Update on Luca

Well Monday turned into a long, long day!

I ended up taking Luca to the Pediatric ER at 6.00 am.

Their advice?

Triple his normal 24 hr dosage of "emergency scenario" cortisone and come back tonight
if it is not better. Despite his peak flow being so low, the on call doctor sent us home as he could not hear much wheezing despite the fact that Luca is constantly coughing.

Well at 9.oopm we returned to the same ER where a different doctor was on call this time.
As Luca had coughed non-stop for 5 hours despite their cortisone advice and several nebulisers we knew we needed something else to get him through the night comfortably. He was pale with exhaustion and tiredness. Her advice? He should learn some relaxation exercises to learn to keep calm!!!!!!!!!!! And then she gave him some form of Codeine with a sedative. Which calmed his cough but knocked him out. As codeine suppresses breathing I do wonder at the wisdom of this choice. But on the other hand we all got a good nights sleep.

I have come to the conclusion that I have probably seen more asthma crisis's than most of our local pediatric ER doctors and that they do not always realise the severity of the problem. Now Luca's asthma always manifests itself at first as constant coughing but it seems that a lot of doctors only consider the asthma to be a problem if there is acute wheezing too. Luca's specialist who is based a 2 hr drive from here drew up an asthma action plan and said that his condition must be measured by the peak flow and not the sounds of his chest. But the local doctors do not seem to take much notice of that (sigh).

And now it is Thursday morning and Luca is coughing up green mucus so it looks like he has a chest infection. Unfortunately his local excellent pediatrician is away on vacation so we can't get an appointment to see him. So we are now faced with another trip to the local Pediatric ER....aaahhhhh. The thought does not fill me with glee.

We have been recently advised by his main specialist that he must always have antibiotics if he is bringing up green mucus as a CT scan has shown that he has some damaged bronchial tubes at the bottom of his lungs and he has already had several bouts of pneumonia in those spots. Unfortunately we do not have the written report of that appointment yet to take along and justify to other doctors, not familiar with his case, the need for antibiotics.

Unfortunately most doctors do not want to prescribe antibiotics. So today we need to go and see a doctor and try and convince them of his need for antibiotics. I feel filled with a sense of dread knowing that I must fight for what is best of Luca today but knowing that a doctor can refuse the antibiotics and then we are leaving ourselves open to pneumonia. Sigh.

I really do not want to return to the Pediatric ER where we were on Monday and am now mulling over what to do.

We have 3 choices...

1) Return to the Pediatric ER and run the chance of getting one of the
"triple the cortisone" or " teach him to relax" doctors again.
2) Try the emergency department of a smaller rural hospital closer to home.
3) Go to our Family doctor who may not be experienced in pediatric care.

Please think of us and with us luck on our quest today.