For some, this post may have reached the point of beating a dead horse, but I’m going to post about it because it’s a question I’m starting to get asked now that Owen’s been healthier. We are still a few weeks from the official start of the cold and flu season, but Owen met with his Pulmonologist on Thursday so I wanted to post it while her thoughts were still in my mind.
To the other preemie moms that are reading this blog and getting the same questions (every single one of you, I know, I follow Life After NICU too!), Dr. Laguna has said we are all free to quote her until we’re blue in the face (well not literally, the Pulmonary folks, and Medical people in general, take exception to that analogy).
So, here’s the typical conversation with fictional character, Imelda:
Me: Cold and flu season is just around the corner, we’re going back into the bubble in September.
Imelda: September, that seems too soon, isn’t that a little overkill?
Me: Once school starts back up, germs seem to spread. We will increase caution in September, with full lock down starting as soon as we get word that the season is in full force. As always we will be very strict on hand washing and limiting kids in our home this fall and winter.
Imelda [in all-knowing voice]: But, if he doesn’t get sick, he’s never going to build up his immunity. It’s good for kids to get sick every once in a while.
What I often want to scream at this point in the conversation is, “He’s STILL on oxygen!!!!!” immediately followed by, “we spent FOURTY-FIVE days in the hospital with Respiratory Illnesses last cold and flu season!!!!!!!!!!”
But, instead of getting all snarky, here’s the Pulmonary approved response (paraphrased).
It is true, for typical babies 6-8 illness per year is expected and normal. However, this is not about building immunity – it’s about lung health. All preemies, and especially those who spent an extended time on the vent, are an exception to that rule. These babies, even when they are acting healthy, have damaged lungs. Every illness that gets into the lungs [anything that gives you the “sniffles” or “a little cough”] damages the lungs further. Every illness increases their chances of hospitalization and prolongs their time with chronic lung disease. We DO NOT want these babies sick! Preemie parents aren’t paranoid – they are right
Imelda typically has one more question: So, how long does this last?
Back to me, on this one: It’s really case by case and should be discussed with the child’s doctors. Some kids had relatively healthy courses and can spend their second cold and flu season in general population. Other kids, like Owen, will need at least two full winters in as much seclusion as possible. We will try to be slightly lighter with Owen this year by letting him go to some in-clinic therapies through the season. However, if he starts heading in the wrong direction, we will go back to only in-home therapies. Even his Pulmonologist doesn’t want to see him in clinic unless absolutely necessary this winter. Next year is still a big question mark, it all depends on how this year goes.
If you’re still not convinced, specifically in Owen’s case, he has three strikes against him.
1)Bronchopulmonary Dysplasia (BPD) – The lung disease that is typical in preemies and is the reason that Owen requires oxygen. Owen is considered to have very severe BPD.
2) Asthma – A second form of lung disease that causes the airways to swell and narrow. It can be triggered by allergies or illnesses
3) Tracheomalacia – a condition that makes the windpipe floppy to the point of collapsing when it’s only supposed to dilate and contract slightly. Tracheomalacia is especially pronounced during coughing or hard crying.
Each of the three factors above, increases a person’s chance of being hospitalized when suffering from a typical respiratory illness. We learned this spring that the three can work together to really wreak havoc. The good news, is we know more this year so can better treat Owen and he has grown and gotten healthier. So, we absolutely do not expect another 45 days this year, but it won’t be surprising if Owen is hospitalized a time or two, even with our precautions.
Okay, I’ll but my soap box away for now. Thank you for reading and thank you in advance to everyone that stays friends with us through another winter of saying “wish we could” to invites. Also, please keep inviting us – babysitters aren’t out of the question!