Thursday, February 19, 2009

Sunday, January 20, 2008

Sunday, December 9, 2007

Baby Kelly's down with bronchiolitis


It all started on Friday when we realized that Baby Kelly has mild cough. The cough was not that serious but Kelly was more cranky than before. She would insist on being carried to sleep in the afternoon and the moment you put her down, whether on the cot, bed, rocking net or her fav car seat, she would wake up and cry. We thought that it's the weather/temp that results in this.

Anyway, she started to cough badly on Sat morning during after her milk feed and we decided to bring her to the PD. PD did a check on her chest and we were given some nose drops, cough medicine.

Kelly's cough did not improve and it got worse. On Monday, she starts to cough very badly and even vomited out her milk. In each cough episode, she would used almost all her strength and will turn red. We also observed that her milk intake starts to decrease.

On Tuesday, we decided to bring Kelly to the nearby kid's clinic for a check again. Waited for 3hrs to get to see the PD and was told that Kelly suffered from mild bronchilties. She was given the neubuliser treatment at the clinic as PD would want to check whether she is able to react well with the medicine. After the assessment, PD adv to use the neubuliser on a 4hrly basis and to return in 2 days time for a review.

We started to use the neubiliser and it does help her when she starts to cough badly. Unfortunately, her cough did not seem to improve and it seems that there is more phelgm accumulating in her. On Thursday, went back to the PD for review and as suspected, Kelly's condition has changed from mild to full bloom and PD adv to admit to hospital for closer check.

After getting the memo from the PD, we went straight to Mt A and admitted Kelly. It was abt 12.30pm.
At abt 1.30pm, her PD came to check on her and ordered a couple of test for her.
Poor Kelly have to went through the following on a single day :
- Blood Test
- X-Ray
- Suction to retrieve the phelgm/mucus from the nose and throat
- Oxygen level in her blood using a device that gets the reading from her small little toe

The x-ray was ok as Kelly was very happy and even smile when the x-ray was taken. She must be amazed by the huge machine with so many tubes.
The nurse poked her small little finger to retrieve the blood and she squeezed out quite a bit from her. She cried at the moment when the needle poked.
Then came the worst treatment that makes her cry so loud and bad when she has to do the suction. Imagine the small little tube have to go down her nose and throat to remove the phelgm, it must be painful and uncomfortable. She struggle so hard every time and cried so loudly. As I watched, tears just rolled down and she have to went through this 1-2 times every single day when she was hospitalized.

In the mean time, PD prescribed her with antibiotics, cough medicine and the neubulizer while waiting for the various results to be out.

- Kelly's lung was cleared with the x-ray result ( a big relieve for us)
- on the 4th day, the phelgm results shows that Kelly contracted both the RSV ( virus infection) and the bacterial infection. Each of them would have already resulted in a lot of phelgm and no wonder Kelly is suffering so much with 2 things attacking her at the same time. Fortunately, the antibiotics that she has been given is able to fight the baterial that was being diagnosed.

During the stay


Information on Bronchiolitis


Bronchiolitis is a common illness of the respiratory tract caused by an infection that affects the tiny airways, called the bronchioles, that lead to the lungs. As these airways become inflamed, they swell and fill with mucus, making breathing difficult.

Bronchiolitis:
- most often affects infants and young children because their small airways can become blocked more easily than those of older kids or adults
- typically occurs during the first 2 years of life, with peak occurrence at about 3 to 6 months of age
is more common in males, children who have not been breastfed, and those who live in crowded conditions
- Day-care attendance and exposure to cigarette smoke also can increase the likelihood that an infant will develop bronchiolitis.
Although it's often a mild illness, some infants are at risk for a more severe disease that requires hospitalization. Conditions that increase the risk of severe bronchiolitis include prematurity, prior chronic heart or lung disease, and a weakened immune system due to illness or medications.
Kids who have had bronchiolitis may be more likely to develop asthma later in life, but it's unclear whether the illness causes or triggers asthma, or whether children who eventually develop asthma were simply more prone to developing bronchiolitis as infants. Studies are being done to clarify the relationship between bronchiolitis and the later development of asthma.
Bronchiolitis is usually caused by a viral infection, most commonly respiratory syncytial virus (RSV). RSV infections are responsible for more than half of all cases of bronchiolitis and are most widespread in the winter and early spring. Other viruses associated with bronchiolitis include rhinovirus, influenza (flu), and human metapneumovirus.
Signs and Symptoms
The first symptoms of bronchiolitis are usually the same as those of a
common cold:
- stuffiness
- runny nose
- mild cough
- mild fever
These symptoms last a day or two and are followed by worsening of the cough and the appearance of wheezes (high-pitched whistling noises when exhaling).
Sometimes more severe respiratory difficulties gradually develop, marked by:
- rapid, shallow breathing
- a rapid heartbeat
- drawing in of the neck and chest with each breath, known as retractions
- flaring of the nostrils
- irritability, with difficulty sleeping and signs of fatigue or lethargy
The child may also have a poor appetite and may vomit after coughing. Less commonly, babies, especially those born prematurely, may have episodes where they briefly stop breathing (this is called apnea) before developing other symptoms.
In severe cases, symptoms may worsen quickly. A child with severe bronchiolitis may tire from the work of breathing and have poor air movement in and out of the lungs due to the clogging of the small airways. The skin can turn blue (called cyanosis), which is especially noticeable in the lips and fingernails. The child also can become dehydrated from working harder to breathe, vomiting, and taking in less during feedings.
Contagiousness
The infections that cause bronchiolitis are contagious. The germs can spread in tiny drops of fluid from an infected person's nose and mouth, which may become airborne via sneezes, coughs, or laughs, and also can end up on things the person has touched, such as used tissues or toys.
Infants in child-care centers have a higher risk of contracting an infection that may lead to bronchiolitis because they're in close contact with lots of other young children.
Prevention
The best way to prevent the spread of viruses that can cause bronchiolitis is frequent
hand washing. It may help to keep infants away from others who have colds or coughs. Babies who are exposed to cigarette smoke are more likely to develop more severe bronchiolitis compared with those from smoke-free homes. Therefore, it's important to avoid exposing children to cigarette smoke.
Although a vaccine for bronchiolitis has not yet been developed, a medication can be given to lessen the severity of the disease. It contains antibodies to RSV and is injected monthly during peak RSV season. The medication is recommended only for infants at high risk of severe disease, such as those born very prematurely or those with chronic lung disease.
Incubation
The incubation period (the time between infection and the onset of symptoms) ranges from several days to a week, depending on the infection causing the bronchiolitis.
Duration
Cases of bronchiolitis typically last about 12 days, but kids with severe cases can cough for weeks. The illness generally peaks on about the second to third day after the child starts coughing and having difficulty breathing and then gradually resolves.
Professional Treatment
Fortunately, most cases of bronchiolitis are mild and require no specific professional treatment. Antibiotics aren't useful because bronchiolitis is caused by a viral infection, and antibiotics are only effective against bacterial infections. Medication may sometimes be given to help open a child's airways.
Infants who have trouble breathing, are dehydrated, or appear fatigued should always be evaluated by a doctor. Those who are moderately or severely ill may need to be hospitalized, watched closely, and given fluids and humidified oxygen. Rarely, in very severe cases, some babies are placed on respirators to help them breathe until they start to get better.
Home Treatment
The best treatment for most kids is time to recover and plenty of fluids. Making sure a child drinks enough fluids can be a tricky task, however, because infants with bronchiolitis may not feel like drinking. They should be offered fluids in small amounts at more frequent intervals than usual.
Indoor air, especially during winter, can dry out airways and make the mucus stickier. Some parents use a cool-mist vaporizer or humidifier in the child's room to help loosen mucus in the airway and relieve cough and congestion. If you use one, clean it daily with household bleach to prevent mold from building up. Avoid hot-water and steam humidifiers, which can be hazardous and can cause scalding.
To clear nasal congestion, try a bulb syringe and saline (saltwater) nose drops. This can be especially helpful just before feeding and sleeping. Sometimes, keeping the child in a slight upright position may help improve labored breathing. Give acetaminophen to reduce fever and make the child more comfortable.
When to Call the Doctor
Call your doctor if your child:
- is breathing quickly, especially if this is accompanied by retractions or wheezing
- might be dehydrated due to poor appetite or vomiting
- is sleepier than usual
- has a high fever
- has a worsening cough
- appears fatigued or lethargic
Seek immediate help if you feel your child is having difficulty breathing and the cough, retractions, or wheezing are getting worse, or if his or her lips or fingernails appear blue.


Information on RSV

RSV stands for respiratory syncytial virus, which causes symptoms similar to those of the common cold. It’s a common virus that affects most babies – in fact, by the age of two almost all children have been infected with RSV. For most babies, this easy-to-catch virus can cause symptoms such as a runny nose, fever, and other cold-like symptoms.

Though RSV is not usually a cause for major concern in most healthy babies, the infection can spread to the lungs causing pneumonia or bronchiolitis, an inflammation in the tiny airways that lead to the lungs.

While RSV isn’t a serious threat for many infants, if your baby is at high risk, RSV can lead to a serious respiratory infection, which may require hospitalization and may even, in some cases, cause death.

Like a cold, RSV is easy to catch and easy to pass on. The virus is transmitted through sneezing and coughing or through physical contact such as kissing or touching. It can also live for hours on surfaces such as countertops or your baby’s toys.

At certain times of the year, known as “RSV season,” the germs that cause RSV infections are most common.

RSV is a virus and so, unlike bacterial infections, cannot be treated with antibiotics. Once your baby is infected, your baby’s doctor can only treat the symptoms of the infection and administer treatments to reduce the risk of further complications.

That’s why prevention – especially for high-risk babies – is so important.



Preventing RSV
RSV is a common, highly contagious virus, but there are things you can do as a parent to reduce your baby’s risk of being infected.
For starters, you can practice basic techniques that have been shown to reduce the transmission of all kinds of infections, including RSV:
Wash hands: Wash your hands frequently with soap and water – especially before you touch the baby. Make sure siblings and visitors wash their hands as well.
Avoid exposure to illness: If you have a cold or fever, avoid kissing your baby, and limit your infant’s exposure to people who have a contagious illness.
Keep surfaces clean: Because the RSV virus can live on surfaces for hours, make sure countertops and bathroom surfaces are cleaned regularly with cleanser – especially when someone in the family has a cold. Make sure to clean toys regularly, and always after a child with a cold has played with them.
Avoid crowds: Try to avoid crowded places such as shopping centers, daycares, and large family gatherings where your baby will come into contact with lots of people – and all their germs.
Avoid second-hand smoke: Minimize your baby’s exposure to second-hand smoke. Exposure to tobacco smoke can increase your baby’s risk of contracting RSV and increase the risk of more severe symptoms if they do contract the virus. Don’t smoke around your baby and don’t let others do so.
Preventative medicine
If your infant is at high risk for serious RSV complications, there is a medication, called palivizumab (Synagis®), which can help to reduce the risk of contracting the virus. Unlike a vaccine, which stimulates the immune system to create its own antibodies, palivizumab provides the antibodies required to fend off infection. Palivizumab is a preventative medication, not a cure, which means it only works to ward off the virus before your baby is infected.
Palivizumab is administered as an injection into your baby’s thigh muscle. It’s given on a monthly basis for five months, starting at the beginning of the RSV season in the fall. The injections must be given every year so long as your child is still considered to be at risk.
Palivizumab has also been shown to decrease the frequency and length of hospital stays if your baby does become infected with RSV.
Side effects can include temporary discomfort at the injection site, upper respiratory infections, ear infections, runny nose, and rash. Other side effects may also occur, so check with your doctor or pharmacist.

Photo Gallery - 2nd month

Photo Gallery - 2nd Month