Saturday, August 28, 2010

Friday, August 27th, 2010

Happy birthday to me! I turned 3 years old today. Since I already had my birthday party on Wednesday, it was a quiet day. There isn't preschool on Friday, so Grandma and I got to have a relaxing morning. In the afternoon, we met Mommy at Primary Children's Hospital for my pulmonology appointment.
Mommy had always been told by the ENT's at UCD that I didn't need to be followed by a pulmonologist - they said just because I have a trach doesn't mean there is anything wrong with my lungs so there was no need to be referred. Mommy understood that part, but when I would get a cold it would be so severe most of the time I ended up hospitalized so eventually, Mommy scheduled with an outside pulmonologist in California. At that time, I was healthy so Mommy was told to follow up as needed.
When we moved to Utah and I was hospitalized in May at Primary Children's for an URI, the attending doctor suggested it might be a good idea to get in to a pulmonologist so today was finally the day. Dr Uchida was running right on time and got right to business. Mommy explained that at my last hospitalization she was given a new term by the doctors - "reactive airway". My pediatrician in California had previously given my parents medication and a nebulizer to use when I was sick but because I was usually hospitalized in the first 24 hours of a cold, they never had a chance to do much to help. After they discussed my previous history, Dr Uchida gave his recommendation. I am considered asthmatic and to this point my trigger has been a cold. As long as I am healthy, my asthma stays in control but when I get a cold, the swelling increases, the muscles tighten and the increased secretions build up and suddenly it becomes very difficult to breathe. Although I had two nebulized medicines they weren't doing much good because very little ended up in my trach and they were started after I was already well into an asthma attack. So here is Dr Uchida's new plan. During my "green" days I will get two puffs from an inhaler. Since I am not quite a mouth breather all the time, I will get a special spacer that will attach to my trach and to the inhaler. When the inhaler is pushed it will store the medication in the spacer and keep it there until I can breathe it all in so I don't lose so much of it. I will also get some Singulair granules mixed in with some formula through my g tube every day. These are considered the preventive medications to hopefully keep me from having an asthma attack. My "yellow" days are those when I am starting to have symptoms like coughing and labored breathing. Then I will get more puffs of my inhaler and some quick relief from Xopenex as well. Should I get to the "red" zone (the previous meds aren't helping) I also have a liquid steroid to take through my g tube as a last ditch effort before heading to the hospital. Despite having to take daily medications now, Mommy is relieved that there is a plan in place that might prevent such serious reactions to a cold - espescially now that I have started preschool and I am bound to get sick more often. Mommy and I picked up three of the four meds - so when the Singulair comes in on Monday as well as the spacer we will start with our new asthma plan of care.
Uncle Jeff and Aunt Viv came by tonight. Although they attended my birthday party, Uncle Jeff doesn't believe in giving presents except on the actual birthday so he brought his present with him. I was super excited to use my new easel - it is just my height and has one side with a dry erase board and the other side is a chalkboard. Perfect!
Peyton Nicole Smith

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