with Bronchiolitis We did puffers for two weeks (two puffs a day of Ventalin and 2 puffs a day of Flovent). After the course of puffers and several check ups, it was deemed without an Xray that her lungs were clear. Less than a week later, her cough returned, as did her runny nose. I had her chest listened to (by her Dr.) twice in one week and by the end of the week she was admitted to the hospital with only 84% oxygen. Her cough was terrible and she had a wheeze. After a weekend in the hospital, on nubulizer treatments, plus baby prednisone and back on the puffers,as well as an antiobiotic, she was released and we were to continue the puffers for a month. After that month was up, we did a follow up Xray and it showed no change in her inflamed lungs.I was shocked, as she was doing better, sleeping better, etc. My Dr. is now having us wean her off the puffers by gradually reducing the dose and we have been referred to a pediatrician, who we will see next week. My family Dr. is now saying that this may be asthma but wants a second opinion. We have reduced her puffers to one puff of each twice a day. Since then, she has gotten her runny nose and just a hint of a very infrequent cough back. We're just holding our course until we see the ped. next week.

Throughout all of this, she has been an amazing eater and is gaining weight. Her stats are between the 50th and 75th percentile for everything.

I am looking for answers as I am hesitant to accept the tentative asthma diagnosis. It doesn't seem to make sense to me. I am wondering if anyone out there, be it moms/dads/physicians or anyone has any thoughts based on her history that I have outlined. I am trying to arm myself with information and questions for the pediatrician next week. Also, can a case of Bronchiolitis be this persistent?

Thanks to anyone with any information that could help.

Worried Mom

[saearl]

She was 5 months old when we started the puffers for the first two week course. There is an aparatus that is used so that she gets the puffer meds sufficiently. She did have a nebulizer when she was in the hospital, but nothing has been mentioned as far as having one at home.

She doesn't seem to have allergies and definitely not GERD. She is a huge eater with a great appetite and doesn't normally spit up alot either. We do have a large dog that sheds though. We have no history of asthma or allergies in our family so the tentative asthma talk is puzzling.

I agree with you that a specialist is the way to go and we see a pediatrician on Friday. I'm just holding out until then as we've been instructed by our family Dr. to reduce the puffers to one puff once daily to wean her off the steroid puffer. I'm just watching her cough...she has a slight dry cough with a runny nose right now but so does my five year old so it's hard to tell if it's just a cold or not.

Thank you for your thoughts...they are very welcomed and much appreciated!

[bsmsl]

Lots of thoughts here.

One, puffers for a 3 month old?  They really can't coordinate breathing to use a puffer adequately even with a spacer.  She needs a nebulizer with a mask.

Two, asthma is hard to diagnose in anyone under 8 years old.  The airways are too small and have a greater tendance towards becoming inflamed and producing wheezing.  Many doctor will treat like a child has asthma, but won't actually give that diagnosis.  

Three, you want to make sure that all possible triggers of her congestion be investigated.  Does she have allergies?  Does she have GERD?  Those types of things. Controlling the trigger to the congestion and inflamation would go a long way in controlling her lung inflamation.  

Considering her age, I would say that one could say bronchiolitis could be persistant if a doctor was trying to avoid the asthma diagnosis.

I would suggest that you request to see a pediactric allergist to start with.  It would be worth being under a specialists care because they tend to treat more for quality of life rather than just keeping the patient out of the hospital.  Your child has a lot of developing to do that you don't want delayed by poor quality of life.  She needs to feel great in order to explore this great big world she is in.

Take care and God bless.