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)