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NEED SOME ADVICE

P

petnurse

New member
I just have a few questions for everyone. My son has had a virus that he caught from his brother. It has been causing runny nose and a cough. He did a round of Bactrim (he cultured staph). The cough/runny nose is till here. Dr thinks it is now a sinus infection. He is on Augmentin now. Dr said if this doesn't help we will likely start Pulmozyme. He currently only gets Albuterol when he has a cough...otherwise, no nebs. He has always been very healthy...no real other symptoms of CF...usually zero cough. This has just gotten me to thinking...what makes doctors decide to admit? A lot of CFers that are admitted don't seem terribly sick (I know that is why they admit...before it gets bad). I'm hoping this cough goes away soon, but right now it is deep and wet. Just not sure where we will go from here. Thanks for your help!
 
P

petnurse

New member
I just have a few questions for everyone. My son has had a virus that he caught from his brother. It has been causing runny nose and a cough. He did a round of Bactrim (he cultured staph). The cough/runny nose is till here. Dr thinks it is now a sinus infection. He is on Augmentin now. Dr said if this doesn't help we will likely start Pulmozyme. He currently only gets Albuterol when he has a cough...otherwise, no nebs. He has always been very healthy...no real other symptoms of CF...usually zero cough. This has just gotten me to thinking...what makes doctors decide to admit? A lot of CFers that are admitted don't seem terribly sick (I know that is why they admit...before it gets bad). I'm hoping this cough goes away soon, but right now it is deep and wet. Just not sure where we will go from here. Thanks for your help!
 
P

petnurse

New member
I just have a few questions for everyone. My son has had a virus that he caught from his brother. It has been causing runny nose and a cough. He did a round of Bactrim (he cultured staph). The cough/runny nose is till here. Dr thinks it is now a sinus infection. He is on Augmentin now. Dr said if this doesn't help we will likely start Pulmozyme. He currently only gets Albuterol when he has a cough...otherwise, no nebs. He has always been very healthy...no real other symptoms of CF...usually zero cough. This has just gotten me to thinking...what makes doctors decide to admit? A lot of CFers that are admitted don't seem terribly sick (I know that is why they admit...before it gets bad). I'm hoping this cough goes away soon, but right now it is deep and wet. Just not sure where we will go from here. Thanks for your help!
 
R

Ratatosk

Administrator
Staff member
We've always done albuterol (and atrovent) with CPT. Since DS was first diagnosed at one week. When he gets a cough we increase treatments to 4-5 times a day. Being that your son is coughing, you should be nebbing and "beating" him to get that junk up and out.

As for the sinus infection -- DS had similar issues and a two week treatment of augmentin didn't cut it -- it kept coming back. His doctor was concerned with it getting into his lungs, so he prescribed it for a month to get rid of the infection once and for all. If it hadn't gone away then he was going to try something else.

If he's culturing something such as pseudo, I believe doctors will sometimes order IVs and/or cipro to try to get rid of it before it colonizes.
 
R

Ratatosk

Administrator
Staff member
We've always done albuterol (and atrovent) with CPT. Since DS was first diagnosed at one week. When he gets a cough we increase treatments to 4-5 times a day. Being that your son is coughing, you should be nebbing and "beating" him to get that junk up and out.

As for the sinus infection -- DS had similar issues and a two week treatment of augmentin didn't cut it -- it kept coming back. His doctor was concerned with it getting into his lungs, so he prescribed it for a month to get rid of the infection once and for all. If it hadn't gone away then he was going to try something else.

If he's culturing something such as pseudo, I believe doctors will sometimes order IVs and/or cipro to try to get rid of it before it colonizes.
 
R

Ratatosk

Administrator
Staff member
We've always done albuterol (and atrovent) with CPT. Since DS was first diagnosed at one week. When he gets a cough we increase treatments to 4-5 times a day. Being that your son is coughing, you should be nebbing and "beating" him to get that junk up and out.
<br />
<br />As for the sinus infection -- DS had similar issues and a two week treatment of augmentin didn't cut it -- it kept coming back. His doctor was concerned with it getting into his lungs, so he prescribed it for a month to get rid of the infection once and for all. If it hadn't gone away then he was going to try something else.
<br />
<br />If he's culturing something such as pseudo, I believe doctors will sometimes order IVs and/or cipro to try to get rid of it before it colonizes.
 
H

hmw

New member
A few thoughts...
I assume you are doing extra cpt (i.e double what you usually do), with albuteral every time. It's especially important for babies since they can't cooperate with huffs and coughs, etc.

Are you using a saline spray and suction bulb to clear as much of the nasal congestion as possible? When he's old enough to do saline rinses that will help a great deal, but for now the spray, letting it sit a bit to soften what's up there, and then sucking it all out as often as needed, will help. The sprays are generally better than those drops.

How long was he on the Bactrim before switching to the Augmentin? Was there a reason for the switch? It can often take several weeks of abx to clear up an exacerbation; the shorter courses of abx commonly rx'ed to typical kids are not long enough for our kids. If the abx alone aren't enough an oral or inhaled steroid is often tried as well.

I hope Philip is feeling better soon. <img src="i/expressions/heart.gif" border="0">
 
H

hmw

New member
A few thoughts...
I assume you are doing extra cpt (i.e double what you usually do), with albuteral every time. It's especially important for babies since they can't cooperate with huffs and coughs, etc.

Are you using a saline spray and suction bulb to clear as much of the nasal congestion as possible? When he's old enough to do saline rinses that will help a great deal, but for now the spray, letting it sit a bit to soften what's up there, and then sucking it all out as often as needed, will help. The sprays are generally better than those drops.

How long was he on the Bactrim before switching to the Augmentin? Was there a reason for the switch? It can often take several weeks of abx to clear up an exacerbation; the shorter courses of abx commonly rx'ed to typical kids are not long enough for our kids. If the abx alone aren't enough an oral or inhaled steroid is often tried as well.

I hope Philip is feeling better soon. <img src="i/expressions/heart.gif" border="0">
 
H

hmw

New member
A few thoughts...
<br />I assume you are doing extra cpt (i.e double what you usually do), with albuteral every time. It's especially important for babies since they can't cooperate with huffs and coughs, etc.
<br />
<br />Are you using a saline spray and suction bulb to clear as much of the nasal congestion as possible? When he's old enough to do saline rinses that will help a great deal, but for now the spray, letting it sit a bit to soften what's up there, and then sucking it all out as often as needed, will help. The sprays are generally better than those drops.
<br />
<br />How long was he on the Bactrim before switching to the Augmentin? Was there a reason for the switch? It can often take several weeks of abx to clear up an exacerbation; the shorter courses of abx commonly rx'ed to typical kids are not long enough for our kids. If the abx alone aren't enough an oral or inhaled steroid is often tried as well.
<br />
<br />I hope Philip is feeling better soon. <img src="i/expressions/heart.gif" border="0">
 
P

petnurse

New member
Thanks to both of you. Harriett: Philip normally gets CPT once or twice a day. He gets it 3 times now, but we also beat on him while we hold him, so he gets beat a lot. LOL. I did saline with him the other night because he sounded so stuffy. I have a special spray saline that has a cool nozzle that goes up his nose. It looks like an old perfume bottle. It's supposed to be the most sterile way to do it. Anyway, I haven't done it lately because the mucus is not thick and is running out. He had a 10 day run of Bactrim. He was finished with the Bactrim and I called the next day. They put him on the Augmentin after the Bactrim finished. He's just as happy as he can be. I just hate to hear him cough! Makes it all more real. Did I mention how much I hate CF to you lately? Ugh. Just when I think I have things figured out, I start to think..and I have more questions!
 
P

petnurse

New member
Thanks to both of you. Harriett: Philip normally gets CPT once or twice a day. He gets it 3 times now, but we also beat on him while we hold him, so he gets beat a lot. LOL. I did saline with him the other night because he sounded so stuffy. I have a special spray saline that has a cool nozzle that goes up his nose. It looks like an old perfume bottle. It's supposed to be the most sterile way to do it. Anyway, I haven't done it lately because the mucus is not thick and is running out. He had a 10 day run of Bactrim. He was finished with the Bactrim and I called the next day. They put him on the Augmentin after the Bactrim finished. He's just as happy as he can be. I just hate to hear him cough! Makes it all more real. Did I mention how much I hate CF to you lately? Ugh. Just when I think I have things figured out, I start to think..and I have more questions!
 
P

petnurse

New member
Thanks to both of you. Harriett: Philip normally gets CPT once or twice a day. He gets it 3 times now, but we also beat on him while we hold him, so he gets beat a lot. LOL. I did saline with him the other night because he sounded so stuffy. I have a special spray saline that has a cool nozzle that goes up his nose. It looks like an old perfume bottle. It's supposed to be the most sterile way to do it. Anyway, I haven't done it lately because the mucus is not thick and is running out. He had a 10 day run of Bactrim. He was finished with the Bactrim and I called the next day. They put him on the Augmentin after the Bactrim finished. He's just as happy as he can be. I just hate to hear him cough! Makes it all more real. Did I mention how much I hate CF to you lately? Ugh. Just when I think I have things figured out, I start to think..and I have more questions!
 
R

Ratatosk

Administrator
Staff member
I'd still do the saline and suction to get that stuff out even though it's running out.

Have the run a recent throat/sputum culture? Could be he's culturing something else and needs a different antibiotic. Even though ds was on keflex and tobi as a toddler, he developed a nasty cough and needed a different antibiotic that was sensitive to whatever he was growing.

Have they tested for RSV? From what I understand that can cause a LOT of mucus.
 
R

Ratatosk

Administrator
Staff member
I'd still do the saline and suction to get that stuff out even though it's running out.

Have the run a recent throat/sputum culture? Could be he's culturing something else and needs a different antibiotic. Even though ds was on keflex and tobi as a toddler, he developed a nasty cough and needed a different antibiotic that was sensitive to whatever he was growing.

Have they tested for RSV? From what I understand that can cause a LOT of mucus.
 
R

Ratatosk

Administrator
Staff member
I'd still do the saline and suction to get that stuff out even though it's running out.
<br />
<br />Have the run a recent throat/sputum culture? Could be he's culturing something else and needs a different antibiotic. Even though ds was on keflex and tobi as a toddler, he developed a nasty cough and needed a different antibiotic that was sensitive to whatever he was growing.
<br />
<br />Have they tested for RSV? From what I understand that can cause a LOT of mucus.
 
H

hmw

New member
I'm so glad that he is happy. As I'm sure you've seen even with your older two when they were sick as babies, when they get lethargic, stop smiling, and are just 'off' and not themselves anymore, that often says more than something like a fever or stuffy nose. I'd pay attention to that and stay on top of any changes in that.

The saline sounds good. The farther up it can get, the better. Even if stuff is clearing out, it might be good to try when he first wakes up when stuff is thickest, and right before you put him to sleep (to get out as much as possible before he lays down and minimize stuffiness for at least a little while.)

I hope the Augmentin helps. Not having a gap between the two abx will hopefully help; both of them are good choices for sinus infections.

If they decide to start Pulmozyme, I will just add that we love it here. It's helped Emily a lot. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
H

hmw

New member
I'm so glad that he is happy. As I'm sure you've seen even with your older two when they were sick as babies, when they get lethargic, stop smiling, and are just 'off' and not themselves anymore, that often says more than something like a fever or stuffy nose. I'd pay attention to that and stay on top of any changes in that.

The saline sounds good. The farther up it can get, the better. Even if stuff is clearing out, it might be good to try when he first wakes up when stuff is thickest, and right before you put him to sleep (to get out as much as possible before he lays down and minimize stuffiness for at least a little while.)

I hope the Augmentin helps. Not having a gap between the two abx will hopefully help; both of them are good choices for sinus infections.

If they decide to start Pulmozyme, I will just add that we love it here. It's helped Emily a lot. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
H

hmw

New member
I'm so glad that he is happy. As I'm sure you've seen even with your older two when they were sick as babies, when they get lethargic, stop smiling, and are just 'off' and not themselves anymore, that often says more than something like a fever or stuffy nose. I'd pay attention to that and stay on top of any changes in that.
<br />
<br />The saline sounds good. The farther up it can get, the better. Even if stuff is clearing out, it might be good to try when he first wakes up when stuff is thickest, and right before you put him to sleep (to get out as much as possible before he lays down and minimize stuffiness for at least a little while.)
<br />
<br />I hope the Augmentin helps. Not having a gap between the two abx will hopefully help; both of them are good choices for sinus infections.
<br />
<br />If they decide to start Pulmozyme, I will just add that we love it here. It's helped Emily a lot. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
P

petnurse

New member
Liza: They cultured him again when we took him back at the beginning of this bug. He cultured staph for the second time. They put him on Bactrim because of the staph. When he finished Bactrim, they told us staph is also sensitive to Augmentin. No tests for RSV, but I do not think it is that.
Harriett: I know the Pulmozyme will help. I was just nervous about starting it since it is not labeled for babies. i was glad to hear they would entertain the thought though. I think the thought on nebs has changed over the last year or so as far as the babies are concerned. I hope this will soon go away so I can stop worrying (for now)!
 
P

petnurse

New member
Liza: They cultured him again when we took him back at the beginning of this bug. He cultured staph for the second time. They put him on Bactrim because of the staph. When he finished Bactrim, they told us staph is also sensitive to Augmentin. No tests for RSV, but I do not think it is that.
Harriett: I know the Pulmozyme will help. I was just nervous about starting it since it is not labeled for babies. i was glad to hear they would entertain the thought though. I think the thought on nebs has changed over the last year or so as far as the babies are concerned. I hope this will soon go away so I can stop worrying (for now)!
 
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