Henry's been coughing since November, when he contracted a run-of-the-mill virus and it caused an asthma flare. When the kids have respiratory illnesses, our pulmonologist doesn't really want to see them. No, no, he doesn't want cooties in his office and instead he provides us with two copies, one for each child, of a generic Asthma Action Plan. The nurse who types them up uses a template that is meant to give the impression they're customized for each individual patient, but there's no fooling me. The plans haven't changed in the nearly eight years we've been putting our kids' pulmonary lives in Dr. DeepBreath's capable hands - Kid coughs? Use albuterol inhaler. Coughing stopped for at least three hours? Good. Keep using the inhaler every three or four hours if the cough comes back. Coughing didn't stop for at least three hours? Uh-oh....
Shit just got serious.
Now Kid needs massive doses of steroids twice a day. And if Kid's chest isn't perfectly clear after 10 days, Kid will continue taking steroids once a day for as long as it takes. Meanwhile, Kid will feel miserable, not only from the cough/pneumonia but from the steroids. Stomach will swell (kid might need a whole new wardrobe - seriously). Face will swell. There will be grouchiness swooping to unbound joy swooping to devastation, all of it unexplainable and surprising to other family members. Blood sugars will shoot skyward. There will be overheating, flushing, and cold sweats. Oh, and don't forget the tachycardia. At least once during the steroid burst, Kid will be so ill from steroids that a visit to the local ER might be necessary. [note: most of this paragraph is not actually part of the Asthma Action Plan, but that doesn't make it less true].
So at our house we work hard to skew and spin symptoms and responses to treatments in a desperate effort to out-maneuver the Dastardly Asthma Action Plan.
*COUGH-COUGH-COUGH-Cough-Cough-cough-cough-cough-cough* [pause] *wheeeeeeeeeeze*
"Hmmmmmm. How long has it been since his last hit from the inhaler?"
"Ohhhhhh, quite a long time. I'd say at least four hours."
"Well that explains it! Henry, please use your inhaler again! It's time!"
{we both know that four hours ago it was 3 am and no one was using an inhaler. we avoid looking at one another}
*COUGH-COUGH-COUGH-dramatic RETCH-COUGH-COUGH-COUGH-gasp*
"That sounds bad."
"Yeah, and his face is all purple now."
"He definitely didn't take enough hits from the inhaler - he needs to do at least six."
"Yeah, that must be it."
*COUGH-COUGH* "I did TEN!" [indignantly]
"You're not doing it right, Henry. Are you sure you're doing it right?"
"Yeah! Are you sure you're doing it right? I don't think you're doing it right."
*COUGH-COUGH-COUGH-RETCH-eyeroll*
So, anyway, today we got caught. Maria had an appointment, and because Henry was up all night coughing until he retched, he had to stay home from school. And therefore he had to come to the appointment. As I filled out paperwork in the waiting room, Henry coughed for the first time since our arrival. Rats.
Nurse J: Henry! You poor baby! Dr. DeepBreath needs to take a listen to you.
SnicketyMe: [quietly but with urgency, points out wastebasket next to Henry's chair and raises eyebrows at him meaningfully - just in case] I was kinda hoping you wouldn't have to hear that, J....
Henry: [face turns lovely shade of purple] COUGH-COUGH-COUGH-cough-cough-GASP!!!
Nurse C: Good Lord!
Nurse J and Nurse C: [shake heads at each other in disappointment at my utter disregard for the Asthma Action Plan]
SnicketyMe: *disgraced*
And we were swooped into a room immediately. Dr. DeepBreath has a particular style for his appointments - for the first part, before the examination, we sit and watch a movie while he peruses his notes from previous appointments and reviews the paperwork I fill out for the current state of affairs. This activity takes quite a while, and his back is to us the entire time. Within two minutes, Henry began hacking up a hairball in his corner of the room. Dr. DeepBreath turned around excruciatingly slowly on his spinny chair and regarded Henry with raised eyebrows and a very serious expression. Then he did the same to me.
And that's when the wheels fell off the wagon. So to speak.
Lots of comments were made after that. None of them were flattering to my person and/or my management of Henry's disorder as indicated by the ASTHMA ACTION PLAN, so I'll just share the one that changed my mind: respiratory distress, he's close to being in it.
Henry took his first dose of steroids this evening. Hold us.
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