(A much younger Alex during one of his many illnesses. Trust me, he still looks just as pathetic when he's sick now)
I must ask for your forgiveness with some of the anger in this post. However, if you’re a parent, you probably understand it and have maybe been there yourself. If you’re not, you’re at least a human being, so you can at least have an idea of how frustrating this is.
We’re on day five of my son Alex’s cold. It’s been a miserable one and that just about sums up his mood – miserable. It just plain sucks when kids get sick. When they get to a certain age, they kind of understand why they’re feeling like they do and know that rest, laying on the couch and some indulgences of watching extra television are in order. It’s not fun, but it’s manageable.
Alex is 3 ½. He has some trouble comprehending some things, like why he feels like crap. He doesn’t understand why he feels like he does and why resting is really the best thing to do to get better. He runs around sick, then gets extremely tired and cranky. He doesn’t want to sleep when he’s tired, won’t drink when he’s thirsty and won’t eat when he’s hungry.
All in all, he’s just not a very good patient.
“I wanna get better.” he whined yesterday, while rubbing his sleeve against his nose for the thousandth time, making the skin on his lip even more raw.
“I know, buddy. We want you to too. But you have to stop rubbing your nose with your sleeve and use a Kleenex. You’re making it worse.”
“I don’t wanna get better!” he whines back, mostly to be contrary and mostly because he’s worked himself into a constant mood of bitchiness the past few days. Once you get into that rut, it’s hard to get out.
We've tried honey, which supposedly coats the throat to help supress coughing. Not only did it not work, but Alex doesn't want anything to do with it anymore. We've got a humidifier running in his room, which as far as we can tell, hasn't had much of an effect. We've tried a bunch of different things, all with the same outcome - no improvement.
After three days of horrible sleep for everyone in the house, we finally went to the doctor’s office. We could only get in to see one of the other doctors in the practice since Alex’s regular physician was booked solid (ah, flu season). I was hoping that we could have something, anything, that would help him get some sleep and comfort rather than the constant coughing every three minutes.
As expected, I got the standard response, “We don’t recommend giving anything to children under 6.”
This made me really mad. Extremely mad. As a parent, there is nothing more heartwrenching and frustrating than watching your child suffer with a cold or an illness. But to have the medication rules changed on you midway through the game, like they have been in the past couple of years, I think just borders on cruelty.
We can’t give him anything for his cold. Amazingly, for older kids, there’s tons of stuff on the shelves to give them. But for the younger ones? Meh, let them suffer. It aggravates me that the pharmaceutical companies can develop drugs to give someone a perma-stiffy for 3-4 hours, but can’t develop over the counter medication that can give some relief from a cold for a 3 year old. I can go to the drug store and pick up a myriad of products to help me with my sneezing or coughing, but for my son?
Nothing. Nada. Zilch. Sorry, kiddo. You're outta luck for another three years.
At this moment, I have him in his bed and he’s struggling to take a nap that he desperately needs. He’s coughing up a storm still, but he’s so tired, he’s doing it in his sleep. I should be resting too, because as all families share their germs, I’ve got it now too. But I’m too busy listening to my little guy hacking up a lung and worrying if he’s going to get the rest his little body needs.
It’s just not fair when kids get sick. It's just plain heartbreaking.
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Comments
Mary Joan King - I did try some childrens Benadryl at a very low dose. Not only did it not work at all, it made him so hyper that he was almost ready to run a marathon.
As someone who got the croup EVERY SINGLE WINTER living in the Midwest and never once got it once I moved to humid Louisiana--set up an old-fashioned hot-water steam vaporizer in his room. Works wonders. The cold-water baby-safe humidifiers don't really cut it.
Also, my mom used to give me a quarter-dose to half-dose (depending on how big I was) of adult Nyquil mixed with water and that knocked me out through just about any coughing fit, and I turned out fine, but don't tell the child welfare Nazis...
But here's the thing. All the cold medicine that my dear husband likes to give himself really has not been shown to do a whole lot to shorten the duration of the cold or truly improve symptoms very much. But he likes the feeling of doing something more than using my method that I use on myself (as do most pediatricians) for treating colds: tincture of time.
Antihistamines: well they dry out the nasal cilia so that they don't move. That's the opposite of what you want and need. You need motility so that the bad gunk (don't you love that medical term?) can move outward out of the body.
Expectorants: Some people say they help you cough up more mucous, but most say that this is only if you have a dry hacking cough that needs loosening. I sometimes used to prescribe them to my teen patients with sinus congestion (along with a decongestant) until an ENT busted me out about making the problem worse. Moisten with saline, he insisted. That's all that is needed. Expectorants are not effective. Yet since most little ones have moist coughs caused by post-nasal drip, expectorants don't help much.
Cough suppressants: The only cough suppressants really shown to work well are the narcotics. Now I don't think anyone wants to be giving munchkins prescriptions for Phenergan with Codeine. For people who can swallow pills, there is an anesthetic for the respiratory tree called Tessalon that is supposed to be almost equivalent to narcotics without the narcotic effects. I've used that for bad coughs in teens, but there is no equivalent for little ones. And my silly teens who assured me they could swallow pills but decided to chew the Tessalon (ulp!) ended up with serious numbing of their throats. "Yeah, I had trouble swallowing for a while." (Watch my hair stand on end.)
The net of it is that cough is a good thing. We want gunk to be coughed out and not sit in the bronchioles and settle.
None of this does us any good as we watch our little one suffer.
Sure there are doctors who will prescribe codeine to 3 year olds and they will sleep better, but...it makes me very, very uncomfortable.
And you know what Mary suggested is just what the American Academy of Pediatrics was afraid of when it pulled the cold medicines from the shelves for kids under 2 and was considering pulling them for those under 6 (since they don't work reliably and are equal to placebo in many studies). The fear was that parents who want to do or give something will resort to giving a smaller amount of an adult or older child liquid and there would be overdoses. Seen a benadryl overdose? Those kids are hallucinating all over the place. So it is tough.
But know that I totally get you. I hate it when Zara is sick and I do silliness like rubbing Vicks on her chest (knowing full well it doesn't work) just because I feel like I need to do something. But get the musical battery operated snot sucker (by BebeSounds), stock up on the saline spray, keep the fluids up, warm vaporizer going and it will pass. It will.
And please don't hear me saying this as an excuse. It's not. I'm just explaining how it is. I kept getting booked with shorter and shorter time slots with my teens (I worked at an academic center) that I would end up running 2 hours behind because I didn't believe in shortchanging my teens in terms of their needs, their questions, and their behavioral risk issues (my practice was just adolescents). It was either be behind or not answer questions/not talk to the kid about depression/not explain how to do breast self exam...you see what I'm getting at.
I don't know one person who doesn't feel rushed by his/her doctor and I don't know one doctor who doesn't feel like they've lost what made medicine great: the connection and time spent with patients. Somethings got to give and quick, I tell you. But I couldn't deal with the guilt of being late or shortchanging and I left practice. I still miss my kids, though.
Lisa: pertussis can be a hard one if the doctor doesn't see the paroxysym of coughing, but if it went on for longer than reasonable, that's a real problem. What's even less likely to be diagnosed is pertussis in an adult! I got pertussis (didn't know what it was at the time...was convinced it was something terminal) during my residency and coughed for 3 months. Coughed so hard I would vomit. And the doctor took chest x-rays and even did a blood gas. He had no idea. Adult docs never think of pertussis. Adult docs missed my brother's chicken pox (he was 30). Anyway, I'm rambling...
I have seen some fantastic doctors that have a great manner with kids (our regular doctor is great with Alex) and I've seen some that I wonder why the hell they're even in pediatrics to begin with. We had an old doctor for Alex that refused to listen to anything you said and if there's nothing worse than bad communication when it comes to the medical community.
That said, it would be awesome if some doctors could take some communications courses on how to deal and speak with their patients. I can't help but wonder how many simple problems could be solved if there were some good listening skills being used.
You're not the only doctor that is getting/has gotten frustrated with the system. I just read in the Denver Post the other day that some doctors are cutting all ties with insurance companies and are offering "concierge" service. For a large yearly fee, of course. (http://www.denverpost.com/search/ci_11936690)
My husband got home at 3 this morning. He rounded yesterday morning, saw patients from 9 to 7, including a whole bunch who knew they had the viruses that were going around but were taking up his time to demand antibiotics anyway. Then he spent all evening and half of the night at the hospital. He got out of bed at 6 to do it all over again. It's entirely possible that someone today will complain that he didn't give them enough of his focused attention, for which he would no doubt be heartily sorry because he's a compassionate guy, but as he says most nights, "It was a good day; nobody died."
Sometimes there's just not enough of anything to go around.
When you bring Alex to see his doctor again, please tell him about the reaction. And never, ever listen to a flight attendant or other airplane passenger who tells you to give Benadryl to your screaming child.
-- Laura
There are some medicated nasal sprays out there approved for 4 and up, I believe but not younger.
Having taken cold medicine myself and having had it work, that is, having had it relieve symptoms, I'm unconvinced that cold medicines don't work on most human beings to some degree at any age. I'm still of a mind that, in a few years or less, suddenly, medicines for colds will be approved for children younger than five or six, only it'll be an expensive prescription and not over the counter. I can't shake myself of this belief because I am cynical.
As a parent, you have my complete sympathy. I feel exactly the same. My BS o-meter has been going off ever since those drugs were pulled from the shelves.
Teendoc's comment about saline spray: works for us! Helps loosen up that stuffy, crusty nose, so you can actually blow some of that crud out.
Although I do sometimes have to break down and give him Children's Mucinex (a.k.a. Snot Monster Medicine, as we call it).
Uh oh. Trainer is here. Gotta go. BBL
dogmom - Alex has a nebulizer too. That was given to him shortly after a breathing issue last year that put him in the hospital. He's really not crazy about it at all and it makes him even more upset when we have to use it. It often ends up in tears all around.
See? This is what the Internets are for! Exchange of valuable information! Seriously, people. Thank you very much for the input and the sympathies. You have no idea how much better this makes me feel. I've gotten more information here in the past couple of hours than I've gotten all week.
Y'all rock.
Very glad to see Teendoc’s comments here. Nice to hear good confirmation of everything we’ve pieced together. We got lucky in finding a pediatrician’s office (on our plan) where our doctor makes a deliberate choice to fall behind in her daily schedule (they tell this to everyone) to enable her to have good contact with the kids and space for full conversations w/parents. Very unusual. She’s worth the wait. But that plus being available for weekend and 3 AM calls – yikes – I don’t actually think she’s human.
sorry about your troubles--it's hard to have a sick child at home. I think teendoc gets it right with her advice--very little really helps except time, rest, fluids.
He is a cutie pie!
as a kid my mom made us hot whiskey lemonades - actually, she still make them. Lemon, sugar, boiling water and whiskey. The hot water evaporates a some of the whiskey but leaves enough so that the whiskey will put the child to sleep. Put in enough sugar to taste, which is also dissolved by the hot water, and lemon for the ickies in the throat. Now that they're out of the womb alcohol is safe for them. Ok, that last bit was a joke.
I personally can't take nyquil et al because it makes me hallucinate and restless, which is the worst when you are sick, so I would never give it to a kid.
Oh, and Vaseline will stop the chapped nose. Poor little guy--I remember well the weeks upon weeks of coughing, coughing until I couldn't not cough, coughing till I was gasping for breath and my sides hurt...it's no fun whatsoever.
Have you tried getting him to sleep with his head and chest somewhat elevated, like in a recliner instead of his bed? That helped a lot--kept the nasty stuff from draining too far into my throat and lungs and setting off another fit.
Really, though--orange juice, sleep, and anything that helps him to sleep through the coughing fits is about all you can do.
Get some of the Eucerin Aquafor to rub on his upper lip. It sooths.
Best of luck.
I wanted to chime in on the humidifier thing. My parents had a humidifier when I was little - I thought these days no one used the darned things. Turned out the stupid cold water humidifier was what was making me sick in the first place - spraying mold all over. Hot ones work better but considering that my colds always got better when I lived someplace dry, I think they're just altogether overrated.
Melinda Meanders - amen on the Eucerin Aquafor. That stuff has pretty much cleared it up. It's the best on really chapped dry skin and here in Colorado, we get that a lot. Thinking about you and your 17 month old and hope he gets better soon.
Allie Griffth - Alex has a warm air humidifier going in his room and has for most of the week. He thinks it's his job to make sure the reservoir is filled up to capacity before nap and bedtime. Because it's so dry here, we're actually on our third one. We seem to go through them pretty quickly.
for colds, cold-eeze zinc lozenges are the best for me *if* I start as soon as I feel a cold coming on. there may be other zinc compounds that would work for kids. one word of warning: they work the best when our mouth tastes like you have been sucking on pennies