Tuesday 28 October 2014

Breathing is not just for Babies

Perhaps one of the first jobs you fully take on board as a parent is that you’ve got to keep this puny little bundle breathing. I spent the first six months of my children’s lives listening to them breathe, compulsively checking for it while they were sleeping. As they grew older, I finally started taking respiration for granted and began worrying about other life skills such as eating their dinner or flushing the toilet.

But as it turns out, that breathing thing is still pretty important—and still a really effective source of stress. That's a clue as to how my weekend went…

My five year old son started coughing on Thursday evening—enough for me to give him some cough medicine to help him sleep.

Friday 6:15am: My son woke up coughing and saying he didn’t feel well enough for school. He didn’t have a temperature, and was generally upbeat if quieter than usual so I was in two minds about whether or not to send him to school, but leaning towards keeping him home, if the cough didn’t settle.

7:30am: He started wheezing. As he has a history of colds developing into bronchial issues, that settled it—he was staying home. I had a dentist appointment at 9am and optimistically thought that perhaps I could sit him in the corner with an iPad during it. My husband took our daughter to school.

8:45am: He had such a violent attack of coughing that he threw up. I cancelled the dentist.

9-10am: He became increasingly subdued, and his breathing grew noisier. I started googling the enterovirus that is currently running around the country and its charming lingering effects of death and paralysis. Luckily, one of the symptoms is fever, and my son remained fever free.

10:30am: By the time we got to our appointment, he was grunting slightly with each breath, and when I was done signing him in, he took me up on my offer to cuddle him on my lap—not unheard of, but certainly not his usual practice.

The staff were alarmed by the sound of him too… we were seen very quickly, and the doctor popped through in advance of our ‘turn’ to OK him for an immediate albuterol treatment. That turned out to be the first of three, along with an oral steroid, while the doctor declared him to be asthmatic and was clearly in two minds about whether or not to send him off to the emergency room.

11:50am: I left my son with the nurse setting up his third albuterol treatment, so I could go outside for the phone signal I needed to call the school and let them know I would be late picking up my daughter. My son did not complain about being left, but he disliked the taste of the albuterol, and this third treatment did him in. I ended up having to hug him and hold the mask on his face while he cried, so we were pretty miserable all round.

12:15am: His oxygen levels had stayed above the emergency room point, if only just, and the treatments improved his wheezing, though it didn’t totally clear it up. We were given a handful of prescriptions and a chit for an X-Ray at the children’s hospital—to check for pneumonia. On our way back from the hospital, we were to return to the doctors’ office for a walk-in. (Our doctors’ office never takes walk-ins.) We were, however, allowed to pick up my daughter, collect the prescriptions and go home first.

12:30pm: I picked up my cheerful child. My less cheerful one fell asleep in the car—huzzah for drive through pharmacists! I managed to get hold of my husband who left a busy day at work to come home, care for our daughter and get her to her gym lesson.

2:30pm: My son and I arrived at the children’s hospital, and he started crying and refusing to get out of the car despite my best encouragement. He just wanted to sleep by that point, and I completely agreed with him, but we didn’t have a choice, and so I had to bully him out. As scary as everything else was, that moment was hands down the worst part of the day for me.

Luckily the waiting room was showing the Lego Movie which improved his mood enough to carry him through the actual X-ray.

3:30pm: We parked our car at the doctors’ office again, and he threw up for no apparent reason other than sheer exhaustion. Luckily I still had a barf bag the nurse had given me that morning, so it was done tidily enough, and after that his mood improved tremendously. The X-rays came back clear, so he didn’t have pneumonia—Hooray!—but they could still hear a wheeze through the stethoscope. Boo! We scheduled a Saturday morning follow up and finally returned home to rest.

Friday evening and night: As prescribed, I helped my son use his inhaler every four hours… including overnight. And there was much stumbling around and yawning.

Come Saturday, he was one hundred percent better in mood and alertness, but they could still hear the same wheeze. We made a follow up for Monday, but were given the OK to drop the inhaler at night. I looked forward to getting a better night’s sleep.

That same Saturday morning, my three year old daughter woke up coughing.

As she has been less prone to respiratory issues, I wasn’t so concerned about my daughter, though she was very sorry for herself, so we sat on the sofa and watched movies together. My husband took our son out in the afternoon, and our daughter fell asleep for a couple of hours—yet still wanted to go to bed at the usual time. She also had no appetite, so it seemed she was very much following the track of my son’s illness, but without the wheezing. Huzzah.

10pm I was preparing for an early bedtime, determined to be horizontal for a full eight hours, when my daughter woke up and wanted to use the bathroom. As I took her, I heard her making the same grunting that my son had made at the height of his wheezing. I gave her five minutes and checked back in on her—she was practically panting in her sleep and sounded like a chain smoker. For half an hour, my husband and I kept an ear on the situation, but ultimately, there was no way that we were going to sleep on this one.

10:30pm I got back into my clothes, readied the car, and then we woke our confused and reluctant daughter, and I took her off in her nightie and a jacket (no shoes or socks). To my relief, the novelty of being out at night took over, and she was perfectly chipper. I couldn’t hear the wheezing so easily in the car, and I began to brace myself for the embarrassment of turning up at the emergency room with a completely wheeze-less child. Not the case!

11pm: They take breathing seriously at ER. I was still filling out the paperwork when the triage nurse called us through—it didn’t help that I was so tired, it was taking me ten seconds to gather my wits every time I was asked for a birthdate. Ten minutes later, I was carrying my daughter to a bed.
Somewhat surprisingly, this was the first time we had taken one of the children to the emergency room. It wasn’t as traumatic as I had expected. She wasn’t nearly as distressed as my son had been the previous day, so I wasn’t unduly afraid, and despite it being a Saturday night, things seemed fairly quiet. We were lucky enough to get a bed on the wall end of the row, so we had less disturbance anyway.

My daughter took things calmly, but after I laid her in the bed, she looked up at me with very big eyes and said: “Don’t go.” I assured her I was going to stay right there with her, though it was a few minutes before she seemed secure. Luckily, since I had already been through the drill with my son, I was able to tell her a bit about what was going on / going to happen. E.g. when the machine measuring her oxygen levels read 93, I could tell her that her brother had had 91, so she was doing better than him. Watching the numbers go back and forth was the game for awhile, and she dozed a little though there was too much going on for her to settle.

She was given a treatment of albuterol, but with a mister rather than a mask. She lost interest in that pretty quickly, and seemed unimpressed by my insistence that she had to breathe it in until the mist ran out. I ended up having to hold it and let the mist play over her firmly closed mouth, though the nurse assured me it was fine being inhaled through the nose as well.

She was also given the same oral steroid as her brother, and much to the nurse’s confusion, she declared that she liked it. (He certainly hadn’t!) And, of course, she was popped in a wheelchair and wheeled for an X-ray. She was getting very tired and overwhelmed at this point and struggled to follow the directions, but she sat cross-legged on her chair and never complained. Back in her bed she said she wanted to go home once or twice but never argued the point when I told her we had to stay.

1am She was finally tired enough to go properly off to sleep. So was I, but I didn’t have a bed to lie down on. I eventually used the end of her bed as a pillow, though it wasn’t enough for me to actually fall asleep. My chief entertainment was listening to what other people were there for, which all seemed tame enough, barring the guy who had been robbed at knifepoint.

2am Then came a patient who had clearly been taking something inadvisable. He heralded his arrival with the screams: “Don’t break my fucking arm! Please don’t break my fucking arm!” He lacked the courage of his convictions, for a few minutes later this became: “Please break my fucking arm! Fuck you, break it! Please break my fucking arm!”

Thankfully, my daughter remained asleep. I poked my head out and ascertained that the screamer was indeed strapped to his gurney and had a couple of burly guys around him wearing Fire and Rescue Dept T-shirts. It seemed I wasn’t going to have to seize my daughter and dive behind the bed while somebody went on a hallucinogenic rampage.

He continued to scream more often than not for the next hour. His arm and breaking or not breaking it was the recurring theme, but we also had moments of “Get this shit off me!” “Don’t touch me, you bitch!” And my personal favourite: (sobbing) “Look at them. Oh, let them live… please let them live…”

Shortly after he first entered, my daughter rolled over and woke up enough to give me a squinty glare for the disturbance before falling back asleep—to my great relief. While the swearing didn’t concern me, the overt rage, fear and despair, were not what she needed to hear in this situation.

After half an hour or so of his screaming, she woke up fully, stared at me and put her hands over her ears. Quite calmly, she told me she wanted to go home now. Just as calmly, she accepted my explanation that we couldn’t, and told me it was too loud so she had to put her hands over her ears. I agreed with her that this man was not in control of his temper. Her hands were insufficient, and she put her fingers in her ears instead, and while I maintained what I hoped was a calming smile (as opposed to a frozen rictus), she was beginning to look stressed and unhappy.

It was one of those situations that couldn’t be helped, and thankfully, the patient finally quietened enough that she was able to fall back to sleep—the following day, when I asked her if she remembered the hospital last night, she replied: “There was a loud noise, and I had to cover my ears.” It's a shame she wasn't fourteen. It would have put her off drugs for life.

3am I hadn’t given much thought to the X-ray, because my son’s had come back clear, so I was completely taken aback when I was informed she had a touch of pneumonia. Also unlike her brother, her temperature spiked, so she was woken up for motrin, which she took amiably and went right back to sleep again. She was more deeply asleep when the nurse brought her antibiotic for the pneumonia, and I had to prop her up, while the nurse tucked the syringe between her lips, though thankfully she went to the effort of swallowing it by herself.

So my daughter slept, while I alternated between dozing at the foot of her bed and walking around shaking my limbs to make me feel better. Finally, after almost five hours, we were discharged, and I woke her for her only meltdown of the night. I told her we could finally go home, but by this point, she was too far gone. I left the emergency room in a wheelchair with a hysterical child on my lap—all very reminiscent of leaving the hospital after giving birth to her, though embarrassingly, the nurse pushing me was six months pregnant and probably more deserving of the wheelchair than I was.

By the time I buckled my daughter in the car, she was screaming as indiscriminately as the stoned guy. There had been no phone signal in the hospital, so I had planned to send my husband a message from the car park, but I abandoned that idea in favour of getting home as quickly as possible. She spent the entire drive home hanging off the back of my seat—it’s about the only time I’ve missed her carseat over the booster she’s in now. At one point, I had to stop the car, because I thought she’d unbuckled herself. (Thankfully, she hadn’t.)

Home at last, I handed the paperwork off to my husband and carried our daughter up to an armchair in the living room. The familiar surroundings managed to give her some coherency and she eventually wailed to me that she was too cold to go to bed. When I suggested that I go upstairs and sit on her bed with her to help keep it warm, she gulped back the sobs, took my hand and walked upstairs herself. Luckily, it took about two minutes for her to pass out again.

Her brother (they share a room) was woken up by the fuss but he was glad to see us. Apparently, he had woken up at 1am, freaked out to find his sister gone and started screaming for Mummy. Daddy had to break it to him that I was gone too. In short, none of us got a great deal of sleep that night, though my husband was good enough to ensure that our daughter and I had a lie in—he got up at the crack of dawn with our son and got him settled downstairs. Our daughter was up at 7am anyway, but I slept in until almost 9am (eventually woken by our daughter bellowing her pants were inside out) and had two or three naps during the day for good measure.

I kept both children at home on the Monday—and regretted it, even though it was the right call. They were bouncing off the walls after a weekend of being ill, but every time they tried to make use of their extra energy, they started coughing. Thankfully, the doctor’s appointment—with their usual paediatrician this time—gave us the all-clear as far as lungs were concerned. Her opinion of my son was that he had reactive airway disease rather than asthma, and it wasn’t something we should worry too much about unless it becomes a more frequent occurrence.

So that was that. A particularly nasty bug from a parenting perspective, and an extremely efficient way to leave the entire family utterly exhausted. Fortunately, the only long term harm is that the children will have to have the flu shot and not the flu mist this year, because they’ve had albuterol so recently. My son is seriously unimpressed by this prospect. I am a teensy bit apologetic for not getting off my backside and sorting out flu shots before now, but mostly, I’m more focused on catching up on my sleep. Beautiful, wondrous, sleeeeeep….