Deep breath

Max has had this weird way of breathing often for about a year now. When he is relaxed, nothing strenuous going on, he would exhale in a strained way like he was partly trying to clear his throat while huffing out. And he would say things like "My breath is making me mad." He is my only kid to get croup. Anytime a cold virus makes its round in the family, his comes with croup. It sounds awful. First time experiencing that he was 6 or 7 months old, and he strained so hard to breath it ended up needing a trip to the ER. So with this new way he was breathing every day, I wondered if he had an underlying respitory issue.

So before Christmas, he had another round of croup, and we talked to the pediatrician about it. She just checked his tonsils, said they looked fine, maybe it was his adenoids. I knew in my gut it wasn't anything like that. I had hoped for a more definitive answer before any major problem occurred.

Fast forward to two weeks ago. Maxwell woke up about 7:30, and started coughing. I heard the familiar seal bark and thought "oh no, croup again." But he kept coughing and wheezing, I could hear he wasn't catching a breath. He was panicking in the living room with Kellan, who became annoyed at his little brother coughing all over him. Kellan didn't realize the severity. I yelled for Max to come to me (as I was running to him too) and found him PURPLE and clawing his throat.

One of the scariest moments of my life!

I grabbed the nebulizer to give him a treatment of albuterol, and placed a cold wet wash cloth across his throat. Works like a charm for croup. But he was still wheezing so hard. I did a second treatment, not much better and I was considering calling for an ambulance. He was able to catch his breath a bit better now, so I decided to just take him myself.

I had his window rolled down as I drove, and the cool 45 degree morning air opened his lungs right up. Made me look like a liar when we arrived at the ER!

He was still wheezing though, and I wanted him checked out. He was seen first by a respitory therapist. His oxygen saturation was borderline low. After I explained the incident, I said "I don't know if he has asthma, I've been wondering for a while now." to which he replies "of course he does, you don't have episodes like that otherwise."

Then the ER doc comes in, says it likely wasn't croup because the peak season isn't right now, probably RSV. Said he had an upper respitory infection is all. I disagreed with that so much so, that when I later got a call from the hospital as a follow up, they asked me if I wanted to comment on my care. I said they could tell their no-exam doctor that RSV is a quick swab to test, which he did not do. And that Max had a case of RSV a few weeks before. He had no fever, and by the end of the day wasn't wheezing even the slightest, absolutely was not a sick boy.

The respitory therapist suggested a 5 day steroid. And wouldn't ya know, he didn't even do his "huff" way of breathing that became the daily norm for so long.

So we had a follow up with the pediatrician about the ER and the episode. Of course it was asthma. I wish I would have been listened to better when I said I was concerned about the way he was breathing every day! Blood test showed no allergy to trigger an episode. So he will be referred to for some pulmonary tests.

In the mean time, he has an inhaler steroid every day, and albuterol every morning. He has a little device to blow in for "peak flow measurements" which he enjoys doing. He loves trying to get the level as high as he can, like a strong man swinging a hammer on a scale contest. Often I see him grabbing his medicine bag just to check his peak flow. Optimal range for his age and height would be 130-160. His normal is below, at 125. Even with the medication. It makes me wonder before all of this, when he had labored breathing, how low his air flow was then. He has not had that strained way of breathing since beginning the steroid inhaler.

We now deal with a 4 year old wild man with a little bit of 'roid rage. But that's a whole 'nother blog entry! I am, however, very grateful to know this is something he will deal with, and can be better prepared.

We talked with the older kids about his asthma, and when to get an adult. Kellan felt very badly for being annoyed at Max's episode, and has been pretty concerned about every cough since then. It is touching though, to see how deeply Maren and Kellan care about him. I hope they always have his back.