Frustrated/Scared/Confused

ReneeP

New member
My daughters with CF are 11 and 7 and this past Tuesday was the worst clinic visit we've ever had. Both girls had a huge drop in PFTs. Comparatively speaking, they are still good, but they are way down from their normal #'s. Both girl's FEV1's were 20% lower than 3 months ago. And the other #'s that I don't really understand were even worse. The dr was telling us all these #'s but I was so upset by that point it just went right over my head. I do remember her saying that the "small airways" were down on both girls from the 90%'s to the 50%'s. I don't even really know what that means but it scared the sh*t out of me. Both of the girls have been so healthy (lung wise anyway) and have never had a decline in PFTs before and to go down 20% at once is unbelievable to me. It's really freaking me out.

On top of that, the dr is sending Kaitlyn to an endocrinologist for possible growth hormone injections because she has fallen off the height chart and referring Kacie to another ENT because the first 4 sinus surgeries (in the last 8 months) were unsuccessful and she thinks she needs another one. Kacie is so blocked right now with polyps that we can't even do nasal washes. The water that normally would go in one side of her nose and come out the other, doesn't come out the other. It gushes out of her throat because it can't get through the nose.

What would cause PFTs to decline so quickly? Is it possible they just didn't feel well and they will be normal again next time? Does that happen? The dr added Pulmozyme for Kacie and Hypertonic Saline for Kaitlyn. She put both of them on Clindamycin and Kacie on Prednisone for the nasal problems. I'm hoping for some improvements. We are also having to do extra treatments for a while which requires the girls to do them at school. That is very hard for my older daughter who hides her problems from everyone. I just learned tonight that she has been doing the treatments in the bathroom of the nurse's office so no one will see her. That just ripped my heart out. But I don't know what to do. I can talk to her till I'm blue in the face about how she shouldn't be ashamed but she just doesn't get it. I respect her privacy and don't make her tell anyone anything but it hurts to know she is so ashamed.

We've been so lucky in that the girls have been healthy so far. I think we take it for granted it will alway be that way. When something happens that forces us to face reality, it's extremely difficult. It's almost like dealing with the diagnosis all over again. It's a wake up call that this is a real disease. This isn't just "take a couple of treatments a day and all will be fine". I cried all night Tuesday and have pretty much been a basketcase since them. I'm holding my breath until they call me and tell me what the girls cultured. I'm basically just wondering how common it is to have such a drop in PFTs from one visit to the next...especially since it was both girls, not just one of them. What would cause that? I have driven myself crazy trying to figure out what has changed since the last visit... we bought a house and moved, literally 2 doors down from where we were living. No change in schools or anything else. The new house has a pool so that is different but I expected that to be a help, not a problem. I keep thinking what if there was something in the water that was really bad... I'm basically just driving myself insane. Anything to calm my nerves would be appreciated.

Thanks!
 

Allie

New member
REneee, I have no idea what to tell you...just <img src="i/expressions/heart.gif" border="0"> *HUG*
 

3timesthefun

New member
Renee,

I am so sorry to hear about your bad clinic visit. Hopefully the girls were just a little tired and didn't put as much effort into their PFT"S. Hopefully their cultures will come back OK. I will keep my fingers crossed for you.

I hate to go to the clinic. I hold my breath every time we go. It seems like they always seem to find something new to add on to one of the kids. I definately feel for you. Good luck, and let us know how the cultures come back.
 

Jane

Digital opinion leader
Renee,

How scary for you to have all of these new things going on. I find that once you get settled into a new routine of medicines and therapies and think you can handle it, EVERYTHING changes again. Big meltdown! You and your girls will handle it this time too. Go slow and let things sink in a little at a time. Do you keep a notebook for clinic visits? It helps me keep things sorted out. Its hard to have two kids with two different treatment plans. And you have three others! wow

I've just gone through a huge crisis period with my boys too. One day at a time, but it is like a rollercoaster. I'm quoting Sean Davis who said
<i><u><b>"I wish I wasn't tall enough for this ride!".</b></u></i>

Please PM me if you want to talk. Maybe we can cry together.

Hang in there.

jane
 

JazzysMom

New member
How long ago did you move 2 doors down? It could very well be something in the house. Mold, dust, mildew etc. Something that you might not actually be able to see or smell even. The fact that both of them are having problems leads me towards environmental influence. It could be the pool also. Tho its great exercise.....do you honestly know its history? Have there ever been problems etc. Even with the best maintenance & chemical watch it could be a problem around it etc. Obviously I am just guessing at this stuff & I dont want you freaking out more, but they are all possibilities. Depending on what info you get back it might be something to check out! Good Luck....Breath in then out...Take one day at a time & please keep us updated!
 

ReneeP

New member
Thanks so much for all your kind words. It does help just to know I'm not alone and that there are people who understand. Sometimes I feel like I'm living in a different world than everyone around me. Kacie went to her friends house this morning to play and when the friend's mom came to pick her up she asked me "what's Kacie doing her classification project on?"... I gave her a confused look and she said "you know they are due Monday, right?" I'm thinking to myself that I have no clue what she is talking about... I just smiled and said, You know, I have had a really bad week and to be honest I don't know what is even going on at school right now. It makes me feel like a horrible mother. Come to find out, 4 of the kids have science projects that are due on Monday and I had no idea. Oh, well... I guess my priorities are just a little different at this moment. The girls both have straight A's in school so I'm trying to tell myself I can't be doing that bad of a job.

I have definately considered the issue of the new house and the pool. I try to be very cautious with mold, dust, etc issues and searched the house for signs of problems before we moved in. We had an inspector do that as well, though he didn't actually do mold testing, just looked for signs that there had been a problem. As for the pool, no, I do not know the history. I am very concerned though. We had the water tested by a pool company and they said it's fine. We've been staying on top of the chlorine levels and stuff trying to make sure the water is okay. Since the girls are on antibiotics and on the new meds, what I think I will do is not make any other changes at this moment. We are going back to clinic next month to see how they are doing. If I don't see a change for the better then I am going to make another change (such as keeping them out of the pool for a while) and see if that makes a difference. I'm trying to do it by process of elimination so that I will know exactly what made the difference and can determine what the trigger was.

As far as the Pulmozyme goes, Kaitlyn has been on it for years. Kacie was never put on it. So, the dr added it for Kacie this time. She also added the Hypertonic Saline for Kaitlyn but not for Kacie because she didn't want to add too much at once. We are going to let her adjust to the Pulmozyme first and then maybe add the Hypertonic Saline a little later. She is also on Mucomyst. The dr did Xrays on both girls and bloodwork but really didn't see anything that would tell her what was causing the problem. I think the antibiotics were just a precautionary thing since we know there is something going on but just can't figure out what it is.

Thanks again for your thoughts and kind words. I guess sometimes we just need reassurance that someone, somewhere in the world knows what we are going through.
 

ReneeP

New member
Oh, one more thing... someone asked me about allergies. Kacie definately has allergies and I give her 2 allergy shots a week at home. Kaitlyn doesn't seem to have the allergy problems. But I talked to the nurse yesterday and one of the bloodtests they did check their allergy levels and they both came back normal so that doesn't seem to be the problem right now.
 

anonymous

New member
Hi Renee.

Sorry 2 sound corny, but you sound like a fantastic mum. Don't beat yourself up about this, just one of those things that's all. I always find when I get any bad news about my daughter (2 with CF) it knocks me sideways. A couple of days later, I get my head round it and I come back stronger. Don't worry 2 much, I know it's bloody hard. I'm sure you're doing all that you can. And as for saying it scared the sh*t out of you, CF scares the sh*t out of me every day, but don't let it beat you, just fight back.

Sorry 2 waffle, hope I've said the right thing. I dunno?!

Charlotte<img src="i/expressions/face-icon-small-smile.gif" border="0">
 

anonymous

New member
PS and as Jane said - 5 kids - wow! You're amazing.

Take care.

Charlotte<img src="i/expressions/face-icon-small-cool.gif" border="0">
 

anonymous

New member
The only thing I could think to add to what others have already mentioned is to ask the doctor about the possibility of aspergillus (mold in their lungs)-- I think they check IgE levels. And to check for Pseudomonas (something I'm sure they will know anyway when you get the results of the cultures) But I do believe either one of those two things could cause the sudden drop in PFT's.

Also are they doing any long acting anti-inflammatory medicine like Flovent or Advair? These inhaled steroid drugs would help with the smaller airway obstruction -- we have seen quite an increase in PFT's in my daughter since she started on Flovent -- also shortly after the Flovent she started using The Vest -- her PFT's a couple of weeks ago are the best we have ever seen! Increases across the board.
 

Alyssa

New member
Whoops - didn't know I wasn't signed in -- that was me that posted about aspergillus, Flovent and the vest
 
L

luke

Guest
Renee,

Many of us have had drastic drops with infections and they come back up after treatment. Was this a "CF clinic" visit or regular doc? I am surprised they didn't go ahead and admit your kids and start treatment. Do they feel sick? It is just to coincindental that both had such dramatic changes at once. Either they both have a bug or the test was off for some reason.

As for the small airways decreasing, normal for fef 25-75 (which is what I look at for small airways) is 60% anyway. I haven't ever seen anyone with a FEF 25-75 that high. I wonder what value your doctor is looking at? Maybe ask to see the PFT's next time and write down the actual numbers and predicteds.


Luke
 
M

melleemac

Guest
Im so sorry to hear what you are going through right now. It all sounds so familiar. My 11 year old twin boys have never had high pfts, normally aound the 50 mark. A couple of years ago they both dropped drastically, Ive never been so scared in my life! They were both given blood tests and broncs, and were finally diagnosed with asprergillious, and also an allergy to it. They ended up being in hospital for 2 months being treated for it. They now taking itraconazole for it although they still get admitted when it flares up bad.
Both of the boys were put on pulmozyme last year and it did improve their pfts a little. They also both have trouble with polyps, but never had surgery. They had been on several medications for them but in the end were put on prednisone to help shrink them. Currently they are using Rhinocourt.
Like Charolette, I too freak out every time the boys are unwell, or when they are diagnosed with something else. I end up making my self sick to my stomach every time they have a a clinic appointment comming up. But we get through it as Im sure you will. Stay stong and take care!
Mel
 

Jane

Digital opinion leader
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>melleemac</b></i>

I end up making my self sick to my stomach every time they have a a clinic appointment

Mel</end quote></div>

You too?

I think we need a special place here just for moms (and dads). We learn so much from those here with CF, but we have different needs as caregiver/parents. Its nice to know that others are feeling the same way. Thanks Mel
 

Alyssa

New member
Luke -- are you saying that FEF 25-75 normal is 60? I could be wrong but, I'm pretty sure I was just told that 85 is normal and anything above that was considered above average/normal. So 90 would be possible -- also I checked some printed out PFT's here from my kids and they vary from 72 to 96. Granted my kids are very mild and the 96 was on my daughter post albuteral and is her best ever PFT since she added The Vest and Flovent to her routine. So these may not be numbers that people are used to seeing, but I do think the 90's that Renee originally posted is possible and/or correct.
 

JazzysMom

New member
It is unusual for us adults to have FEF that high. My most recent pfts showed a 65% increase in my FEF (but is still low in %, but that always happens while on IVs. As a child I couldnt tell you what my FEF was, but I would assume much better & then with time it was some of the first to go to pot!
 
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