Potentially stupid question- How can you tell if DC is "wheezing"?

[LarsMal]

I am completely clueless when it comes to "wheezing". Does wheezing happen during regular breathing, or while coughing, or both?

DS has a little cold with a pretty dry cough. He has had a few coughing spells where he ends up gagging himself, and tonight I thought I heard what I consider to be wheezing. When I looked it up online, though, it was talking about the whistling sound during breathing.

I'm all freaked out now that he's going to have some coughing attack in his sleep tonight and not be able to breathe. I gave him some Robitussin before bed, so hopefully that will help.

I guess I'll just sleep with the monitor up really high so if he starts I'll be able to hear him!

[bubbaray]

You know, my DD (who has asthma) has had wheezing diagnosed by various dr's, but I've never heard it on those occasions (and I have exercise-induced asthma, so I know what it sounds like in me). I have only heard her wheeze once, during her peak allergy season.

If you think he's wheezing, he probably is. Its hard for me to describe.

FWIW, DD's allergist says not to give an asthmatic child cough medicine, b/c the coughing is the parents' cue to give more asthma meds.

If you hear wheezing, I would suggest you take your child to the dr tomorrow if possible. He'll probably be fine tonight, but I wouldn't let it go too long.

Hope he's better soon.

Melissa

DD#1: 04/2004

DD#2: c/s 01/2007

[SnuggleBuggles]

To me, I think of wheezing as just sounding like breathing in is really challenging. My mom was asthmatic and that's how it would sound at first then you could call it whistle like (more a low sound than a high sound).

Wheezing happens while breathing not coughing.

I would recommend looking up croup and see how those symptoms match up. I would also suggest putting a humidifier in his room. If he wakes up coughing either take him into a steamy bathroom or out into the cold night air. Either helps if he is really having a hard time. Those are croup recommendations but I have had success with those for regular colds.

Another pillow to sleep with can help as well.

Coughing is a good sign. I am reluctant to treat a cough (for reasons that coughs help move things around and all the studies that show that it is hydration that helps and cough medicine is as effective as a placebo).

He will be fine. But, definetly look up croup. It often strikes a few hours after they have gone to sleep and depending on the severity it can be a really scary sound (almost like they are having an allergic reaction). Usually it is just a seal like barking cough.

Sleep well!

Beth

[jasabo]

Wheezing occurs primarily on expiration. When your ds breaths out, it'll sound as though he's having a hard time pushing the air out of his lungs, which is actually the case b/c the airways are constricted.

Wheezing can also be heard when coughing - as he's coughing, you'll hear it when he pushes the air out of his lungs as he coughs. It does sound kind of like whistling - it generally will sound like his chest is tight, if that makes any sense.

If he's having a hard time breathing, his ped can prescribe nebulizer treatments which will loosen his airways.

[Fairy]

This is exactly correct. Additionally, look at DC's chest when they're breathing in. If they look like they're sucking in significantly and working very hard to get the air in -- often you can see the ribs "fingering," meaning the outline of their ribs very prominently on the inhale -- that's almost always a positive indicator of wheezing.

[o_mom]

If the noise is when he breathes out it is wheezing, if it is when he breathes in it is stridor. Very important distinction to make when you call the doctor (ask me how I know, LOL).

Anyway, as the PP said, watch the chest movement when breathing without a shirt. If you see the skin sucking in between the ribs or at the collarbone when breathing at rest, call your Ped ASAP. You probably should call in the morning anyway - I know ours always wants to see them if there is any funny breathing sounds.

[bubbaray]

>Wheezing happens while breathing not coughing.

I have heard my DD wheeze and cough during an acute asthma attack.

>Coughing is a good sign.

Not according to DD's pediatric allergist. He (along with DD's GP) say that coughing, especially at night, in small children is often the only sign of asthma -- frequently, there will be no wheezing. He also said that in young children, they treat croup the same way they treat asthma (with asthma drugs) and that in young children, the dr's don't really differentiate between the two diagnoses.


There are 4 things to look for in an acute asthma attack, retractions between the ribs being one thing, the tracheal tuck (retractions below the adams apple, in the triangular area where the neck meets torso), wheezing and one other I can never remember.



Melissa

DD#1: 04/2004

DD#2: c/s 01/2007

[juliasmom05]

>
>There are 4 things to look for in an acute asthma attack,
>retractions between the ribs being one thing, the tracheal
>tuck (retractions below the adams apple, in the triangular
>area where the neck meets torso), wheezing and one other I can
>never remember.

The other thing we have been told to look for is flaring of the nostrils. Luckily, we have never witnessed this sign.

Marci

[bubbaray]

YES! That's it!! Thanks, I have baby brain, LOL!


Melissa

DD#1: 04/2004

DD#2: c/s 01/2007

[DrSally]

How is your DS doing? Thank you for asking this question about wheezing, I have been wondering the same thing. Ds has food allergies and eczema sometimes, so I'm always listening for anything suspicious that would indicate the dvmt of asthma. Sometimes he makes this loud sound when he breathes in that sounds like a loud squeal coupled with taking in air. At first I worried it was "wheezing", but after reading other's replies, I think it's just a sound he likes to make.

[o_mom]

Some of the drugs to treat croup are the same, but not all. The difference between croup and asthma are significant - rescue medications do not help a severe croup attack like they do for asthma. Croup presents with stridor (upper airway, usually on inspiration), not wheezing (lower airway, usually on expiration).

[LarsMal]

DS Seems to be doing better today, thanks for asking! DS also has allergies, which is why I got so worried last night. The allergist had told me that b/c of his allergies, any wheezing (from a cold or otherwise) should be addresed b/c it could be a sign of asthma. After reading the posts, though, I think he just had a bad coughing spell and had some trouble catching his breath. It was kind of a "whistle" but it only happened once. I hadn't thought of the croup, but he hasn't been coughing much at all today, and he did pretty well last night, so I think it's just part of his cold.

Thanks again, and thanks to everyone else for their input. Very helpful- as usual!

:-) Julie

[bubbaray]

Guess DD's pediatric allergist is wrong. I'll be sure to tell him that at DD's next appointment. :(



Melissa

DD#1: 04/2004

DD#2: c/s 01/2007

[elephantmeg]

OK, not a professional statement, what does Beth say? :) Not a replacement for a medical exam yadda. And I am just a nurse-not a doctor!

OK, wheezing is the forcing of air through tight air spaces and can be heard on inspiration and expiration, but is more common in expiration. Stridor is heard higher when you're listening with a stethescope (like around the collarbone). Interestingly enough "audible wheezes" (wheezes you can hear without a stethescope) are sometimes inaudible by stethescope. Technically wheezing happens with breathing but kids with asthma often have a "wheezy cough", dry, tight, spasmodic cough which is usually what we tell parents is a signal that they need a treatment/inhaler. Then you have the "happy wheezers", kids who are in no distress at all but when they are playing and happy they wheeze. In my experience the RSV virus causes wheezing for a long time (both in my patients and myself!) I actually had an albuteral inhaler for about a year after I had RSV because when I would get a cold I would start to wheeze :)
here's an interesting link (I don't have sound on my computer so I can't vouch for it's accuracy!) but the info is good
http://www.health24.com/child/Cough/833-3456,11488.asp

Try: humidifer (but keep it clean!), warm baths, lots of fluids and call the doctor if you see any signs of trouble breathing (sucking in between the ribs (retracting), breathing really fast, not interested in doing much (too tired to eat/interact etc), color change, or your mommy alarm goes off!

[SnuggleBuggles]

Sorry, my brain wasn't on something like asthma. It was solely resting on just a cough and cold symptoms which is what it sounded like from the OP. Sorry.

Beth

[bubbaray]

Its just a sensitive topic for me, b/c for a loooooong time, I thought DD's cough was "just a cough", KWIM? We now know that its more serious than that. Our standing instructions from her allergist are to treat any cough with asthma meds and to not try to get rid of the cough (as we would do for ourselves), b/c that's the only good early sign with her that she's having trouble breathing. This allergist d/n want her to get to the wheezing/retractions stage and if she does, we have to go to the hospital.

Anyway, like I said, its just a touchy subject for me b/c frankly, I still feel a little guilty for letting DD go with her cough (which we d/n realize was asthma) for so long (not that we didn't take her to her dr, we did, but it took a specialist to figure it all out).

Plus, I'm sick, DD is sick (again. sigh) and we've had no sleep in for-ev-er. So, I'm not really functioning on all cylinders.


Melissa

DD#1: 04/2004

DD#2: c/s 01/2007

[o_mom]

It is hard sometimes because many doctors will use the terms incorrectly, interchangably or just not explain them. Then there is the whole subsets of croup w/wheeze and croup w/o wheeze. If they have it w/wheeze they are at increased risk of asthma so some peds will treat it like asthma long term.

My boys are prone to croup (w/o wheeze so far) and I wish I could just have a rescue inhaler or something that would work immediately, there just isn't anything outside of an ER (nebulized epinepherine) that will reverse a severe attack quickly. If we can catch it early, we now have nebulized steriods at home (Pulmicort - which is an asthma drug) or injectable at the doctor's office (Decadron), but they take 8 hours or so to really take effect.

[bubbaray]

Sorry to hear both of your boys have croup. That sucks!

Maybe that's what DD's allergist was talking about/not explaining, the croup w/wheeze, I dunno. When it comes to DD's coughs, I think he has us treat all of them as early asthma signs b/c, quite honestly, even other dr's have not picked up on her wheezing at times (as in, she's seen her GP the same day as an allergist appt, and only the allergist hears the wheezing). We do definitely see a difference after treating her with asthma meds, to the point now where when she's coughing, she asks for a breathing treatment (so, presumably, it must make her feel better).

In any event, hopefully the pulmicort works for your guys and they don't end up in the ER or hospitalized much at all. I find that the pulmicort takes a day or so (2-3 tx) to help DD's asthma (which is why we combine it w/ ventolin).


Melissa

DD#1: 04/2004

DD#2: c/s 01/2007

[o_mom]

I have also heard that in small children, one of the things they consider in diagnosing asthma is the response to asthma meds - if it helps the breathing, then it is more likely asthma. Since kids under 4-5 years can't do the lung function tests that are the "standard" for asthma diagnosis, they have to be creative :-). With croup, Ventolin (albuterol) has no effect since it targets the lower airways. We travel everywhere with the nebulizer now and Pulmicort Rxs - PITB, but better than the ER.

[SnuggleBuggles]

I understand better now. Since I haven't had to deal with anything beyond coughs, colds and croup (one serious enough to have to go to the ER for steroid shot) I totally missed any further idea. Sometimes I probably should think before posting.

I hope you feel better soon! :)

Beth