MY HAPPY WHEEZER

HAPPY WHEEZERS = happy baby, but having wheeze

what it is exactly??

This is a condition in which a child, usually under 1 year old, has a chronic, persistent or intermittent wheeze, heard without a stethoscope, but is happy and smiling, not at all distressed.

It is thought that inflammation and oedema account for a more significant part of the airway obstruction in the very young child and hence bronchodilators are less effective.

The diagnosis "Happy wheezer" is thus for the most part a psychological reassurance, both for the parents and the physician. However, there is debate as to what the smiling actually means and whether is important to monitor oxygen levels in this apparently benign condition.

this happened to Faris since Monday.. but monday evening, he had wheeze but not really a happy one lah.. he looked 'uncomfortable' with the wheezing.. i'd partly blame the cold weather and rain in Cheras since morning and partly the 'secretions' that he had since God-knows-when..

i gave him syrup Ventolin, partly resolved but still wheezing..
when i listened to the chest -- wallahhh.. prolonged expiratory phase, rhonchi (wheezing) and also crepitations... temp - normal.. chest - subcostal recession but no laboured breathing..

i just watch an eye on him..
thank Allah, feeding OK, sleeping also OK. He was not cranky but i knew he was uncomfortable..
around 9.30pm, the wheezing almost gone.. and he slept soundly through the night.. alhamdulillah

but yesterday around 10am, my maid called up and
told me "Faris bernafas macam semalam la kak"

alamak.. my DH had a class in UM, and i stucked 'carless' (we carpooled today and he had the car keys)..
but later maid said, he slept ok after had his EBM.

@ 2pm, after DH finished his class we brought him to A&E..
his lungs had generalized rhonchi & creps.. so he had a nebuliser...
alamak.. payah nye nak bagi... he cried all the way.. cian nengok!!
then when the MO reviewed, lungs were clear, so he was discharged.

But then @5pm, when we were just about to leave the hospital ground, he wheezing again... huwarghh i'd blame the air-cond (in the car) this time (cos i left him with daddy in the car for 10 mins before i managed to 'cabut lari ' from bosses who were having discussion in front of the pintu jabatan)


so we went back to the A&E.. when examined, he still have the rhonchi and creps... (owh my poor baby...)
but no respiratory distress..
and he is the most happiest patient in the ER at that time.. ( I thanked Allah for that)

he had another nebs -- this time no crying at all.. the trick was -- i let him 'take' the mask voluntarily.. and being mummy's good boy, he was 95% compliant with the nebs.. (fuuhhh lega, at least i can guarantee he gets most of the medication)

after review, still generalized wheeze and creps.. so another nebs after half an hour.. (huwarghh kena tunggu lagi...)
so we waited, whilst i breastfed him.. then he slept..
this time much easier, with him soundly asleep, the nebs gets directly into his nostrils.. luckily the 'sound' of the gas did not scare him (or woke him up)..
after that, the lungs were clear.. alhamdulillah we went home.. cian kakak & abang (who cried gila-gila when we left the home with Faris)

last night, he was OK -- no more wheezing but he is still a HAPPY baby like always...

this morning, before i left -- i listened to his chest, alhamdulillah clear... creps also gone..
"hope that was our last visit to the asthma bay ok my dear Faris... "

so, the bottomline is:

if u are worried, just bring ur child to the nearest hospital... among the signs of respiratory distress (which necessitate emergency or immediate treatment) are:

- difficulty in breathing

- increased respiratory rate (normal : 20-40 per minute (infants), 20-30 per minute for preschool children)

- cyanosis (blue discoloration of face/extremities)

- fever, fits

- wheezing (not a happy one)
- use of accessory muscles eg neck muscles

- nasal flaring (idung kembang kempis bukan kerana dipuji )

- subcostal recession, intercostal recession

- chest indrawing


errr.. these are among the signs that i can still remember... uhh.. i tak buat Paeds rotation, so my knowledge agak kureng.. sorryyyyy.....

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