Emergency advice needed bronchiolitis and albutrol nebulizer!!! PLEASE HELP!!

Sorry I know this is a long story but I think all this info is important and I seriously need help and advice!!! I'm losing my mind here.:drama:

I spent Thurs. night and all day Friday in the hospital with Marshall. He had brochiolitis and was turning blue from lack of oxygen so they were giving him breathing treatments. The first thing they gave him was albuterol which seemed to work the first time and then stopped working so they gave him epinephrine breathing treatments which did the trick and by Fri afternoon he was mostly back to normal again. Then they prescribed albuterol again (gave once in the hospital) and gave me this nebulizer to take home and give to him every 4-6 hours.

When we were in the hospital both my husband and I noticed that he did not seem to like the albuterol treatments. When he was given the epi treatments he just relaxed and would breathe it in but with the albuterol he fussed and tried to get away, and on the last treatment in the hospital I noticed he was grinding his teeth and licking his lips a lot in a weird way, to the point where I asked if it seemed normal, and the respiratory therapy lady said that it was because it gave him a dry mouth.

Anyway, I waited the full 6 hours before dosing him again because the albuterol makes him act like a crazy man and then gave it to him. He got fussy again but I stuck it out through the whole treatment at which time I noticed that the skin on his lips was pale, yellow in a couple of patches. It looked like blisters but it wasn't, the skin itself was a different color.

It did not seem to be an allergic reaction and he seemed fine after the treatment was done. It was more like the nebulizer itself was irritating his lips, inside his mouth seemed fine, no discoloration. But then again thinking back to the hospital, he did not like the albuterol at all and after the first time, it did not seem to help. In retrospect I wonder if it might have even made him worse because his oxygen levels dropped from 90-92 into the mid-80's after he was given the albutrol a couple of times. But allergy to albuterol is super rare, almost unheard of, the pharmacist told me, and seemed to think that it would have manifested itself while he was taking it in the hospital.

I called the pharmacy, the emergency room, etc. but none of them had ever heard of it and of course now it's the weekend so I can't follow up with our reg. doctor or our allergy doctor until Monday. The only thing that they told me to do was bring him back to the ER for evaluation, well I really didn't want to do that because he had been through so much already with poking and prodding and he seemed ok. So I decided to wait it out for a few more minutes because they didn't seem to know what was going on anyway. While I was on the phone (about 10 minutes) he played normally and the discoloration vanished.

I hit the Google Med School and found only one reference to skin discoloration, on an eHow page and I usu. don't take those too seriously as sources of info - it said to stop giving the medicine right away which of course I already did. But the hospital put this huge fear of relapse into me and now I'm scared that if I stop using the nebulizer for very long, he will get really sick again.

Anyway, so my question is, has anyone ever experienced this with an albuterol nebulizer?? If so, did they ever find out why? Did they tell you to keep using it??

He seems fine this morning (better than yesterday definitely) and so far I have not given him the nebulizer since 6 pm yesterday. But I am really worried about him relapsing. For right now my thinking is that I will just wait and then if he gets worse at any point I can use it then. I am supposed to follow up with my reg. doctor on Monday and obviously I will ask about it then. Does this seem like a crazy idea?? What would you guys do???

And one last q - what do you do with a REALLY expensive nebulizer that your kid is allergic to??:suprise: Is there any other medicine that they give kids via a nebulizer?? (they seemed to think he might develop asthma at some point because of this bronchiolitis and that he might need the nebulizer with every cold he gets for awhile and gave me a massive amount of albutrol because of this)

I'm sorry Atomic, I wondered if something was up when you weren't around yesterday. I don't have any answers regarding the skin discoloration but I just wanted to say that DS1 has seasonal asthma, which means he only gets symptoms when he has a cold (like they said might happen with Marshall). He was far worse when he was younger and does occasionally now get a 'normal' cold (he's 6). We know when he needs his inhaler with a cold because we'll look at his sternum or the part of his neck where the Adam's apple is and see extra 'sucking in' which shows he's struggling. I personally would be happy to give the inhaler only if he seems like he needs it - it's not going to cure the bronchiolitis, it's just for treating the symptoms right? Was he ok during the night? I often find it's worse during the night.

I also wanted to say that DS2 had a case of bronchiolitis which required hospitalisation when he was around 6 months old and I felt sure he would have asthma like his big brother but he never did - so I hope that's also the case for Marshall.

Im sorry I have no idea bout this but I think it's better you stop if you feel something is wrong then usually it is. I hope nothing happens until Monday and you can tell all this to the doctors.
XX

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Originally Posted by zanacal

I'm sorry Atomic, I wondered if something was up when you weren't around yesterday. I don't have any answers regarding the skin discoloration but I just wanted to say that DS1 has seasonal asthma, which means he only gets symptoms when he has a cold (like they said might happen with Marshall). He was far worse when he was younger and does occasionally now get a 'normal' cold (he's 6). We know when he needs his inhaler with a cold because we'll look at his sternum or the part of his neck where the Adam's apple is and see extra 'sucking in' which shows he's struggling. I personally would be happy to give the inhaler only if he seems like he needs it - it's not going to cure the bronchiolitis, it's just for treating the symptoms right? Was he ok during the night? I often find it's worse during the night.

I also wanted to say that DS2 had a case of bronchiolitis which required hospitalisation when he was around 6 months old and I felt sure he would have asthma like his big brother but he never did - so I hope that's also the case for Marshall.

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Thank you so much!!!

Yes, they said that only his body could cure the bronchiolitis itself and the albutrol was only for the symptoms, but then they said that the albutrol could help maintain the airways staying open so now I have paranoia about not using it. o.O

TBH I cannot say with 100% certainty how he did during the night because I'd had about 2 hours of sleep in the 48 hours prior and I was seriously comatose (mommy fail) but he was sleeping on my lap the entire time and he didn't wake up at all (the night before he went into the hospital he woke up prob. every 20 minutes because he was struggling so much to breathe.) My husband couldn't help either because he had been up both the night he got so sick and then the night we took him to the hospital, he left the ER at 1 am and had to leave for work at 5 am and worked for 14 hours and didn't get home until 9 pm. Plus, he is sick too. (His stock just went up A LOT. ;))

The one time I did wake up, his breathing was perfect, better than it had been even in the hospital under medication. Much slower and more even, and his stomach wasn't heaving with the effort. This morning he is also breathing normally.

In my experience they will wake in the night if they're struggling. I know what they're saying, we're told to give Zander his inhaler every 4 hours when he has a cold too, but if you feel he's breathing normally and you're seeing a doctor on Monday morning and that's your instinct then I think I'd feel happy with that instinct if it were me. {hugs}

Atomic,

I have asthma and also use Albuterol. I've never heard of that kind of reaction to it, but that doesn't mean he isn't having some kind of reaction to it. It does tend to make kids hyper. :) I would probably continue doing what you are. Don't use it unless you see him having some breathing difficulties. Albuterol has a fast onset of action. So if you catch him when he starts having problems you can give him a treatment and he shouldn't escalate to a "turning blue" episode. I agree with Zanacal night time is usually the worst for breathing. You may try to prop him up some that helps me.

Yes, there are lots of medications that are nebulized. They have steroids which help keep inflamation down in the lungs for a longer period of time. They also have other bronchodilators like Albuterol that may work much better for him (Xopenex).

Thank you so much that really helps put my mind at ease (and also makes me feel a lot less stupid for buying the nebulizer haha.) Since it is fast acting I will keep it in case of emergency and follow up with the doctor and our allergist also and see what they have to say. He seems fine. THANK YOU GUYS SO MUCH.

Poor Marshall and poor you! How scary for everyone.

I don't know anything about nebulizers or albuterol, so you can take my advice with a grain of salt. But I think if it were me, I would continue the treatment if he needs it until Monday, when you can consult your doctor. I mean, breathing is the most important thing, right? Hopefully he won't need many more treatments before Monday, and then you can get some answers. If he seems to be having some sort of reaction that is really worrisome, then I would take him back to the ER.

I hope he is better soon!

Thanks Hobber! My paranoia is because if he's allergic to it, it can actually backfire and cause his airways to close up, so I feel like I'm between a rock and a hard place! He is doing really well though so I am just going to :pray: and try to keep my mind off of it by dispensing swaying advice haha.

The stupid thing is we have like 17 epipens lying around here and they are all adult size!! :/ If I had a kid epipen I wouldn't worry about using the stuff.

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Originally Posted by Flava

Im sorry I have no idea bout this but I think it's better you stop if you feel something is wrong then usually it is. I hope nothing happens until Monday and you can tell all this to the doctors.
XX

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Thank you flava!!! I agree. I had a really weird non-allergy reaction to a medicine once so I figure it can happen again. Just wish it didn't have to happen to US again. :p

Sorry, I'm no help just wanted to offer my sympathies to you! Ds1 has asthma (and peanut allergy) and he uses albuterol with none of those scary side effects. The dr. did put him on flovent as a preventive and we paid $300 for 2 inhalers only to have them sit in our cabinet b/c they made him act so crazy. It sucks. Hope you are able to get some answers and that Marshall feels better soon!

Oh, and would benadryl help? I think it is a miracle drug! ha ha!

If he was allergic, he would have already had a serious reaction ith his airway. It is a steroid so that is why it makes him hyper. I think it can make their levels drop after using it because although it does open the airway, it also stirs up all that junk making it seem like things are worse temporarily.

My DD had RSV and if he is using his stomach muscles to breathe, that's how Children's Hospital told me that they are then struggling for breath.

Children's also told me to use a humidifier and if the mist wasn't getting her blanket wet, it is not close enough to her. They said that is a must have with breathing difficulty when sleeping. Other than that, suction, suction, suction.

Thanks you guys! He did just take a turn for the worse a little while ago (he was running around a lot) and the respiratory therapist finally called me back at about the same time to tell me it prob. wasn't an allergy but I didn't have to give him the medicine if he didn't need that. Right after that was when he really did to seem to need it (stomach heaving and throat) so I decided to go for it with the Benadryl standing by at the ready if I needed it, but it went fine this time with no ill effects.

NBP - I TOTALLY agree about the steam!!! :agree:

Hope he is better very soon Atomic!!!!!

I'm glad you were able to recognise that he needed the inhaler and that it worked - mummy obviously knows best! When DS1 needs steroid tablets he turns into a hyperactive crazy person, it's not pretty!

I'm just reading this...hope he is feeling better soon! My sister is coming by tomorrow. She is a pediatrician and I'll ask for her input. I'll let you know what she says.

Just reading this too atomic! I am glad thing to be working out. How stressful! xo

I am a respiratory therapist. Not very often now that I have kids. Only one night a week now. Anyway feel free to email me and you can call me by phone if you have a question. I would love to help you because you have been so helpful to me. You could try using Xopenex instead of Albuterol it is more expensive but sometimes people get jittery and hyper from albuterol. The steroid pulmicort can be given 2 times a day by nebulizer and has less systemic effects than oral steroids. You need to rinse their mouth or give them a drink after an inhaled steroid because it can cause thrush. In fact if he is having mouth irritation after any treatment it is a good idea. The treatments also have saline in them and is sometimes irritating. Alot of times if there us airway inflammation they give a steroid shot, iv, or oral med and that can make people act weird. Good luck. Hope that helped a bit.

So sorry you're going through this....my husband is a pediatrician and this is what he says (I'm typing as he's telling me this) : It seems like he's having an adverse reaction to the albuterol, which is common in kids which include increased heart rate, agitation, poor sleeping, behavioral changes and skin color can change....an alternative med to this is xopenex you may wanna ask his doc about this but it tends to have fewer side effects. If he's not having any breathing difficulty now such as his chest is not sucking in and out, you can just observe him at home. Bronchiolitis is a viral illness but he may have underlying asthma. Sorry hope this helps somewhat. Let me know if you have other questions...you can always msg me.