Reagan

It seems like our evenings are just crazy, with dinner, baths, cranky kids and bedtimes. But, it's also the time when our family calls, and while we love to hear from them, I always feel like there isn't enough time to explain or tell every detail. So, many of you have been asking about Reagan, her allergies and asthma and how things are going since the move.

The short answer is, good, she has a slight cold right now, the first since our move. We enrolled her in kindergarten here, and in order to do so we needed a doctors note for her to carry her asthma medication and her epi pen (for her tree nut allergy). If you don't already know, Reagan had a reaction to a piece of candy when she was 2 years old; broke out in hives, complained of an itchy tongue, and then vomited. We had her tested, and she is allergic to many outdoor trees and pollens (seasonal allergies) some indoor ones, like mold and dust mites, but most alarming was that she tested positive for a tree nut allergy. She is allergic hazelnuts and peanuts, and to a lesser degree all other nuts. It's been a challenge to watch her diet, especially as she gets older and eats at school or other activities away from our supervision. Her school has been great, we met with her teacher and the nurse. She attends afternoon kindergarten, brings her own snack and the teacher always lets us know if there will be any outside food brought into the classroom. For her valentines day party last week, we sent a nut free cupcake with her, and she just avoided the other treats. She's very great about it, never complaining that she can't eat what the other kids to. Truthfully, I think she's afraid of the epi pen, which needs to be stabbed into her thigh to administer. We've never had to use it, in fact, in 3 years she's never had another reaction (knock on wood!). At some point she will get restested and we just pray that she will grow out if it. One doctor told us that she has about a 20% chance of outgrowing this allergy. So far shots are not an option for food allergies.

As for Reagan's asthma. We found a new doctor here that we really like, it's a family practice that we can all use. We had a consultation with her to go over Reagan's medication and get the forms needed for school. When we moved Reagan was taking Singulair, one pill daily, Advair (500mg) twice a day, and using her Xopenex inhaler for wheezing. The first two meds are for daily control, and the inhaler is meant to be used occasionally for rescue purposes, or when she is sick. Too much use of the inhaler means we are doing something wrong. The new doctor took one look at our plan and didn't like it. We've run into this before and found that there are strong opinions, and different views on the treatment of asthma. Kevin and I always fall in the camp of less is more and would rather dial back her medication as long as it is safe to do so. Dr Palmer thought that her Advair dose was too high (our pediatrician in PTC, prescribed it last fall when Reagan was wheezing in the cold october weather). She found the literature from the pharmaceutical company and showed it to me. The 500mg that Reagan was on was clearly not recommended for anyone under the age of 12, much less Reagan's weight. Great. We changed her dose to 150 mg and agreed to recheck her in 8 weeks (early March) to see how she was doing. The other issue the doctor had was with our use of the inhaler. She felt (and again, we've heard this before) that children under the age of 6 can't hold their breaths for the 10 seconds needed to get the medication properly into their lungs. She would rather us use the nebulizer, which is a machine that adminsters a liquid form of the meds while the child wears a rubber mask over their mouth and nose. It takes about ten minutes to set up and is very inconvienent for wheezing episodes outside the home or at school. This is why we asked for the inhaler when Reagan was 3.5. It was so much easier to use it at the playground, or last fall when she would start wheezing at every one of Sydney's soccer practices. So, we agreed to keep the inhaler since Reagan is 5.5, and she needs one at school. But, the doctor was very clear that if Reagan got sick, and there was any congestion in her chest, we were to start the nebulizer immediately. So far we haven't had to use it, and we just hope that continues.

So for now we are using the 150 mg Advair (purple disk) twice a day and a Singulair tablet once a day. The New Hampshire climate seems to agree with her lungs, so far. One theory is that the cold weather kills most of the pollen and mold. We've been careful to watch her reaction to the cold weather itself, and so far so good. She has a slight cold now, but it's mostly a sniffly nasal cold, and there is no sign of chest congestion. The hope is that as the weather gets warmer we can back off the daily medications and wean her from them. As with any drug there are side effects and we hope she'll grow out of her need for them.

Sorry this was so long, I felt like I could write a book on the subject! I'll post again after her follow up appt and let everyone know how she's doing.