Anaphylaxis - The Call I Never Wanted to Receive

Friday, July 25, 2014

Tate and I had a leisurely morning at home.  I tried to sleep in til around 7am while Tate played downstairs with some of his new birthday toys...his train, his Legos and especially his Lego 'Planes' set.

Around 9am I took Tate to camp and dropped him off via the car pool line.  He took his time getting out which prompted the counselor to try to move him along.  He's in a 5 point harness, so it takes a bit longer to get out as he doesn't know how to open it himself...I have to do it for him.  But she called him by name and helped him out of the car.  All seemed great!

I drove off to my 9:30 physical therapy appointment for my torn medial meniscus on my left knee.  This was my first appointment in 3 weeks, one week after having returned from Disney World.  I was so pleased with my therapy up until this point as I've had minimal pain while walking and my discomfort, while definitely still present has decreased on stairs.  Most importantly I didn't experience any discomfort with all the walking I did in Florida!!  I was thrilled.  Justin put me through the paces and after icing my knee I was off to my 90 minute massage with the fabulous Jane.

Goodness I was looking forward to this massage.  My legs were aching as were my feet after pounding the pavement for 5 days straight!  My muscles were practically whining from the overuse :).  I was just walking back to the massage room with Jane when my phone rang.  I didn't recognize the number, so I just hit 'end'.  It rang again not 2 minutes later. 

I answered it this time as in the back of my head I thought to myself "Tate's at camp, I might not recognize a number they call me from.  This might be them for some reason."

In that short amount of time between seeing the phone ring, deciding to answer and actually answering I realized something might be wrong.  I thought "I hope he hasn't broken a tooth or hurt himself badly" as the blood started draining from my face.

To be told "Ms. C we had to give Tate a shot with his epi-pen a few minutes ago.  We've called an ambulance." was the last thing I expected to hear.

I was in shock, quickly told Jane I had to leave and rushed downstairs to my car in a frightened frenzy.  I was all over the place with my questions...

"What did he eat?"

"Is he breathing?"

"Where is he""

"What happened?"

"Is 911 on the way?  You have to call 911!"

"IS HE BREATHING?"

The 15 minute drive to the camp was excruciating.  Construction cones were all over the route I opted to take as I'm frantically trying to not cry, so that I'll be able to see.  I'd hung  up with the assistant director, so she could attend to Tate, but called her back once I was on the road.  Kayla assured me EMS had arrived, that Tate was breathing much better and he was on oxygen, crying but ok.  I asked her to please not let EMS transport him until I arrived unless it was necessary.

The idea of my baby riding in the back of an ambulance, sirens wailing, tires screeching around corners, strangers putting monitors on him without me with him put me in a state of sadness I cannot express. 

I also recognized that it might be the only thing to save his life, so I reiterated that if the EMS team deemed it necessary that they should take him without me if they had to.

Luckily, he didn't have to be transported.

I was barely holding it together as I weaved in and out of traffic.  I wanted MY mommy, but knew if I called my parents they would be beside themselves with worry and I would have to calm them down before they could help me calm down.  Luckily I got a hold of my best friend just as I pulled into the parking lot, and I was able to stop crying before getting out of the car.

One of the camp counselors met me at my car to walk me in to Tate.  As we were walking in one of the EMTs walked by and told me "He's just fine!!"

We rounded the corner and there was my sweet boy on a chair, nasal cannula in his nose, red and teary, surrounded by EMTs, firemen and camp counselors.

I walked over and hugged him as best I could; he wanted to be picked up, so I took the nasal cannula off after being sure it was ok, and hugged him like I would never let go. 

After putting him back down, I talked with the head EMT as well as his counselors to try to determine what happened.  The assistant director had given me a brief rundown as I drove over, but we went over it again.

Around 11:10am, the kids were laying on the floor in their classroom on their backs having just come back from the gym where they had been running around.  Tate's counselor looked down and saw that Tate looked red and splotchy.  She asked him if he was ok.  He said he wasn't.  She asked him if he could breathe.  He said no.  She realized he was indeed having lots of difficulty breathing.  By this time the assistant director was coming into the room and Miss M had just decided to administer the epinephrine into Tate's right thigh.  She did it quickly and absolutely in accordance to the action plan I had provided.  Within 1 minute they both reported that Tate started breathing better.  They then followed the action plan calling 911 then calling me.

Noone had eaten anything in the room as lunch is served elsewhere.  They had not had any snacks in the room.  No food had been consumed or opened in the room.  The children had not been outside except to walk from one building to the next.

Tate's vitals were great, all within normal limits.  His chest was clear, he was breathing well on his own and appeared to be in no apparent distress.  I discussed our next steps with the head EMT.  I have been told by his physicians that if epinephrine is administered Tate would need to be monitored.  The EMT said they would be happy to escort us to the ER in the ambulance, or we could see our pediatrician.  We actually had an appointment scheduled at 4pm that very day for a well child 5 year old visit, and his pediatrician was 2 blocks from the camp campus.  I quickly called the pediatrician's office and spoke to the triage nurse.  She said she couldn't tell me what to do, but recommended that I do whatever the EMTs told me.  I relayed this to the head EMT who recommended that I see his regular pediatrician as she knew his complete medical history etc.  So I sent EMS on their way and scooped up my boy to head over to see the pediatrician.

As I was buckling Tate into his carseat his pediatrician herself called me.  She advised me that I needed to go to the ER because Tate needed to be monitored for a period of time with proper monitors that they don't keep in their offices.  I was to tell the triage nurse immediately that my child had received an injection of epinephrine and needed to be monitored for a rebound reaction as well as the affects of the drug on his little heart and system.

We made our way to the ER....a world renowned children's hospital which was about 10 minutes from where we were.

I quickly valeted the car, grabbed a couple of coloring books for Tate and thankfully his lunch! and made our way inside.  We checked in around 12:10pm, told the staff who gave me my paperwork that Tate had received an epi injection for an anaphylactic reaction and waited to see the triage nurse.  I saw the triage nurse who I again told about Tate's injection and anaphylactic reaction and that his pediatrician wanted him monitored.  We were shuffled to the next waiting area to do some financial paperwork and then moved to the big waiting room completely devoid of any nurses, doctors or medical personnel but full of sick, pale, miserable children.

Of course he found the one train in the waiting room.
Also I realize he doesn't look the least bit sick, however
a rebound reaction can occur within minutes, hence the need
for monitoring after an anaphylactic reaction.

At 2pm after having let Tate eat his lunch complete with milk, I was beyond frustrated as were several of the other mothers in the waiting room with me;  some had been in this waiting area for 4 hours!!  I decided to go ask someone if this was their idea of monitoring my child post epinephrine injection because I could do this at home, for free.  I also mentioned that my pediatrician had sent us, and that we had an appointment with her for that afternoon at 4pm;  I would be happy to head back over to her right then and there.

This immediately got a nurse to come look at Tate and magically there was a room ready for us!

Our nurse placed an EKG on Tate and a pulse ox, and thus began our new wait for a physician to have time to come look at Tate.  Just to have a look at him!  I mentioned to this nurse that we had an appointment at 4pm with our regular pediatrician that I really wanted to make it to.  She told me there had been 2 traumas, and all docs were involved with that, but she'd get someone in to see me as soon as she could!

Really not liking all these 'sticker's on his body...
my sweet, scared little boy :(

He was a trooper and got used to the EKG monitors quickly
and started coloring and smiling within minutes!!
Love this brave boy so much!

At 3:15 I had had enough.  I told Tate he could take off his monitors and I was going to go see about getting us out of there to go see Dr. R.  He was ecstatic!  I went to the nurse's desk to tell my nurse we were leaving.  I felt a bit bad for her as it seems she spends her days at this place managing parents' irritation with the long waits.  She got a doc on a phone who asked the nurse if the parent (me) knew that a child who had been administered epinephrine for an anaphylactic reaction needed to be monitored for 6 hours.  The nurse said "No she probably doesn't, but I can tell her."  So she told me.  (very nicely)  I said that was fine, thinking to myself it would have been nice had they asked her to tell me that at the outset, so I could call to cancel our appointment.  Mostly it would have been nice for the physician to actually see me and tell me her treatment plan as I'd been in their hospital for almost 3 hours at this point and yet to see a doctor!!

I was hustled back to our shared! room and the resident hustled in herself.  Soon after the fellow made her presence known and lo and behold the attending was available all of a sudden as well!!  

Tate's monitors were replaced, and we settled in for a seemingly  long winter's night.  Rest assured I was prepared to remove everything from his body at 5:15pm on the dot and be on my way home at 5:16pm.

Throughout the entire stay in the ER Tate was incredibly well behaved.  He never once cried, whimpered or complained.  I did end up feeding him his lunch in the 3rd waiting room we were in...yes, it's hard to keep up with which waiting room I'm referring to...the 3rd one was the one we waited 90 minutes in with the rest of Houston's sick children.  I let him watch his beloved Lego 'planes' on my phone while I laid on his tiny hospital bed with him trying to get some sleep.  I did manage to doze off a few times.

At 5:15pm his nurse came bustling into the room followed within 10 minutes by his physician.  Tate was deemed healthy enough to leave with enough prescriptions to fill my medicine cabinet.  They prescribed a 4 day course of steroids and 2 histamine blockers...benadryl and zantac to keep all histamine pathways clear.  

We couldn't get out the door fast enough.  Our car was brought around, and we were finally on our way home before 6pm.

I got Tate some dinner, got him bathed and we climbed into bed to read stories and cuddle.  Needless to say I rocked my sweet boy to sleep that night and held him in my arms for way longer than normal.

Absolute exhaustion set in for me quite soon after he fell asleep.  Surprisingly, I never lost it after my initial crying jag in the car as I was talking to Susan.  And I've yet to really cry about it.  I've told the story countless times, but I haven't cried.  Two weeks later I think I'm still in a bit of shock.  With all that's going on in our lives...having just returned for a week long trip to Disney World, work being crazy busy, this incident, trying to prepare for the start of kindergarten and all that entails I'm just running on fumes.  That massage I missed was going to be the start of some serious downtime that day that I desperately needed.  I needed that break.  I didn't get it.  Our weekend that weekend was already packed to be followed by one of the last weeks at work before school starts...we are always swamped, just swamped the last 3-4 weeks before school starts.  In addition, Tate started zoo camp that Monday after that Friday's incident.  I opted to take him to camp that morning instead of having my dad take him as we had planned to just make sure the new counselors 100% understood the severity of Tate's allergies and that he had just suffered an anaphylactic reaction 48 hours prior to them meeting him.  As I drove away after dropping him off I was almost apoplectic.  I didn't realize how very worried I was until I left my sweet child with virtual strangers.  It took all my self control to not turn around and go get him and just keep him with me all day.

We saw our allergist last Friday, and what happened that previous Friday will undoubtedly remain a mystery to us all.  We have no known trigger, so it's an idiopathic reaction.  This is so much scarier than knowing he ate a peanut butter cookie (which would undoubtedly kill him);  the fact that we have no idea what caused him to have the reaction is so much worse.  And there's still that part of me that wonders...did he really have an anaphylactic reaction?  Not knowing what he really looked like, what his symptoms were is difficult to swallow.  I'm relying on the report of a young girl, no more than 19 or 20 years of age.  Don't get me wrong...I'm eternally grateful that she acted quickly to keep my son safe; epinephrine will never hurt someone, so when in doubt, give the shot!  She responded beautifully as did the entire staff.  And Tate!  The EMT team was so complimentary of the staff's response and the fact that Tate articulated that he didn't feel right.  They were incredibly impressed with the camp's behaviour as was I.  I definitely will send him to that camp again next summer.

Tonight I'm still exhausted.  The stress and fear of the past two weeks is really catching up to me.  I have been able to hide my fear and anxiety from Tate (well I think I have);  I just don't want him to be scared or worried.  I know he understand he has food allergies, and he knows he has to question everything he eats, but I so don't want him to be scared.  I can be scared enough for the two of us.  

In addition, the stress and nerves of the next 9 days as we gear up to start kindergarten on the 18th lay before me.  There are so many unknowns with this new school as there has been absolutely no contact with new families, like ours, since the end of May.  None.  Zilch.  Nada.  I'm actually quite angry about it.  I'm paying a hell of alot of money for my child to go to this school; the least they could do is communicate with me before the first day of school in 9 days.  

But as exhausted as I am, I'm eternally grateful.  Grateful my little boy is upstairs asleep and happy.  Grateful my sweet son is healthy and safe.  Grateful my child is surrounded by people who care about him and for him when I cannot.  Grateful that the two of us have more years ahead of us together than I can count.  Grateful for God's healing, mercy and love that dark Friday and all the Fridays and days in between.