Monday, October 19, 2015

The Cough (Update)

Sorry that it's been a few weeks, but I wanted to make sure all tests were in before updating.

Last time we discussed this, Eli 14.2 was--once again--enduring the cough from hell. This time, though, instead of just seeking short-term treatment, we decided to go longer term and try to figure out why this kept happening.

Gloria made two appointments--one with a high-level specialist, and one with a more general level allergist. The specialist appointment isn't until next month, but we saw the allergist fairly quickly.

One thing he told us right off: don't expect an "ah ha" moment (I was certainly hoping for one). He said that what was happening was, most likely, a combination of things. He did say, though, that it certainly wasn't normal for Eli to develop this cough most of the times he had a respiratory infection, and it was especially unusual for someone who was so healthy otherwise.

Broadly, he wanted to answer three questions:
1. Does Eli have asthma?
2. Does he have any immune-related diseases?
3. Does he have allergies?

They conducted multiple breathing tests during the first office visit--while Eli was still sick--and he still passed all of them easily. So while the doctor said that exercise induced asthma was still a possibility, he didn't think Eli had any significant asthma issues.

The next day, he went for a blood draw, for the immune system testing, and that all came back negative as well.

I was almost certain that he had significant allergies, and he went for testing about a week later, but the results were a big surprise: no cat allergy, not even any allergies significant enough to need allergy shots.

That was a big surprise. I have lots and lots of allergies--if it's in the air, I'm basically allergic.

So Eli's treatment, up to this point (as recommended by his G.P.) had been:
--Flonase
--Albuterol inhaler (when he was sick)
--Flovent inhaler (also when he was sick)

With those results, the doctor recommended the following modifications:
--discontinue the Albuterol inhaler
--change the Flovent inhaler to Dulera and use daily
--take 5mg of Singulair daily
--continue with Flonase

The inhaler takes less than 20 seconds, twice a day, so it's basically zero inconvenience.

We're still going to see the specialist next month, but we've learned quite a bit from this first specialist. Most importantly, he helped us understand that finding out what's causing something like this is a process, and not a dramatic one. Also, that your general practitioner is probably not the best person to be diagnosing a long-term issue like this. Specialists see variations of this problem all the time, and are more likely to be successful in figuring out the cause (or managing the condition).

Eli, of course, is strong enough to run through a wall again, but that doesn't mean anything. When he gets some kind of respiratory infection, we'll see if this new regimen helps stop the cough from developing.

If not, that's still a clue, at least.

I'd like to specifically thank three people (among quite a few of you guys--thanks very, very much) for their submission: Brian Witte, Megan H., and Dan F.

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