Tuesday, December 12, 2017

When Rosie Went to the Hospital

It's Tuesday night. This time last week, I was taking Rosie to the Respiratory Outpatient Clinic inside the children's hospital ER. It was our second of three visits. She was breathing so fast, and retracting, and burning up and I was so tense waiting there, knowing that she needed suctioning, but knowing I hated seeing them put that catheter down her nose.

We would've actually qualified for hospital admission that night, but she seemed to improved when they suctioned some of that thick junk out of her airway, so we went home. She had a feverish, sad night. She wasn't eating well, and was lethargic, resting on my chest, as hot as a little space heater because she was refusing to take her Tylenol. When morning came, I took her to the ROC clinic again. They suctioned her again. But by the time we got to the car, she was already retracting and breathing fast and looking so, so sad. So I grabbed some sustenance, made some phone calls, and walked into the ER with my baby and asked to be seen. The nurse counted her respiratory rate at 80 breaths per minute, and they took us back to a room right away. They put her on a monitor, suctioned her again, and then the doctor came in to chat.

I was honestly relieved when the doctor decided to admit her. The previous few nights had been so scary. I was calling the on-call pediatrician's line almost nightly. I think I knew what was coming. She got oxygen for about an hour in the ER, and rested so comfortably on it. She was breathing fast and hard when we got her up to her room, but since her sats were 90-92%, they didn't put the oxygen back on, which I was a little anxious about. (For the record, I did NOT like our day shift nurse those first few days). By evening, she was a little more comfortable, albeit still sat-ing in the low 90s, and sometimes dipping below when she was asleep.

It's funny, I've kind of been regretting not staying that second night in the hospital after she was born, just to snuggle. Well, we got our extra nights in the hospital. But snuggling was really hard with the big uncomfortable chair, a sick baby, a sick mama, lines, and oxygen. But I still relished that time when I literally had nothing to do but attend to her. Even though it did wear on me, especially by the evening, when it started to get dark out and I realized I somehow needed to shower, and eat, and pump, and wash pumping parts all alone with a fussy baby. I was so grateful when my parents decided to come down to help out.

Rosie had basically been sick since October 21. All of us came down with a pretty brutal cold that weekend, and then Noah, Rosie, and I got pink eye. Right as we recovered from the last of the cold symptoms, we got the stomach bug. Ross and Noah had about 24 hours of discomfort, but Rosie and I had a solid week. I woke up that day in mid-November with a high fever and body aches that were so awful, I could barely walk. I hadn't even gotten the GI symptoms yet! Thankfully my mom was still in town. She was just about to leave after helping out over the weekend, but instead she was able to take Noah to school and hold Rosie while I slept and then went to the doctor. Aunt Karen came over later to hold Rosie, too. I've been sick a lot in the past year, but that Tuesday I was just truly incapacitated. Rosie started throwing up that afternoon, and continued to do so for the next 4 days! Days 2 and 3, she was basically projective vomiting after most of her feeds, and we were watching wet diapers to make sure she didn't have to go to the ER. At once point, she only had 2 wet diapers in 24 hours, which was fairly scary for a 3 month old. I had the fever and body aches for 4 days, and then finally got the GI symptoms right before leaving town for Thanksgiving.

So we were all healthy for about 2 days, and then... RSV hit. Noah stayed in Omaha for a few days after Thanksgiving, and came back with the sniffles. They very quickly progressed into him sleeping for hours and hours one Sunday, which is completely unlike him. He also had a high fever and I had a really bad feeling about it. Sure enough, Rosie started to get sick later that day. We were all congested and exhausted by Sunday night. Rosie's RR was in the 60s, so I FaceTimed my dad for some triage. We decided to just take her to the pediatrician first thing in the morning, which was good because he had a RR of 65 and temp of 101 overnight and I had to suction her a few times.

At the pediatrician on Monday, Rosie's O2 sats were 95-96%, HR 136, and RR 56. She was having some very minor retractions though, so they did do an RSV swab. It came back positive, and they gave us a script for the Respiratory Outpatient Clinic at the children's hospital. I took it but kind of shrugged it off. We'd been using the Nose Frida with decent success. By Tuesday morning, Rosie was either lethargic or fussy-- never engaged and happy like she'd been with previous illnesses. She didn't pee overnight, and her morning RR was 80 with some pretty noticeable subcostal retractions.

By 9am Tuesday morning, I knew she needed more suctioning and care than I was able to provide at home, so I drove her to the ROC. I was so stressed, and basically prepped for the worst, expecting to get admitted. Noah even drew a sweet little picture and rolled it up and put it into Rosie's hand before we left! Turns out, that the ROC doesn't even have a doctor, and they don't really triage. So they deep suctioned her (wow-- so hard to watch even though I've done it to smaller babies before at work), and sent us on our way with a RR of 43 and sats at 98%. The RT told me that days 4-5 of RSV are the worst, and this was the morning of day 4. She seemed more comfortable, albeit still pale and sleepy. Meanwhile, though, she just wasn't staying hydrated even though I was feeding her often. (Probably a combo between a fever, insensible water loss with such fast breathing, and just not eating well because she was so congested). She'd only had one wet diaper in 12 hours, so the pediatrician said if she didn't have 2 more by bedtime, she'd need to go into the ER. But by 2pm, she seemed happier and more active, had eaten 3oz pumped milk by bottle, and peed and pooped once.

At this point, we were all so sick. Noah was over the lethargic phase, but I was exhausted. All of us had fluid behind our ears and tons of congestion, so he'd say something, I'd respond (losing my voice), and he'd go, "what'd you say?" All day it was a constant cycle of, "why? what? what did you say? why? what? what did you say?" Aunt Theresa brought us dinner that night, which was SO SO appreciated. But seeing Rose through another person's eyes made me realize just how sick and sad she looked. Sadly, she was looking worse again after a 4 hour nap!!! RR 90, temp 100.9. She peed and pooped again, so we avoided the ER by a 5 hour margin! But she was retracting even more, and still had a RR of 80 an hour after Tylenol (aka not just breathing fast because of a fever) so we went back to the ROC. And the second visit was so much more stressful! We'd been the only ones there at 10am, but at 7pm, the waiting room was packed with sick babies. An hour and a half later, we finally got back to a room. RR 54 O2 sats 95%. After suctioning sats went up to 100% so we went home. That night, though, was rough.

I suctioned Rosie before bed, but in the middle of the night, she was so miserable. She wouldn't take Tylenol, she had refused bottles since her second round of deep suctioning, but was tiring easily at the breast, and she was working so hard to breathe. It was awful. I allllmost took her in then, but I was able to get her to sleep and I slept lightly while holding her . At 6am, her temp was 101.8, RR 80+, so we got ready to head to the ROC first thing. Thankfully she was still drooling, and her fontanelle felt normal, but I was afraid that if the respiratory symptoms didn't admit her, the dehydration would. At the ROC, they suctioned again, but she was already retracting so much by the time we got to the car. I called my dad to discuss options, I drove through at eCafe to grab a treat, some coffee, and some food for lunch, and drove back to the ER and walked in with my baby, which I had yet to do in 3.5 years of parenting.

Rosie ended up staying in the hospital for 3 nights and 4 days. It was hard. Really hard. Even though I knew she was going to be fine and it could've been so much worse! But sleeping 3 hours a night, being super sick myself, nursing and pumping and not being able to feed the pumped milk due to an oral aversion from all the suctioning. The first time they weaned her off her IV fluid, she was running too dry and they almost gave her an NG tube. Thankfully, we avoided that and just did fluids for another 24 hours and tried again. The third night, they went back and forth on discharge 3 times. They decided to keep her, so I went home for a real shower and a change of clothes, and Ross called at 10pm saying the new resident said we could go. By that point, I said I wanted to stay overnight because it was already so late.

The things that surprised me most about this whole series of events:

1. The reassurance I felt when my mom gut was validated. I knew she was getting admitted when I walked into the ER.

2. The relief I felt when they did admit her. I only slept 3 hours a night in the hospital, but I slept better than I had been at home, because she was on monitors and I knew I wasn't the only person responsible for knowing if she was having too much trouble breathing.

3. I thought I'd have time to read, so I brought books. This was shockingly not true at all! I did read for an hour one night, and I loved this quote from Lisa Jo-Baker's intro to a book called Anchored:

"I'm constantly surrounded by the fact that we consider motherhood 'ordinary.' When it's outrageous in its courage. When it, quite literally, bleeds life from the giver. Bleeds prayers and tears and blessings and terrible, holy faith. When it opens our eyes to the majesty of the world we have no control over, reminding us how vulnerable we are and how parenting is this living, breathing parable of surrendering control to the God who had the whole world in his hands all along. We just hadn't stopped to notice until we became mothers and discovered that most of what happens to our kids and our own bodies is entirely outside our control."

This so perfectly captures this season of sickness for me. Being a mother makes me more vulnerable, and I will fiercely protect my little ones and run myself into the ground doing so. But God is reminding me that he loves us, too. He bleeds for us, he cries for us, and he, unlike me, is actually in control.