Our 1st Unplanned Hosptial Stay

Disclaimer:  I've written this blog over the course of 2 days of half asleep hospital stay, so don't expect perfection.  My thoughts are choppy.  And I tried to go back & edit, but didn't get real far, soexcuse me if I have tenses wrong!

In our mere 2 years of life.....in addition to the 5-6 weeks spent in the NICU.  And Livi's day of eye surgery.  We have already conquered 2 different ERs in town from all various standpoints, allergic reactions to pneumonia.  Each child has been.  We have managed this year alone to meet not one, but 2 insurance deductables (thanks to a mid-year job change).  {Not to mention what our 2009 bills could have been if not for amazing insurance!}  But this is our first ER visit turned hospital admission.  And I'll tell you we were less than prepared.  There will be some household updates that go on as soon as we get home!

One... invest in a land line when you have kids.  The one time you need it, the $20 or whatever it costs a month will seem worth it.  Trust me.  I've been meaning to get us one for 2 years now.  For exactly the reason that cell phones are not permanent.  Thank heavens for amazing friends at 2:30am!! 

Two... I will be putting together (& giving at baby showers from here on out) a pack that fits in a diaper bag & says "Take with you to the ER."  Full of travel size lotions, soaps, a comb, tooth brush & paste, deoderant, razors, clean socks, underwear, a roll of quarters & a powder puff for all those zits weeks like this create.  {At least I have clean clothes & undies thanks to a little grandparent & sister respite.  Ones mind just never thinks to ask for the little things like deoderant in the moment.}  Anything else anyone suggests I add to the pack?!  Seriously, I'm making it!

So why are we in the hospital? 

My poor princess. 
She hadn't eaten anything all day Monday.  She took an extra nap.  I knew she wasn't feeling well.  Just figured the stomach flu that I had Sunday was hitting her too.

By 6:30pm she was wheezing.  Not totally surprising, she'd had a runny nose for days. So I gave her a breathing treatment we had at home.  Put her to bed at 8.  She was breathing heavy & having retractions. I definately wasn't completly comfortable putting her to bed, I just wanted to see how she settled in.  I checked on her every hour x2 hours & she was just laying there awake. Breating too hard to sleep!! I gave her one more breathing treatment & watched her breathe for a while.  I could count 4-5 ribs with each breath & she wouldn't sit still or settle to sleep.  That did it for me.  Restlessness I can not take.  {Pretty sure I've said that before!}  And hell, like I said, our insurance deductable is already met, whats another ER visit!!  So at 12:30am, we headed on in.....

We went to Children's & got right in the ER.  I was concerned, as our last visit there wasn't my favorite ER trip of our previous 3.  But this one I was pleased with.  She got back-to-back treatments right away, 1 albuterol & I'm not sure what the other one was, a combo of Albuterol & something else. Finally she relaxed & her breathing slowed down to closer to normal, but then her sats dropped to 87-88.  So we did a 3rd treatment, got some oral steroids & ended up on 1.5L of oxygen. (Which is apparently just a whif in their terms, sounds like a TON to a NICU nurse!)  We did an x-ray.  And as the ER doctor so appropriately put it "They can send babies home from the nursery on oxgyen, but from the ER we can not."  And so, we got admitted.

Her chext x-ray they say looks fine.  One small spot of some atelectasis.  But they don't think she has pneumonia.  She is afebrile.  We did not do RSV cultures.  At first they thought maybe it was a true asthma attack (with her history).  But it sounds like for now they have settled on a diagnosis of bronchiolitis.  Just something viral, so no antibiotics.  Just with her history of premature lungs & her either having asthma or reactive airway disease, it was just too much for her. {Apparently croup is going around like wild-fire here too, just an FYI!}  They are not diagnosing her with asthma yet, they say its too early to tell.  But we treat reactive airway & asthma the same at this point anyways.  We have seen various residents, the ER doctor, the on call ped Monday night, our pediatrician & today we also consulted with Dr. Thomas (the respiratory doctor Livi has seen in the past & has an appointment with in January.) 

Tuesday, we had a racemic epi treatment (and watched her heart rate for hours afterwards!). And 2 more doses of steroids. 

She has managed to drink well, so thus far we have avoided an IV.  Though it came close!  Tuesday, her blood pressure after everything was through the roof! I'm talking 135/88 type BPs! And she wasn't peeing despite drinking. Her abdomen was distended & I was getting worried.  We weren't sure what was going on?  We ended up doing a bladder scan & finding she had 200+ mL urine in there. We were talking about cathing, IVs, etc & all of the sudden she said "Pee potty" & we took her to the toilet & she sat down & peed 100mL! Then 5 mins later said it again, & we found a 150mL wet diaper. Sheesh girl!  After that, her blood pressure was back down to almost normal.  Baffles me?  She has asked to go potty here 2x since. I swear we'll leave her potty trained.  Heck of an expensive potty training course!

By evening (after a massive nose, booger sucker outer fest by the respiratory therapist!) we had her on room air satting 94%.  And she was pretty spunky tonight after a good nap.  So the test was to see if she could keep her oxygen sats up while asleep.  Knowing she had needed at one point up to 2L during the day while sleeping, I was doubtful.  And unfortunately, as soon as she sacked out, her sats slumped down to 85!  So we spent the night back on oxygen.  So we are pretty much guarnteed to be here for at least another night.
Last night her & I finally got a little sleep.  She had slept probably just 4 since we got here at midnight Monday  And I had slept maybe 1.5 hours since Monday at 8am.  My head last night was getting dillusional! 

Wednesday so far is about the same.  I'm at the hospital with Livi.  Jeff had to spend a day at work, preparing to take more days off of work.  And the boys are enduring their first day of daycare without Livi.  My heart breaks for them too!  We were able to get her off the oxygen again this morning.  But when we got her down for a nap, her sats dropped back down to 88-89.  (They want them above 90).  So she is back on 1/2L of O2.  An improvement from last night's sleeping sats though!! 

We are going to re-start her on her inhaled steroids that she was on last winter.  We "challenged" her this summer by weaning off of them.  And had a great summer.  But this was her first respiratory "challenge" off steriods.  And it looks like a big fat fail!  So back to the preventative steroids we go (its an asthma medication).  Per protocol, we'll get all the asthma education before she goes home.  Visit Dr. Thomas mid-January.  Hopefully have a less than eventful remainder of our winter.  And go from there...

My poor baby!  She has had a hard, hard year!  She is such a trooper!  The only time she has cried was for x-ray & one middle of the night breathing treatment.  Oh, and of course booger sucking.  She holds my had like a grown up & is so, so brave!  She needs a toy doctor kit though... as she's learned to enjoy playing with the stethoscope! Making me lift up my shirt to listen to my belly! LOVE HER!!