A Long Friday

Well today simply sucked.

I woke up around 340am and tossed and turned for at least 30 minutes.  I've been waking up like this in the middle of the night for as long as I can remember.  I don't think I have slept through the night since Tate has been born.  Sigh.

Around 515 or so, Tate started coughing.  He would cough, turn over and try to get comfortable. A minute or two would go by and he would do it again.  I kept thinking he would stop, but he continued to toss and turn and cough. (We were in my bed together...I've been bringing him into my bed when I go to sleep.)  The coughing got worse and worse and he sat up and was obviously having difficulty with the coughing stopping.  I grudgingly sat up and decided to go get him a cup of water.  He refused to drink it as I cradled him in my arms.  

The coughing started to sound like stridor, then it started to sound like croup.  Horrible stridor.  Horrific croup.

Then he started retracting, and I knew we were in trouble.  He was very red, almost purple and his lips were turning blue.  I realized my baby was having difficulty breathing and we needed help fast.  I raced around putting on my contacts, a bra and some clothes and scooped him up along with some socks/shoes for him.  Grabbed my purse on the way out the door, wanting to cry, but realizing I didn't have time to do so.  

This is when I HATE being a single parent.  I wanted someone with me.  Someone to tell me everything was going to be ok.  I considered calling my next door neighbor to go with me or my sister, but opted not to bother them.  I got Tate in the car and we headed down to the ER right down the street from me which we've visited twice.

It was about 45 degrees outside this morning, thankfully, and once we were outside his breathing became much less labored, but the barking sound continued especially as he cried and whimpered from the back seat.  

We were there within 5 minutes.  Of course it took longer to check in than it did to get there because as usual the computer system had been changed since we were there a year ago, and they had no record of him.  Ugh.

Once back in our little room, the drama continued or shall I say nightmare.  I gave them his most recent medical history...the diagnosis of walking pneumonia or bronchitis last Tuesday the 5th.  Told them he was put on a Zpac for 5 days which finished this past Sunday.  That we saw the pediatrician on Monday, and the bilateral rales and rhonchi she had heard the week before were gone, and she was very happy about that because she had never heard him sound so congested in his lungs.  The wet cough that had sent us to see her on the 5th was definitely better, so I thought we were on the mend.  As did she; but she reminded me that if his cough wasn't gone by next week that we should consider getting an inhaler just in case this was actually a first asthma attack as it can sound very similar apparently.

So armed with the information, the examination began.

Tate was most uncooperative which is definitely not like him (don't all parents say that about their kids?).  He refused to open his mouth for his temperature, but seriously what 3 1/2 year old is going to do that?  They insisted they needed it, so since apparently they are not prepared for children with a temporal or ear thermometer we had to do a rectal temp.  

O.M.G.  That was awful...took two of us to hold him down while he cried and wailed "No No No".  This absolutely broke my heart, as I know it hurt and I know it was really scary;  he hadn't even wanted to take his pants off.  It was just awful.

Oh and his temp was 98.4.  This I could have told you by kissing his forehead.  This child rarely runs a fever.  

This set the tone for the entire visit.  They ordered a chest x-ray which went a bit better, but the nurse didn't seem to have the touch for pediatric patients especially a 3 year old, but Tate cooperated and stayed still for the AP and lateral views.  

Back in our room I let him have a couple of the M&Ms I had from his Valentine from me from yesterday that I hadn't given him and let him watch his precious trains on my phone.  This seemed to help lessen his upset.

Then the doctor came in and he wanted to see Tate's chest (I'm sure to see if retractions were still present).  Good grief...the tears over that and the squiggling around.  Then the hysteria over having his lungs listened to...the doctor got firm on this and raised his voice saying "Are you 1 or are you 3???"  Well that shut Tate right up who then became still, but had a hard time breathing in as requested...yeah deep breaths mean nothing to a tired, scared 3 year old.   Then the obligatory ear check...no issue whatsoever!!!!  He was perfectly still, though I suppose he's used to having his ears checked all the time.  Looking in his mouth was another story...clamped shut.  I put my fingers in there and pried him open.  Both the nurse and the doctor were shocked I would do that and asked how did I get him to open.  I explained what I did for a living and how I got him to open :)  Duly impressed they were.

So after all this business the chest film report came back with a differential diagnosis of viral bronchiolitis or reactive airway disease.  Some tiny right pleural effusion.  

Based on the exam, radiographic findings, Tate's history we decided that he had probably has an upper respiratory issue going on as his lower respiratory area was relatively clear.  The virus was settling in his trachea causing the constriction hence the stridor and difficulty breathing.  He didn't sound particularly asthmatic as he just wasn't having difficulty on expiration and no wheezing sounds were heard.  But it's hard to be sure.  He was still having stridor while we were there, but only when he was upset and crying.  In any event, the physician and I were both comfortable with giving him a breathing treatment with Xoponex to relieve some of the inflammation immediately and getting a dose of Decadron on board for a bit of longer term help. 

Who knew a breathing treatment was like having an appendectomy with no general anesthesia?  And my kid who LOVES to take medicine refused to open his mouth (The doc had asked how he was taking oral meds, and I said he loves to take medicine.  As such he opted to give him the meds PO instead of IM.  Ugh.  I had to force the Decadron down him, but no matter, I just held his little nose and he got it all.  Mommy does not play with not taking medicine.)  

But the breathing treatment?  What a nightmare.  He was furious.  Squirming, kicking...it was horrible.  AND they left me alone after showing me how to do it.  I suppose it was better than them helping me hold him down.  Thankfully, he did get alot of it in while running amok and he was breathing a bit easier within 10-15 minutes.

We left about 30 minutes after the breathing treatment with instructions to follow up with our pediatrician.  

We made our way home, and I was just exhausted.  I had to work today, so I was obviously already late.  My parents were already going to be at my place to take Tate to swim lessons, and they as always went beyond the call of duty and kept him all day for me.  They drove my grumpy son back to their house which is 30 miles away.  Any plans they had for the day were now up in smoke.  I was beyond grumpy and exhausted, and they took it in stride.  Thank goodness.  I finally got to work around 945 and was just exhausted all day long.  

Then my parents brought Tate BACK to me at my office, so I wouldn't have to go get him in the evening, as Houston traffic is horrendous on a Friday, so I wouldn't get to their house much before 6 and then have to drive back in traffic with my sick, overtired child.  Aren't they just fabulous?

Tate spent the day watching as many trains as he could, not napping and not really eating.  He had a cup of hot cocoa in his beloved Polar Express cup tonight and some mini Oreos for dinner.  His teeth will be ok :)  I anticipated some sort of meltdown at some point because I know he was just exhausted, and that came about around 630...just constant crying and whimpering.  I got him bathed (standing up), dressed in Valentine pjs and into bed asleep at 7:14 after loading him up with his Singulair, Benadryl and probiotics.  The humidifier is going and he is snug as a bug in a rug.

We shall see how the weekend goes.  Thankfully my pediatrician's office has sick kid hours Saturday and Sunday mornings.  My girlfriend who is a Family Medicine physician in Dallas called in a script for a Xoponex inhaler with a spacer for me for just in case.

So tonight I'm going to crawl into bed with my sweet son and cuddle him close.  And pray for a better morning tomorrow!