Dr. called me

[oneaddress]

Asthmatic child's Dr. called me last week and said that his allergies were severe. No smoking or pets. Dr. also called mom with test results.  Today he came home reaking of smoke. What should I do to prove that he is always returned in this condition? I know that smoke smells evaporate. He also said that he was given allergy meds. She did not tell me. I will text her to find out what he has taken, because I do not want an overdose. How do I preserve the evidence or can I.

[ocean]

You could go back and have a line added "no one will smoke around the child inside/outside and in vehicles as child has severe allergies" Have the dr write something up about child's condition for proof.

[sillystring]

We have that same line in our CO and honestly, the child still comes smelling like smoke and we haven't been able to do anything about it.  There's not really an easy way to prove that the mother is letting someone smoke around the child. 

[tigger]

Put the child's shirt in a sealable plastic bag (like a gallon size ziploc bag) for evidence.

[ocean]

Take child right to dr...and have them document it? 
You can have a lawyer threaten her with medical neglect...? Pay a lawyer just to write a letter on letter head and that if child comes to you smelling like smoke again you will file?

[grapeape]

take the child directly to the pediatrician. the doc with talk with the child and of course can smell the smoke on the child. also take a tobaccalert test that you can purchase at a local pharmacy. it is a urine test for second hand smoke exposure. this will document the ACUTAL amount of exposure.

the pediatrician is obligated to contact child protective services for medical neglect. (i know this because i have been in the exact same situation and unbeknownst to me dd's pediatrician called cps)

is the child's asthma exacerbated by the second hand smoke exposure? DOCUMENT
has he/she been to the ER on steroids, etc... DOCUMENT


also, does your CO contain any wording that refers to both parents following physicians medical advice or medical care?
if so, file contempt.

[oneaddress]

I will take child to doctor and obtain a test kit. Takes steroids often because of asthma. As a matter of fact, BM says that steroids cause to much "hyperactivity" and therefore does not want to give the full amount. BM does not think that asthma is a serious disease and thinks that I take it too seriously. Anytime you have a hard time breathing, it is serious. Thanks for the suggestions.

[Kitty C.]

'BM does not think that asthma is a serious disease and thinks that I take it too seriously.'

Pardon the pun, but she's dead wrong.  A good friend's otherwise healthy 12 y.o. son died of an asthma attack, even tho he had it well controlled via medication.  You are absolutely right to be seriously concerned and if the asthma is smoke-induced, you will need the medical back-up and resources to take action in court.  Long-term steroid usage is not good, so if the asthma can be controlled by staying in a smoke-free environment, it will limit the amount of steroids needed to keep it at bay.  Stay on top of it..........

[grapeape]

oh NO!  if BM isn't giving the full dosage of the steroid she is actually doing more harm than good. you must inform the doctor of this.
not properly administering prescribed medications for lung disease coupled with second hand smoke exposure is MEDICAL NEGLECT.

is the child seeing a specialist (pulmonologist)? larger clinics even have a large (step-in) approximately 6-7 ft tall spirometry machine. this machine is vital in measuring inspiratory and expiratory air flow.

during a flare-up the child probably needs albuterol or xopenex via nebulizer every 4 hours as well as the oral steroid.

the child's lungs can be permanently damaged from recurrent attacks. it is called lung remapping.

think about a machine, with moving parts. if you toss sand in it every once and a while... it still may work. not as well. and over a long time of having sand in its moving parts you can bet it will not function as well down the road.

please document everything... every event. get copies of medical records, ER records. you will also need to prove that she smokes in the child's presence. that is very difficult. so other than what i have said to do... if you can get photos or video that would be even better. i cannot advise on how to obtain this evidence unless you hire a PI, like i did.

otherwise, it is very difficult to prove it happens.

did you say whether you had a part in your CO about following medical orders/advice/prescriptions?
if it is there, you can file for contempt yourself.

oh... and did the asthma develop after the CO was entered or before?

[phil]

Everyone means well, but the focus (legally) is not right.  If there are no orders to the contrary, Mom can smoke around the child.  Of course as a Mom, I cannot imagine for the life of me doing that, but ugh...anyway.  You need to file for an emergency order asking that Mom, visitors, etc... are not allowed to smoke in the same house/car/vicinity of the child.  You also need to ask that Mom must comply with the physicians orders as written.   But honestly, these are difficult orders to enforce.  The other problem is - child comes home smelling like smoke, or so you claim.  You put clothes in a bag.  Problem with this is - this is so easy to dispute in court, Mom says she didn't smoke around child, you said she did.  You have the bag with shirt in it. How do you prove this came home that way and was not altered by you? Same thing with the test to measure second hand smoke.  You cannot prove that the child was only exposed at Mom's.   It's a very easy thing to have thrown out. You can take child to the doctor too, but it is YOUR allegation she is not giving the meds as prescribed. You have no proof of that, so medical neglect is extremely difficult to prove. Also, you can't prove an asthma attack was precipitated by smoke rather than another factor.  I don't mean to sound negative, just have seen this so many times and nothing is ever done. It is such a difficult thing. My sympathy is with you.    What you can do - get the orders for no one to smoke, must give meds as prescribed, file contempt for her not giving you the information on the meds...have an attorney threaten her, maybe she will shape up.  Truly , my best to you.

[Kitty C.]

'......you can't prove an asthma attack was precipitated by smoke rather than another factor.'  Maybe a layperson can't, but a medical specialist CAN.  They can run tests...not so different than allergy testing...to prove what triggers the asthma.

One thing to realize, phil..........this is not criminal court we're talking about here, where you have to have proof 'beyond a reasonable doubt'.  This is family court where all they need is the preponderance of the evidence to weigh in favor of one party over the other...at the discretion of the judge.  So if you come to court with enough evidence, whether you can prove beyond a reasonable doubt or not, and convince the judge, you CAN get an order to eliminate anyone in either household from smoking around the child.  You can even get sanctions in the order if the no-smoking order is violated....some judges have reversed custody, because we're talking about child endangerment here.

[phil]

Kitty,
I absolutely agree with you and know we are talking family court.  That is why it is extremely important to get an order stating no one can smoke around the child and the child must be given meds as prescribed.  That is the posters starting point. 

It is very important to understand there are different classifications of asthma..intrinsic, extrinsic and mixed.  Understanding that is critical because intrinsic asthma is not allergy-related, in fact it is caused by anything except an allergy. It may be caused by inhalation of chemicals such as cigarette smoke or cleaning agents, taking aspirin, a chest infection, stress, laughter, exercise, cold air, food preservatives or a myriad of other factors. (which would be important if it is this type and Mom is smoking around the child.)

Treatment of intrinsic asthma is not easy as it may not be known what triggers the asthma in the first place and therefore avoiding triggers can be impossible.
Avoidance of things with strong odours such as perfume or cleaning agents may be possible at home. Not going to smoky areas, avoiding air which is hot/cold/humid/dry - depending on your particular trigger and keeping calm can only be maintained up to a point.

Extrinsic is when an "allergen" or an "antigen" is a foreign particle which enters the body. The immune system over-reacts to these often harmless items, forming "antibodies" which are normally used to attack viruses or bacteria. Mast cells release these antibodies as well as other chemicals to defend the body.
Extrinsic asthma is caused by this type of immune system response to inhaled allergens such as pollen, animal dander or dust mite particles.

The different types of asthma are very important to understand because if the child is diagnosed with extrinsic asthma, while second hand smoke is always harmful, it would not be what precipitated the asthma attack.   It is very important for the poster to clarify with the doctor what type of asthma it is. 

Also regarding what you said, there can't be any sanctions if there aren't any orders forbidding it, so that is why I said the focus needs to be on getting the orders. 

[Kitty C.]

Phil, you missed the whole point of my post.  Even tho I've been involved in healthcare for 25+ years, I will not debate diag. or tx with anyone, but will give my opinion based upon what I've been taught.

None of my post had anything to do with what kind of asthma the child had......that is not for me to decide, only the practitioner diagnosing her.  What it did have to do with is evidence and what kind of weight it is given in court.  Only in criminal court is evidence held at such a high standard, but in family court, sometimes all you have to do is allege (many here can attest to that) and a judge will make an order in your favor.  So coming to court with the child's smoke-filled clothing and a statement from the diagnosing MD stating the smoke is doing her serious harm will carry a LOT of weight.  It is still on the whim of the judge presiding as to how much weight they choose to give it.

As for sanctions, you HAVE to have orders in place in order to have sanctions against them.  My point is don't wait and put the child's life in danger by having the other parent violate the order and be forced to go back to court to have it enforced (contempt).  By having sanctions added with the order when it's made, it will save the child's health, stress, time, and money.

[grapeape]

phil....
my focus is legal... if the CO at the very least contains a portion referring to following doctors advice, giving proper medications the OP can file for contempt. and BM telling the OP personally that she didn't give the child all the meds can be enough. depends on the judge. and on that basis have additional more strict wording entered into the CO.
with a cps investigation... i did achieve this contempt. it can be done. even without a no-smoking clause.

my other question as to whether or not the asthma developed after the CO was entered... goes to substantial change. it constitutes substantial change.

the OP just needs to collect as much documentation as possible. and yes the test will work since it tests for exposure in the last 24 hours. so if an appointment is made for the day the child returns from BM's house. doesn't mean that BM smoked but reasonable enough to show that despite the doctors caution she allowed someone to expose the child to smoke since the child was not in the possession of the OP.

it can work... just have to get ducks in a row. and for the sake of a child a parent would do everything in their power to warn the court of the possible threat to their child.

I have been in this situation and went to court.