edan~ You definitely went about it the right away~ trying it first in the office setting and monitoring everything to be sure all went well. 
Given your dd's reaction to bronchodilators (I have heard of others having the same response) it's certain that you are doing the right thing! Our clinic was quite careful when we first introduced albuterol for Emily. We started at a low dose and we had to monitor her pulse and watch for potential side effects, etc, and be sure she could tolerate it before any increases. I appreciate our clinic's attention to detail in things like this and it makes me feel confident in how they manage their care- yours is as well in taking into consideration HER needs and not some blanket standard for how to use the hts. Fortunately Emily does well with albuterol, with no noticeable side effects, even on large doses (her pulse and bp is always low end of normal when monitored inpatient, for example, when on large amounts of nebs.) I say fortunately, because she needs it- she has a major asthma component to her cf.
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<br />Lindsay~ I am sorry this isn't the first time you have had trouble at your clinic. :-( We depend on them SO much to take good care of our children and need that good communication and trust. I wish you the best in getting things resolved.
Given your dd's reaction to bronchodilators (I have heard of others having the same response) it's certain that you are doing the right thing! Our clinic was quite careful when we first introduced albuterol for Emily. We started at a low dose and we had to monitor her pulse and watch for potential side effects, etc, and be sure she could tolerate it before any increases. I appreciate our clinic's attention to detail in things like this and it makes me feel confident in how they manage their care- yours is as well in taking into consideration HER needs and not some blanket standard for how to use the hts. Fortunately Emily does well with albuterol, with no noticeable side effects, even on large doses (her pulse and bp is always low end of normal when monitored inpatient, for example, when on large amounts of nebs.) I say fortunately, because she needs it- she has a major asthma component to her cf. <br />
<br />Lindsay~ I am sorry this isn't the first time you have had trouble at your clinic. :-( We depend on them SO much to take good care of our children and need that good communication and trust. I wish you the best in getting things resolved.