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Dear Doctor Letter

Illnesses

About the illnesses Our Children Sometimes Get

Illnesses, especially ones involving the respiratory tract are our children's biggest enemies. On this page I've included information about the infections our kids are most susceptible to and some tips on preventing or minimizing the effects of them.

I asked a Dr why children with severe neurological damage are so susceptible to respiratory problems. The following is her answer:

"Well, basically the respiratory problems come from several areas:

1) impaired brainstem functioning- can include aspiration during swallowing as you mention, 40% of which is silent, and it is really unknown how much can be tolerated chronically without long term lung injury- can also include lack of good deep breathing that fully expands lungs, making atelectasis or pneumonia more likely; also a poorly coordinated or weak cough can contribute.

2) GE reflux can cause laryngitis and aspiration also, and generally poor handling of secretions leads to aspiration outside of swallowing also.

3) any additional pulmonary problem may be kind of a double whammy effect- if you had great motor pulmonary function and healthy lungs to start with, you might handle the usual viral infections and reactive airways disease (asthma) etc. with usual treatment but if not, they can really cause greater problems and lead to more lung injury and poor function also.

So I guess the moral is get those flu shots and investigate for aspiration and get respiratory therapy to compensate the poor expansion or weak cough, and hope this is helpful!" (Vikki Stefans, Physiatrist, Arkansas Children's hospital)

Some of the more common respiratory problems our children have are:

1.       Aspiration pneumonia

2.       Reactive airways disease or asthma

3.       Viral infections such as colds and RSV (rhinal syncytial virus)

4.       Problems related to GERD (reflux)-this is explained in more detail in the links on the Feeding difficulties page.

5.       5. Respiratory complications from Influenza (flu)

Prevention methods can include:

1.       Yearly flu shot

2.       Pneumovax: this is a once every 10 years or so vaccination that protects the child from 23 different strains of pneumococcus bacteria.

3.       Investigations to rule out aspiration or reflux

4.       Chest physio and suctioning are also helpful in clearing secretions from the lungs so they don’t have a chance to get infected.

 Cause of lung damage and increased need for oxygen in our children
The following was told to a parent by a Dr in California
"kids who have very severe neuro problems usually have reflux.  It could be obvious or silent (probably both).  In the silent reflux these kids can have a tiny drop of stomach Acid enter the lungs each time they reflux bus we wouldn't necessarily notice it.  However it damages that part of the lung and causes scarring.  In a regular lung we have lots of surface that if one part has a problem we just use another part to exchange oxygen but with these kids if they have repeated episodes of reflux then when they get even a tiny bit of pneumonia, reactive airway disease or asthma they have no other surface area of lung to used to breath with.  Therefore they breath faster and have added need for oxygen.  It is very important to stop the reflux as soon as possible."

Word of hope about lungs
Children grow healthy lung tissue up till the age of 8.  Therefore if you control the risk factors (aspiration, reflux, etc.) every day without pneumonia is a chance for healthy tissue to grow.

Pneumonia and aspiration
For many of us these two words are our child's worst enemies. I'm including some general information on Pneumonia in children as well as information on specific types of pneumonia that our children tend to get.

Pneumonia Signs and Symptoms:
http://kidshealth.org/parent/infections/bacterial_viral/pneumonia.html  

Aspiration Pneumonia
http://www.ecureme.com/emyhealth/Pediatrics/Aspiration_Pneumonia.asp 

Bacterial Pneumonia
http://www.healthsquare.com/mc/fgmc0406.htm

This information is similar to the previous info on Bacterial pneumonia but is different enough that I thought it should be included.
Viral Pneumonia
http://www.healthsquare.com/mc/fgmc0407.htm 

Walking/Mycoplasma Pneumonia
http://www.drgreene.com/21_206.html

Pneumonia, Pneumococcal
http://blueprint.bluecrossmn.com/topic/pneumococcal  

Other Bacterial & Viral infections common in children with Hydranencephaly

Pseudomonas
This bacteria is often found in children with Hydranencephaly.
Pseudomonas infections  http://www.healthatoz.com/healthatoz/Atoz/ency/pseudomonas_infections.jsp# 

Respiratory Syncytial Virus (RSV)
http://www.cincinnatichildrens.org/health/info/infectious/diagnose/rsv.htm 
RSV is common in children with Hydranencephaly and can cause severe illnesses.

Bronchiolitis
http://www.cincinnatichildrens.org/health/info/chest/diagnose/bronchiolitis.htm

Flu (Influenza)
http://www.cincinnatichildrens.org/health/info/infectious/diagnose/influenza.htm 

Upper Respiratory Infection (URI, or Common Cold)

Sinusitis

MRSA Information for the Public
http://www.cdc.gov/ncidod/hip/Aresist/ca_mrsa_public.htm
(this is an increasing problem for children with Hydranencephaly)

Prevention of Illnesses

Immunizations - General Information

http://www.cincinnatichildrens.org/health/info/immunize/imm_gen_info.htm

The Importance of Immunizations
http://www.cincinnatichildrens.org/health/info/immunize/importance.htm

Reactions to Immunizations
http://www.cincinnatichildrens.org/health/info/immunize/reactions.htm

Vaccine Myths
http://www.immunize.org/catg.d/4038myth.htm 

RSV Protection
At this time there is no immunization against RSV.  However, Synagis contains antibodies against  RSV. It needs to be given monthly during the RSV season. As it is very expensive (over $1000 per dose) it is only given routinely to children most at risk (Premature babies, babies with compromised immune systems and kids with severe medical problems such as those with Hydranencephaly).

Synagis:
http://www.medimmune.com/products/synagis/index.asp

Pneumococcal Vaccines:
There are now 2 different vaccines that can prevent pneumococcal infections. Here is information on the newest of these vaccines that is now available to children under the age of 2.

Pneumococcus (Prevnar)
http://www.keepkidshealthy.com/welcome/immunizations/pneumococcus.html

Pneumovax® 23
http://www.rxmed.com/b.main/b2.pharmaceutical/b2.prescribe.html 

Other pages in this section:
Illnesses
Immunization Experiences
Antibiotic Use Information
Care of Ill Child
Illnesses Experiences
Illnesses Glossary

 

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August 16, 2001- January 12, 2005

This website is funded in loving memory of Jason S. by his mother Kammy

The information on this site is provided by families, caregivers, and professionals who are or have been caring for a child with Hydranencephaly.

Please report any broken links or missing photos to angelbearmom@shaw.ca