Apollo spent most of Tuesday night coughing. And by coughing I mean episodes that lasted several minutes and often ended with him literally choking on his mucus (remember he has the equivalent of a rubber band wrapped around his trachea and esophagus). And yes, he’s had his dtap shots, so no worries there. Wednesday morning found him coughing even more. So I called Wednesday morning to see if I could get him in to our doctor. He was out for the day but I could make an appointment with Dr. O.
Dr O, if you recall, is the one who disastrously stitched up Avi’s head back in 2009. But then again she’s also the doctor who acted quickly and had me take Apollo to the ER when he had RSV and pneumonia. So maybe she’s great and she just doesn’t like doing stitches…
When we arrived I explained to Dr. O that Apollo has a double aortic arch and is having it repaired on March 7th. We talked about his cough. I explained the severity of it and that he wasn’t able to eat or sleep. She said, “Okay, I’ll write him a prescription for Promethazine-Codeine syrup”. She explained the Promethazine-Codeine would make him sleepy. I remembered that certain medicines that cause drowsiness (like muscle relaxers) aren’t safe for someone with respiratory issues. So I asked if this medicine could supress his respiratory system at all…”No, not at the dose you’re going to give him”.
So, off I went on my merry way. But something was bothering me in the back of my mind. I kept thinking about the pulmonologist saying “Apollo has to work way too hard to breathe”. “It’s like he’s running in place all the time”. “It’s like he’s breathing through a straw”. I know he wakes up at night because he can’t breathe…so what if he couldn’t wake up to breathe? I decided to ask the pharmacist about the drug. He gave me the same answer, “It’s fine at the dose you’re giving him”. So I came home and read the information included. At the very top of the page was this:
Warning: This medication should not be used with children younger than 6 years due to an increased risk for serious (rarely fatal) slow/shallow breathing (respiratory depression). This infrequent side effect may occur even with usual prescribed doses….it goes on to say some manufactures say this combination should not be used on children younger than 16.
Keep in mind, this is not buried down in the side effects, but is the first thing you see on the information sheet. Now tell me, if Apollo was your son, would you be comfortable giving him a medicine with a warning like that? Well I wasn’t.
Remember how I mentioned that I ran into the pediatrician who treated Apollo in the hospital at a friend’s baby shower? Well Tami filled her in when he was diagnosed with his double aortic arch and she sent me an email offering to answer any questions and be a sounding board if I needed one. So I called her. Unfortunately I couldn’t reach her.
I have a handful of doctors, former doctors and future doctors who read this blog and have emailed me in regard to Apollo. So I emailed two of them, and the local pediatrician I couldn’t get on the phone. I let them know about Apollo’s cough and asked if they thought this medication was safe for him. I got two responses that afternoon (thank you Robyn and Susan).
Both said, no way would they ever give Apollo that medicine. So I spent the afternoon worried about his cough and worried about the medicine. Apollo spent most of Wednesday night coughing and then was down with a fever all day Thursday. So I called the doctor’s office again and made an appointment for him to see our family doctor.
Friday morning I was back at the doctor’s office. Our doctor was rather guarded when speaking of his colleague, but did say, “I never prescribe that medicine. Dr. O uses it all the time though”. And no, he didn’t think I should give it to Apollo.
I feel like I can’t let my guard down for a second with him. Even when talking to a doctor.
Friday night the local pediatrician called me and spent ten minutes on the phone discussing Apollo. She agreed that was not a medicine that should ever be prescribed to Apollo. I guess you could say, four out of five doctors think that could be a dangerous medication for Apollo.
What a week. Sickness and fever. Coughs and chills. A day full of appointments at Seattle Children’s. Homeschooling and meals. Feeling despair as I watch Apollo cough and choke. Then feeling so thankful that by
coincidence God’s providence, I can talk to the very pediatrician who treated Apollo for his RSV and pneumonia back in June 2011…
It’s been a wild ride. I’m just thankful we’re all still holding on.