Dry Coughs and Mist Collars

KSEThree · #1 04-13-2008, 12:06 PM

Elizabeth has had her trach for almost two months. She is a "gurgly girl", needing to be suctioned every three hours, after the hiccups and after she coughs... until now.

She's only had one plug in the hospital. Her trach care has been so easy. We just finished antibiotics for a trach site infection. (No coughing, just thicker white secretions) Anyway, now she has started this dry, wheezy cough. It is totally unproductive. Her sats are good 95-100.

She totally hates the mist collar. Holds her breath. Turns her head. We even have a heater now, but she still won't wear it more than an hour at a time. How important is it to wear the coallar?

Could a granuloma cause this type of cough? I've noticed a small one at the base.

TommysMommy · #2 04-13-2008, 02:34 PM

Can she just wear an HME when she is awake? (sometimes called a "nose") Usually the trach collar is used for sleeping, unless like Tommy, she's on blow by O2 as well. If she just has the trach, then an HME should be okay.

Tommy has a dry, wheezy cough too. His was diagnosed with asthma. It is a dry, unproductive cough that looks like will never end. A chest xray can help to diagnose her if she continues. It could just be allergies or a normal kiddy cough. If it keeps up more than a few days, I'd mention it to the doctor.

drct1245 · #3 04-13-2008, 04:56 PM

I can't remember - do you have nursing? Do they have any ideas? Sometimes they have had experience and can give you a little more insight. Like Rene said, could you put it on her when she naps and at night? (after she's asleep?) Ayden actually does well on a nose all day and night. Does it help to put drops of saline down the trach? Some days we end up putting a drop down each hour just for extra humidity.

If it continues I would get her in to see someone - ped or pulm. Ayden has that right now, but he is getting over a cold, so... that's more explainable.
Hope she gets through it... those unproductive coughs take a lot out of the kiddos!

As the kids get older w/ the trachs, secretions change.

alizesmom · #4 04-13-2008, 05:03 PM

Alize keeps getting a harsh, nonproductive cough that goes away when we use xopenex. I'm guessing asthma. Could be the same with you. Karen

KSEThree · #5 04-13-2008, 06:29 PM

You know I've never thought of asthma before. We live where it's really dry. I have two room humidifiers around her bed. She wears her HME daily. If my other two had a cough, I would medicate with Benadryl. With Liz, I guess I'm paranoid.

If you don't mind my asking, how far are you from your pulm. and surgeon?

We are four hours away from everyone. She has a wonderful ped here in town, but he's not real familiar with trach babies. Our ER is not equipped to handle Liz. The closest PICU is two hours away. I know that God is in control, but sometimes I stay awake wondering about the what if's.

We go back to see neuro, surgeon and geneticist in May. The pulm in July.

TommysMommy · #6 04-13-2008, 06:34 PM

We are blessed to be a ten to twenty minute drive from our Children's hospital and all of Tommy's specialists. He's never even been seen by a doctor without an office at the hospital.

drct1245 · #7 04-13-2008, 07:56 PM

If you have a good ped, they should be able to help w/ the cough as it could be unrelated to the trach.

We are in a metro area, so we are only about 20 min too from all our Drs.

KSEThree · #8 04-13-2008, 09:24 PM

Thanks so very much!

alizesmom · #9 04-13-2008, 10:40 PM

2 hours on a good day to the specialists. We, too, have a inexperienced local ED. I am trying to work with them to improve their rediness since we're here to stay. Not too happy with the local peds either.

Karen

Jack'smom · #10 04-14-2008, 08:55 AM

Jack developed an unproductive cough and extra white secretions at about 4 months old and we were worried it was something wrong with the trach because he didn't act sick and the secretions weren't discolored. But we called our ENT guys and they said go to the ped first. We were not convinced Jack was sick but we went anyway and turns out he had a lung infection (diagnosed by X-ray), probably caused by a bit of bacteria on our hands when we suctioned him so it went right to the lungs without causing other symptoms. Just another thing to consider.