November 18, 2014

an er visit

Currently Elsie is quickly becoming the more expensive child in the medical department.  Ryann has had a non well visit, maybe, um, twice?  Maybe?  Yeah Elsie, I don't even know.  Not an absurd amount, she doesn't have chronic ear infections or anything.  But I can almost guarantee that at 21 months Elsie has gone to the doctor more times than Ryann has in her 4.5 years of life.

So a little recap of our last couple of days... over the weekend Elsie developed a cold.  She goes to mother's day out, the gym daycare, gymnastics, playdates, you get the idea.  That kid is going to get something, there is almost no way around it.  I wasn't worried.  It was a cough and congestion, totally normal.  Monday morning she was coughing a TON.  I felt like she couldn't get a break, it was continuous.  So after dropping Ryann off at school and attempting a Target run (dumb idea, not even signing Christmas toys could comfort my little miss) we headed back home for liquids and some Mickey Mouse Clubhouse.  I try to refrain from using shows outside of our regular one in the morning and the evening, but she was so darn pitiful there was no other option.

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Since she was pretty content and occupied, I opted to clean out the pantry.  I mean if we aren't going to be playing I might as well make the best of it, right?  I periodically checked on her, made sure she hadn't spilled her food, wiped her nose, etc.  I got to the point where I had a pile of Chris's food left that I wasn't sure if he was ever going to eat, so I texted him a picture of the stuff and went to cuddle with Elsie while I was waiting for a response.  It was then that I noticed how labored her breathing was.  Her breathing was fast and shallow.  She couldn't complete words or phrases because she just didn't have enough air.

Part of me thought I was imagining it.  I was already on watch because she wasn't feeling well, so it was possible I was over thinking it.  But she just didn't sound right.  I took a video and sent it to Christopher.  After a bit of him not responding I sent the video to Sarah and asked her if she would take her kid in with that kind of breathing.  She replied without a doubt, that it sounded scary.  Even after that I stalled a bit more, called my mom, waited a few more minutes for Chris to respond.  But he didn't, so I called the pedi.  They said that anytime someone suspects breathing distress they need to be seen, so we planned to arrive in just over an hour for their urgent care hours.

In the meantime Elsie asked to take a nap (NEVER HAPPENS), so I let her lie down.  Christopher finally finished his morning clinic and said she didn't sound great but he couldn't make any guesses without listening to her lungs, so taking her in was the best bet.  We were fairly quickly taken to a room when we arrived at the pedi.  The nurse asked me some standard questions, and about her symptoms.  Then she hooked up a device to check her oxygen levels (I don't know what those things are called, whoops).  She kept moving the thing around on Elsie hand without saying anything.  At first I thought she was having a hard time getting a reading.  But then she opened the door and asked for another nurse, the PA, tape and bubbles.  I was a wee bit confused, and worried.  Truthfully the bubbles confused me the most at first.  :o)  Apparently her oxygen level was in the 87-88 range.  She was pretty lethargic and non responsive (not completely though), but I figured I dragged her out of her crib and she was sick.  Not surprising that she was just laying around.  They blew bubbles to try and perk her up, but it didn't help a ton.

We ended up doing two breathing treatments at the pediatrician's office.  They helped a little and her numbers went up to 94, but the PA still wasn't super thrilled, so she sent us for a chest x-ray to rule out pneumonia or anything else, plus gave us a nebulizer to take home.  I quickly drove to pick up Ryann from school and headed over to the imaging center.  Chris had finished with his afternoon patients so he stopped at the pharmacy to get E's meds and met us there.  Elsie was perkier at this point, but her breathing had already become more difficult again, and it hadn't even been two hours since we finished her last treatment.  Got the x-ray done and everything was all clear.  The PA said just be consistent with the breathing treatments, but to take her to the ER if she got worse.

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We did another breathing treatment when we got home, but it just didn't really help.  Her attitude was fine.  She was up and trying to play.  Eating some food.  Drinking some water and juice.  Chris and I waivered back and forth about taking her back in.  We almost planned on just giving her breathing treatments throughout the night, but her little chest was working so hard, lots and lots of retractions.  It really was just better safe than sorry.  So after bath her and I headed out to Children's Mercy. 

It was only about 7:20pm when we got there, not terribly late.  The nurses were great and got us through triage in maybe 15 minutes.  Her oxygen level was about 92, and the retractions were still as strong as ever.  We were taken back to a room and waited to be seen by the doctor.  A respiratory therapist came in and gave Elsie a couple puffs of albuterol on a spacer, but confirmed it didn't seem to be doing anything to help her breathe.  We waited a bit longer and then the doctor came to see us.  She said E had a viral infection with bronchiolitis.  Essentially the little tiny airways in her lungs were infected, swollen, and full of mucous.  She said she wanted to do a deep suction to help her breathe a bit better, and test for RSV.  Sounded like lots of fun.  HA.  Not at all.  And it wasn't.  E was PISSED.  But they got a ton of crap out of her lungs and she instantly sounded so much better.  She passed out on my chest while we waited for them to run the RSV test.


I was just sitting there with her asleep, happy that she looked like she was breathing so much easier, when all of a sudden a nurse popped in with an oxygen mask.  Damn.  I couldn't see the monitor screen from where I was sitting, but her levels had dropped back in to the upper 80's.  They put her on blow by oxygen which helped.  The doc came back in and said the RSV was negative but if she couldn't maintain her levels we'd have to be admitted.  She turned off the oxygen and sure enough, her levels dropped.  Boooooo.  Admissions came in, followed by the doctor on call that night, then we waited for them to get the room set up.  At some point Elsie woke up and freaked the heck out.  She kept slapping the oxygen mask away from her, pushing me, thrashing around.  I tried to get her to go back to sleep so I could hold it on her, but her levels dropped too quick so a nurse came in telling me to get the darn mask on her.  Yeah, I know lady, I'm trying.  It took a bit, but she gave in.

About 30-45 minutes later we were taken to the room we'd be staying in.  Once we got up there they decided to take her off the oxygen to see how she did.  She surprised me and stayed above 94.  They took all her vitals and did all the necessary admissions stuff and left us to get some sleep around 11pm.  Elsie flat out refused to get in the crib, I don't really blame her, so she ended up sleeping on me in a recliner all night.  I didn't sleep much, and I got so uncomfortable, plus the nurse was in and out a couple of times, but E slept.  That is what matters.

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Around 5:30AM Elsie started really stirring and just couldn't get back to sleep.  She asked for a drink and to eat, and really started to perk up.  Her oxygen levels went up a bit to the 95-97 range and stayed there.  I was thrilled they hadn't put her on oxygen all night.  The nurse told me she was close at one point, hovering at 90 for a bit, but it never dipped in to the 80's again.  Even though she was still tired I just couldn't get Elsie to go back to sleep, so we watched movies and Mickey Mouse, played iPad games and colored.  Elsie kicked me out of the recliner and claimed it as hers, and got some of her spunk back.


The remainder of the morning was pretty much spent waiting for rounds and waiting for discharge papers.  My mom drove up to take care of Ryann so Chris could come hang out with us (which at the time she left we weren't sure if we'd be discharged or not).  By the time they came to let us leave Elsie was crawling all over the place, full of energy.  Or as much energy as you can have as an almost two-year-old on six hours of broken sleep.

Overall Elsie was a champ throughout the whole thing.  She was great during the day yesterday, letting the doctors do what they needed, and didn't really start to get upset with them until she was incredibly over tired, and they had already tortured her with the suction :o).  I'm so glad we followed our guts and got her in.  Everything might have been fine, but it might not have been too.  Always better safe than sorry!

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