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Happy New Year!

Yes, I’m still alive. I must apologize for the silence. It has been an adventure. Let me share. Where were we? Oh yeah, roseola in one kid. Followed by a second child. But we still made it to see Santa. Then there were our flu shots, although it was only me and Zoe since Eva can’t have hers for a few more weeks. And then we were off on vacation! True to form, by the time we’d landed in Italy, Eva had a fever. She started wheezing a day or so later. Bronchiolitis. Revisited.

For those of you who pay attention and memorize my every word (ha, I know that is exactly no one!), bronchiolitis is a viral inflammation of the small airways in the lungs in kids under 2. It is a virus and can’t be treated with antibiotics. Also, it generally doesn’t respond to any of the wheezing medicines that we give kids with asthma since the reason for the wheeze is swelling and snot, not hyper-reactive airways. But even for me, this point is a hard one to drive home. In the ER, most of us find that we will try treating the kids who show up in November, at the beginning of bronchiolitis season, and by February we’re so sick of wheezing children we can’t help, that we just don’t bother. The same thing apparently holds true at my own house.

We were on holiday with my entire family, most of whom have an inhaler. We’re a sickly bunch. Anyway, with Eva wheezing her head off, refusing to eat and coughing to the point of puking, it was a real battle to continually argue the difference between bronchiolitis and asthma. After all, both cause wheezing and for a clan of asthmatics, it seems absolutely negligent to not at least try to help her out. So I caved. We fashioned a little mask out of a styrofoam cup and put my inhaler (albuterol) in a hole at the end. I gave her two little puffs over a couple minutes, with the cup firmly sealed to her face. (And with at least 2 other well-meaning family members holding down the rest of her body!)

I’m not convinced that it did any good. My family thought otherwise. It’s hard to say. My gut says that it was the adrenaline rush from the fight that helped ease her breathing for a bit. Now it is always possible that a child actually has a bit of asthma underlying a bronchiolitis infection and therefore asthma medicines might help. For instance, if I see a baby with bronchiolitis and the whole family has asthma, that might be a child who would benefit from medication. But most kids just won’t. Of course, if she had been really working to breathe, turning blue or unable to drink enough to stay hydrated, we would have been at the hospital. Instead she was just annoying, hacking her head off all day and night.

Anyway, about 3 days later Zoe started wheezing. I didn’t even bother with the inhaler on that kid. She was like my February. It’s bronchiolitis. I can’t fight it. I’ll never win. It’s a few days of fever and misery, then just a horrid hacking cough that will probably last for weeks. Time to cry, “Uncle.”

But now everyone is once again back to normal, with runny noses of course, but full of energy and enjoying all our new Christmas toys. Which gives me time to wish all of you a very Happy New Year. May 2011 bring you much joy, health and happiness.

Dr. Lara Zibners, Jan 02, 2011

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