My Asthma Kid and Her H1N1

So.

Yes, it’s the swine flu.
Last Friday I took my daughter to the doctor who, once she heard how sick I’ve been and listened to AG’s hacking cough, administered a flu test. Now, this wasn’t the H1N1 test specifically. As far as I can tell, no one’s giving those anymore except to patients in the hospital. The pediatrician used a rapid-response test for influenza A because H1N1 is the only strain of influenza A going around right now. When patients test positive for flu type A, as AG did, doctors are something like 99% sure they have H1N1.

Having gone through the virus myself, I concur. Not that my guess bears any medical or scientific weight, at all.

No, I didn’t take Tamiflu.
I chose to suffer in silence instead.

Well maybe not in silence, as my family would gladly attest, but not in the doctor’s waiting room. Never at any point during my week in bed did I feel I wouldn’t improve, even if that rate of improvement creeped forward slowly over the hours. Since I don’t suffer from any health problems that would put me at high risk for secondary infections like pneumonia, I’d rather leave the Tamiflu for the patients who really need it, like my kid. (Not that any doctor would’ve prescribed it for me, anyway, because I really didn’t need it to recover.)

Yes, AG is on Tamiflu.
She took her first dose on Friday afternoon. Even if I hadn’t wanted the prescription, the pediatrician preferred the idea of my kid on a drug that could shorten her illness from the very start, reducing the amount of time her lungs would have to start flailing around and devolve into pneumonia, vs. the specter of AG toughing the symptoms out and later ending up on oral steroids (or worse) for lung inflammation.

No, the Steadfast Sidekick is not sick, too.
Hard to believe, huh? My house actually works perfectly in a quarantine situation, and we’ve managed to keep my 7 year-old away from me at first, and now her sister.

Yes, H1N1 is bad, but it’s no worse not that much worse than the seasonal flu.
At least, that’s been our experience.

ETA:
Okay, except the lingering cough. That was worse. I originally wrote this post on AG’s fourth day of illness, having no idea how long the kid would hack away afterwards. She took around 5-6 days to completely recover from actual flu symptoms, and the cough lingered somewhere between 7-9 days after that.

Here’s how it played out for me:

Day 1: Severe exhaustion, aching muscles, and moderate fever come on suddenly
Day 2: Exhausted, achy, feverish
Day 3: Fever reduced, exhaustion the same
Day 4: Fatigue reduced, fever gone and apparently traded for severe head congestion and subsequent frequent coughing
Day 5: Tired but not exhausted, congested and coughing, somewhat mobile
Day 6: Mostly mobile but still coughing and easily tired

Check out the difference between that and AG’s course of illness below:

Day 1:
Coughing, exhausted, feverish
Day 2: Same
Day 3: Fever mostly gone, somewhat tired and achy, coughing worsens
Day 4: (Today) Fever completely gone, severe coughing, peak flow wavering between green and yellow

A few obvious differences are at work here. For one, my kid’s been hacking away worse than me and from the very beginning. That’s the ol’ asthma speaking, of course. Her peak flow hasn’t dipped down into red, but if this bronchial cough doesn’t ease up or gets worse, I fear she’ll end up needing prednisone.

On the other hand, AG’s actual flu symptoms are much milder than mine were. I’m guessing that hiking at 10,000 feet on a cool windy day, as I was right before I came down with this flu a week ago, probably didn’t help me.

Finally, the Tamiflu has helped beat this virus down for AG, and thank God. As bad as her asthma coughing is right now, at least she doesn’t have the fever and muscle aches to suffer through as well. If not for that cough keeping her awake and the round-the-clock inhaler treatments, she’d probably feel fine.

Yes, I found the (tiny) silver lining on the swine flu cloud.
I guess AG and I no longer need the H1N1 vaccination, right? The Steadfast Sidekick, as you might imagine, does not like this turn of events in which she has to have a shot her sister now gets to skip.

More
All the asthma and H1N1 reading fun you could ever hope to have, right here.

79 responses to “My Asthma Kid and Her H1N1”

  1. kerri says:

    Best of luck in fighting this out for you and your Asthma Girl, Amy! Hopefully she and the Tamiflu fight it off fast
    Here’s to avoiding the dreaded pred.

    Hugs to you both!

  2. Steve says:

    Glad to hear that you were only sick for a few days.

    Hope you’re feeling better now!

  3. Her Grace says:

    Sounds like everything is moving in the right direction. Whew!

    I had a few questions for you, not related to h1n1:

    My 6-year-old has twice now (once in May and once just now) developed a sinus infection and subsequent bronchitis/wheezing about 10 days following a cold. They’re calling it RAD w/virus, not an official asthma diagnosis.

    She’s on a seven day burst of pred right now — not happy about that with h1n1 floating around. But I’m wondering, how do you know when the asthma cough is serious or it’s just bronchitis? Her cough was tight and raspy with just a little squeak of a wheeze. She never seemed short of breath, but got tired easily. I’m wondering if I had just kept the breathing treatments up and not got scared and gone to urgent care, maybe she could have fought it off with just the nebulizer.

    But then again, there’s the antibiotic issue, so maybe not. Long story short, have you learned to “read” AG’s coughs? Do you have tips?

    Thinking of your family this week, hope all goes well!

  4. Amy says:

    Thanks, all.

    Her Grace–This is a really good question & I’m not sure it’s one I can answer briefly, but I’ll try.

    Now that she’s older, my daughter can tell me if her cough’s coming from her throat or her chest. When she was younger & didn’t really have the vocabulary or the self-awareness to understand my question, I relied on a couple of clues:

    1. I listened for any congestion in her cough. If it was at all productive, I treated w/the nebulizer at home.

    2. For dry coughs, which are–as you mention–the most confusing, I relied on whether she could stop the coughing on her own, with the help of her inhaler/nebulizer. She tends to have coughing fits, where it’ll just go on and on and on for something like 15 minutes, until her lungs either give up or her bronchioles open up, no idea which, lol. A coughing fit every once in awhile wouldn’t send us to the dr., but if she had one of those every hour and I couldn’t stop them, I’d take her in.

    3. Sometimes, though, she has dry coughing all day long with no fits, but it just never stops. That’s something she’s doing right now, in fact, but again–she’s 10 and told me her throat tickles. So while I know some of her coughing is lung-related, not all of it is. Her peak flow hasn’t dropped below yellow, so I’m cautious but not super-worried. If it weren’t her throat, and if her dry coughing didn’t calm down in a day or two, I’d take her in.

    Basically, for dry coughs, my two main signs are the peak-flow meter and observation. If at any time I feel like she can’t stop coughing on her own for extended periods of time, then I take her in.

    For example, the night before last, AG coughed all night long and I had to get up at 1 am to tell her to use her inhaler. She was up on her own, coughing and using it at 5 am.

    Last night, though, she slept all night w/out coughing until about 4 am, when I woke her up to use it again. So although she’s home again today and sounds terrible, making it through those extra couple of hours tells me she’s doing better. If she keeps improving tonight, she’ll go to school tomorrow, but if she’s up coughing again, then she’ll end up at the dr. instead.

    Hopefully that makes sense……

  5. Tamara says:

    Hello, another asthma mom here. Been trying to get objective information on H1N1 vaccine. My 13yr old is a sickness asthma sufferer. Just fine normally on Singulair 1x and Flovent 2x day. Only needs nebulizer when sick, but even a runny nose type cold can be serious. Has had penumonia twice and hospitalized at 4yrs old the first time (asthma begin then with seasonal flu or strep throat, cannot recall both are triggers). Ok, background done, here it is: my long-trusted pediatrician will not be carrying the swine flu vaccine. She sadly tells me she will not advise me whether to get it (liability advice I assume). She, of all people knows my son’s condition best. At a previous visit, the dr did say all cases she has seen have been mild, less than the seasonal flu. I am also under strict instructions to call her day or night immediately upon any fever for Tamiflu right away if he is infected. The nurse confided “perhaps there is concernt about how fast the vaccine has been approved without long-term and thorough testing?”. We always get seasonal flu shots and no issues ever there. I can only seem to find “scary sites” for negative information, or “government sites” who will approve getting it as that is the stance required. I am trying not to cry writing this, I am terrified. If I get him the shot and he develops who knows what, perhaps lifelong effects, my fault. If I do not get it, and he gets real sick, or, you know what I am thinking, my fault. My husband has to be dragged in for seasonal flu shots, he is not for the H1N1 but will allow me to do it if I deem best. I just don’t know what to do and not sleeping well anymore. This language on this site so resembles things I have thought or have gone through, so reaching out here. Any advice or comments are appreciated.
    Good luck with AG, sincerely! I too have a younger one, 10yrs, who fortunately seems to have a great immune system, so hoping your little sidekick stays well.
    Thanks again.

  6. Elisheva says:

    Oh no! Feel better AG! Does she have a neb at home?

  7. Jessica Lynn says:

    Hello. I have a daughter that is 2 now and was diagnosed with asthma last october. She has been hospitalized 4x since she was 8months old with pneumonia. She has had it more than that, but not bad enough to go into the hospital. She takes singular 1x and flovent inhaler 2x per day. I use her neb whenever she gets congested to try to stay out of the hospital. But i took her in Friday and she has a small spot of pneumonia but we have been treating it at home so far. They swabbed her and said that she doesnt have the flu. There was a 6 year old boy here in my home town that died yesterday from pneumonia caused by the h1n1. I am terrified. I cant think about anything else, i can feel myself panicking. Should I pull her out of daycare? I am freaking out…some one tell me something to stop my panick!! lol Please!

  8. SJMom says:

    I hope your daughter feels better soon. My 11 yr old has this too. It started on Wed. Day 2 tested positive for Type A, started Tamiflu. The fevers went down (had gotten up to 103.8) and Day 4 she seemed to have energy. None since then though. She continues to cough. Went back to the Dr yesterday and added Prednisone, and cough medicine to try to get some sleep. Still doing albuterol in the nebulizer, and pulmicort flexhaler. Today is Day 7 and she is soo tired, and worn out from coughing it hurts her stomach and throat.

    I hope your daughter gets over this quick and the others in your family dont get it.

  9. Her Grace says:

    Thanks, that is helpful! My daughter also does the dry cough “tickle in the throat” thing. I wonder if it’s an indicator that something mild is going on.

    My allergist thinks that kids (like my daughter) are undertreated. HER allergist says that he’s not ready to call it asthma, that she might outgrow it. So I’m just sorting all of this out.

  10. mindy says:

    thanks so much.. my son has asthma and he just tested positive for Influenza A and they put him on Tamiflu.. The doctor was more concerned about the asthma. But he told me that it would cost 300 dollars to send the test to the state to find out if it was indeed swine. So I am just going to try and keep the rest of the family well. Thanks again

  11. Shelly says:

    I am wondering if any of you know how long the cough lingers after H1N1? We have been told in the past that my daughter has “underlying” asthma, meaning it would only flare up with exercise and a respiratory illness. She had pneumonia during July and got H1N1 early October. At first they just treated it as a sinus infection, so she did not get the Tamiflu within the time she would have needed it. She has been suffering with a cough for 3 weeks now. She had only had an asthma attack at peak exercise during basketball conditioning in the past, but she has had 4 attacks in the last two weeks, two severe that got her an ambulance ride to the hospital. She is a cheerleader and one of the attacks were during practice and the other at a football game out in the cold air. She has been on Prednisone, Advair, Singulair, DuoNeb treatments for two weeks now with some decrease in her daily couging, but still very low exercise tolerance. She typically is not on all these meds, only use of Advaid occastionally with an illness and Albuterol inhaler pre exercise. Do you think this is typical, especially for someone with “underlying” asthma? I have heard people without asthma having coughs lasting for several weeks post H1N1. I just wish she would have been treated with Tamiflu soon enough, can’t help but wonder if that would have helped. We definitely don’t want any more trips to the emergency room!
    Thanks
    Shelly from Nebraska

  12. Amy says:

    Hi Shelly–
    I’m the owner/author of this site, and I hope your daughter gets over this residual stuff soon & she can avoid the ER again.

    I don’t have asthma, and my cough lingered for about 4 days after I felt better otherwise. That’s actually pretty unusual for me.

    My daughter with asthma (AG), had a lingering cough for a good 7-8 days after she got better–it was bad enough that even with her maintenance and controller meds, I didn’t let her go to P.E. or recess until it ended.

    It’s hard to say what’s typical since this flu strain is new and asthma can be so different from person to person, but my general rule for my own child (age 10) is that if her coughing is not noticeably improving over time, then I take her in to step up her treatment, and I also decrease her physical activity.

    I have heard, though, that the cough for most people w/this flu is especially lingering.

  13. jenny says:

    Hi. I have a daughter who is a freshman in high school. She is diagnosed with chronic, severe asthma, and has had it in earnest since 4th grade when she “popped” holes in each lung by coughing so much.

    She is on Xolaire once a month, zyflo, symbicort, allergy shots, and herbal meds. Yikes! She is a great patient and has as good an attitude as she can.

    Until about 7 months ago, she was on monthly prednisone bursts. Scary stuff. We are just past the 7 month mark now, however, with no prednisone and feel we have won the lottery.

    Going into the winter months, however, is tricky, and the H1N1 scare has me on red alert. She got the H1N1 vaccination over two weeks ago, and I am wondering if anyone knows if that means we are out of the woods. Do we know if her risk of serious illness are gone, extremely low, or what?? Can I stop worrying about the flu, and just concentrate on getting her though the winter?

    Also, does anyone have advice on keeping high school kids’ grades up when they miss so much school?

  14. Aysegul says:

    Dear all, just wanted to tell you that things are pretty much the same everywhere. We live in Turkey, and the swine flu cases have started about 6 weeks ago and are increasing at a frightening rate. My 9-yr-old daughter tested positive 4 weeks ago, had fever only for 3 days (high for a day only) and negligible cough (guess Tamiflu helped). My asthmatic 4 yr-old, who happened to be on the antibiotics at the time, very surprisingly did not catch it. Schools were closed down for 2 weeks here in Ankara. Now they are both back at school, and I am about to go crazy thinking what we should do: Should I keep him home for 1 month until the vaccine arrives (2 weeks more) and the required 2 doses take effect, is the vaccine safe for him (he’s never had a flu shot before), is it truly protective (Novartis says 80% only)? Guess there is no definitely correct answer:(

  15. Amy says:

    Thanks for your input on how it’s going internationally. In my part of Colorado, I haven’t heard of any schools shutting down but there have been some closures in other parts of the state.

    When my older asthmatic daughter caught H1N1, her younger (non-asthmatic) sister didn’t get it–but then she did (untested and therefore unverified, tho) 2 weeks later.

    Some parents on this site have decided to keep their asthma kids home until they’re vaccinated, but not all of them. I guess it’s mostly a question of whatever helps you sleep at night and helps your sanity and how severe/mild/controlled your child’s asthma is.

    Either way, I hope he stays as healthy as possible this winter.

  16. Worried Mom says:

    My 12 year old daughter came down with probable H1N1 on Saturday. She has asthma that only flares up with colds, etc. Her cough got dramatically worse (she is nebulized every 4 hours) on Wednesday so the doc said bring her in for a chest x-ray. No pneumonia so he prescribed prednisone. But, according to WHO (http://www.who.int/csr/resources/publications/swineflu/clinical_management_h1n1.pdf):

    Moderate to high-dose systemic corticosteroids are NOT recommended as adjunctive H1N1 treatment. They are of unproven benefit and potentially harmful.

    I would think the immune-suppressant properties of prednisone would put her at greater risk of secondary infection. The doc was the new guy in the practice and I am waiting for confirmation from our primary that this is a reasonable course of action.

    Any thoughts on this?
    Thanks.

  17. Amy says:

    Oh, I’m sorry she’s having such a hard time. From what I’ve read on that pdf, I’m thinking it’s saying that corticosteroids aren’t recommended for the flu itself. If I’m reading it correctly, I don’t think it’s saying not to give corticosteroids for asthma problems caused by that flu, if you see what I mean.

    I understand your concern with the immune suppression/infection connection, but since her cough got worse I’m guessing the dr. (and I don’t want to speak for him here) thinks a severe flare combined with the flu itself is the greater risk.

    I hope that helps, and I hope she turns a corner soon.

  18. Worried Mom says:

    Thanks Amy. I had assumed that the term adjunctive treatment meant treatment NOT for the primary illness (i.e. flu, in this case) but for problems caused by it ( in this case, asthma). But in either case, she is now on the prednisone for the first time and we haven’t seen any improvement in 24 hours. I guess I will have to be patient and watchful. Thanks again.

    Worrier and Warrior

  19. Amy says:

    I’m glad I wrote, “If I’m reading this correctly” because apparently, I wasn’t. You’re right–I completely missed the adjunctive part! Hoping you see some improvement soon……

  20. Leafie says:

    I am just wondering what the after effects are after having the h1n1 virus, treating with tamiflu, then also having asthma. My son is 6 and had been tested then they pres. tamiflu. He seemed o.k. with it and did go back to school 2 days later. That Friday he got the reg. flu shot cuz we were told he should. 13 days later he got vomiting and diarh. bad….had him stay home that day and was great next day so he went to school. Now it is 6 days and he has been complaining about stomach pain, has a runny/stuffed nose. Not sure if this is a side effect of it all or something more serious. Spoke to pedi. and she suggested maalox or pepto. Of course kids don’t like it, but you do what you must. Will see how it is tomorrow. He is in better spirits after taking the pepto pill. He also has good appetite. Just not as active as usual. I am just concerned this is all linked and maybe I should just forget the vaccines from now on. It is awful. Just don’t know what to tell him sometimes.

  21. Leafie says:

    and another thing…this has all happened in less than 30 days and now he is getting a cough.

  22. Amy says:

    Hi there–Tamiflu does cause nausea in some kids but, to my knowledge, only while they’re actually on it. I’ve never heard of it causing stomach symptoms that long after taking it, though. Is there a stomach bug going around his school? It could be that his immune system was vulnerable to anything contagious after fighting off the H1N1.

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