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DD won't take a nasal spray, but it's our last resort before oral steroids, and I'm at wit's end.

post #1 of 12
Thread Starter 

This spring, DD developed severe environmental allergies that are worsening her asthma. We're on this crazy medical journey, crazy because it's so much medicine that's having so little effect.

 

She is 4 and on singlair, claritin, high doses of prednisode inhaler 2 x day, and she still needs her albuterol frequently (more than once a day). We've steam cleaned the carpets, bought allergen bedding covers, wash the sheets and blankets in hot water, run the stuffed animals through the dryer, and she's no better than she was a few months ago, before we even started all these meds. Actually, I'd venture to say she's worse, but maybe that's because the type of pollen has changed.

 

Now they've given her a nasal spray which they think will really help a lot because her nasal passages are very inflamed. Well, she's only 4, and the thought of spraying something in her nose is terrifying. The first time I understood she was scared, but she did it and said it was actually fine. The second time it took a lot of coaxing, more than the first, but she did eventually let me give it to her. And again, she said it wasn't that bad. The third time, after an hour of crying, pleading, coaxing, she consented to spraying a tiny bit - a very tiny bit - herself. And then she as done (as was I).

 

Now she's lying in bed coughing, sniffling, having nightmares (from the singulair), and I'm wondering what on earth to do next. Spray it in her nose while she's sleeping, find a new allergist, move to the North Pole? 

 

Has anyone had any success coaxing a reluctant young child to take a nasal spray? Anyone have NO benefit from singulair and OTC antihistamines? The doctors all talk like this is some miracle drug and it's not doing anything for my kid but make her moody and give her nightmares. She's been on it six weeks.

post #2 of 12

I wish I was replying to tell you how we managed to get through the environmentals, cough, etc., but I am not. I'm replying because I can almost completely sympathize. The only thing we haven't tried with DS1 is nasal spray. He's gotten antihistamines daily, we're currently relying on albuterol daily (which obviously is not a good sign!), we've tried singulair & qvar with no success. Last fall was the first time we tried singulair and it made him stutter, but made his cough go away. I didn't want to keep him on it, though, because the stuttering plain freaked me out. We decided to try it again a couple months ago because we were desperate to get the cough to stop, it had no effect on stuttering or coughing. We also tried qvar twice a day that had no impact. I don't do anithistamines daily because they also make no impact. If he actually is having a reaction to his environmentals with cough, itchy eyes, runny nose, etc. I'll give it to him and it does help. It's just so dang confusing. This week we're doing allergy testing (both patch & prick) and on Monday, he had a lot of environmentals show up. Nothing we didn't expect, but I guess now they are just 'real' allergens, instead of suspected...grasses, molds, dust, cat, dog, mice, birch...but we've done the allergy bed and pillow covers, clean regularly, wash sheets weekly, everything they recommended to us on Monday for environmental allergens we're already doing, with no obvious impact. Our allergist also had DS1 sinuses xrayed, to see if there was possibly a sinus infection underlying to cough, but his sinuses look perfect. Depending on what his patch test results show tomorrow, he may want to pursue reflux as the cause of the cough. At first I thought 'yeah, right,' but I've been doing some reading on it the last couple days and I think it may certainly be a possibility. His cough is really bad after he runs around (which I know could be athletically induced asthma, but it seems more intense than that) and he's been having 1-2 attacks nightly. He just starts coughing out of nowhere and can't stop, then it becomes real wheezy. We give him his albuterol and it's completely gone. I don't understand it and feel like there's always something we're missing with him, so just hopeful we figure it out this week with all these doctors visits....I'll update if we find anything out. I also was going to ask the allergist about postnasal drip causing the cough, which I think would result in nasal spray prescription? another thought I had for you, have you tried a netty pot? I know they can be great for allergies, I tried it with DS1 and it was def. a struggle to get him to let me do it. It lasted about 3 days before he flat-out refused (he's 4-1/2), but maybe you'd have different results? Good luck!

post #3 of 12

Have you ever used a nebulizer?  I have done pulmicort through the nebulizer with a mask for my DD.  The doc tried to convince me to use a spray since she is 6.  But I'd rather use the nebulizer even if it takes more time.

post #4 of 12
Thread Starter 
Quote:
Originally Posted by mbbinsc View Post

Have you ever used a nebulizer?  I have done pulmicort through the nebulizer with a mask for my DD.  The doc tried to convince me to use a spray since she is 6.  But I'd rather use the nebulizer even if it takes more time.


We do have a nebulizer and use it frequently. She's good with that, and her inhaler. It's having something sprayed into her nose that she's hesitant about.

 

 

post #5 of 12

Instead of the nasal steroid could you do Pulmicort through the nebulizer?

post #6 of 12
Thread Starter 
Quote:
Originally Posted by mbbinsc View Post

Instead of the nasal steroid could you do Pulmicort through the nebulizer?


It's a nasal antihistamine. She already takes pulmicort through either the nebulizer or inhaler twice a day, pretty high doses, too, and she's heading towards needing an oral steroid if we can't rein in her need for the albuterol on top of this. The idea is that if we can get her allergies under control, she won't have to take so much of the asthma medication.

 

 

 

 

post #7 of 12

I am so sorry that she is going through this.  That is alot of meds for a 4 year old.  Have they ruled out food allergies?  So many of the environmental allergens have cross reactivity with food.

post #8 of 12
Thread Starter 
Quote:
Originally Posted by mbbinsc View Post

I am so sorry that she is going through this.  That is alot of meds for a 4 year old.  Have they ruled out food allergies?  So many of the environmental allergens have cross reactivity with food.



They have ruled out a dairy allergy, I asked her to be tested because I suspected it. But not others. Once we get through this difficult stretch I'll ask again about other food allergens.

 

We just returned from the doctor and they said just to force the nose spray because it will be so helpful, and are fine about us dropping the singulair.

 

I have really mixed feelings about forcing the nasal spray, yes, she needs it, and if she has it enough times she might get over her fear. But it feels like such a horrible thing to do, and it goes against all my instincts of supporting her body integrity.

 

post #9 of 12

This might be too simple but I used to breath in too deeply and the nasal spray would wind up in my mouth, which was not fun. I am also very ticklish. Maybe you can take a break for a day and get her to try again and tell her to breathe naturally? My doc told me that's all a nasal spray should require. One last thought...maybe you could get a saline nasal spray for yourself and try the monkey-see monkey-do approach? She might like to have you as a partner in her pain/treatments. 

post #10 of 12

Hmm, we squirted saline nose drops in dd's nose all throughout toddlerhood.  Then she learned to do it herself at age of three.  Eventually, we taught her to do the sinus rinse bottles.  That was a real challenge, but eventually we succeeded when she was 5 years old, I think, and the payoff was huge.  I remember reading of one mama on this forum whose 4 year old child did the sinus rinse bottles by herself.  When we finally decided to try the nasal steroid, it was a walk in the park, compared to the sinus rinse.

 

I suggest you buy a sinus rinse bottle, and try doing it on yourself.   It's just harmless salt, water and baking soda, so it will do no harm. This experience will give you some insight about what your child is experiencing, and give you some ideas of things to try.

 

Some thoughts I have because I use the nasal antihistamine and they are helpful:

 

Make sure that child's chin is touching her neck.  You want the head tilted down when you do the squirting. It is an unpleasant feeling if the head is tilted up because the residual medicine will trickle down the back of her nose into her throat and make her feel like gagging.  Is it a gagging/choking sensation that you child dislikes?

 

I think you might want her to time her breathing so that she is exhaling, not inhaling, when you squirt.

 

I also think that you want her to have her mouth a little open.  i.e., you don't want her lips sealed shut.  If the nose is blocked by the bottle, she wants an easy way to breathe, and her mouth will provide it. 

 

One of the nasal antihistamines is famous for having a bitter aftertaste.  Perhaps that is what is bothering your dd.  If that is the case, ask the doctor to prescribe the nasal antihistamine that is sweetened and therefore doesn't have the bitter aftertaste.

 

 

My dd has tried and/or is using all the medications you named, except for the predisone.

We found that, for our dd, the pulmicort and albuterol did not help at all.

 

Here is what helped us the most:

1.  IQAir air cleaner

 2. Sinus rinse bottle

3.  Nasal steroid (which I fought hard against, but finally succumbed)

4.  Sinus rinse bottle

5.  Duct cleaning (ours was a special circumstance, however)

6.  Switching from zyrtec to xyzal

7.  Still trying to decide whether singulair is helpful

 

post #11 of 12

My 15 year old has been prescribed nasal steroids since he was about your kiddos age.  It has always been a battle, he just absolutely hates it (can't say I blame him - I don't like the feeling ether).  Does it have an odor to it?  When he was about 7 we discovered one of the name brands was actually scented to smell like roses and that was a big trigger for his refusal. 

 

One of the listed side effects of Singulair is vivid dreams.  Luckily neither ds or dh seem to mind.  Dh loves xyzal for his antihistamine.  But of course it's $$.

post #12 of 12

My son (4.5) has been on nasonex for about 1.5 years.  We started off doing straight up bribery to get him to allow us to use it- we bribed with M&Ms, and it worked.  Now he does it himself, no problem.

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