The doctor described what was happening as a bronchospasm. "A Bronchospasm or a bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles or smaller airways. The overactivity of the bronchioles' muscle is a result of exposure to a stimulus which under normal circumstances would cause little or no response. The resulting constriction and inflammation causes a narrowing of the airways and an increase in mucus production; this reduces the amount of oxygen that is available to the individual causing breathlessness, coughing and hypoxia"(courtesy Wikipedia). Sounds about right.
You may wonder why we let this go on for 10 days before calling the doc, and there are a couple of reasons. First, we felt that continuing on the Tobi was important in the process of pseudomonas eradication. Second, there was no real fear that he was going to stop breathing. I've seen him in total distress and this wasn't that. It wasn't easy for him to breathe but it wasn't emergency room worthy. We were able to regain control with an Atrovent treatment (a medication that helps to relax and expand the airways). Third, I had hoped that it wasn't really the Tobi causing the problem. The girls have had little colds and I thought that perhaps he was just getting their cold which usually causing him a little bit more difficulty breathing, but after a few days of observation and being able to isolate the increased difficulty to the times when we were doing the Tobi treatments, I realized that it wasn't going to be something that we could continue on.
Drew's doctor does want us to continue on an inhaled antibiotic so that we can still try for pseudomonas eradication, so our next option is to try Cayston. Apparently there is an entirely different nebulizer system used for administering this medication that I should be receiving in the mail tomorrow. The plus side to this medication is that it only takes a few minutes to administer three times a day (like 2-3 minutes). The Tobi took us over 30 minutes twice a day, on top of everything else we were already doing, so this buys back a little bit of our time. Hopefully he won't have such a strong reaction to Cayston like he did to the Tobi, but I guess time will tell. Cross your fingers!