Re: silent sinus infection? when treat?

[Guest guest]

Hey everybody, need advice or experience.

Usually is pretty textbook with everything. After she started school

she got a cold and got this awful cough. After 12 days I took her in -- I had

thought her chest sounded clear, but at 12 days figured I better get a

professional opinion to see if it was into a secondary infection yet. I have a

Walgreen's $10 stethescope and the stupid thing picks up the CREAKS in my

fingers!!!

So I'm never completely sure~

Ped agreed she was clear. Waited another 12 days (!!!!!) -- that's 24 days of

wet coughing, worse at night, during the night she'd cough every (literally!)

5 to 25 seconds for an hour straight. But on day 24 I heard some " meows " in

her chest on exhale, and that's why I took her in (I start listening to the

chest on day 10 of coughing). I figured bronchitis.

The ped noted cobblestoning in the back of the throat indicating drainage (I

noticed that with the original cold and didn't know what it was, it was more

pronouced than I had seen before)... but besides the coughing she really hadn't

had major sinus indicators except CRABBINESS, but hey, she's six after all.

She had the dark circles starting during the cold, but up her nose looked okay,

no swelling in the face.

Well, the ped put her on 600mg Augmentin, thinking sinus, I mean, how many

days are you going to let her cough, right? Well, she improved within 36 hours.

This is really the first time though that it hasn't been really obvious before

we started abx.

Do any of you use a magic number of days coughing or other... where you treat

with abx without more specific signs? It was obviously the right thing to do,

but if the ped had said to wait and watch I would not have argued.

(mom to , age 6-1/2, dairy intolerant-related GERD -- currently

has polysaccharide antibody def, previously had transient IgG, IgA, t-cell &

other defs... and also to Kate, age 3!, more dairy intolerant but very healthy!)

[Guest guest]

hi im nancy mother of mikey a 3 yr old with hyper ige and digoerge syndromes

when mikey starts coughing im running to peds you can never be sure...and you

are the voice for your child, so if your child does look right or if you dont

feel right about your child take them in , and normal time to see any diffence

depends on each child it took mikey 2 days to start lookin and feelin

better......i hope this helped ......good luck nancy

bunneegirl@... wrote:Hey everybody, need advice or experience.

Usually is pretty textbook with everything. After she started school

she got a cold and got this awful cough. After 12 days I took her in -- I had

thought her chest sounded clear, but at 12 days figured I better get a

professional opinion to see if it was into a secondary infection yet. I have a

Walgreen's $10 stethescope and the stupid thing picks up the CREAKS in my

fingers!!!

So I'm never completely sure~

Ped agreed she was clear. Waited another 12 days (!!!!!) -- that's 24 days of

wet coughing, worse at night, during the night she'd cough every (literally!)

5 to 25 seconds for an hour straight. But on day 24 I heard some " meows " in

her chest on exhale, and that's why I took her in (I start listening to the

chest on day 10 of coughing). I figured bronchitis.

The ped noted cobblestoning in the back of the throat indicating drainage (I

noticed that with the original cold and didn't know what it was, it was more

pronouced than I had seen before)... but besides the coughing she really hadn't

had major sinus indicators except CRABBINESS, but hey, she's six after all.

She had the dark circles starting during the cold, but up her nose looked okay,

no swelling in the face.

Well, the ped put her on 600mg Augmentin, thinking sinus, I mean, how many

days are you going to let her cough, right? Well, she improved within 36 hours.

This is really the first time though that it hasn't been really obvious before

we started abx.

Do any of you use a magic number of days coughing or other... where you treat

with abx without more specific signs? It was obviously the right thing to do,

but if the ped had said to wait and watch I would not have argued.

(mom to , age 6-1/2, dairy intolerant-related GERD -- currently

has polysaccharide antibody def, previously had transient IgG, IgA, t-cell &

other defs... and also to Kate, age 3!, more dairy intolerant but very healthy!)

[Guest guest]

,

This very thing was an issue for us in the past. has CVID. He

would get " the cough " . No fever, no wheeze...so I would wait and see.

After a week, I would go to the Dr....He was fine, sent me home....another

week...same thing....another week...then finally they (the pediatrician)

would finally give antibiotic and it would be GONE within a day or two.

Well, this kept happening over and over. When I went to the Children's

hospital for a regular check up...I told them what was happening. His

immunologist said, " The pediatrician is treating him like a normal kid with

a cough...and he is NOT a normal kid with a cough. It will NOT go away

without antibiotic and it is too risky to let him cough for weeks at a

time " . (Bronchiactisis was his concern which I believe is scarring or

damage in the lungs due to repeated infection....nurses out there please

correct me if I am wrong...) Our Immunologists rule is...day two of

cough...antibiotic...period. He put it in writing to the Ped for his file.

Now, has CVID and every kid is different so I am not saying this is

what should be done with your child...but this was my experience.

Currently, is on prophylactic Augmentin 400mg 2x's a day because it

was happening every month. So now instead of getting " the cough " every

month...he gets it every few months...and when that happens, we just switch

to a different antibiotic for a period of time.

Also, keep in mind...most pediatricians are not experienced in treating kids

with immune deficiency. Do you have an experienced immunologist that you

could ask what kind of protocol should be followed. Still, after 4

years...mine still wants to treat him normal. They are getting better...but

I still have to remind them now and then.

I hope this helps...

Kim, Mom to 9 - CVID

Re: silent sinus infection? when treat?

> Hey everybody, need advice or experience.

>

> Usually is pretty textbook with everything. After she started school

> she got a cold and got this awful cough. After 12 days I took her in -- I

> had

> thought her chest sounded clear, but at 12 days figured I better get a

> professional opinion to see if it was into a secondary infection yet. I

> have a

> Walgreen's $10 stethescope and the stupid thing picks up the CREAKS in my

> fingers!!!

> So I'm never completely sure~

>

> Ped agreed she was clear. Waited another 12 days (!!!!!) -- that's 24 days

> of

> wet coughing, worse at night, during the night she'd cough every

> (literally!)

> 5 to 25 seconds for an hour straight. But on day 24 I heard some " meows "

> in

> her chest on exhale, and that's why I took her in (I start listening to

> the

> chest on day 10 of coughing). I figured bronchitis.

>

> The ped noted cobblestoning in the back of the throat indicating drainage

> (I

> noticed that with the original cold and didn't know what it was, it was

> more

> pronouced than I had seen before)... but besides the coughing she really

> hadn't

> had major sinus indicators except CRABBINESS, but hey, she's six after

> all.

> She had the dark circles starting during the cold, but up her nose looked

> okay,

> no swelling in the face.

>

> Well, the ped put her on 600mg Augmentin, thinking sinus, I mean, how many

> days are you going to let her cough, right? Well, she improved within 36

> hours.

> This is really the first time though that it hasn't been really obvious

> before

> we started abx.

>

> Do any of you use a magic number of days coughing or other... where you

> treat

> with abx without more specific signs? It was obviously the right thing to

> do,

> but if the ped had said to wait and watch I would not have argued.

>

> (mom to , age 6-1/2, dairy intolerant-related GERD -- currently

> has polysaccharide antibody def, previously had transient IgG, IgA, t-cell

> &

> other defs... and also to Kate, age 3!, more dairy intolerant but very

> healthy!)

>

>

>

[Guest guest]

Kim:

Thanks for sharing your experience. We always seem to be trying hard to avoid

antibiotics if we are not sure they are needed... the peds never want to

treat unless they are " sure " about an infection, thinking ahead to abx

resistance.

Our old immuno (I was never happy with them and we will be seeking another

if/when needed) did not believe in prophylactic abx.

But while was coughing so much, I was thinking about a sort of modified

prophylactic antibiotic. Not daily all the time, but maybe during a bad cold

with alot of mucus. After 487 billion secondary bacterial infections, we all

know which colds are more likely to spawn one, right? With , I know that

the really THICK stuff inevitably gets infected. I can see it coming a mile

away. Maybe if we head it off at the pass it will be better for everyone.

I think the next time I take her in at 12 days I'll bring that up. We

wouldn't do it at day two, simply because 's PID is not as involved and she

does

get some colds that don't turn into anything worse. I try to treat her with

expectorants (guaifenesin) to loosen the secretions, hoping to prevent lung

involvement.

Speaking of lungs, how much is too much with LRIs and pneumonias? I feel like

has had too much in the past three years (two LRIs and one pneumonia

per year, I'd say is her average), and I worry about scarring or damage. But I

don't know how much is really too much. Any info?

Thanks --

(mom to , age 6-1/2, dairy intolerant-related GERD -- currently

has polysaccharide antibody def, previously had transient IgG, IgA, t-cell &

other defs... and also to Kate, age 3!, more dairy intolerant but very healthy!)

[Guest guest]

In a message dated 10/26/2005 3:23:24 PM Central Standard Time,

knmb2@... writes:

> As far as being on the prophylactic antibiotics

Kim:

I hope you didn't think I was criticizing your protocol... that is certainly

NOT what I intended. Just putting in the info we were given which has shaped

our own set of fears or whatever. My biggest concern about prophylactic (what

is the abbreviation for that?) abx for would be vaginal yeast infections.

She gets them when on abx for a long time or for several courses in a short

period of time. This just breaks my heart -- these infections are horrible

enough for grown women, and it hurts to see her have to deal with that at such a

tender age. By the time we realize it's going on it's always far gone enough

that regular miconazole BURNS terribly, so we have to go to Rx Nystatin. Here I

am trying to put the cream on her and she's screaming in pain... you get the

drift.

My point was that we've never had preventative abx, but I'm convinced now

that there are plenty of times it would be so helpful, even with 's limited

PID.

Thanks again!

(mom to , age 6-1/2, dairy intolerant-related GERD -- currently

has polysaccharide antibody def, previously had transient IgG, IgA, t-cell &

other defs... and also to Kate, age 3!, more dairy intolerant but very healthy!)

[Guest guest]

,

I know every experience and diagnosis is different and every Dr. has a

different opinion about EVERYTHING. I just wish they were all on the same

page. As far as being on the prophylactic antibiotics...he had

virtually zero IGG, IGM and IGA at diagnosis. The IVIG does not replace his

IGA, which leaves him vulnerable to infection still...therefore, we use the

antibiotics and he is pretty healthy now. I also was concerned about the

long term use of antibiotics...the possible resistance...his stomach...etc.

They felt we had to weigh the risks and for Chris...the risk was greater

without them than with them, so we agreed to the antibiotics. But I never

stop worrying about any and all decisions we make about his health. Now

that he takes them and is healthy...even though I remain concerned about the

effects...I worry more that if I stopped them and he became really ill, I

wouldn't be able to forgive myself...so I have some issues of my own...LOL.

As far as the scarring...I don't really know specifics about how many

infections are considered too many...but I know that was their specific

concern about the recurrent coughing infections. Maybe you can google

bronciactasis (not sure of the spelling) and get more info...And like you

said...maybe for your daughter, day 2 may not be appropriate to

medicate....but I would think by day 14 they should be looking at

something....

Good luck to you.

Kim, Mom to 9 - CVID

Re: silent sinus infection? when treat?

> Kim:

>

> Thanks for sharing your experience. We always seem to be trying hard to

> avoid

> antibiotics if we are not sure they are needed... the peds never want to

> treat unless they are " sure " about an infection, thinking ahead to abx

> resistance.

> Our old immuno (I was never happy with them and we will be seeking another

> if/when needed) did not believe in prophylactic abx.

>

> But while was coughing so much, I was thinking about a sort of

> modified

> prophylactic antibiotic. Not daily all the time, but maybe during a bad

> cold

> with alot of mucus. After 487 billion secondary bacterial infections, we

> all

> know which colds are more likely to spawn one, right? With , I know

> that

> the really THICK stuff inevitably gets infected. I can see it coming a

> mile

> away. Maybe if we head it off at the pass it will be better for everyone.

>

> I think the next time I take her in at 12 days I'll bring that up. We

> wouldn't do it at day two, simply because 's PID is not as involved

> and she does

> get some colds that don't turn into anything worse. I try to treat her

> with

> expectorants (guaifenesin) to loosen the secretions, hoping to prevent

> lung

> involvement.

>

> Speaking of lungs, how much is too much with LRIs and pneumonias? I feel

> like

> has had too much in the past three years (two LRIs and one pneumonia

> per year, I'd say is her average), and I worry about scarring or damage.

> But I

> don't know how much is really too much. Any info?

>

> Thanks --

>

> (mom to , age 6-1/2, dairy intolerant-related GERD -- currently

> has polysaccharide antibody def, previously had transient IgG, IgA, t-cell

> &

> other defs... and also to Kate, age 3!, more dairy intolerant but very

> healthy!)

>

>

>

[Guest guest]

I didn't think you were criticizing AT ALL....I was just pointing out how

every situation is different...every diagnosis is different and Drs.

opinions are different. That's what I like about this forum...is the wide

variety of information that we all share with each other. I am sorry if I

sounded put off...I was NOT at all. I did not mean for my note to sound

that way. I was just explaining how we got there and why. My pediatrician

doesn't believe in the overuse of antibiotics...so I have constant stress

between 2 doctors. We all just make the best decisions we can with the

information we have.

Sorry again if I sounded funny...I really didn't mean it that way.

Good luck!

Kim, Mom to 9 - CVID

Re: silent sinus infection? when treat?

> In a message dated 10/26/2005 3:23:24 PM Central Standard Time,

> knmb2@... writes:

>

>

>> As far as being on the prophylactic antibiotics

>

> Kim:

>

> I hope you didn't think I was criticizing your protocol... that is

> certainly

> NOT what I intended. Just putting in the info we were given which has

> shaped

> our own set of fears or whatever. My biggest concern about prophylactic

> (what

> is the abbreviation for that?) abx for would be vaginal yeast

> infections.

> She gets them when on abx for a long time or for several courses in a

> short

> period of time. This just breaks my heart -- these infections are horrible

> enough for grown women, and it hurts to see her have to deal with that at

> such a

> tender age. By the time we realize it's going on it's always far gone

> enough

> that regular miconazole BURNS terribly, so we have to go to Rx Nystatin.

> Here I

> am trying to put the cream on her and she's screaming in pain... you get

> the

> drift.

>

> My point was that we've never had preventative abx, but I'm convinced now

> that there are plenty of times it would be so helpful, even with 's

> limited

> PID.

>

> Thanks again!

>

> (mom to , age 6-1/2, dairy intolerant-related GERD -- currently

> has polysaccharide antibody def, previously had transient IgG, IgA, t-cell

> &

> other defs... and also to Kate, age 3!, more dairy intolerant but very

> healthy!)

>

>

>

[Guest guest]

In a message dated 10/26/2005 3:52:31 PM Central Standard Time,

knmb2@... writes:

> Sorry again if I sounded funny...I really didn't mean it that way.

>

>

Cool. You didn't sound put off really, I just wanted to make certain that I

hadn't sounded critical. It's tough enough making these decisions for our

children when none of the doctors even seem to agree, right?!

(mom to , age 6-1/2, dairy intolerant-related GERD -- currently

has polysaccharide antibody def, previously had transient IgG, IgA, t-cell &

other defs... and also to Kate, age 3, more dairy intolerant but very healthy!)

[Guest guest]

In a message dated 10/25/2005 7:00:16 PM Pacific Standard Time,

bunneegirl@... writes:

Do any of you use a magic number of days coughing or other... where you treat

with abx without more specific signs? It was obviously the right thing to do,

but if the ped had said to wait and watch I would not have argued.

,

Bri has been having what I thought was SIB lately (SINUS INFECTION

BEHAVIOR)...so I took him to the Ped's yesterday. It turns out that he is

healthy,

even after a cold (YAY) . This means he is just having 12 year old

behavior--including knowing everything (not YAY)!!!

I have never had a magic formula--each episode is different. I hope

is feeling better--the Augmentin usually works fast.

Sandi, Mom to , age 12--CVID, Tetrology of Fallot, Pulmonary Valve

transplant (2003), allergies (including meds), asthma, GERD, Carnitine

deficiency--also an aspiring Doctor and Director!