Sunday, March 31, 2013

Really? Pneumonia...again?

Lochlan spent 5 days in the hospital with RSV and pneumonia in late January/early February this year. It was awful. He had to be suctioned many times which was even more awful. I can still remember him crying and screaming: "Is it done? All done? All done?" Then once it was done, we'd say all done and he'd say "all done!" It got to the point where even if I tried to put saline drops in his nose, he would start to freak out. And anytime they came to suction him, he'd say, "don't do my nose okay? Do my finger!" Poor guy. My heart still breaks just thinking about it.
Thankfully, after 5 days, Lochlan made a quick recovery. I wish I'd written more about the experience but time got away from me. He went home with oral antibiotics and to take his puffers regularly. When he went to his follow up doctor's appointment, she changed his Flovent puffer to a puffer called Alvesco. With the plan to remain on that for the remainder of the winter flu and cold season.

He had a random fever in the beginning of March for a few days just before March Break as did Abby. But other than that, he did pretty good health wise. Until this past week.

He had a high fever (103.5) mid week and just could not recover. He had no other symptoms other than the fever and we kept up with alternating between motrin and tylenol. It seems to bring it down but never fully "broke" it. Thursday he started to get less active and lost his appetite. That evening he began grunting as he exhaled. I gave him his ventolin every 4 hours or so still not really sure what was going on. Thought that maybe he just was feeling icky and it was more of a groan than anything.

He also complained about his tummy hurting. I gave him some Gravol hoping to help settle it. On Friday, he looked very pale. And just not well. He was grunting again and was pretty clingy and not eating a whole lot. We kept up with Ventolin and the fever meds (his temp was just over 100) but you could tell he was feeling pretty rough. He went to bed and at 1:30am came into our room and was very upset that his tummy was hurting. I tried rubbing it, he had no fever, and brought into into bed with us. I don't think he was in bed with us for 5 mins before it was super clear that he was having a hard time breathing. His grunting was very loud. (yes the house was quiet with it being bedtime but it helped to heighten the urgency)

Rob and I both agreed that he needed to go to emerg. I told Lochlan that I was going to take him to the doctor and he said "Ok, mom. Bye, daddy."

We made it to the ER and surprisingly went straight to triage (no one else there). The nurse said we timed that pretty good cause they just had a three hour wait. She took his vitals and his oxygen saturation was about 94/95 if I remember correctly. I actually was pretty shocked given the grunting.

We went straight to a bed in the emergency department after registering. And there we waited. And waited. Guess that three hour wait still affected us. A RN finally came and talked to us to get the scoop and take his temp and listen to his chest and said a doctor would be by soon.

We waited.

During our wait Lochlan tried to sleep but if was difficult given the bright lights and the patient beside us in the next bed. He was loud and must have forgot the curtain didn't mask his loud voice and farts. Terrible.

Anyway, finally had a resident come by who then had to report back to her superior. Up to this point we had been waiting about 2 1/2 hours.

She came back with the attending who I could hear say, "so you aren't recommending a chest X-ray?"

Once the attending came in she asked a few questions then said "ok, we are going to get a rectal temperature, (it showed he had no fever in triage and he felt warm) she thought he had one too. And take him for a chest X-ray. "

A paediatric consult was also recommended.

So he had his X-ray, and turned out he did have a fever. So he got some Tylenol. We both ended up falling asleep. I felt like I was asleep for 5 mins when the consultant showed up. It was 6:30. I must have been asleep for at least an hour. Maybe maybe not. Anyway he came in and was so super chipper and completely oblivious that he woke us up. And wanted to do a full history. He introduced himself - and said he was a psychiatry resident who was starting his paediatric round and he tanked me for helping to further his knowledge and education.

Which I'm all for. But at this point I didn't wish Lochlan to be a guinea pig, I just wanted to freakin' sleep!!!! And to figure out what was going on. I had started to question whether or not Lochlan even needed to be in the ER. Perhaps I had overreacted. They certainly didn't seem to take him being here too seriously. I mean, he hadn't had his vitals checked since triage and that was 4 1/2 hours later!

The resident went to look up at the monitor to write Lochlan's stats down and was like, oh. To which I said pretty loudly, they haven't checked his stats since triage. A few mins later a nurse came in. Lochlan was at 91-93. He ended up getting oxygen nose prongs put on. (Adult ones by the way)

Oh and by this point another nurse and doctor were starting so they were great at letting me know what was going on. His X-ray showed pneumonia and a pocket of fluid both on his left lung.

So he was admitted and we finally arrived on the paediatric floor just before 9am Saturday. They put an IV in to give him antibiotics. Thankfully they got it in the second try. Cause man that is so awful.

So here we are. Still waiting for him to get better. He is improving little by little.

Saturday night he woke up complaining his tummy hurt and also he insisted on sleeping on me and when I tried to shift or move, he'd start to cry for me to stay. I literally had him snuggled like a baby.

Yesterday was a bit rough. (Sunday) His o2 was turned down and then not monitored very well so he got really subdued and just didn't look well. After I left with Abby, Rob became increasingly worried and asked them to check his sats. Then he said it became pretty hectic. The resident rushed off to find his attending and said Lochlan may have to go to the ICU. Guess his o2 was at 85%. They quickly put a mask on him and turned his oxygen up. And he started to perk up by the time I came back to switch out with Rob.

It had been pretty scary for a bit. So this morning he was at 40% oxygen when I arrived but he was also playing with a car and big garage ramp toy and having a grand ol time and now he is back to nose prongs and at .5 litre. (Whatever that is in percentage.) definitely feeling better. So it's a waiting game. He has to be fever free and off the oxygen in order to go home. Getting closer. Oh and his paediatrician is on duty today so that was a relief to see. She knows him get well. She's en showed me his X-ray. Oh my goodness. Half of his left lung was covered with pneumonia. She showed me his pneumonia from his stay in jan/feb and it was nothing compared to this. It was a massive pneumonia. Poor guy.

So we wait. As long as he is getting better and responding to the antibiotics we don't have to worry about that pocket of fluid. If he starts to have a recurring fever and gets more sickly we can guess the fluid is not being absorbed and the infection is spreading and will need to be drained. Not cool. So praying he just continues to improve.

He'll probably be here until at least tomorrow. Still praying and holding out hope he could come home tonight. But also trying to be realistic. But if you know me, I believe stranger things can and do happen!

I would never have thought Lochlan would need to be back in the hospital so soon. (Of course was hoping and praying we'd never be back!) but definitely not this flu/cold season. It almost feels surreal. Like I'm just having a bad dream. And on the other hand, it feels like we never left from the first episode this year. So over the sickness. And ready to enjoy spring and summer.

And to start planning a third birthday party!!!! (May 5th)