Mar. 13th, 2011

Well, foo.

Mar. 13th, 2011 11:06 pm
marydell: My hand holding a medusa head sculpture (by me) that's missing its snakes (Default)
Charlie woke up at 1:30 am (pre-DST-time) and eventually went back to sleep at 5 am (post-DST time) and stayed asleep until 9. Managed to have a playdate with only a couple of meltdowns, then took a nap (half an hour shorter than usual).  Don't recall if there was another meltdown after that or just generally being an asshole - in either case there was hitting, biting, and scratching, also some pushing and bouts of clinginess.  In between all that he took a bath without complaining and was cheery and hypomanic in phases. 

On the good side, this has shown us pretty definitively that his aggressive and moody behaviors come from being tired, period.  The fact that some drugs make him extra tired (benadryl) and that tiredness makes him less verbal also play a part.  Based on what we've seen over the last month, we can say with confidence that good sleep equals good behavior.  This is huge because it means he doesn't have a neurological/developmental problem, or at least not a serious one.

On the bad side, Singulair goes on the no list, because these recent sleep disturbances appear to be tied to taking it.  We stopped giving it today (we had been giving it in the morning, to better monitor its effects and to try to separate it somewhat from sleep, to no avail apparently).  If he's in clear need of it we can probably give it for 3 days or so, but we can't use it for regular maintenance. (We use albuterol for rescue bronchodilation during a flare, but the idea of the other drugs is to prevent flares from happening at all)

On the other good side, there's a possibility that the asthma improvement we've been seeing is really down to taking Tums twice a day, rather than due to things he reacts badly to.  This isn't entirely absurd, because he does have a history of reflux, and his asthma typically manifests as a cough with eventual vomiting, which could easily be GERD.  Also he's been eating us out house and home all week, coinciding with the Tums regimen.

Now I have to decide if my asthma doctor should continue to be his asthma doctor, or if we should go back to the overly busy other asthma doctor who is a genius-by-reputation and was on Mystery Diagnosis and is the regular pulmonolgist at the local Children's hospital.  They both do pediatrics but that's his specialty; her approach to immunology is more to my liking, but his approach to prescribing is a little more nuanced.  Before I take him back to either, though, we'll be seeing the GI specialist, which will inform the rest of the approach, I hope.

Meanwhile I really hope Singulair has a short half-life!  Because this up-in-the-wee-hours horseshit has worn out its welcome, for serious.

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