Pneumonia

It's been a long last 24 hours at our house. It all started with a sweet little two year old who had a coughing fit after our kindergarten tour at a local school. She threw up her breakfast from coughing so much. But she still seemed to be feeling fine. And had no fever (99.45). As the day progressed, she had little appetite but otherwise acted well. She coughed up her fruit from lunch and I grew more concerned... but still, no fever. And no other symptoms. Must be a cold going around... again. Seems like they're never ending in our area this year! And we've been blessed to avoid almost all of the bugs.

 

I put Ruth down for naps with a humidifier, advil and some peppermint oil to help her breath better. She slept well and woke her normal self. She ate two helpings at dinner, and joined us for a movie and popcorn in the living room after. That's when the coughing came back, and up came the popcorn. Must be the popcorn irritated her, right? I gave her some advil and took her temp - 99.3. Now I'm confused...

 

She started breathing heavily as we got ready for bed. And wheezing. Do I call the doctor in the morning or take her to the med clinic at 9pm tonight??? Ug, I hate the decision.

 

I googled her symptoms and found they were a dead on match for RSV. So off to the clinic we went.

 

The doctor was.... well.... a piece of work. He came in the exam room saying, "Someone in here has asthma, I can here the wheezing from the next room". I explained no one had asthma, my daughter was sick. The doctor sternly corrected me and told me, without a single exam, that she had asthma. She wasn't sick.

 

He asked for her medical history and was puzzled that she'd never had RSV or bronchitis before, usually kids get asthma after exposure to those illnesses a few times. So he asked about family history and, again, was puzzled. No one has asthma?! He didn't believe me. He told me someone in my family was hiding the truth, someone somewhere has asthma. So at this point, I have lost 100% faith in this doctor and if it weren't 9:30pm, I'd of demanded to see someone else. But there was no one else.

 

When he left the room to get the nebulizer machine, I googled "Treat RSV like its asthma" and found that many doctors do, in fact, treat RSV the same way they'd treat asthma. So I let the doctor do the nebulizer. Her oxygen level was 92 before the procedure. No one ever explained to me that 92 is the lowest most docs deem safe.

 

 

Ruth didn't like the nebulizer mask... but she was tired and sick and willing to obey, mostly. She got plenty of wiggles out after the 5 minute session. But her oxygen level was 85 afterwards, and her wheezing wasn't much improved. Again, I was ignorant that 85 was very dangerous. I just wanted meds and to go home to treat my child for the RSV I was sure she had. Afterall, it's going around church. And Ruth was a wiggly toddler who, aside from a cough and wheezing, was acting normal.

 

However, the doctor told me that she needed hospitalization, because "it is clear she has uncontrolled asthma since her ears and throat all looked fine". Um.... HELLO DOCTOR! YOU NEVER CHECKED HER EARS OR THROAT!!! He never did a nasal swab, a blood test, an xray.... He was a total quack set on his first impression that she had asthma and was unwilling to be proven wrong.

 

The doctor did look in her ears and throat after I informed him he had yet to do that. He apologed and told me he sees too many patients in a day. Um... great, thanks, that gives me even LESS confidence in you...

 

At this point, I've decided to take Ruth to REAL doctor in the morning. But this clinic doc won't let me go. He doesn't explain anything to me. He just tells me I need to get her to the hospital via ambulance asap. Huh? She's SICK doc. She needs antibiotics and maybe a steroid shot. Not an ambulance... are you crazy? I thought he was, after all, he'd given me ZERO reason to trust him thus far. And no one had explained why 85 was so scary.

 

The doctor decides, instead, to do a second nebulizer treatment with oxygen this time. Afterwards, not much improvement but her O2 level is 97. I knew that was good! Lets go home now...

 

But the doctor, again, refuses to let me go. He is insistent now that I take an ambulance to the children's hospital. No explanations. I have zero reason to trust his gut feeling and blow $$ on a seemingly unnecessary ambulance ride... So I quietly asked the nurse, when the doctor left, "Do you trust this doctor? If it were your kid, would you listen to him?" The nurse, earlier in the visit had acted as though she also felt he had some loose screws, so I thought she'd be honest with me. She told me she'd go by ambulance. I asked her to do one more pule oxygen test, now that 5 minutes had passed since the last one. She agreed. Ruth's #s had dropped to 92 in those 5 minutes. And she explained that under 94 is worrisome, under 90 is serious. That brain damage could occur. She convinced me.

 

Two minutes later the doctor comes back in a fury. He slams open the door and yells at me: "Do you have any idea how serious this is?!?! She could D I E (he spelled it out)"... I tried to explain he'd given me little information and no reason to trust him - but the nurse had explained things much better and I was OK with the trip to the hospital with Ruth on oxygen. He was furious at me. But I was still really confused... what was I doing?! Surely this isn't THAT serious. Is it?!?!

 

Ruth was a trooper on the ambulance!!!

I'm still in awe of how calm she was, just taking it all in. She couldn't see me on the 20 minute ride, I was behind her. And she never freaked out, not once. She even left the oxygen tube alone.

 

(Sorry for the blur, we were walking and I just had my cell phone).

 

Once in the hospital, the doc poked her head in to see how serious Ruth was. She explained she had 5 patients all come in at the same time and needed to determine who was in worst shape so she knew who to see first. 30 seconds later, she was back telling me Ruth won. What?! Really?!?! Now I'm starting to worry.

 

The hospital doctor agreed with me that this is probably no asthma and the clinic doctor had no right not even testing for other things. She explained they would test for RSV and a couple dozen other things. As well as xray. They also wanted to put her on an hour long albuterol treatment. So now I'm starting to think the clinic doc may have been a quack, but at least he was treating her the right way (even if for the wrong thing).

 

Ruth's xrays came back positive for double pneumonia. Bloodwork would later tell the doctor is was bacterial. Ruth got a heart monitor, a blood pressure leg cup, a pulse oximeter on her big toe, and an IV and split in her right arm. Oh yeah, and another face mask. Poor kiddo. Bubbles cheered her up some. But she was also exhausted. Afterall, by now its 1am.

 

She really liked (and still likes) her glowing pulse oximeter on her toe ;)

 

Mommy and Ruthie snuggled most of the night away as I tried to get her to go to sleep. But the mask was too annoying to her, she finally did fall asleep around 5. And after each hour long treatment, she was retested on the respiratory therapists scale, and remained at a #7 all night and all day Thursday. She arrived at #8 - going down is good. But she needs to go down much more.

 

Her heartrate climbed higher with each albuterol treatment (which we were told to expect, but that didn't make it less scary!). And once they uped her oxygen to 50%, her oxygen levels stabilized at a good spot. But most of the night and morning they fluctuated between 86-92. Keeping her above 90 was my job. Lots of snuggles, and readjustments of her body position and the mask.

 

Late morning, Jacob came to replace me. And let me get home to let big kids have lunch and naps. And, mostly, let me nap. By then I'd been up for 30 hours straight. Don't judge... but I let the kids get babysat by Netflix and I went to bed for 2 hours. That's all I could nap (thanks to my darn pregnancy that wakes me with dizziness when I need food). But the kids were great. They ADORE their baby sister. Nathan brought a whole backpack of books to read - books are Ruth favorite thing in the world. I'm pretty sure they beat out chocolate and mommy. Maybe not quite Daddy ;)  The big kids were worried about their little sis and so sweet to her during their short visit in the ER. Yes... ER... we still didn't have a real room.

 

While Daddy was on hospital duty, I think he read 100 stories to Ruth and got her giggling! She ate lunch and started to come back to life - yay! They even had her off oxygen for half an hour!! That was huge!! I was really worried about her that morning as treatment after treatment did nothing for her breathing (avg 45 per min, should be 20ish), retractions, or oxygen level and just made her heart go faster and faster. By the time we got back to see Ruth, and bring dinner, she was in a regular room, off the albuterol mask and on a regular oxygen nose tube thing. Only at 1 liter oxygen, too!

 

The nurse told us they'll probably cut it back to 1/2 a liter in the morning and then try to wean her off completely by afternoon. 24 hours after she's off oxygen, she'll be able to go home - assuming she does well.

 

So our sweet little angel is enjoying Daddy time tonight (with his phone!). And slowly getting back to her normal wiggly self. The nurses have all warned us that albuterol makes kids HYPER, so when she's feeling better, she'll be a bit wild. Sounds like fun.... wrangling a 2 year old attached to wires, in a tiny room, all day long. We shall see. I should go rest to prepare!! After all, 2 hours of sleep is not nearly enough for the last 38 hours...

 

I'll update the blog later tomorrow when we know even more. But in the mean time, we are so thankful for your prayers! And very grateful that Ruth has progressed so much today. And I'm even thankful for the crazy med clinic doc (who I will never see again). He may be a quack, but he knew enough to know those retractions in her neck and belly were not to be handled lightly and he got me to go to the hospital (well... his nurse did). The docs at the hospital have told us that Ruth may develop asthma later. But right now, their only priority is to clear up the real problem - double pneumonia. Oh yeah, and a double ear infection to boot. Praise God for getting me to get Ruth where she needed to be, in spite of my ignorance. I cannot imagine what we would have found this morning if I'd waited to call the doctor in the morning! Lesson learned.... listen to your gut!