2 am: The whole house is shaken by a loud, deep, rattling, “bark!” I sit straight up in bed, and realize the noise is coming from my 3 year old’s bedroom…”bark! bark!” My heart is racing, as I fly out of bed, throw on my robe and rush toward his door…”bark!” my imagination conjures images of a broken window and a wolf standing over my child’s bed waiting to devour him…

When I round the corner and throw open the door, there is my sweet 3 year old, kneeling on the floor, bracing his hands against his knees and, with his mouth wide open comes the most unholy and supernatural sound I’ve ever heard from a being so small – “BARK!” Flooded with relief (no broken glass, no wild salivating carnivores…) I sweep down to wrap my arms around my sick kiddo. “Oh, Jimmy! You’ve got a nasty cough. Mommy’s here to help.”

Those have got to be some of the best words in the world – “I’m here to help.” Just that little touch of confidence and calmness was enough to still his coughing. That loud, seal-like, barking cough is the hallmark of Croup, a respiratory virus that causes dangerous swelling in the trachea, impeding air flow.

from: http://www.anejo.eu/croup/

However, he was still struggling to breathe, so the First Responder in me went into action with the following protocol:

1. Call for help. At 2 am on a Saturday, no less, you are either calling 911 or a Nurse Hotline. As Jimmy was conscious, responsive, and able to speak, this was not a life-threatening emergency. As we have a close relationship with the doctors and nurses at Denver Children’s Hospital, we called their 24/7 “Parent Smart Line”, which would have us talking with a live nurse within 15 minutes.
2. Assessment: You don’t need any special training to perform a quick assessment for potentially life-threatening situations or imminent danger. Check skin color, LOC (level of consciousness), muscle tone (gently hold his arm and lift, bend, lower. Normal resistance indicates healthy tone, and probably good oxygen/blood perfusion, and abnormal stiffness or flaccid responses indicates insufficient circulation or oxygenation.) Any discoloration – especially blue lips or blue rings around the eyes means they are not getting enough oxygen, call 911 immediately.
3. Stay calm, reassure your child: One of the most amazing therapies for respiratory distress is DO NOT PANIC. Your stressful response can frighten your child, which triggers a tightening in the diaphragm and larynx, inhibiting optimal breathing. One technique that is simple and effective is called “Mirroring”: start by imitating his or her strained or labored breathing. You can even talk them through this, “I know it’s hard to breathe when your throat is tight like this…” then slowly change your breathing to be more relaxed and smooth. The child will naturally imitate your breathing pattern, improving the condition dramatically. “That’s good! I’m going to stay with you and take several long, deep breaths…”

The assessment and mirror techniques can be done while you are waiting for a call back from emergency dispatch or a nurse hotline.

2:15 am: Jimmy is stable, still has labored breathing (called strydor, on both the inhale and exhale), no discoloration, normal LOC, normal muscle tone. He is running a low fever at 100.4 degrees Fahrenheit. He can talk and walk and take small sips of water. As soon as I realized he was not in serious trouble, I reached for my Homeopathic First Aid kit and grabbed Drosera 30c. Jimmy had one dose at 2:05 and is already breathing easier, and wanting to go back to bed.

It is pertinent to note the timeline, here as well: with any symptoms of difficult breathing time is the essential factor in response, treatment, and outcomes. When you can’t breathe, there’s no waiting for a treatment to work. Even significantly lowered blood-oxygen saturation can impair cognitive function and essential biological functions.

With homeopathic remedies in a crisis, it is often necessary to repeat the dose several times at short intervals. As Jimmy responded well to the first dose of Drosera 30c (within minutes he was breathing easier, and asking to go back to bed), I knew I had a well chosen remedy that might help get him through the night. Right as he lay back down in his bed, his breathing became harder and he started coughing again. Another dose of Drosera 30c, and within minutes he is reclining comfortably (propped up on pillows in a “moderate Fowler’s position” – something we do instinctively to maximize chest/diaphragm expansion).

Other things the nurses with Denver Children’s Hospital Partent Smart Line recommended for us to do safely, at home, for Jimmy:

• Run a hot shower and sit with Jimmy in the warm, humid air. Alternatively, if the warm air does not improve breathing within minutes, try cold, humidified air.
• Run a humidifier in his room all night, keep it close to his bed.
• Fill a pot with boiling water and add kitchen herbs like sage, rosemary, thyme and oregano and set the steam by his bed, or have him lean over the steam with a towel over his head. My mom did this for me all the time, especially when I had a sinus infection or a deep cough.
• Monitor constantly for use of accessory muscles in breathing (i.e., lifting the shoulders or nodding the chin forward), for changes in breathing patterns (not able to catch breath, hiccough, long intervals between exhale and inhale), and for any changes in skin tone.

Needless to say, mom and dad were at his bedside all night just watching him breathe. The following Monday we took him into his pediatrician first thing and obtained a nebulizer with albuterol. Luckily, we never ended up needing it. The doctor also advised that croup can last up to 2 weeks, and that it is usually worse at night. Jimmy recovered within a few days with plenty of rest and chicken noodle soup, immune supportive herbs like echinacea and with the help of homeopathy.

It is important to note, I have also seen cases of croup where a child did not respond to homeopathic treatment, nor to herbal regimens, nor to an inhaler with albuterol, nor to the use of a nebulizer, or supplemental oxygen. (This was witnessed within a matter of minutes – time is essential!) The underlying pathology was far more serious than any of these treatments options could address, and the child ended up going to the hospital where he received atomized epinephrine (in the ambulance) and steroids (at the Emergency Department). These treatments were lifesaving in this case, and the parents made the right call. Once this child recovered sufficiently to be sleeping through the night and not struggling for breath, his cough can be treated safely at home, as well as any lingering side-effects from the epinephrine and steroids.

Croup is a serious medical condition and should be watched very closely. If you feel that your child may have developed a respiratory infection or is having difficulty breathing, contact your pediatrician immediately. While I believe strongly in the power of natural medicine to heal, I am also adamant about the wisdom of modern, emergency medicine – it is truly one of the things “conventional” medicine does best. When in doubt, call 911.