Expert: Jennifer Steele RN - 4/22/2011

Question
Okay I don't want to ramble on here but I  also want to be very detailed. We took my 7 year old son to the doctor a few months ago. The reason we took him at the time was because he was getting a lot of colds and he would often have coughing fits (and throw up) during heavy activity. He's also a bit overweight. Well because of all these colds/congestion he was having he was having bad snoring at night (even a year after the removal of his tonsils and adnoids). The doctor told us it may be a mix of sleep apnea and asthma. He's never had any wheezing or shortness of breath, chest pains, etc. Just the coughing and that was mostly at night or during exercise. The doctor referred us to a pulmonlogist and a sleep specialist. But we had a sleep study run first. The sleep study was inconclusive because they thought the monitor kept slipping off during so they want to reschedule that.  Well the pulmonologist put him on FloVent (up to 4x daily) and Ventolin HFA (2x daily). He doesn't need the FloVent that often but we've been regularly giving him the Ventolin.
My concern is that since he's started taking these things he is having pretty severe aggression/irritability/sadness. One minute he's fine and the next he's either getting VERY angry (sometimes even physical) or he's crying his heart out. It is so upsetting and frustrating to see him this way.
My concern is that the medicine is not helping his overall well being if he's having these severe mood swings. And I am wondering if part of his was allergies. Some of the things we've eliminated (no one that visits is allowed to smoke in the house, the animals are outdoors and he doesn't sleep on feather pillows) seem to have helped a good deal. No one has ran any allergy tests on him. And another thing that has worried me is that his appetite has seemed to really increase (which isn't good since like I said he's already overweight and we were trying to work on that). Anyway, I don't know what to do from here. I don't know if I should just have more testing done or if I should go BACK to his pediatrician or what. If you have any advice please do help me. Thank you for your time

Answer
This is very irritating as a parent.  Have they done allergy testing? Did they try some antihistamines prior to steroid inhalers.  There are many over the counter antihistamines that would be a good place to start.  Steroid's can cause aggression and Flovent is designed to be taken twice a day.  If he is needing Ventolin frequently then there is underlying inflammation in his lungs that is causing some twitching and making him cough.  The doctors need to do more testing before they give him medications that are obviously causing him grief.  My suggestion would be to ask for pulmonary functions testing to be done asap as well as allergy testing and a referral to an allergist so that you can protect your son.  Please keep me posted.

Sincerely,

Jennifer Steele RN