Jenna used a nebulizer for her respiratory problems until she was hospitalized for pneumonia in March. We had been having problems with compliance because Jenna hated the mask and the noise that the nebulizer made. She would fight it and cry and the whole process was stressful for everyone. When we talked to the pulmonologist in the hospital, he suggested that we try a metered-dose inhaler (MDI) with a spacer. What a huge difference! Jenna doesn’t fight her meds anymore and the inhaler is MUCH faster. Hallelujah!
We also started noticing that Jenna’s heart rate would increase and she acted super-hyper whenever we gave her Albuterol via MDI. Hyperness is definitely not fun, but the rapid heart rate is what worried us most. Jenna’s rapid breathing rate already makes her little heart work too hard, and they’re watching her for any signs of pulmonary hypertension. She also can’t afford to burn the extra calories that get burned when both her breathing and heart rate are elevated. We talked to our pediatrician about our concerns, and she switched us to Xopenex. Apparently, it’s functionally the same med as Albuterol minus one ion that causes rapid heart rate, agitation and general hyperness. Xopenex is newer, so many docs just still prescribe Albuterol because it’s what they’ve always done. Additionally, insurance will sometimes refuse to cover Xopenex because it’s more expensive, but if you can get your doc to give a medical reason for using it over Albuterol, you should be covered.
I should also mention that we received mixed opinions on the subject of nebulizer versus MDI for toddlers. We had one pulmonologist tell us that kids receive more meds (and hence more benefits) from using a nebulizer and three other docs who said there’s no difference except for the way it’s administered. You should (obviously) discuss the subject fully with your own doc(s), do your own research, and make the decision that’s best for your own child. Ultimately, we decided that Jenna was often not getting much of the med via nebulizer anyway because of the crying, pushing the mask away, and outright refusal. The MDI is worth it just for everyone to have significantly less stress.
P.S. No – the picture above is NOT Jenna. Hee! (It’s from a medical site showing how to use an MDI with a spacer, and it’s just like Jenna’s)
6 comments
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August 12, 2008 at 12:04 pm
kari
I have to hold Tristan down during breathing treatments it’s awful. I have both for Tristan but so far no success with the MDI spacer. I am happy that Jenna is having success. I am hoping we will too in the future. Actually since Tristan had his T@A surgery and we put him on Singulair his breathing has improved so much. YAY Jenna great cooperating!
August 12, 2008 at 12:22 pm
susanlindgren
Great info, thanks
August 12, 2008 at 6:31 pm
Trish @ Another Piece of the Puzzle
I am so happy for you – I know how exciting it is to find something that works for a difficult situation! Thanks for sharing this.
August 13, 2008 at 5:43 pm
Julie
We also like this thing over nebulizers. Thankfully Daniel hasn’t needed it at all this summer. We (with Dr’s. supervision) are cutting back on asthma meds. Since Daniel was supposed to inhale 6 times, I found that tickles helped get it over with quickly because he’d inhale and laugh. Daniel liked that…or we’d both “blow” at each other. That worked too.
It took awhile before he’d cooperate, though.
August 13, 2008 at 8:46 pm
psychmamma
Kari –
When Jenna started with the MDI, we still faced a little resistance. We’re big on giving her choices, which often diffuses situations. We would tell her she could choose between sitting and “helping” us do her “puffs,” or we would hold her still and give them to her. We never presented NOT doing it as an option. I think we only had to hold her 3 times until she decided helping was more fun. When we held her, we sat her on our lap facing away from us, wrapped one arm around her chest – pinning her arms down, and administered the meds with the other hand. She hates being held still, so this was NOT fun for her. We also had her help us “give puffs” to favorites stuffed animals and dolls. We let her hold the mask over their faces and we would make sound effects of puffs. She thought that was great. Finally, we count her breaths out loud with her. She loves counting and thinks it’s a fun game.
Even the 3 times we had to hold her still were MUCH easier than the nubulizer, just because it was over so much faster.
Wishing you lots of luck! It’s so hard to give them meds that they hate and fight so much.
August 13, 2008 at 8:48 pm
psychmamma
Julie –
So glad that Daniel’s doing better! Can’t wait for the day when we don’t have to use this!
I love hearing other moms creative ideas with their kids. Your tickles and blowing at each other are brilliant “tricks” to make something that’s a little scary and our of their control a little more fun and silly. Thanks for sharing!