Finally, in mid-March, when she was still having at least one spell a night, I took her in. Her regular doctor was on vacation, so we saw a physician's assistant. Her lungs and ears were clear, but he could see some irritation in her nose that looked like a sign of allergies.
Two days later, we saw a pediatric allergist. He couldn't see distinct signs of allergies and thought that the cough might be caused by some residual spasming in her upper respiratory tract. He suggested testing for allergies, just to be sure.
Luckily, Sarah has conquered her fear of doctors, for the most part. She's reached the point where she's more interested in the process of being examined than frightened of the caregivers. When the technician arrived with a marker and a rack of tiny vials, she was intrigued. She sat calmly as the woman marked the places on her arm then innoculated her with various allergens. A few minutes later, she looked as though she'd been the victim of some S*tanic ritual.
The testing showed she is allergic to grasses, but that wouldn't be a problem during the winter. The allergist said he could prescribe a short course of steroids to calm the cough but he thought it would go away in a couple of weeks. I chose to wait.
A couple of weeks later, the cough was still around, so we tried Pr*dnisone for five days. The house was quiet on the second night, for the first time in months. Third and fourth nights, same story. On the fifth night, however, it returned. The next day, Sarah had a runny nose and a cough, and the following night, she awoke with a 103.5 degree fever. She has had a fever only a couple times since she's come home. Decreased immunity is a side effect of being on oral steroids, however, so perhaps they allowed a virus into her system.
I brought Sarah to her regular pediatrician, who said her lungs still sounded clear. The doctor had seen a lot of high fevers in kids lately, however, so she wanted to check for flu, even though Sarah had a flu shot. She said she'd like to do a nose swab to test for flu. It sounded harmless to me, so I agreed.
I became concerned when two somber nurses arrived. One told me to lay Sarah on her back and hold her hands. "She's not going to like this," she said. The other held Sarah's head while the first stuck a tiny-but-way-too-long Q-tip up her nose. It was quick, but obviously very uncomfortable. Sarah winced and squeezed her eyes shut to keep the tears in. I did my best to console her, while the nurse did the other nostril quickly. Sarah lunged into my arms and melted into tears. I felt like a traitor. How I hate being a party to causing her pain. (The test result was negative.)
As for the cough, the doctor suggested we try a nebulizer with Alb*terol and a corticost*roid for 30 days to try to calm down Sarah's upper respiratory tract. She sent us home with a mini air compressor connected to a medicine cup by rubber tubing. For the last two weeks, Sarah has had four 10-to-15-minute sessions a day on "her machine," as we call it. Although she's pretty good about sitting and listening to me read books, and sometimes just looks at books by herself, it's a real pain. My heart goes out to parents of small children with chronic health conditions who need frequent treatments. Getting a three-year-old to sit still and cooperate is no picnic.
Fortunately, the regimen seems to be working. The cough is gone, and we're all snoozing through the night. I'm sleeping more soundly than I have in years, I swear. I'd forgotten how it felt to wake out of a deep sleep in the morning. But enough about me. Sarah's got two more weeks of treatments, and I pray the cough doesn't return when she stops. I'd hate to have her machine take up permanent residence in our house.
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