Hi, Lori!

Iain is undergoing scopes again on Monday. We met up with the anathesiologist (forgive me, I can never spell or pronounce that word) today for his assessment.

She noted the continues snot drain off the kid and she asked how many days he has had it. It has been uh, since October.... She said his chest sounds clear for what she could detect above the screaming and the problem seems to lie in his sinuses, etc. We have him on a flovent protocol where he gets one shot in the morning and evening and she said to continue that. We usually give him ventolin as required, but she said to give him shots of it everyday until the surgery to keep him "open and clear". Will this actually work? I avoid ventolin use like the plague unless he truly needs it and I did not think to ask her if I should give it once or twice a day with the flovent or how she wants this done. Usually when I give the two together I use the ventolin first, then give flovent.

Do you have suggestions for how much I should give him when he is not wheezing? And is this normal to do?

We are to skip his prevacid on Monday and yet transfer his zantac dose from noon to morning before surgery, too.

**mental note to write all this down** :)

Leigh,
This is not at all unusual. We routinely administer albuterol (Ventolin) to patients pre-anesthesia to "tune-up" their airways. Anesthesia frequently causes bronchospasm, so we like to see those airways in the best shape they can be prior to giving anesthesia. Older adults are often considered not to be surgery candidates if they have lung disease. As for dosing, I would do it just like you do when he is wheezing, at least twice a day. And great job with the two. Giving the albuterol first is exactly what you should do!!!

If you have any other questions, please ask. You're in my thoughts and I pray that all goes well.