TP2, You could of been on my unit.

We are not allowed to say certain things. People always ask: Do you like my md? Is he a good md? Are they doing the right thing for my dd? Cannot really answer any of those. (or get fired?) BUT If I am asked " what would you do if you where her mom?" "What pediatrician do you use?" "would you ......." Always turn the question as if the person was the mom. We can definately answer than. It is a game. So many times, a md is playing around wasting time, when we all say to each other "pt needs to get out of here and be transfer to children's in chicago ...." But cannot suggest it to parents. But if the parent ask "if this was you child would you transfer them?" They want to answer you, but there are loop holes. There are many md's out there, that are great but if you have a sick kid, not so great. I personally don't care for md's that use alot of pa's or nurse practitioners. Especially for sick child visits. Regular physicals is one thing, but sick kids. Your paying him, and he is working for you. There are many mds in america, if you don't get good service > move on. Same thing at our hospital. Lots of competition in the area > so we have to do alot of "extras" just to stay in business. Hate to think of medicine as business, but it is. Don't feel bad about changing an md. Good you found out now before something bad happened and he didn't handle it right. (ie = you florida incident)
I have gotten some 3 yr olds to do peak flows. Make it a game / not associated with meds, or treatments. Let older sis do it, and you and she will want to play too. Just a matter of timing, & ability to blow.
Be very careful with her when retracting etc.. .they can be very dangerous signs. Don't feel like your a hypocontriac, this is very serious. Asthma is a disease for the ER. Can get worse fast, and be dangerous. Older kids with a large history, will acctually tell you "i am getting tight" Need a treatment. As you both get used to it, you will pick signs up earlier and earlier. If you wake up at nite and she is bad, and worse than usuall > feel free to call 911. This is a perfect use of the system. She might need 02, the crew can provide. 911 might have you giving neb, till they arrive > and it is safer to take to hospital this way, than in your car with no care available.
I hate to bring up the puppy, but does it bother her? Was she asthmatic before he came into the family? Animals are a big issue. Something to think about. Carpets are good to remove. But does she have alot of stuffed animals? Same problem. md will tell you to get rid of them. Anything for dust. Hepa filters are great. I have a large honeywell in bedroom, (jet engine sounds) and a hepa vacumn cleaner too. Both have helped. Vader is an outside dog. Allowed only in certain rooms of house. If he is bothering my allergies He has to go out. Something now that is setting me off: is the fire pits. They smoke up our neighborhood and sis and I cannot breathe. Had to turn the air conditioner on, to feel better. Weather (seasons) also will trigger. Turning on furnance the 1st time and the vents dusty is a trigger. Spring is bad, everything enviromental. You will start checking the mold count. I used to wonder: who cares? Now I know. If I wake up coughing > I will have a busy day at work, cause everyone else did too.
Nebulizer, if she is asleep try blowing it on her. Especially if she won't wake up and cooperate. with small infants we just blow the neb on the nose and mouth. Did they give you a mask for the neb. or just the mouth piece? Either one works the same, I prefer mask on smaller kids. You can usually rig up one if you put a styrofoam cup on end of it and the cup fits to childs face. Cut a nickle size hole for outside air to mix. Hold in place. That way the treatment doesn't all go into the atmosphere. Of course, ask you md too.
Part of her being disagreeable might be your neb medicine. Albuterol is a good drug and used widely. But side effects are hyper! Trouble sleeping, concentrating, upset stomach, you feel "nervous". Xopenex is a refined albuterol = supposed to be a little easier on the side effects. But VERY expensive. Any oral / iv drugs: are usually in the steroid family. Same side effects here and multiple by 10. Togther they work great, BUT you never sleep, and feel wound up.
Sounds like you have a great support system, and new md. Those will help so much. You probably already been here. But webmd.com is every easy to use and fairly easy to understand the info. If you haven't been there yet. If your at the mall, Barnes and nobles has a nursing / medicine section with great books for reference. Look up drugs, or treatments. Gives you info to talk to md about.
Hope she is feeling better soon.

You might need to breath some of the albuterol > to stay awake every nite too?

Just kidding, try to get some sleep.
mky
