croup- any relation to asthma/food allergy?

[evergreenmom]

Hi All-

I have some questions related to asthma and croup if any of you have knowledge in this area I'd really appreciate it!

My son is dx'd as anaphylactic to peanuts. A few months ago he underwent brain surgery for complicated neurological conditions he suffers in addition to PA. Anyway, last week he developed an awful case of croup. I took him to the ped on Monday- she dx'd croup and gave him one dose of oral steroid. He has had croup and received this treatment several times in the past and it has always worked well coughing eased right away and ceased within a few days. Not so this time. On Tuesday- day two- he had several coughing fits in which he became distressed because he was coughing so hard he felt it was difficult to breathe. I gave him warm liquids, advil, a hot shower, a teaspoon of honey, and a couple of puffs of my daughter albuterol inhaler(ped approved of this, daughter doesn't have asthma but has been dx'd with reactive airway issue- she gets cold and upper airway gets wheezy and she develops wet cough easily so we treat any cold with albuterol and flovent). Anyhoooo... I wasn't too worried because I could see that he could breathe despite his becoming a little panicky. Well early the next morning he starts violently coughing and becomes terrified that he can't breathe... this time I was worried- I opened the window and had him breathe early morning cool air while I started shower and grabbed advil... within a few minutes his breathing improved thank goodness but this time I did think he was actually struggling to get enough air in. Got him to the ped and she gave him a 4 day course of oral steroids saying that is how they treat kids with asthma and croup. I left confused though because while there she gave him a nubulizer treatment saying if he does have asthma this will help but it didn't help! So now he's had the steroids, the cough is pretty well gone but I am left feeling panicky for the next time this happens and worried because he has been intubated around ten times in his life (several for surgeries and the rest for MRI's) and I have read that multiple intubations can make a person prone to croup. So I'm thinking he'll get croup again and worried he now has asthma- I know there's a link between asthma and food allergies... I'm afraid I aM RAMBLING NOW, SORRY IT'S GETTING LATE BUT i AM JUST WONDERING IF ANYONE HERE CAN SHED ANY LIGHT ON THIS! OOPS caps off now sorry... Additional worry he's due for another sedated MRI w/intubation next week- do I try to reschedule? Feeling totally overwhelmed    like Peanut allergy and brain surgery weren't enough to worry about now I have to figure this out too!!! Thanks for reading and thanks in advance for any insight you all may have...

[Janelle205]

I don't know if there is an official connection, but I have really severe asthma, and tend to get croup once or twice a year, even as an adult.  The frequency for me has decreased since I started daily steroids three years ago, but I wouldn't recommend that to anyone.


When I get croup, it tends to crop up first thing in the morning when I wake up.  There is a couple of differences between croup and asthma - croup constriction is generally higher in the airway, and you have trouble getting air in - with an asthma attack, there is more constriction on exhaling.  If you hear wheezing or angry noises when breathing in, you're looking at croup or vocal cord dysfunction, if you're hearing wheezing on breathing out, then you're looking at asthma.  Do you know what med the doc put in the nebulizer?  Albuterol is good for asthma, but for croup, I have better luck with atrovent (impratorium) or duoneb, which is a mixture of atrovent and albuterol.  Atrovent is better at treating constriction in the upper airway.

As for the MRI next week - I would call the doc that has ordered it, let the doc know that he has been sick with breathing issues (I would mention that you had a pred course as well), and let them decide how to proceed.

[GoingNuts]

Evergreenmom, I have to run off to work but will try to get back to this tonight.  Suffice it to say that I used to joke that we could have as many words for croup as Eskimos have for snow.  My now 20 year old used to get it horribly, several times per year.  In fact, anytime he had even the mildest cold, he got croup.  He also has asthma and FA's.

I seriously have PTSD from his croup.  No lie.

[momma2boys]

I will also come back after work, but I have that same ptsd as goingnuts. If I hear a kid with a croupy cough,I start to panic.

[evergreenmom]

OK going nuts and Momma2boys- I'll look forward to hearing what you have to say about croup... I get what you are saying about PTSD over this I think I am right in the zone on that at the moment. Jannelle I will ask the ped about Atrovent... maybe I can get a Rx for that to have around for next time... I just feel like between peanut allergy, brain surgery, recovery from brain surgery, trying to get little man back on track school wise after brain surgery and now scary as heck episode nearly going to the ER with CROUP to add to the long list of worry's I am literally going to lose it here soon!

I guess I could also use advise from anyone here whose dealt with significant croup like this- what home remedies/prescriptions work best in your family???

[Janelle205]

I agree with everyone that mentioned the PTSD.  I have severe asthma.  I am really used to not breathing.  When I get croup, I panic - it is such a different feeling from asthma.  The last time I woke up with croup, DH stayed home from work because it was so scary.  We had to drive DSD to school, and he insisted on me coming with because he wouldn't leave me alone.

[GoingNuts]

Sorry I couldn't get back last night, and I have to be brief; headed to work again.

When DS got croup he never got the cough; he got stridor, which is that awful noise upon inhalation.  He had his first episode at 4-5 months, which was absolutely terrifying and it continued until he was about 10.  He still gets it, but not nearly to that extent.

The only home remedy that ever really worked was cool night air.  We did a lot of walking around the neighborhood in the middle of the night.  I made a homemade croup tent out of a cool mist humidifier and sheets over his crib, and used to sleep in it with him.   But there were still many, many trips to the hospital, or to his peds office (he opened the office for us more than once late at night to keep him out of the hospital).

I don't think there is any direct relationship between croup and FA's other than the fact that atopic folks are more prone to overreactive airways.

There's more to the story but I have to dash.  Will hopefully get back later for more.

Good luck - sounds like you have had your hands more than full lately. 

[momma2boys]

My ds had croup so much that the er nurses knew us by name. The pediatrician eventually just started giving me refills on prednisone. It was pretty bad. Several times after croup he developed pneumonia. Sometimes cold air helped, sometimes the steamy bathroom. Sometimes just nebs, prednisone and waiting it out.

His worst case, I heard him coughing shortly after going to bed. Went to check on him and he was struggling to breathe. Rushed him to er and he was in respiratory distress. They had him on continuous nebs and started prednisone but nothing was helping. They finally gave him a neb treatment of racemic epinephrine and that stopped it and pulse ox started rising.

That was the point where I started wondering if food allergies were triggering croup. Or maybe just that one instance? Who knows. He had rsv as a baby, the constant croup, pneumonia, asthma issues when sick, and one period during middle school where he coughed for months. A bad cough! Eventually diagnosed as a pertussis like virus.

When the pediatrician walks in the exam room now, she warily looks at him and says "you aren't coughing, are you?"

I totally get where you are coming from! I may have missed it, but how old is your ds? I hope things resolve and I'm so sorry you had to go through brain surgery with him. I cannot even imagine!

[YouKnowWho]

DS1 developed his issues with croup past the point when kids outgrow croup per our ped (usually it happens before the age of three).  One thing that I noted for us that the fast acting dose in the ER worked much better than the several days of steroids prescribed by ped (also didn't struggle with the pred side-effects which equaled no sleep for a week - I once dreamed Mater was the boys dad while drifting off during the repeated watching of Cars).  We struggled on and off with pred for several years until his tonsils and adenoids were removed = then it disappeared.

He does have asthma - that was diagnosed just before or after his first croup diagnosis.  He does get pneumonia often (usually in relation to fall allergy season/first days of school plus another round between Thanksgiving and Christmas but has not dealt with that since we started homeschooling last year).  His only surgery was the tonsils and adenoids which seemed to end his issues with croup.

I wonder if the croup is in relation to your son's last surgery.  Everytime I have surgery, I end up with goopy lungs for lack of a better term. 

[GoingNuts]

Yes, DS had RSV @ 9 months.

[momma2boys]

Ykw, they did a blood test for my ds and saw he had no immunity built up for pneumonia. They gave him a pneumovax injection and that pretty much ended his tendency towards pneumonia.

[YouKnowWho]

Ykw, they did a blood test for my ds and saw he had no immunity built up for pneumonia. They gave him a pneumovax injection and that pretty much ended his tendency towards pneumonia.

He had the pneumovax twice - he has some sort of immunity to it.  Dr was surprised when he turned up with pneumonia post vax and baffled when he did the second time. 

I honestly wonder about my families issue with vaxing and wonder if it plays into our strong drug allergy/intolerance issues.