Bronchospasms

[Momi2AntnJadyn]

I don't know if something new is in the air or WHAT is going on but Jadyn is not sick right now, but for the past month or so she has been having these harsh coughing attacks... are these bronchospasms? She is on Flovent BID for bronchospasms, and Albuterol PRN. She's fine most of the time, but 2 or 3 times a day she'll have one of these "attacks". She just coughs and coughs so much that she can barely get a breath in... I will suction her, put her on the mist, give her albuterol, and eventually it stops... I don't know what it is that stops it, but obviously it can't go on forever, and it subsides eventually. It's just this high pitched squeaky kind of cough, and her face turns SO read and the veins pop out of her head, it's the worst cough... takes everything out of her. Anyway, she's always done this every now and then since I can remember, whenever there's something that irritates her, something in her trach, smoke, dust, whatever... and one of her nurses said she never heard a kid cough that way before? I just thought that's how everyone sounded coughing through a trach, but I've never heard another person with a trach cough before, I guess LOL... but I don't know what is irritating her so bad lately that is causing these to happen so often. Does this sound like bronchospasms, or an asthma attack, or something?? I don't know... what else do you do to help when this happens, besides what I'm already doing?? I thought about getting one of those air filters for the room, but she's not really always in there anyway.

[hcs_mom]

Amanda,

It does sound like she's having some kind of asthma attack. I guess the best way for me to describe Hannah's sounds are this "whistle". Hannah had a horrible episode a few months ago. Her sats were floating around, and I listened to her, she sounded wheezy, but it was loud and high pitched. I'd never heard it before. I MISTAKENLY gave her a Pulmicort treatment...BIG MISTAKE. Inhaled steroids are a big no-no if they are in the middle of one of these. Unfortunately, I didn't know what it was at the time.

So, it sounds to me like she's having some sort of attack. Albuterol is the way to go if you think this is what's going on. We used to give Hannah FloVent, but this seemed to set her off and I think the package insert actually says it can cause bronchospasms. Keep note of what happens just prior to these episodes...maybe you can narrow it down to certain weather patterns, FloVent, etc. Another thing we did...Hannah didn't tolerate Albuterol very well. Her HR would shoot up into the 170s (at the time her normal was 150s) and it would take 15-20 mins to return to baseline. And if you would need to give treatments back to back, it made it very scary. So, we are now using Xopenix. It's much more expensive, but we've had much better luck with it.

I hope you figure out what's going on with Jadyn. I know how frustrating it can be.

Take care.
Jennie

[lac]

It does sound like bronchospasms.
Did you change the size of the trach recently?
I remember when we had to go up on Collin's trach size and Collin started having these spasms. He would also have a wheezy, spastic type of cough too. When I had asked ORL about it the said the trach tube may have been too long. If the trach is too long they just have to move a certain way and it will hit what is called (if i remember correctly) the carina and this will trigger a spasm. Sometimes if you go too far down while suctioning this can also cause the same reaction. You might want to talk to ORL about this. See if there are any precautions you can take to avoid this. In the mean time what worked for Collin were cold saline nebs. I kept some bullets in the fridge and when he had a spasm I would give him a little (not the entire thing just enough to soothe him).

Good Luck

[Momi2AntnJadyn]

Quote[/b] (hcs_mom @ Oct. 10 2004,07:07)]Amanda,

It does sound like she's having some kind of asthma attack. Â*I guess the best way for me to describe Hannah's sounds are this "whistle". Â*
Yeah, that is exactly how I would describe the coughing Jadyn does too... and her heart rate also is up there after she gets albuterol. As for the question about whether she's had the size of her trach changed lately, she hasn't, not that recently... awhile back. But she is VERY sensitive, if her trach is touched at ALL, she just gags and coughs. But her "attacks" didn't start happening right after the size change, it has been more recent. I think it might be the cooler weather? I don't know. In any case, she has an appointment with her pulmonologist next week, and I plan to bring it up then, see if we might need to try anything different.

[Christamae]

I get those too-I call it wheezing. My inhaler (Atrovent or Combuvent) helps calm the coughing. Also squirting a little saline down sometimes helps. What happens with me is that really dry mucus gets stuck on my trach so I can't suction it out. This dry junk creates resistance and can make it particularly hard to breathe out. The saline gets the junk loose so I can suction it. Hope I helped!

Christamae