Reactive Airway Disease -- anyone have experience?

[Mama Bear]

We were in ER last night and have a steroid scrip.

Bleh.

Any experience?

[OneRoomHomeSchool]

My oldest son developed this from an immunization at 6 months old. We had to use the steriods in a nebulizer, 4 times per day...he did grow out of it. If I remember correctly we only had to do the treatments for about 4-5 months.

How old is your dc?

[Wendy in ME]

Reactive airway disease is a generic way of saying that airways became sensitive or reacted to something by both swelling and becoming inflamed as well as constricting and becoming narrower. The steroids will help with the inflammation. Bronchodialators are usually prescribed for the narrowing or constricting to help "open up" the airways. These symptoms the same as asthma but if this is the first or second episode or if your dc is very young, it is referred to as reactive airway disease. It may very well be a fluke caused by having a cold already or being exposed to a new irritant. It is only after multiple episodes that a diagnosis of asthma would be made.

[TengoFive]

My 2 younger girls both have this. Anytime they get a cold it turns into RAD. Our allergist has us start the albuterol at the first sign of a sniffle to prevent it from scarring their lungs.

[Ellie]

although my dd was diagnosed with asthma when she was little, I'm pretty sure it was RAD (this was over 25 years ago, before anyone had invented the term RAD). She had one or two big episodes a year, usually requiring prednisone treatment.

[Mama Bear]

My 12yo has asthma (tho now I'm wondering if it's really RAD since he is mostly asymptomatic) so the Albuterol/Atrovent, Xopenex, Pulmicort, NEBs scheduling is nothing new here. Sadly. I had no idea that the two could be so closely linked. Usually I'd go Google something like this, but I'm just wiped out after days and days of sleeplessness/coughing getting progressively worse.

(Wah.)

Little guy is 2, had bronchiolitis at 2 mos and I was made aware that it would increase his risk for other repiratory illnesses so he's been watched pretty carefully. Last night when I took him in he was having just enough sternal retractions to move us right to the head of the line. His sats were hovering around 95, so not too bad. He was at 100 before we left and his color was much improved.

Any other info is much appreciated. Thanks, as always. :)

I can't figure out how to post a link so:
http://www.duramater5.blogspot.com/ :D

[kalanamak]

Any other info is much appreciated. Thanks, as always. :)


You can also get bronchospasms from aspiration, even if the person is on an acid-blocker (food can bother the lining of the trachea/bronchi just like acid can). A person can have wheezing for up to 6 weeks after an aspiration episode.
This is info on adults....I don't know about children. I recall your kiddo, however, has some reflux....right?

[Mama Bear]

He has had reflux (a swallow study was clear), but it's been ages since he had any symptoms. He's had a cold and I thought perhaps it was a result of the phlegm migrating south, but who knows. Thanks for the aspiration info. The pediatrician thinks the episode of bronchiolitis at 2 mos likely set him up for this. S, 5, the bigger sister, has had some of the same symptoms -- she had a white count of 25,000 at 19 mos with pneumonia. Everyone else but these two are long since recovered.

Gak.

[kalanamak]

Swallowing studies test for aspiration during the act of swallowing. One can reflux without the gastric contents really getting up far enough to give your swallowing hardware a chance to do its stuff. I recall a violent burp on my back after a vinegary salad. I coughed and wheezed for an hour.

[BizyPenguin]

We found out he had reactive airways when he was 3 yrs old. He'd cough until he vomitted. It was so scary. He had a couple of emergency treatments at the doctor's office and then we'd give him albuterol with a nebulizer (??) Can't remember if that's what it's called. The trick was to give him the treatment as soon as we noticed a lot of post nasal drip/sniffing b/c that's what triggered his coughing (this occured after every cold bug.) By the time the coughing spell begins, apparently it's harder to treat. They said he'd outgrow this by the time he was six. It did get better, but did not go away completely. He is 10 now and still has this problem after a cold bug, but it's not as bad as when he was younger and we don't use albuterol any more. We give him allergy meds. My neighbor's boys have reactive airways now. They just brought home the machine for home treatments recently. Their boys are 5 and 2. Personally, I'm hearing way too much of this and I think the environment is to blame. It's basically baby asthma, but they don't like to call it that.

[Brenda in MA]

when they were younger. One organization I found helpful was Allergy and Asthma Network/Mothers of Asthmatics.

http://www.aanma.org/

I'll pray that your little one feels better soon.
Brenda

[Rebecca in GA]

Reactive airway disease is a generic way of saying that airways became sensitive or reacted to something by both swelling and becoming inflamed as well as constricting and becoming narrower. The steroids will help with the inflammation. Bronchodialators are usually prescribed for the narrowing or constricting to help "open up" the airways. These symptoms the same as asthma but if this is the first or second episode or if your dc is very young, it is referred to as reactive airway disease. It may very well be a fluke caused by having a cold already or being exposed to a new irritant. It is only after multiple episodes that a diagnosis of asthma would be made.

This is exactly the information our doctor gave us when our then-5 yo was diagnosed, and he in fact eventually was diagnosed with asthma.

[Lizzie in Ma]

By our primary physician. This year we needed more answers due to consistent chest tightness. Our pulmonary specialist said doctors use the term "reactive airway disease" because it is less scary than asthma. I felt like an idiot! He said reactive airways mean asthma by definition.
It will be ok though, those first trips to the ER are scary, but managed well it isn't so bad. We only had to go to the ER the first time. My dd, now 11, is doing great and I am sure your dc will be fine too.

[Wendy in ME]

"Our pulmonary specialist said doctors use the term "reactive airway disease" because it is less scary than asthma. I felt like an idiot! He said reactive airways mean asthma by definition."

As a respiratory therapist, I can't help but disagree with this statement made by the pulmonologist. RAD and asthma have the same cause and symptoms. However, Asthma is a chronic disease and RAD can be a one-time fluke that may never happen again or maybe just once a year. Asthma treatment requires maintenance therapy to help prevent episodes as well as a "rescue" inhaler or neb. A child with RAD that flares up very infrequently such as just with a bad cold will only use bronchodialator treatments when he is experiencing symtoms. You definately should not feel like and idiot. Very young children are always said to have RAD before a diagnosis of asthma can be made. When you are talking about a very young child or a child experiencing his first couple of episodes, it is quite preliminary to diagnose the child with a chronic disease such as asthma.

[Lizzie in Ma]

I do so appreciate this board and everyone on it!

[Doran]

As a respiratory therapist, I can't help but disagree with this statement made by the pulmonologist. RAD and asthma have the same cause and symptoms. However, Asthma is a chronic disease and RAD can be a one-time fluke that may never happen again or maybe just once a year. ...

Thanks for this clarification, Wendy. I was really puzzled by all the statements that were equating asthma and RAD.

Mama Bear, our oldest (13) has RAD. When she was quite young, we were able to control her "episodes" with liquid albuterol. Episodes always and only coincided with a cold. She seemed to outgrow them for a time -- from ages 5-6 until about 11, she never had any real struggles. But, winter of 2005, she developed pneumonia as a result of a bad cold. We used nebulizer treatments at home and didn't have another episode until winter of 2006/7, when she had pneumonia twice -- once in December, and again in February. It came on very quickly - we're talking five days from onset of any symptoms to dx of pneumonia. All the while, we thought we were doing the right thing by starting the nebulizer treatments early on, trying to be proactive. Essentially, despite some attempts at early intervention, dd developed pneumonia three times in just over one year.

The doctors were talking about putting her on steroids as a preventive, year round. We were unhappy with the idea of that, so as an alternative, we decided to wean her off of nearly all wheat and dairy. Since Feb. '07, she has been on a diet which restricts her intake of these two foods. She's had two minor colds since then, and one major. The major cold struck at a time when we were to be traveling out of town, so rather than take chances, we started the nebs and the inhaled steroid. She got pretty junky sounding and we were both convinced we were headed for another pneumonia dx. But, when we got home and went to the doctor, she was found to be "just fine". We were elated!!!

I have to add here that her environment and physical being have both changed dramatically in that year of restricted diet. We moved from a drafty, moldy farm cottage with a wood stove and chicken care duties to a more modern, better insulated house without stove or chickens. Dd has since begun menstruating. Both of these could have had equal or higher impact on the apparent shift in her ability to stave off severe illness after a cold. But, we also believe the dietary changes have been beneficial.

Not sure if this helps much - just wanted to share our story. It is SO scary when they can't breathe!! Hope you get some rest soon.

Hugs,
Doran

[Mama Bear]

It's so helpful to hear from both professionals and professional mamas. ;) The definitions and experiences will prove quite useful as we go. I'm wondering now about my oldest who has been on Singulair for years. Other than his first episode (which could easily have been allergies), every single incident that I can recall has been cold-related. He's used his inhaler twice in nearly three years. Q's episodes have also been related only to colds.

Thanks very much, all.

[Tracey in TX]

DS was dx'd with RAD at 6mo. old. Ped suggested that label in lieu of asthma b/c insurance rates may change. Give it time to see how it develops. He was asymptomatic for 6 yrs. We now have constant bouts and he's used multiple inhalers, nebulizers, etc.
Ironically, just a few minutes ago he had an episode and I wondered when the diagnosis would change. Spring and fall are the worst b/c of allergens in air. :( It's so hard on his little body.

[Tracey in TX]

Both DSs now diagnosed with asthma today :(
Little Soccer Dude always had RAD, but is now officially asthma.
Soccer Dude began complaining of his heart hurting after a soccer tourney. He was dx'd today with sports-induced asthma. We didn't catch it earlier b/c he is such great shape that the symptoms were masked.

[Wendy in ME]

I'm sorry to hear that but at least now you can focus on controlling his asthma with some of the maintenance medications that are available. It may take some time to get just the right medication going but as you become more familiar with his warning signs and triggers you will be able to head off many episodes before they get worse.

[Tracey in TX]

I'm sorry to hear that but at least now you can focus on controlling his asthma with some of the maintenance medications that are available. It may take some time to get just the right medication going but as you become more familiar with his warning signs and triggers you will be able to head off many episodes before they get worse.

Thank you, Wendy. We're still talking DS through this as he's a bit freaked out, as well as we're hoping the diagnosis is correct and not something more serious.