Vn78.1 Allergies Controlled 8/26/77-9/2/77
8/26 Today we took Miriam to her doctor, a pediatric allergist, and
explained both her symptoms (waking in the middle of the night, wheezing,
coughing, and vomiting) and our own sense of their severity (it has been
happening regularly; Miriam has had only 2 uninterrupted nights of sleep
since our return from vacation). The doctor’s response was threefold.
He gave her a shot of adrenalin, which rapidly cleared up her wheezing
(it was not so bad as it had been anyway). He prescribed for use tonight
a sustained release form of her regular medicine and offered to proceed
with a cortisone analog medication if the other prescriptions were not
effective. Gretchen and I are reluctant to proceed to cortisone treatments
unless absolutely necessary because we believe titrating the hormonal balance
is a much more profound intrusion than is the bronchodilator medication.
8/27 Miriam slept ill last night. She waked again in the middle of the
night coughing and threw up accumulated mucus. The change resulting
from the sustained release drug is that Miriam waked at 4 am instead of
2 am. Once she reaches such a state, she is unable to take a new dose
of medicine without risk of regurgitating it. This will not do.
8/29 Since entering the cortisone regimen, Miriam’s condition has
improved radically. She has had 2 successive nights of uninterrupted
sleep and is no longer physically depressed. I judge this regimen, to
be continued for about 4 weeks, worth the risk of the two most prominent
side effects: fluid retention and increased appetite (Miriam has lost
4 pounds since the beginning of the summer).
8/30 Information relayed by Hal Abelson from his wife supports the
doctor’s judgment that the addition of cortisone medication is now the
treatment of choice. In her work Lynn has seen many children whose
conditions have been radically improved by this treatment with no ill
effects. The synthetic analogs of cortisone engender fewer side effects
than the drug form of which my mother had a very bad experience a decade
or more ago.
9/2 Last night was Miriam’s first following a day wherein her cortisone
intake was nil (she has begun a schedule of alternate day doses).
Miriam slept well till 8 am. The doctor now advises reducing her
medication further to 2 cortisone tablets every other day.
Relevance
These notes recount Miriam’s rapid improvement from the intensified
allergic reaction experienced this August (the first time) at the beginning of
the ragweed season. Skin tests last winter indicated her vulnerability, but we
had not before seen such a manifestation of her allergic sensitivity.