Thursday, December 18, 2008
Friday we headed out to run some errands just as soon as he woke up from his nap. He was fussy in the basket at wherever place I went. I did need to run into Walmart and do an exchange (two glass gallon jars - bulky and a little heavy), so I figured I could do one more thing. I loaded the awkwardly large jars into my oversize reusable grocery bag and just carried it and my purse on my shoulder with Sammy on my hip and took Zack by the hand.
Sure, Sammy was much happier being held, but picture me by the time I had crisscrossed the store twice and added my three purchases (two of them slightly smaller glass jars) to the load. The glass jars in the bag are clanking together, I'm trying to hold a fussing baby, contain Zack, and convince him to carefully help me carry this stuff. Just as we get in line (a Walmart line during Christmas season, no less), I realize that Sammy is not fussy anymore. He's flushed, and he's hot, and he's listless.
Zack had one specialty of illness as an infant and toddler: high fever with some congestion - viruses like Roseola, or it's relatives without the rash. We figured Sammy for the same thing as his temperature climbed. We had to put him in a lukewarm bath to get the temperature under 104, which was not a popular move around here - neither with baby nor with mamma. We went through a couple of days of battling the fever, checking him every two hours, alternating Motrin and Tylenol, and using cool compresses that he hated. Just when we figured the worst of the fever should be past, it was up again and we had another night just like the worst one, bath and all. Meanwhile, his cough is sounding worse and worse. So, out we go into the 32 degrees and misting (that's crazy cold to us Texans, and we sure don't know how to drive in it, just to get everyone oriented) to the Dr., though I really feel like it's viral, and what can they do?
Viral it was, but it was more than I thought. I had only been able to get in to see the nurse practitioner rather than his usual pediatrician and after examining him, staring strangely at his chest with his sleeper open (what is she looking at? what is she counting? why is she frowning?), the NP was back in with his usual doctor.
"Well, he's borderline for hospitalization right now. We would definitely be justified hospitalizing him if you're more comfortable with that."
Mamma is at full alert.
He had something I hadn't heard of, but I guess a lot of people have, RSV or respiratory syncytial (sin-SISH-uhl) virus. They had done nasal swabs and confirmed it (also confirmed negative for flu, which was good). He had another virus, roseola or the like, overlapping it; the rash started as we were in the office. He had two ear infections. The thing concerning the doctors was his labored breathing and low blood oxygen saturation. Apparently, RSV often causes enough breathing problems that it's the number one cause of hospitalization in children under two (so said the doctor anyway). But, in the hospital, they would mostly just give him fluids and breathing treatments, and I could do that at home if I was comfortable with it. I was a little concerned that I hadn't known what "labored breathing" looked like. The NP could see his chest pulling in at certain spots and hear a wheeze in his breathing that was very noticeable to me once she pointed it out. But I still wanted to avoid the hospital if at all possible, not wanting him exposed to more illnesses and woken for meds and checks on the floor's schedule instead of his own.
They tried out the breathing treatment on him in the office to see if it helped enough to justify sending me home with a machine. The nurse set it up, then slipped out of the room a nanosecond after turning on the machine. Sammy hated it, screaming and thrashing the whole time. I was supposed to be doing the treatment and didn't know what I was doing, alone in the examination room for what seemed like an hour (it was more like 15 minutes), trying to hold him upright and still with this loud mask over his face. I am not sure how much medication he actually got. It didn't change his blood oxygen saturation but he seemed to be less labored, so they said I could take him home if I could do this every three hours, waking him at night. My brain was in crisis mode, so of course I could do this. I can do a lot in crisis mode, and do it all with logical efficiency. I don't panic, which is handy. Of course, I have to come down from crisis mode sometime, but at the time, it is effective.
We started him on antibiotics for the ear infections (and to keep the RSV from going into pneumonia) and continued the regime of fever meds and breathing treatments. It was a little like nursing a newborn in that the three hours counts from the beginning of the treatment, so by the time we did it and got him calmed down again (which usually did require nursing) there wasn't much time before the next one. He wouldn't eat, but he would drink milk, so that was ok. We had a houseguest and a catering order and a party I was helping with, so I juggled. Our housegeust was actually more help than hindrance, playing with Zack and staying at home with him while I took Sammy to the doctor. We're supposed to be leaving on a 1140 mile trip (that's the distance one way) day this coming weekend. The Christmas shopping needs to be finished, the Christmas cards need to go out, I've lost the paperwork to get the (overdue) registration on the car, I need to prep for a wedding that I'm coordinating when we get back... you get the idea. That crisis mode was handy, I guess, because that list is not far from being done. The catering order looked great. Thanks to James' parents coming and staying with the boys for an afternoon, the shopping is mostly done. The Christmas card envelopes are printed. James saved me and took car of the car registration. The party was fun and had plenty of food. I haven't slept much, but hey, I'll pay that bill when it arrives (hm... my throat is sore... maybe that bill is here already).
Today I'm rejoicing that Sammy has no fever (so far), and is smiling again. He even got dressed today, much to his brother's relief (Zack doesn't hold with staying in jammies all day). Sammy still won't eat, but we're down to breathing treatments every five hours (longer if he's sleeping) and he seems like himself. Check out this face - there's no doubt he's getting better.