Tuesday, March 31, 2009

In which I attempt optimism

I took Iyyar to the doctor today. He (doctor) said that his (Iyyar's) muscle weakness is not what he would expect in a kid with [horrible disease we talked about last night], which is reassuring. However, if he's weaker/less coordinated than he used to be, that's concerning, and so we did a blood test, which will be back on Friday. "He doesn't look to me like a kid with [horrible disease], but I've been wrong before, and what you're telling me is something we need to follow up on." So.

My hopeful idea, as of half an hour ago--could this (wobbly legs, bumping into things, not being able to get up without hands) just be a post-tonsillectomy growth spurt? Growth hormone is secreted during deep sleep, of which Iyyar has had practically none for probably months. He's got his appetite back and is doing some serious eating these days. Surely he's doing some growing. Could that be it? Maybe?

Please?

Blindsided

I don't read a huge number of blogs regularly--about a dozen or so. Each is interesting to me, or speaks to me, in a different way.

Some of them are written by people like me, in whatever way. Some of them are written by people I know. And some of them are written by people to whom bad things have happened.

One of the worst things you can say to someone dealing with something terrible--a health crisis, a loss--is, "I don't know how you do it." It is a way of saying, I couldn't do it. I couldn't be you. I can't be you. What happened to you can't happen to me, and it won't.

I've thought for a long time that there are two categories of people in the world; people to whom nothing really bad has ever happened, and don't think it ever will; and people to whom it has. I'm in the former category. Once something bad has happened--something that changes your life in ways you never thought to expect--it changes the way you see everything, and it changes it forever.

I worry. Grandma E tells me that there is no use in borrowing trouble, and she's right. But I know that the bad things that people think you're silly to think will happen really do happen. To someone, somewhere, they happen. Maybe today it will be me.

I read, or have read, a few blogs that started out as ordinary blogs--about work, about family, about anything--that turned into Bad Things blogs. Someone is diagnosed with cancer. Someone has a terrible accident. Sometimes it is the blog writer. Sometimes a child.

Yesterday I watched Iyyar go up the stairs. He has trouble going up the stairs. I've noticed it for a while, but chalked it up to his big heavy boots. Yesterday he wasn't wearing boots, and I saw his legs tremble and give under him, unable to support him. He grabbed onto the railing, and went the rest of the way on all fours, unperturbed.

And suddenly I started thinking about all the little things I've seen him do in the last few months--things I haven't thought much of because of being busy dealing with the tummy issues, the tonsils, the sleep. The way he walks sometimes. The way he can't stand up by himself, without grabbing onto something. The way he can't lift his head off the floor and sit up if he's lying on his back--something none of my kids can do. The way people have mentioned to me that he seems uncoordinated, that he doesn't seem to have a lot of muscle strength, that he's cautious physically. Individually, not things that are a big deal. Maybe he needs some OT. Together, those things are on a list of signs of something so terrible I can't think about it too much.

So I called the doctor last night. I told him what I'd been seeing. I knew he wasn't going to say it was nothing, but I was hoping for a little reassurance. I told him the diagnosis I was worried about--the worst case thing. And he said, "That was my first thought too." It's very concerning, he said. He needs to see a neurologist. I should bring him in, right away, so we can get started on this.

It could be nothing. It's probably nothing.

But maybe it's not.

Monday, March 23, 2009

Kol simcha

I tried to post this morning but Blogger wouldn't let me sign in, and now I'm tired and can't quite remember all the things I wanted to post. Oh well.

In short: I took Barak to his first chasuna last week. It was hilarious. We went shopping that morning, initially just to find a white shirt free of grape juice, blueberry yogurt or chocolate stains, but ended up buying an actual suit: Target had little boys' polyester suits in navy blue for what I would consider a reasonable price, so I bought a jacket and two pairs of pants. It was worth it just for the look on Barak's face, of barely suppressed glee at this unexpected initiation into the world of adulthood. A suit! An actual suit! (He thought it was black, like Abba's, but I couldn't quite go that far. He's four and a half; he gets navy blue.) I also bought him shiny new black Shabbos shoes, which he was in line for anyway; his current pair have an actual hole.

I had to hem the pants, but the jacket was fine, fortunately. He was incredibly excited, totally dressed and ready to go an hour early, and standing by the window asking every minute WHEN exactly our ride was arriving. WHEN? In five minutes? Two? Maybe she came already, and we missed her? He looked positively chassidish, with the white short, dark suit, no tie and payos. Hesat beautifully through the whole chuppah, stood up when everyone else did, and was completely entranced by the dancing. I couldn't get him to dance with me at all--he just spent the whole time staring at the men. When dinnertime came along, he was unimpressed.

"What's that?"

"That's chicken."

"It's chicken?"

"M-hm."

Pause. Then, with unconcealed disgust,

"Is it dead?"

"Yes, it is dead."

"I don't want to eat that."

"Okay, you don't have to. But enough with the commentary please."

"Okay. Are we going to have dessert?"

"Yes."

"Can I have it even if I don't eat the dead part?"

"Yes!"

"Okay."

I should point out here that after our Target trip, we'd stopped at the grocery store, where they have a fish case, which was full of whole dead fish, which Barak had asked about. So... yeah. Dead food was a topic of interest.

I should have taken pictures, but didn't. Alas. He'll be wearing the suit again soon enough, but it'll be yom tov when he does.

Oh, and there are plans afoot to toilet-train Iyyar. Stay tuned. I did buy him, on the ill-fated Walmart expedition, two packages of Sesame Street underwear that included two with Super Grover, if you can believe that. He loves them and carries them around by the handful, but does not seem to have connected the underwear with the act of potty-using. We'll have to work on that one.

Friday, March 20, 2009

Friday roundup

1. After several nights of almost-hourly night terrors ending with a shrieking Iyyar in my bed, kicking me, Iyyar more or less slept through the night last night. He did start a few times with the slow, monotonous wailing that has, to date, portended hysteria to come, but the full-blown howling, screaming, flailing attack never materialized--he settled himself back down without my having to do anything. This, clearly, is a Very Very Big improvement.

2. Pre-tonsillectomy, and the week or so following, Iyyar's nighttime breathing was so loud you could hear him in every room of the apartment. Now, you have to bend way over and put your ear right by his mouth even to hear him breathe. It's disconcerting, but definitely an improvement. The other thing that appears to have stopped, along with the snoring, is the drooling: yesterday I realized that his shirt, which is usually soaked in front and requires changing at least once midday, was bone dry. Wow.

3. Last night I went to Wal-Mart, which I think I've done now twice in my life. I'm hoping that the third time will be the last. I HATE Wal-Mart. When I was a kid and would go shopping with my mother, she used to say I got shopping-itis; after twenty minutes in A & S, I'd start complaining that my head hurt, I was tired, and I wanted to go home. Now, I do most of my shopping either in small local stores (food) or online (almost everything else). The main exceptions to this are Target shops, which I do once or twice a month. Target doesn't bother me; other than the rampant consumerism, I like going there, because I know where everything is, I can stock up on everything quickly, and then I won't run out of garbage bags for a while. But Wal-Mart, holy cow, it was like being 14 again. I literally got tunnel vision, it was hard to see anything clearly, and I starting feeling a sense of impending doom. I had to wait for my friend Yehudis to finish shopping before I could leave, since I'd gone with her; otherwise, I probably would'be abandoned my shopping and run for it.

4. Avtalyon has been so hilarious lately there must surely be something specific to mention here. Oh yes. Remember this song? Avtalyon loves it. Every time I play it, which is often since Jasmin decided to be a total enabler and send me the CD, he stops whatever he is doing, his eyes get really big, and he dances.

5. One of Iyyar's playgroup-mates is a boy named Moishy who likes to sing the Hashavas Aveida song, the first line of which is "Hashavas aveida, what does it mean?" I don't know what any of the other lines are, other than a mention of "return it right away," because Iyyar hasn't picked those up yet. Moishy has a toy guitar and he likes to play the guitar and belt out Hashavas Aveida at top volume. Iyyar does not have a guitar, but belts out the song at volume regularly. "Ha SHAAAVAS AH! VEI! DAH! What! DOES IT MEAN...!" He does this not quite all the time, but almost. Today, on the way to playgroup, he started singing it. And I couldn't resisit. "Iyyar, what does Hashavas Aveida mean?"

Pause.

"I don't know."

6. The amount of candy Barak gets at school is incredible. He gets candy for Shabbos party, he gets candy to make projects with (!) and every time there is a birthday he comes home with a pekel full of junk. He even got two (TWO!!) huge bags of shaloch manos from the school. Now, Barak is four and a half and he really doesn't react well to sugar. But oh, does he love it. So I did what any sensible mother would do in this situation: I bribed him. I sent him to Target with Ada, and let him pick out a small box of pirate Lego. Then I made a sticker chart, with 16 spaces on it, and every time he handed over a piece of candy he got at school, I put a star in one of the spaces. When he filled up the chart, I told him, he could have the Lego.

It took two weeks and one day to fill fifteen of them. (To be fair, Purim was in there. But still. Fifteen pieces of candy from school in two weeks and a day!) He handed everything he got over, not only willingly but enthusiastically. He's got one space left, and he'll probably fill it via the school's Shabbos party. If he doesn't, I told him he could earn a last star by doing an extra Shabbos job (usually, picking up toys/books/whatever). He'll be pretty happy tonight. His behavior has been noticeably better after school. And I already have two more little boxes of Lego stashed in the closet. I thought about whether this was a really good idea as an ongoing thing, and I decided yes, it was; the boxes of Lego are the $5-6 ones (the first one was more, but he doesn't know that) and would I pay $6 to prevent Barak from eating half a pound of sugar and artificial color? Yes, yes I would.

The next chart might have more spaces on it though.

7. Iyyar's tummy seems to be doing much better, after something of a setback following surgery. I've got him off dairy completely and taking probiotics and acidophilus, which can't hurt. Now that he's not having dairy, I've been doing a lot more fleishig cooking: one of the few meals that everyone will eat happily without complaining is chicken soup with matzo balls, so I do that midweek at least once a week. And it never fails to amuse me that neither Barak nor Iyyar ever distinguishes between meatballs and matzo balls: they are as likely to ask for matzo balls with spaghetti as they are to ask for chicken soup and meatballs.

8. Avtalyon has developed a taste for cucumbers. He loves them and will shove every available cucumber into his mouth before touching anything else. I find this very amusing: personally, I think eating cucumbers is like eating crunchy water. Harmless, but unappealing.

9. Barak also likes cucumbers. His standard favorite Shabbos lunch is cucumber and bologna sandwiches. No need for bread. He puts bologna between two slices of cucumber, nibbles off the excess bologna, and then has himself a sandwich. He'll make several that way before eating them all.

10. Avtalyon wants so much to be one of the big boys. When Iyyar and Barak are on the floor playing, he's always skulking around, poking his nose in, trying to get in on the action. Sometimes Iyyar and Barak are tolerant of this. Sometimes not.

And finally, a picture of said big boys, courtesy of Ada:


And one of the little boy, who is getting bigger daily.

Saturday, March 14, 2009

Day Three

It says in the Torah that the third day after surgery is always the hardest. We had evidence of this today, with a lot of rolling around and wailing and "my mouth hurts!" After that first fantastic morning Iyyar slowed down a lot, but he's basically been okay; three-hour naps in the afternoon, kind of fussy etc., but all right as long as he gets Tylenol every 4 hours. Oh, and that bit about "he'll have bad breath"? Not a joke.

Some friends brought us Shabbos food on Friday afternoon, which was amazing--much more food than I would ever have made for us, plus apple cake, which the kids loved. And bologna! Which Avtalyon thought was fantastic.

Barak is very much enjoying the new routine of frequent popsicles, jello, and sorbet morning and evening (in which Iyyar's antibiotics have been hidden), and seems to accept the idea that this will only last until Wednesday. Oh, and today Avtalyon decided he was old enough to drive and climbed into the Little Tikes car, with not terribly successful consequences. He's too little to sit on the seat and have his feet touch the floor, so he can't actually go anywhere, which he found rather frustrating; also, climbing up on the seat was such a challenge that he kept sliding down and getting stuck underneath, requiring frequent rescue missions. None of this dissuaded him from trying again and again, of course. If at first you don't succeed, &c.

On an unrelated (is any of this related) note, I love how Iyyar pronounces "sandwich." It's "shammish." And he likes it "sho muchsh!"

Thursday, March 12, 2009

Home!

Iyyar and Abba came home this morning, after getting discharged at the crack of dawn to allow Abba to get to work. Iyyar had a great night; his SpO2 never dropped below 96, which is fantastic, especially compared to the horror show of his sleep study.

I got the amoxycillin down him this morning by melting an Italian ice, mixing in the medicine (which I'd had the pharmacist flavor lemon, just to be safe), and freezing the whole thing back up. Down the hatch, no problem; same thing for the chewable grape-flavored Tylenol. If you come at him with a medicine dropper, the teeth clamp shut, so the skulduggery was definitely in order.

I can't believe the difference in him already. He's been off for months, and while a big part of it was obviously the tummy issues it looks like a lot of the general unhappiness must have been the sleep. He got home with Abba while I was dropping off Barak at carpool, and Asnat was here with Avtalyon. I walked in the door and the first thing she said was, "I can't believe how happy he is! It's the old Iyyar back!" I forgot that he used to be Tigger--just less furry, and twice as loud.

Wednesday, March 11, 2009

So far...

Iyyar did great in surgery and afterward. He set some kind of popsicle-eating record, such that the nurse who initially said "no such thing as too many fluids, just keep bringing them on" finally called a popsicle time-out at around 8:30 pm after the seventeenth popsicle (and that's not counting the Italian ices, or the juice). He spend the afternoon zoned out in front of Sesame Street with the popsicles; the only thing that really seemed to be bothering him was the IV and the ID tag, which he cried about every time he noticed them.

I came home an hour ago and Abba is at the hospital now, which I'm starting to feel was a mistake; I called a little while ago and heard a lot of howling. It's not that Iyyar needs me more or is more attached to me (not at all, in fact) but he doesn't settle as well with Abba, who he knows is, well, more or less wrapped around his little finger.

If all continues to go well he'll be discharged in the morning. Right now the main issue is seeing how he breathes when he's asleep. Here's hoping that all goes well, and he'll be eating his popsicles at home.

Tuesday, March 10, 2009

601

When I signed in to blogger I noticed that I have just hit 600 posts. So here is post number six hundred and one.

Iyyar's surgery is scheduled for tomorrow morning; we have to leave at 6:30 am to get there at 7:30 for surgery at 9:10. I wish he'd gotten to bed earlier, but it was hard with Purim.

I think I'm packed; the food is in the fridge, but everything else is in two bags on a kitchen chair. Carseat in kitchen. Iyyar's blankie, a few books, Grover, and the fireman that is a present from his morah are all in his backpack (or as he puts it, pack-pack.) I'm bringing my laptop and some Sesame Street DVDs, which should come in handy. I'm not bringing overnight clothes for me; I'm going to have to come home tomorrow evening to nurse Avtalyon, and either Abba will spend the night at the hospital or I'll grab what I need and go back.

I should be editing a speech, but I really really really can't concentrate. I should probably just go to bed.

Monday, March 09, 2009

Just Tonsils

Not heart surgery, chas v'shalom. Nothing huge and scary. Just. Tonsils.

I took Iyyar for his preop physical on Friday, and asked if the results of the sleep study were in the computer. They were, and holy cow. One of his apnea episodes was so bad that his oxygen saturations dropped into the 70s. I kind of thought that if your sats were in the 70s they'd call an ambulance but my pediatrician didn't seem worried. "He really needs his tonsils out." But they wouldn't have just sent him home if they thought he wouldn't wake up the next morning, right? Right?

When Barak had his adenoids out, almost exactly two years ago, I was worried in advance but recognized that the fear [that he would die] wasn't really rational. I was worried because I was his mother, not because there was anything that wasn't totally routine about an adenoidectomy and ear tubes. With Iyyar, they're treating him as high-risk, which, I have been assured, is a Good Thing; the problems come when the high-risk kids are not identified as such. They know he tends to stop breathing (she says calmly) and are prepared to deal with such eventualities. (Me to pediatrician on Friday: "What would they do if he did stop breathing?" Her, with a casual shrug, "Bag him, put a tube down his throat. Get him breathing again." I managed not to actually faint.) He is not having his tonsils out at the local hospital where Barak had his ear tubes; instead we are going to the less local but still fairly nearby children's hospital, which has an excellent reputation and is one of the best children's hospitals in the country. Not only that, but Ada works there (though she won't be there when we are). We've been there before and have been impressed. They know what they're doing.

I know I shouldn't be this worried, and that IY"H he'll probably be just fine, and we'll be there for a couple of days or maybe three for them to keep an eye on his breathing and then he'll be miserable for a few days at home. There will be a lot of tears and ice cream and Sesame Street and then he'll be happier and he'll sleep better and this will all be behind us. And in a way I wish we could just fast forward, not even to next week, but just to Wednesday morning, just to have the waiting over with. Good thing it's Purim tonight, right?

Just tonsils. It's just tonsils.

Friday, March 06, 2009

Bits

1. Iyyar's surgery is scheduled for this coming Wednesday, as in, the day after Purim. At least I won't have much time to worry the day before.

2. It's getting really really obvious how much he needs his tonsils out. He sleeps so badly that he is impossible to wake up most mornings. To get to school on time he needs to be up by 7:30 at the absolute outside, and that means eating breakfast in the stroller. This morning he got up at five minutes to 9.

3. Avtalyon said Barak's name this morning, clear as anything. He said it a few times.

4. In other good news, Iyyar's tummy issues are, for the moment at least, gone. He says nothing about his tushy hurting, poops without commentary, and has been eating much better. I don't let him have anything with even traces of dairy anymore. Last Sunday he had some cereal that was OU-D (whey all the way down in the ingredient list) and the next day he was screaming. I think we have moved past the point where this could possibly be coincidence.

5. I need to figure out hospital knitting. When Barak got his adenoids out I did the stupidest thing imaginable, which was bring along an Eris to finish. Ha ha ha. It stayed in a bag for months before I could bring myself to repair the wreckage. This time I'm thinking Noro stripes. Interesting, but brainless.

6. The anxiety about Iyyar has settled into a sort of moderate level of panic that is almost, but not quite, enough to prevent me from doing anything else.

7. I'm feeling much better physically, though. As in, I actually cooked dinner last night AND the night before, for the first time in about a week. Now my kids have to get used to the idea that no, we do not eat cereal for dinner, all over again.

Tuesday, March 03, 2009

Soha soha senki

Today's been hard. Nothing in particular, just one of those days when I didn't manage to do anything right. And as if that wasn't enough, I have this stuck in my head, which, well... you probably have to be Hungarian to get the full gloom value of it. Don't bother with the English version either--it's pointless, as most English translations of Hungarian poems are.

As a point of side interest, the poet (Jozsef Attila) once wrote love letters to my great-great-aunt, who was a psychiatric nurse in one of the hospitals in which the poet (Hungarian poet, remember) spent time. (This is less impressive if you are Hungarian. Apparently he wrote a lot of love letters.) She tossed them, because, well, he was crazy. He later killed himself by jumping in front of a train. (Not because of her, I assume.) And they named a university after him. (The one I went to, in fact.)

Only in Hungary. Seriously. I mean, just imagine that here. Sylvia Plath University? Not so much.

Listen to this instead. More fun.

Sometimes

Last night was hard. I couldn't sleep, my head too full of worries about Iyyar. The minute I heard my husband fall asleep, I got out of bed, pulled on a sweater and went back to reading journal articles on obstructive sleep apnea (which, truthfully, was good for me; it's better to be informed). By the time I was really ready to sleep, it was 2 am; as I walked past the boys' room, I heard Iyyar wake up and cry for me. I went in and settled him, but it was too late; Avtalyon was up. I nursed Avtalyon back to sleep and got into my own bed, but just as I was getting under the covers I heard Iyyar wailing again. So I went back into their room and just climbed into Iyyar's bed next to him. "I'm right here," I whispered, "Go back to sleep." He gave me a look of mingled surprise and delight, and went right back to sleep with a contented smile still on his face. I went to sleep too, after a while, and slept till around five, but curled up on half (okay, two-thirds) of a toddler-sized mattress bordered on three sides by headboard, wall, and footboard (and on the fourth side by a sleep-disordered toddler) is not the path to restful slumber. I woke up at around 5:30 and got into my own bed; a few minutes later I heard Avtalyon, up for the day. My husband got him up and changed and let me stay in bed until 7:30 or so, at which point I did finally stumble out of bed and into the kitchen.

Barak was already there, dressed and ready go to. "Am I going to school this day?" he asked me, as he does every day, in his own peculiar turn of phrase. "Yes, but Iyyar's still sleeping. Did you eat breakfast?" "No." "Okay, go get a banana while I nurse Avtalyon, okay?" He did, and found the banana good. "There's no squooshy stuff and no brown! It's just white! I'm going to gobble it all up!" Avtalyon, having at this point been up for over two hours already, was ready for a nap by the end of the nursing session; I went to put him down and was surprised to find, on my return, Barak standing there in coat and mittens, totally ready to go. I was so tired it was as though someone had hit the fast-forward button--wait, wasn't he just standing there not in a coat? What happened? I looked at the clock, and saw that we still had ten minutes. I looked at the counter, and saw a bag of Brussels cookies. I wanted one.

"Barak, if I do something that I am never ever going to do again, are you going to want me to do it again or will you just accept it as a pleasant surprise?"

"I'm going to just assept it as a pleasant surprise."

"Okay." I took out two cookies and handed him one. I cracked open a diet coke and took a swig. We stood there munching, and just as I was contemplating a second cookie for each of us, Abba walked into the kitchen. "Abba, I've been meaning to talk to you about these hallucinations you've been having. Because you're not seeing anything at all unusual right now. You and your dad both have this problem, I've noticed it before." I passed Barak another cookie and we crunched on companionably.

"Yeah, I should probably look into that, shouldn't I."

"Uh-huh." Crunch, crunch, crunch.

"Abba, can I have some milk?"

"That part's not a hallucination. You can give him the milk."

"Um, okay."

Someone, at least, had a very pleasant morning.

In which I don't even know where to begin

Earlier today I had in mind the post I was going to write tonight. It was going to be quite the post. I was going to bring you all up to date on the soap opera that has been our household for the last week or so. I was going to vent. I was going to yell and scream. I was going to bellow my outrage to the very corners of the Internet.

Yeah, well, I was going to. But it's 11:20 and I'm too tired, and I already told it all to Grandma E on the phone earlier. So you get the short, drained, low-volume version.

1. I have bronchitis. I had another episode of asthma or bronchospasm or whatever you want to call it on Shabbos, and on Sunday I got antibiotics. It all sounds so quick and easy when you put it in one sentence like that, doesn't it? Believe me, it wasn't.

2. Iyyar needs his tonsils and adenoids out and it all sounds rather scary and urgent. At the last ENT appointment (which, at the time, sounded scary to me) I was told to schedule the sleep study, and then make a followup appointment two weeks later to discuss the results, which (said the good doctor) took two weeks to come in. I was surprised, therefore, to get a call from the doctor this morning. Somehow or other he had the results already. I did not feel that this boded well. I was correct.

The sleep study was awful. Really really bad.

[Blog post interrupted to go deal with screaming children.]

One of the numbers that should have been, at most, 5 was in fact 80. That one sticks in my head. Anyway, he has very severe sleep apnea, and while this means he really needs his tonsils out, it also means that he is considered very high risk, which means doing it at the children's hospital, with an ICU available, etc. The doctor was explaining to me all the risks (yes, I want to know, but I don't!) and at the end there was a bit of a pause. Which I filled by telling him, point blank, "Don't kill my baby."

There was another pause after that. Apparently no one has ever told him that before. Strange, isn't it?

3. Work is insane. Quite literally in at least two respects. I can't get into more detail here because I don't blog about work. But oh, if I did... I would have a lot of material.

4. It's my anniversary today. Six years! And we still like each other most of the time. (Okay, there were a few minutes yesterday when I wanted to kill him. But only a few.)

5. I'd like to tell you about the appointment I had on Sunday morning about my inability to breathe. I'd also like to tell you about the total jerk of an osteopath I saw, and about his inability to imagine that I had accurately read the package insert that came with the albuterol inhaler, or that I knew the difference between "teratogenic" and "tumorogenic." I'd like to tell you about how much his attitude, and his disinclination to get his information right, ticked me off. But I'm tired, so I won't. Instead, I'll let you read the following, cut and pasted from the original. Note that the correspondent who can't read package inserts is, inexplicably, the only one capable of using the shift key.

----- Message -----
From: UBERIMMA
Sent: 3/1/09 07:38 PM
To: NAME WITHHELD ON THE ADVICE OF THE CHOFETZ CHAIM, DO
Subject: Medication Advice

Dear Dr. Withheld,

When I came home I checked up on albuterol online. It is indeed an FDA category C drug, with both teratogenic and tumorogenic risks, not a category A as you assured me this morning. Also, so far as I can tell the categorization system is per the FDA, not the WHO.

Summary can be found here:

http://www.drugs.com/albuterol.html

Fuller info here:

http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=3780

The package insert advises to either discontinue the medication or discontinue breastfeeding.

I thought you should be aware of this.

Uberimma

To:

Uberimma

From:

NAME WITHHELD, DO

Received:

03/02/2009 1:20 PM

thanks for the update. i must have misspoken if i used the term "class A'.
as you know, the FDA category system refers to drugs in pregnancy, not drugs in lactation.
in our discussion yesterday i was referring to the World Health Organization listing, which for albuterol is
"1. Compatible with breastfeeding
Drugs are classified as compatible with breastfeeding if there are no known or theoretical
contraindications for their use, and it is considered safe for the mother to take the drug and continue
to breastfeed."
different organizations and dr's do use different classification systems and have differences of opinion.
cautions for using a drug are weighed against expected benefits and i knew you were aware of the information on albuterol since we discussed it. i'm sorry for the mix up.