One Thousand Words

I just thought I’d toss out a little inhaler update.

Niko has asthma. We use an inhaler 2-3 times a day, 2 puffs, with a spacer, and a dose of claritin in the morning because he also has allergies.

We had serious, severe problems getting Niko to calm down and cooperate with the inhaler/spacer at first. We mitigated these problems in part by giving him M&Ms after each dose and praising him for specific behavior: sitting still; being calm; cooperating; breathing in and out; etc. His initial spacer had a small sized mask, and when we got a refill of the medication we also got a new spacer and mask. The new one’s medium sized and fits him better, and we let him play with the old one with the small mask. He carries it around and “doses” his toys… his trains, his baby doll, his cars.

We give him the first dose almost immediately after waking up. Actually, our routine is like this:

• I eventually drag myself out of bed, and go to the bathroom and brush my teeth.
• Niko starts clamoring for his vitamins, which are gummi vitamins. I give them to him. He does a little dance.
• I dose him with claritin while he’s sitting on his changing pad, still in his pyjamas. If he spills, it’s on his jammies which are going in the hamper.
• I change his diaper and get him dressed.
• We go into the living room and sit on the couch together. He sits on my lap, I give him one puff and count slowly to 30 while encouraging him to breathe in, then give him praise and M&Ms.
• He runs off and plays a bit, or sometimes brings me a book to read, and then I call him back and we repeat the dosing.
• We read a book together, and then I sort out the breakfast situation.

I don’t like to give treatments closer than 4 hours apart, so his next treatment is either right before his nap or right after he wakes up, and then if he gets another one it’s before bed. If he gets too much albuterol he gets hand tremors and is a little bit hyperactive and his heart races a bit. The same thing happens to me when I have too much albuterol; it’s a collection of known side effects. His inhaler doesn’t have a little thing that counts down how many doses are left, and it became VERY clear that we’d run out of doses prior to our refill, when his first treatment with the new inhaler left him tremulous. But he soon adjusted.

Niko knows roughly when it’s time for his treatments, and he will remind me that it’s time for one. He thinks the spacer looks a bit like a train, so he’ll say “tootoot! *heavy breathing noise* myom myom” and point to where we keep it. He doesn’t always want M&Ms now; sometimes he takes a dose and then wanders off to play, not super interested in the reward. He does put up a fuss sometimes, but calms down pretty quickly once the mask is on his face and we’re counting to 30 again.

My ultimate hope is that his lungs improve and we’re able to get him to a point where he doesn’t need daily medication. Statistically, with treatment, 50% of childhood asthma cases resolve; so my hopes are pretty realistic here. I also realize how lucky we are that his asthma is relatively minor. In retrospect, I probably had asthma from a pretty young age, but it’s cough-variant asthma and not the more common wheezing asthma that everyone recognizes. It’s caught much more often now, people know more about it, but untreated asthma really messes up lungs. I absolutely don’t want Niko to have to live with that.

I’m going to call our pediatrician at the end of the month and see if she wants to discuss his treatment. He’s doing better than he was, but seems to have plateaued. He gets a little grunty sometimes, and has a cough when he over exerts himself (or it’s really cold, or he’s been screaming/crying). I’m optimistic, though!

Mirrored from Now Showing!.