question about coughing and IVs

[Mommafirst]

I don't want to call the on-call doctor for this yet, so I thought I'd ask you experts.

Alyssa is on IV tobra and timentin for her CF exacerbation. She has never had a baseline CF cough... if she coughs, she's sick. She started IV's Tuesday night in the hospital. At the time she had lots of "crackles" in her lower left lobe. Dr. said we could go home on IVs when a) her cough shows improvement and b) when the crackles start to improve as well. So Yesterday (Friday) they let us come home. The cough being better was based on MY assessment, as the doctors aren't really around long enough to assess that. But he said the crackling in her lung was showing improvement.

So now we are home on IVs and I'm noticing her cough is getting WORSE. More frequent is what I mean. The depth and junkiness of it is the same. But today she is coughing every 10 minutes, whereas yesterday it was only 2-3 times an hour.

What could this mean? Are the IV drugs not working? Her culture came back clean, but that's because they only did a throat culture and her problem is clearly pretty deep in there. She tends to culture staph only, but I'm wondering if maybe they are missing something else? PA maybe??

I soooo don't want to be back in the hospital, but this whole experience has made me realize how easy it may be to miss that my little one is struggling with an exacerbation.

Any thoughts would be appreciated.

 

[Mommafirst]

I don't want to call the on-call doctor for this yet, so I thought I'd ask you experts.

Alyssa is on IV tobra and timentin for her CF exacerbation. She has never had a baseline CF cough... if she coughs, she's sick. She started IV's Tuesday night in the hospital. At the time she had lots of "crackles" in her lower left lobe. Dr. said we could go home on IVs when a) her cough shows improvement and b) when the crackles start to improve as well. So Yesterday (Friday) they let us come home. The cough being better was based on MY assessment, as the doctors aren't really around long enough to assess that. But he said the crackling in her lung was showing improvement.

So now we are home on IVs and I'm noticing her cough is getting WORSE. More frequent is what I mean. The depth and junkiness of it is the same. But today she is coughing every 10 minutes, whereas yesterday it was only 2-3 times an hour.

What could this mean? Are the IV drugs not working? Her culture came back clean, but that's because they only did a throat culture and her problem is clearly pretty deep in there. She tends to culture staph only, but I'm wondering if maybe they are missing something else? PA maybe??

I soooo don't want to be back in the hospital, but this whole experience has made me realize how easy it may be to miss that my little one is struggling with an exacerbation.

Any thoughts would be appreciated.

 

[Mommafirst]

I don't want to call the on-call doctor for this yet, so I thought I'd ask you experts.

Alyssa is on IV tobra and timentin for her CF exacerbation. She has never had a baseline CF cough... if she coughs, she's sick. She started IV's Tuesday night in the hospital. At the time she had lots of "crackles" in her lower left lobe. Dr. said we could go home on IVs when a) her cough shows improvement and b) when the crackles start to improve as well. So Yesterday (Friday) they let us come home. The cough being better was based on MY assessment, as the doctors aren't really around long enough to assess that. But he said the crackling in her lung was showing improvement.

So now we are home on IVs and I'm noticing her cough is getting WORSE. More frequent is what I mean. The depth and junkiness of it is the same. But today she is coughing every 10 minutes, whereas yesterday it was only 2-3 times an hour.

What could this mean? Are the IV drugs not working? Her culture came back clean, but that's because they only did a throat culture and her problem is clearly pretty deep in there. She tends to culture staph only, but I'm wondering if maybe they are missing something else? PA maybe??

I soooo don't want to be back in the hospital, but this whole experience has made me realize how easy it may be to miss that my little one is struggling with an exacerbation.

Any thoughts would be appreciated.

 

[Mommafirst]

I don't want to call the on-call doctor for this yet, so I thought I'd ask you experts.

Alyssa is on IV tobra and timentin for her CF exacerbation. She has never had a baseline CF cough... if she coughs, she's sick. She started IV's Tuesday night in the hospital. At the time she had lots of "crackles" in her lower left lobe. Dr. said we could go home on IVs when a) her cough shows improvement and b) when the crackles start to improve as well. So Yesterday (Friday) they let us come home. The cough being better was based on MY assessment, as the doctors aren't really around long enough to assess that. But he said the crackling in her lung was showing improvement.

So now we are home on IVs and I'm noticing her cough is getting WORSE. More frequent is what I mean. The depth and junkiness of it is the same. But today she is coughing every 10 minutes, whereas yesterday it was only 2-3 times an hour.

What could this mean? Are the IV drugs not working? Her culture came back clean, but that's because they only did a throat culture and her problem is clearly pretty deep in there. She tends to culture staph only, but I'm wondering if maybe they are missing something else? PA maybe??

I soooo don't want to be back in the hospital, but this whole experience has made me realize how easy it may be to miss that my little one is struggling with an exacerbation.

Any thoughts would be appreciated.

 

[Mommafirst]

I don't want to call the on-call doctor for this yet, so I thought I'd ask you experts.
<br />
<br />Alyssa is on IV tobra and timentin for her CF exacerbation. She has never had a baseline CF cough... if she coughs, she's sick. She started IV's Tuesday night in the hospital. At the time she had lots of "crackles" in her lower left lobe. Dr. said we could go home on IVs when a) her cough shows improvement and b) when the crackles start to improve as well. So Yesterday (Friday) they let us come home. The cough being better was based on MY assessment, as the doctors aren't really around long enough to assess that. But he said the crackling in her lung was showing improvement.
<br />
<br />So now we are home on IVs and I'm noticing her cough is getting WORSE. More frequent is what I mean. The depth and junkiness of it is the same. But today she is coughing every 10 minutes, whereas yesterday it was only 2-3 times an hour.
<br />
<br />What could this mean? Are the IV drugs not working? Her culture came back clean, but that's because they only did a throat culture and her problem is clearly pretty deep in there. She tends to culture staph only, but I'm wondering if maybe they are missing something else? PA maybe??
<br />
<br />I soooo don't want to be back in the hospital, but this whole experience has made me realize how easy it may be to miss that my little one is struggling with an exacerbation.
<br />
<br />Any thoughts would be appreciated.

 

[grassisgreener]

My understanding is that "crackles" = pneumonia, is that what they said? My daughter (5wcf) had the very beginning of pneumonia in September and her cough did go through phases of sounding better then worse then better again before it finally went away. It also changed from productive to dry then productive again. It took about 2 weeks although some of her cough was due to post-nasal drainage, so it wasn't all "lung coughing". Can you listen to her with a stethoscope? For my daughter, the post-nasal coughing can sound horrible but when you listen with a stethoscope her lungs usually sound clear.

I hope she is over it soon!

 

[grassisgreener]

My understanding is that "crackles" = pneumonia, is that what they said? My daughter (5wcf) had the very beginning of pneumonia in September and her cough did go through phases of sounding better then worse then better again before it finally went away. It also changed from productive to dry then productive again. It took about 2 weeks although some of her cough was due to post-nasal drainage, so it wasn't all "lung coughing". Can you listen to her with a stethoscope? For my daughter, the post-nasal coughing can sound horrible but when you listen with a stethoscope her lungs usually sound clear.

I hope she is over it soon!

 

[grassisgreener]

My understanding is that "crackles" = pneumonia, is that what they said? My daughter (5wcf) had the very beginning of pneumonia in September and her cough did go through phases of sounding better then worse then better again before it finally went away. It also changed from productive to dry then productive again. It took about 2 weeks although some of her cough was due to post-nasal drainage, so it wasn't all "lung coughing". Can you listen to her with a stethoscope? For my daughter, the post-nasal coughing can sound horrible but when you listen with a stethoscope her lungs usually sound clear.

I hope she is over it soon!

 

[grassisgreener]

My understanding is that "crackles" = pneumonia, is that what they said? My daughter (5wcf) had the very beginning of pneumonia in September and her cough did go through phases of sounding better then worse then better again before it finally went away. It also changed from productive to dry then productive again. It took about 2 weeks although some of her cough was due to post-nasal drainage, so it wasn't all "lung coughing". Can you listen to her with a stethoscope? For my daughter, the post-nasal coughing can sound horrible but when you listen with a stethoscope her lungs usually sound clear.

I hope she is over it soon!

 

[grassisgreener]

My understanding is that "crackles" = pneumonia, is that what they said? My daughter (5wcf) had the very beginning of pneumonia in September and her cough did go through phases of sounding better then worse then better again before it finally went away. It also changed from productive to dry then productive again. It took about 2 weeks although some of her cough was due to post-nasal drainage, so it wasn't all "lung coughing". Can you listen to her with a stethoscope? For my daughter, the post-nasal coughing can sound horrible but when you listen with a stethoscope her lungs usually sound clear.
<br />
<br />I hope she is over it soon!

 

[Nightwriter]

Hi Heather,

I'll take a shot at offering some thoughts. There are different kinds of crackles (also called rales. They can be from infection or inflammation. It does not necessarily mean pneumonia. In fact, some CFer's have crackles all the time. So you would have to ask your doctor for more information on what kind of rales he/she hears.

I am not really sure why your daughter is on IV meds. Did they just do a throat culture? But not a sputum culture? Do they think she has a staph infection although there is no recent culture? I'm guessing they must think it's more then the garden variety of bronchitis or pneumonia that they usually treat with common antibiotics. Staph infections are usually effectively treated by oral drugs like Z-pak or Bactrim. And at times, even with antibiotics it usually returns at some point anyway. And most of the time staph does nothing, so they don't even treat it, unless it's causing symptoms.

So what do the doctors think is causing your daughter's symptoms?

Usually once someone is on IV meds, their coughs don't become significantly worse. Sure it can vary day-to-day as the antibiotics work on the infection, but what you descibed sounded like a very big increase in her cough. Does she have fever, chills, aches(how do you tell aches on a 2 year old anyway) or any other symptoms? What did her bloodwork show? Was there infection? Did they take an X-Ray? Did it show anything? Any pneumonia?

Your daughter is on Tobra which is the powerhouse drug for Pseudomonas in addition to Timentin which also works on Pseudomonas. So if she had PA (which there is no evidence that she has this) between these 2 drugs and no history of prior Pseudomonas, she wouldn't be resistant yet.
So the cough increase can not be from Pseudomonas. And both these drugs work on Staph.

If the cough doesn't subside, it is because she has something that these antibiotics are having no effect on: perhaps a virus, inflammation, fungal infection, sinus inflammation or infection with mucus dripping down.

The two drugs your daughter is on cover so many bugs. If she had what they called community-acquired pneumonia(which is the garden variety of pneumonia which I have had) it is treated with drugs like Z-Pak. But they'd see a pneumonia on her X-Ray and her white count would be way up.

So I guess I'm asking about blood tests, X-Rays, and sputum cultures for more clues. And by the way, I would use Tobra very judiciously if she does not have Pseudomonas. It is the most widely used drug for PA and when the PA becomes resistant as it always does, it removes a very powerful drug our your arsenol of medications.

I hope you figure out what this is and your daughter is feeling well soon.

 

[Nightwriter]

Hi Heather,

I'll take a shot at offering some thoughts. There are different kinds of crackles (also called rales. They can be from infection or inflammation. It does not necessarily mean pneumonia. In fact, some CFer's have crackles all the time. So you would have to ask your doctor for more information on what kind of rales he/she hears.

I am not really sure why your daughter is on IV meds. Did they just do a throat culture? But not a sputum culture? Do they think she has a staph infection although there is no recent culture? I'm guessing they must think it's more then the garden variety of bronchitis or pneumonia that they usually treat with common antibiotics. Staph infections are usually effectively treated by oral drugs like Z-pak or Bactrim. And at times, even with antibiotics it usually returns at some point anyway. And most of the time staph does nothing, so they don't even treat it, unless it's causing symptoms.

So what do the doctors think is causing your daughter's symptoms?

Usually once someone is on IV meds, their coughs don't become significantly worse. Sure it can vary day-to-day as the antibiotics work on the infection, but what you descibed sounded like a very big increase in her cough. Does she have fever, chills, aches(how do you tell aches on a 2 year old anyway) or any other symptoms? What did her bloodwork show? Was there infection? Did they take an X-Ray? Did it show anything? Any pneumonia?

Your daughter is on Tobra which is the powerhouse drug for Pseudomonas in addition to Timentin which also works on Pseudomonas. So if she had PA (which there is no evidence that she has this) between these 2 drugs and no history of prior Pseudomonas, she wouldn't be resistant yet.
So the cough increase can not be from Pseudomonas. And both these drugs work on Staph.

If the cough doesn't subside, it is because she has something that these antibiotics are having no effect on: perhaps a virus, inflammation, fungal infection, sinus inflammation or infection with mucus dripping down.

The two drugs your daughter is on cover so many bugs. If she had what they called community-acquired pneumonia(which is the garden variety of pneumonia which I have had) it is treated with drugs like Z-Pak. But they'd see a pneumonia on her X-Ray and her white count would be way up.

So I guess I'm asking about blood tests, X-Rays, and sputum cultures for more clues. And by the way, I would use Tobra very judiciously if she does not have Pseudomonas. It is the most widely used drug for PA and when the PA becomes resistant as it always does, it removes a very powerful drug our your arsenol of medications.

I hope you figure out what this is and your daughter is feeling well soon.

 

[Nightwriter]

Hi Heather,

I'll take a shot at offering some thoughts. There are different kinds of crackles (also called rales. They can be from infection or inflammation. It does not necessarily mean pneumonia. In fact, some CFer's have crackles all the time. So you would have to ask your doctor for more information on what kind of rales he/she hears.

I am not really sure why your daughter is on IV meds. Did they just do a throat culture? But not a sputum culture? Do they think she has a staph infection although there is no recent culture? I'm guessing they must think it's more then the garden variety of bronchitis or pneumonia that they usually treat with common antibiotics. Staph infections are usually effectively treated by oral drugs like Z-pak or Bactrim. And at times, even with antibiotics it usually returns at some point anyway. And most of the time staph does nothing, so they don't even treat it, unless it's causing symptoms.

So what do the doctors think is causing your daughter's symptoms?

Usually once someone is on IV meds, their coughs don't become significantly worse. Sure it can vary day-to-day as the antibiotics work on the infection, but what you descibed sounded like a very big increase in her cough. Does she have fever, chills, aches(how do you tell aches on a 2 year old anyway) or any other symptoms? What did her bloodwork show? Was there infection? Did they take an X-Ray? Did it show anything? Any pneumonia?

Your daughter is on Tobra which is the powerhouse drug for Pseudomonas in addition to Timentin which also works on Pseudomonas. So if she had PA (which there is no evidence that she has this) between these 2 drugs and no history of prior Pseudomonas, she wouldn't be resistant yet.
So the cough increase can not be from Pseudomonas. And both these drugs work on Staph.

If the cough doesn't subside, it is because she has something that these antibiotics are having no effect on: perhaps a virus, inflammation, fungal infection, sinus inflammation or infection with mucus dripping down.

The two drugs your daughter is on cover so many bugs. If she had what they called community-acquired pneumonia(which is the garden variety of pneumonia which I have had) it is treated with drugs like Z-Pak. But they'd see a pneumonia on her X-Ray and her white count would be way up.

So I guess I'm asking about blood tests, X-Rays, and sputum cultures for more clues. And by the way, I would use Tobra very judiciously if she does not have Pseudomonas. It is the most widely used drug for PA and when the PA becomes resistant as it always does, it removes a very powerful drug our your arsenol of medications.

I hope you figure out what this is and your daughter is feeling well soon.

 

[Nightwriter]

Hi Heather,

I'll take a shot at offering some thoughts. There are different kinds of crackles (also called rales. They can be from infection or inflammation. It does not necessarily mean pneumonia. In fact, some CFer's have crackles all the time. So you would have to ask your doctor for more information on what kind of rales he/she hears.

I am not really sure why your daughter is on IV meds. Did they just do a throat culture? But not a sputum culture? Do they think she has a staph infection although there is no recent culture? I'm guessing they must think it's more then the garden variety of bronchitis or pneumonia that they usually treat with common antibiotics. Staph infections are usually effectively treated by oral drugs like Z-pak or Bactrim. And at times, even with antibiotics it usually returns at some point anyway. And most of the time staph does nothing, so they don't even treat it, unless it's causing symptoms.

So what do the doctors think is causing your daughter's symptoms?

Usually once someone is on IV meds, their coughs don't become significantly worse. Sure it can vary day-to-day as the antibiotics work on the infection, but what you descibed sounded like a very big increase in her cough. Does she have fever, chills, aches(how do you tell aches on a 2 year old anyway) or any other symptoms? What did her bloodwork show? Was there infection? Did they take an X-Ray? Did it show anything? Any pneumonia?

Your daughter is on Tobra which is the powerhouse drug for Pseudomonas in addition to Timentin which also works on Pseudomonas. So if she had PA (which there is no evidence that she has this) between these 2 drugs and no history of prior Pseudomonas, she wouldn't be resistant yet.
So the cough increase can not be from Pseudomonas. And both these drugs work on Staph.

If the cough doesn't subside, it is because she has something that these antibiotics are having no effect on: perhaps a virus, inflammation, fungal infection, sinus inflammation or infection with mucus dripping down.

The two drugs your daughter is on cover so many bugs. If she had what they called community-acquired pneumonia(which is the garden variety of pneumonia which I have had) it is treated with drugs like Z-Pak. But they'd see a pneumonia on her X-Ray and her white count would be way up.

So I guess I'm asking about blood tests, X-Rays, and sputum cultures for more clues. And by the way, I would use Tobra very judiciously if she does not have Pseudomonas. It is the most widely used drug for PA and when the PA becomes resistant as it always does, it removes a very powerful drug our your arsenol of medications.

I hope you figure out what this is and your daughter is feeling well soon.

 

[Nightwriter]

Hi Heather,
<br />
<br />I'll take a shot at offering some thoughts. There are different kinds of crackles (also called rales. They can be from infection or inflammation. It does not necessarily mean pneumonia. In fact, some CFer's have crackles all the time. So you would have to ask your doctor for more information on what kind of rales he/she hears.
<br />
<br />I am not really sure why your daughter is on IV meds. Did they just do a throat culture? But not a sputum culture? Do they think she has a staph infection although there is no recent culture? I'm guessing they must think it's more then the garden variety of bronchitis or pneumonia that they usually treat with common antibiotics. Staph infections are usually effectively treated by oral drugs like Z-pak or Bactrim. And at times, even with antibiotics it usually returns at some point anyway. And most of the time staph does nothing, so they don't even treat it, unless it's causing symptoms.
<br />
<br />So what do the doctors think is causing your daughter's symptoms?
<br />
<br />Usually once someone is on IV meds, their coughs don't become significantly worse. Sure it can vary day-to-day as the antibiotics work on the infection, but what you descibed sounded like a very big increase in her cough. Does she have fever, chills, aches(how do you tell aches on a 2 year old anyway) or any other symptoms? What did her bloodwork show? Was there infection? Did they take an X-Ray? Did it show anything? Any pneumonia?
<br />
<br />Your daughter is on Tobra which is the powerhouse drug for Pseudomonas in addition to Timentin which also works on Pseudomonas. So if she had PA (which there is no evidence that she has this) between these 2 drugs and no history of prior Pseudomonas, she wouldn't be resistant yet.
<br />So the cough increase can not be from Pseudomonas. And both these drugs work on Staph.
<br />
<br />If the cough doesn't subside, it is because she has something that these antibiotics are having no effect on: perhaps a virus, inflammation, fungal infection, sinus inflammation or infection with mucus dripping down.
<br />
<br />The two drugs your daughter is on cover so many bugs. If she had what they called community-acquired pneumonia(which is the garden variety of pneumonia which I have had) it is treated with drugs like Z-Pak. But they'd see a pneumonia on her X-Ray and her white count would be way up.
<br />
<br />So I guess I'm asking about blood tests, X-Rays, and sputum cultures for more clues. And by the way, I would use Tobra very judiciously if she does not have Pseudomonas. It is the most widely used drug for PA and when the PA becomes resistant as it always does, it removes a very powerful drug our your arsenol of medications.
<br />
<br />I hope you figure out what this is and your daughter is feeling well soon.

 

[Mommafirst]

Thanks for your input. She has only had throat cultures because she can't cough up sputum yet. She chronically cultures staph. She was on augmentin and bactrim before they decided that nothing was working, mainly because after those orals she started retracting.

Her X-ray showed no pneumonia, but a CBC showeed her white blood cell count was very high with young something or other. I wasn't sure what this meant but it was explained that this probably started out as a virus and then whatever is in her lungs multiplied and it turned into a bronchial bacterial infection.

Her crackle sounds are very low in the lower left lobe, so I guess they are hitting it with the big guns because the only way to figure what is in there is to do a bronch and they don't really want to put her under with this cough.

Her cough isn't as frequent today. If it increases tomorrow I'll call the CF center. I hear what you are saying about overusing these very powerful drugs and it worries me to no end.

 

[Mommafirst]

Thanks for your input. She has only had throat cultures because she can't cough up sputum yet. She chronically cultures staph. She was on augmentin and bactrim before they decided that nothing was working, mainly because after those orals she started retracting.

Her X-ray showed no pneumonia, but a CBC showeed her white blood cell count was very high with young something or other. I wasn't sure what this meant but it was explained that this probably started out as a virus and then whatever is in her lungs multiplied and it turned into a bronchial bacterial infection.

Her crackle sounds are very low in the lower left lobe, so I guess they are hitting it with the big guns because the only way to figure what is in there is to do a bronch and they don't really want to put her under with this cough.

Her cough isn't as frequent today. If it increases tomorrow I'll call the CF center. I hear what you are saying about overusing these very powerful drugs and it worries me to no end.

 

[Mommafirst]

Thanks for your input. She has only had throat cultures because she can't cough up sputum yet. She chronically cultures staph. She was on augmentin and bactrim before they decided that nothing was working, mainly because after those orals she started retracting.

Her X-ray showed no pneumonia, but a CBC showeed her white blood cell count was very high with young something or other. I wasn't sure what this meant but it was explained that this probably started out as a virus and then whatever is in her lungs multiplied and it turned into a bronchial bacterial infection.

Her crackle sounds are very low in the lower left lobe, so I guess they are hitting it with the big guns because the only way to figure what is in there is to do a bronch and they don't really want to put her under with this cough.

Her cough isn't as frequent today. If it increases tomorrow I'll call the CF center. I hear what you are saying about overusing these very powerful drugs and it worries me to no end.

 

[Mommafirst]

Thanks for your input. She has only had throat cultures because she can't cough up sputum yet. She chronically cultures staph. She was on augmentin and bactrim before they decided that nothing was working, mainly because after those orals she started retracting.

Her X-ray showed no pneumonia, but a CBC showeed her white blood cell count was very high with young something or other. I wasn't sure what this meant but it was explained that this probably started out as a virus and then whatever is in her lungs multiplied and it turned into a bronchial bacterial infection.

Her crackle sounds are very low in the lower left lobe, so I guess they are hitting it with the big guns because the only way to figure what is in there is to do a bronch and they don't really want to put her under with this cough.

Her cough isn't as frequent today. If it increases tomorrow I'll call the CF center. I hear what you are saying about overusing these very powerful drugs and it worries me to no end.

 

[Mommafirst]

Thanks for your input. She has only had throat cultures because she can't cough up sputum yet. She chronically cultures staph. She was on augmentin and bactrim before they decided that nothing was working, mainly because after those orals she started retracting.
<br />
<br />Her X-ray showed no pneumonia, but a CBC showeed her white blood cell count was very high with young something or other. I wasn't sure what this meant but it was explained that this probably started out as a virus and then whatever is in her lungs multiplied and it turned into a bronchial bacterial infection.
<br />
<br />Her crackle sounds are very low in the lower left lobe, so I guess they are hitting it with the big guns because the only way to figure what is in there is to do a bronch and they don't really want to put her under with this cough.
<br />
<br />Her cough isn't as frequent today. If it increases tomorrow I'll call the CF center. I hear what you are saying about overusing these very powerful drugs and it worries me to no end.