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Wednesday, March 30, 2011

airways, steroids and beloved felines

Maya has had a cough most of her life.  A pesky, hacking, compulsive cough that, untreated, kept her up at night and made it so that she got used to coughing and talking at the same time.

We've been treating her for probably a year and half with allergy medicine.  For some unknown, nebulous environmental allergy.  She coughs significantly less but you can almost set your clock by her need for her next 24 hour dose.  She was never diagnosed with asthma but when a cold hits her respiratory track, her airway becomes quickly and critically compromised requiring nebulizers and oral steroids to open her back up.

The idea of consulting an allergist has been discussed at length between us and our pediatrician.  She informed us that it was unlikely that we would pin point one thing that was causing Maya to cough.  And if we did and it was, say our cat or dog, would be be willing to make such sacrifices?

Today we finally saw the allergist. 

And I wanted to throw darts at her. 

First off, oral steroids are bad, bad, bad for you.  Even the three times in her young life she has had them may have stunted her growth.  They commented a few times on her short stature.  (I reserve the right here to believe that she is just a peanut. Her growth has always followed the same percentage curve.)

Second, the doctor felt she does have asthma.  (A coughing type of asthma.)

And, third, (you saw this coming didn't you?) she is allergic to cats.

Remember this guy?

We are literally SO torn up about this situation.  

The doctor said that even though the allergy medicine quiets her cough, she is not well controlled by it because of her compromised airway over the last 2 winters from cold.  She recommended a daily inhaled steroid (it would take 5 years for the inhaled steroid to equal the effect on the body of only 1 dose or oral steroids) that would control her asthma and, likely, prevent such catastrophe from winter bugs.  The problem?  It is impossible to know how much of Maya's "asthma" is really just a cat allergy. 

These are our sucky options:
-Keep the cat and give Maya medicine she likely doesn't need.
-Keep the cat, give her regular allergy medicine and deal with the threat of colds and airway problems.  We could also potentially use the inhaled steroid in these cases but it usually takes 1-2 weeks to work so we would have to catch it way early.
-Give the cat away (sob) and not medicate her at all, hoping all will be well when she gets a cold, although there is no guarantee.
-Give the cat away and still have problems because she has asthma, not just a cat allergy.


Sandi spoke to Ella tonight about Maya being allergic to Coconut (he is Ella's cat after all).  She was incredibly mature and sensitive about it.  The first thing she said was, "Do we have to give Coconut away?" (Sandi told her we truly don't know.)  Also: "Is Maya going to be OK?" followed by "We should have had Maya tested before we got him."  and  "I will make sure that I keep the door shut to my room so he can't come in.  I will tell my friends when they come over."  We were so proud of how she handled it.  Which was better than the bawling mess I was over it this afternoon.

What we decided for now is this:  we are going to do some research, continue to use the air purifier that has been helping significantly with Maya's coughing, we washed her bedding and won't let the cat in her room (he loves to sleep on her bed), we will institute better cat touching/hand washing protocols, we will study our hearts, and hire a maid to clean up the cat hair weekly (I wish).

The allergist said that she might outgrow it.  A family can hope, can't they?

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