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Respiratory Disorders

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      12.05.2009 19:35
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      A life threatening condition

      I usually like to make my reviews fairly light-hearted and entertaining, but I am going to make an exception here as it concerns the most worrying and stressful time I have ever experienced. It concerns my son, who at the age of 11 months, was admitted to hospital no less than three times in just two months after being diagnosed with Viral Bronchialitis. It is very personal to me and I only feel comfortable writing about it now because of the amount of time that has elapsed since this illness took over our lives, and also the fact that Matthew, now 4, is back on top form, full of beans again and totally clear of the infection. I would add that I am not attempting to produce a first class piece of writing, review, op, whatever you want to call it, but merely want to share my experience with you in the hope that it may help anyone whose baby should ever be unfortunate enough to contract Viral Bronchialitis.

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      A Brief Description of Bronchialitis
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      Up until October 2005, I had never heard of Bronchialitis. I was familiar with Bronchitis having suffered from it myself when I was in my teens, but Bronchialitis was certainly a new one on me.

      Essentially, Bronchialitis is a viral infection which affects the bronchioles in the lungs, and is most common in babies under the age of twelve months. The bronchioles are the tiny airways within the lungs, and should not be confused with the bronchi (the larger airways) which are affected by bronchitis. Bronchialitis is usually contracted when the baby breathes in water droplets from a sneeze or a cough where the virus is present. The bronchioles become full of mucus and swell up, causing severe breathing difficulties.

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      My Experience
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      Matthew was born in November 2004, and although he decided to surprise us all by arriving five weeks early, he weighed in at 6 ½ pounds and was a healthy little boy. During his first 6/7 months, he caught a couple of very minor colds which didn't seem to bother him and they both cleared up very quickly. It was only when he came down with cold-like symptoms in October 2005 that things took a turn for the worse. The runny nose only lasted a couple of days or so, but then turned into a dry, 'tight' cough.

      Within 24 hours of the cough starting, Matthew's breathing had become quite laboured and, during the night, things got so bad we decided to take him to A&E. In fairness to the hospital staff, they did take him through to the treatment room straight away and connected him up to an oxygen tank. Unfortunately, he was so stressed out by the breathing difficulties that he was kicking out all over the place and would not keep the mask over his face so we had to physically hold him down and press the mask down over him until his breathing eased a little. After a couple of hours, Matthew was admitted to the Paediatric Unit, all the time remaining connected to an oxygen tank. In order to breath, he was pulling on his tummy muscles and this has to be one of the most upsetting things you could see your baby go through. Once his breathing had steadied slightly, he was given some oral steroid tables (Prednisalone) which were dissolved in a syringe of water. He was also given a Salbutamol inhaler which will be familiar to asthmatics. Basically, this is a 'reliever' inhaler which, in normal circumstances, is designed to bring quick relief to breathing difficulties caused by the likes of asthma and lung infections. As Matthew was only 11 months old, he was given this via a volumatic which is a plastic cone with a valve at the end. These are designed for children or for people who are unable to use an inhaler in the normal manner. Generally, when using an inhaler, the trick is to press the canister of the inhaler at the same time as breathing in quickly. Obviously, young children are unable to do this so the drug from the inhaler is dispersed into the volumatic and the child breathes it through the valve as normally and evenly as possible. Fortunately, the medication worked wonders and, within 24 hours, Matthew's breathing had calmed down immensely and we were sent home with an inhaler, volumatic and two day's worth of Prednisalone. At this stage, we were given no indication as to what may have caused the breathing difficulties other than it 'could be a virus and will probably clear up'.

      Life returned to normal until the week before Matthew's first birthday. And then the runny nose started again, which led once again to breathing problems. It is very hard watching your baby fighting to breathe. Under normal circumstances, if anyone has ever sat and watched their little one breathing, the chest goes up and down nice and evenly, but with Bronchialitis, the stomach is being pulled in due to the force of trying to take in each breath of air.

      So once again, we rushed off to A&E, probably breaking the speed limit at the same time. The procedure took the same route as on the previous occasion, with Matthew having to be nebulised with a combination of oxygen and Salbutamol. For anyone not familiar with nebulisers, this is where a mask is placed over the face and the medication is administered in a measured form of steam so that it can be breathed in more easily. Again, Matthew was placed on a monitor to measure his blood saturation and pulse rate. After a few hours, his breathing calmed down and he was given some more diluted oral steroids and regularly dosed with more Salbutamol through the volumatic. He was kept in hospital overnight and released in the morning with a further two day course of steroids.

      Everything returned to normal and then six weeks later, in fact it was the week before Christmas, we were back to square one. This time, the runny nose started in the night, and by midday the following day, the breathing problems had started again but not so badly. We therefore decided to get an emergency appointment with the GP in the afternoon, but things took a turn for the worse before we had chance to go.

      And then the most frightening moment of my life happened. Matthew had been having such a struggle breathing that he just keeled over and seemed to 'pass out'. I was trying to wake him and he wouldn't move or open his eyes. It only lasted for a few seconds and I can't describe what was going through my mind at that point. We forgot about the GP appointment and just went straight to A&E again where he was nebulised. He was so bad this time that it took a total of 8 sessions of nebulisation before his breathing calmed down. However, he could still not breathe properly on his own and remained on oxygen for 24 hours. Each time the oxygen mask was removed from his face, his pulse rate and saturation slowed right down and would not stabilise. On this occasion, the nurses sent both me and my husband home as we were both totally drained after having no sleep. I didn't want to leave Matthew but he was sleeping all the time and we were assured that if there was any change, we would be called straight away.
      First thing the next morning, we phoned the ward only to be told that Matthew was sitting up, playing with toys and had had his breakfast, and we could bring him home. If anything could be classed as being a 'weight off my mind', it was being given this news.

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      Diagnoses
      ~~~~~~~~
      It was only after this final occasion that we were visited by a paediatric consultant while we were still in the hospital. It turned out that, the first time Matthew was admitted, there was a severe case of Viral Bronchialitis doing the rounds in the north west area of England, and the consultant's opinion was that Matthew had caught this back in October, i.e. the first time he was admitted to hospital. The problem with Viral Bronchialitis is that, once the child has had it, it weakens the immunity of the lungs so that any cold or chest problem that is contracted causes the same symptoms again until the child either builds up an immunity, or is old enough to fight off this type of virus.

      ~~~~~~~~~~~~~
      Related Problems
      ~~~~~~~~~~~~~
      If left untreated for any length of time, there is the possibility that the condition can turn into Pneumonia.

      It is also said that children run a higher risk of contracting Bronchialitis if there are smokers in the house, but to be honest, I don't know if the child has to have suffered from it first to be at risk.

      It is now four years since all of this happened, and I am pleased to say that Matthew is back to his normal devilish self, full of mischief, very happy and very healthy. After being discharged from the hospital, we were required to visit our own GP for a general check-up and Matthew was prescribed a separate inhaler containing Beclamethasone, which is a mild steroid intended to recondition his lungs.

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      Worries about Steroids
      ~~~~~~~~~~~~~~~~~~
      There have been many controversial reports on steroids over the years, especially when being prescribed to infants. The medical profession are very reluctant to give oral steroids as too much use of these can affect the growth in young children. If the use is limited to emergency conditions, as in Matthew's case, the risk is minimal.

      Inhaled steroids, such as the Beclamethasone, are a lot safer. With an inhaler, the medication is going straight into the lungs where it is required, and has been proven to be a safe method of treating lung conditions such as asthma.

      Viral Bronchialitis is an awful thing to experience for anyone, but I imagine that it is worse in babies and children as they do not understand what is happening and why they cannot breathe. I know for a fact that it is easier said than done to advise a parent to be calm so that the baby does not pick up on the stress, but if you are a parent and your baby comes down with this virus, I have added a few pointers in the hope that it will be of some help to you:

      *If your baby is suffering from Viral Bronchialitis but is not ill enough to be admitted to hospital, keep him upright as much as possible. The mucus which has collected in the lungs will eventually loosen and is often coughed up and the baby will be able to do this more effectively if he is upright. At nighttime, elevate the mattress slightly if possible so that the baby is not lying totally flat.

      *Keep the baby well hydrated. In Matthew's case, his difficulty in breathing also made it difficult for him to eat and drink and this can cause dehydration.

      *If the baby's breathing deteriorates, don't bother with the GP's surgery - get straight down to A&E. Once they are in the hospital, babies take priority over sprained ankles, cut fingers etc. and will be seen straight away. They will be given oxygen immediately, and no matter how long it takes for the medication to have an effect, at least they will be on the right track.

      *One thing that I noticed when Matthew was ill was that it came on so suddenly, literally in the space of hours. He went from having a little cough to major breathing difficulties in such a short space of time. And then once he had been discharged from hospital, it took only a couple of days to get back to normal.

      I apologise if this 'review' has been a little on the depressing side and longwinded, but I felt I had to give all the details if it was going to help anyone unfortunate enough to find themselves in this situation.

      Finally, I would say that I am not in the least medically qualified and the information I have given in this review is based solely on my experience in the three months before Christmas, 2005.

      Thank you for reading.

      (also posted on Ciao)

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