Tale of the Masked Baby (or Why I Hate Albuterol)

The day started as too many others had.  My baby (age 2 at the time) had that dreaded cough.  I jumped on it.  I knew exactly what that cough was, asthma.  I hated that sound.  It sent me into the worst mood.  I knew what was coming.  My little one was going to have to sit through nebulizer treatments, aka “the smoke,” every few hours.  There would be no school for him so that he could be near his nebulizer mask and could tell me when his chest hurt by saying “Mommy, I need a treatment.” It broke my heart.  Not to mention I knew I would need to set my alarm to wake up at least twice during the night to blow that mist in his face.  No one was happy when the baby had an attack.

So, we started Albuterol and Budesonide treatments.  It seemed that the first round did its job and, like always, I thought to myself “I did it!”  I thought I had I caught it early enough and that he wouldn’t have a bad attack.  And, like always, a few hours later he needed another treatment.  Seemed to me like maybe he needed it a little more than he did the first time, but I kept hoping.

Murphy’s law would have it that just as the pediatrician’s office closed, the baby was having a nasty attack.  It was time for a doctor and this time it would have to be urgent care.  I put both boys in the car, called my husband to meet me, and hurried off with a coughing, but not yet wheezing baby.

When we arrived, the nurse rushed us back to a giant tank of Albuterol and began a treatment telling us she would do this every 15 minutes or so to get the attack under control.  Fifteen minutes after the first treatment, he definitely needed another.  After the next dose, he was wheezing badly and gasping for air.  When the doctor suggested another dose before I “left for the emergency room,” I screamed, “STOP!”

It doesn’t take a medical degree, or a high school diploma for that matter, to see that he was getting much worse with each treatment.  I said to the doctor, “Look at him. He wasn’t this bad when we got here.  Do something!”  The doctor said he was going to try something that wasn’t usually done.  He gave my little one Epinephrine.  It worked!  The doctor explained that this is the sort of treatment kids got in the 80s, but it wasn’t preferred anymore.  Then he said something really interesting, “Some kids just don’t do well on Albuterol.  They seem to get worse.”  Thanks for the news flash.  That was clear.  My question was, if some kids get worse on a drug why did he seem so perplexed by my baby’s reaction?  And why would doctors give the drug without question?  And was there a better alternative?

This sent me straight to Google for some investigative work.  Turns out, many experts say Albuterol is pro-constrictory, pro-inflammatory, and accumulates in the lungs.  I said “pro” that means in kids who are in the middle of an asthma attack, whose lungs are inflamed and closed off are taking a drug that will increase the inflammation and constriction from which they are suffering.  To say I was livid was an understatement.

Each time he had gotten sick I had hoped for the best.  Each time I had done what a professional told me to do.  And each time he got worse.  I thought it was the asthma’s fault.  Turns out it was mine.

I told my doctor who seemed to dismiss my research and my description of what had happened at urgent care.  Regardless, he gave me a prescription for Xopenex ((R)-albuterol/levalbuterol).  According the studies I read, Xopenex costs more but doesn’t increase inflammation or constriction and doesn’t accumulate in the lungs like Albuterol.  Seems my doctor isn’t alone in dismissing my observations.  The internet is full of doctors and pharmacists that say Albuterol is just as safe and effective as Xopenex.  I disagree, at least as far as my baby goes, and I’m not alone.

What a difference! He responded, his condition didn’t deteriorate with each dose, and he could sleep through the night without coughing.  He doesn’t need either drug anymore, and I’ll tell you why in a different post, but if your child has asthma, research this yourself and, if you are having similar issues, considering talking with your doctor about switching from Albuterol to Xopenex.  Hopefully, you and your child will sleep and breathe a little easier.

*Please note that I am not a doctor, I am a lawyer (thus the disclaimer), and nothing I stated in this post is intended to be medical advice or used in the diagnosis or treatment of any individual.  Talk to your child’s doctor before administering any medication and do not withhold any medication mentioned in this blog without first speaking to your child’s doctor.

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About Peace, Love, and Toys

As a mom of 2, I know that the recipe for a happy child is simply peace, love, and (who are we kidding) toys. I'll try to share my tips on how to get all 3.
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