Monthly Archives: November 2009

Red Man Syndrome……or not?

When Sam had his open heart surgery he got vancomyocin for his peri-operative antibiotic.  When you have surgery you always get an antibiotic ward off any surgical infection. There are 2 they usually pick from. One is ancef which is in a family that is closely related to penicillins (which Sam is highly allergic to) and can lead to cross reactions. For this reason the surgeon picked to use vancomyocin. No chance of reaction….or so he thought!Sam got the first dose during surgery. The second dose was given 8 hours later in the PICU and about 1/2 way thru he looked like this:

Sam’s vanco reaction

They called it not an allergic reaction but an adverse reaction called Red Man Syndrome (RMS) which can happen with vanco. But I had a patient with that once and Sam looked nothing like that patient. If you look at the pic his eyes and lips are swollen. He got better with benadryl. If it is RMS then they can give it again just with benadryl before the dose and then run it slower. So, they did 8 hours later and he this time just got 6-8 hives on his face.
 
I showed the pic yesterday to Sam’s GI and she agreed with me that it was an allergic reaction! I told her I was considering taking him to a pediatric allergist (appt on Dec 17) and talking it all over with him. She agreed that was a great idea! So, I guess that’s the next step for my little antibiotic allergic one. Uggh! Does it ever end!!!!!
Advertisements

GI appt — Sam

Sam had his latest GI appt today for his cyclic vomiting syndrome (CVS).  He has been episode free since before his surgery so there will be no dosage changes.  This is fine with me as I don’t really want to go up on his periactin at all.  In fact, I wanted to and asked to have a trial off of it.

Sam is a very wild child.  Some would describe him as a “typical boy” but I’m not sure it isn’t more than that.  He is just downright crazy!!!  And more than anything he doesn’t sleep well.  They really grilled me as to if this started when he started the periactin and if so why I hadn’t said anything before now.  Well, first of all, he has been on the periactin so long that I really cannot remember what he was like before it and second of all I didn’t realize this was possibly one of the side effects. 

But they didn’t agree with me and say that periactin is the #1 best med for CVS so we should continue on it.  To pacify me it was agreed that we would give 1/2 the dose in the morning and 1/2 the dose in the evening and see if that had any change in his behavior  or sleep habits.  I’m not convinced……

Oh and he gained a pound and grew 1/4 inch in the month since he was seen last!  Quite amazing since he was recovering from open heart surgery during that time!!!


Bronchitis Now….uggh!

Poor poor Ben!

First the cold, then the asthma diagnosis, then the seasonal flu and now bronchitis.  Can it just stop already????

He had a dry hacking cough when he had the flu but it changed to this wet productive yucky cough.  He then started complaining that when he coughed stuff was coming up from his lungs.  Off to the pediatrician we went.  Sure enough….wheezing and junky lungs.  Pedi said he had a secondary bronchitis from having the flu.  Breathing treatments and z-pack, recheck in 2 weeks.

G I V E      H I M    A    B R E A K!!!!!!!


Finally feeling better

Poor Ben just got the asthma diagnosis after having a cold and coughing and coughing and coughing after it.  Then the poor thing got the flu.  The seasonal version, not the piggie (swine or H1N1) version.  His highest temp was 101 not super high like with the H1N1 version and he was able to have periods of being up and around not stuck in bed for 4-5 days like those that I know that had swine.

But at the same time it kicked his butt much more than a cold will.  It was easy to compare this to a cold since he was just getting over one a few weeks ago.  He ended up missing 2 days of school this past week along with the day of no school for Veteran’s Day.  Poor guy.  But finally he’s feeling better.  Hopefully he will catch a break now.  He’s my one that really doesn’t get that sick often so keeping my fingers crossed for him.


Laryngeal cleft message board up and running!!!

The new board is up and running!!  Please visit and join it here.  If your child has been diagnosed with a laryngeal cleft or is in the process of being worked up for one then this is the place for you!!  We also welcome parents of children with dysphagia and aspiration with other causes.

 

*******THIS BOARD IS NO LONGER UP***********


Cough-varient asthma

Benjamin was just diagnosed with this this evening.  It is the form of asthma that I have so I’m not too surprised.  I saw signs of it in him last winter too but this year it’s worse and it’s not even winter yet.  Uggh!
He is getting over a cold and just coughs and coughs.  A l l   d a y   l o n g.  But it’s at its worst when he is trying to do anything exertional.  He plays soccer (though the season is over now) and at both his last practice and last game he had to stop and rest because he had to catch his breath and get control of the coughing.  It’s so hard to watch especially since I know what it feels like.
The pediatrician put him on singulair to try and prevent any further episodes.  He said it will take up to 2 weeks to really make a difference.  If that doesn’t work then he will start on an inhaled steroid.  Hopefully we can get it under control before basketball startes at the end of the month.