Vigorous Little Champ

Our Sweet Sam has been sick. Hospital sick. ICU sick. Bronchiolitis caused by RSV (Respiratory Synctial Virus) sick.

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Last week Adam and I had chest colds (perhaps caused by the RSV) and we unintenionally shared it with Sam. By Thursday Sam had a thick cough and sustained sleepiness, and by Friday night he had a fever. Overnight I noticed his rapid breathing and when I removed his pajamas we saw his chest was contracting with each breath. We called his pediatrician and were instructed to give Tylenol for the fever and monitor him. If symptoms worsened we were to take him to the ER. We were in Cleveland visiting family and he had his 2-month checkup scheduled for Monday morning.

Not feeling well

On Saturday he seemed better -- still fevered with che-contracting breaths but his breathing was more normal otherwise. He slept most of the day, ate (with a diminished appetite) and had a few quiet wakeful periods, but he never looked relaxed.

He worsened again overnight and Sunday morning had shallow, wetter-sounding respiration. We feared he was on the road to pneumonia. We packed up the car in a hurry and headed toward home to take him to the hospital by our house in case he was admitted.

On the drive he looked better. He ate some and looked comfortable. We decided to still go to the ER to have him checked. Within 5-miles of our house we have a Children's hospital. We drove straight there.

We checked in to the ER and within 3 minutes we were called back to a small triage room with two nurses. They took his pulse and blood-oxygen level, and immediately I knew something was amiss. I questioned Michael and he said his blood-oxygen level was low. It was in the 60s. The nurse looked up and told me it should be 100. Whoa. At that time another nurse came in and they moved him to a much larger room for treatment.

We knew it was serious, but we didn't realize how serious until we were in the larger room.

I felt like we stepped into an episode of ER. It looked to me like a large operating room. Michael placed Sam on the gurney and removed his pajamas. The doors opened and people started rushing in. At one point I counted 12 people in the room. A security guard was also on hand, perhaps to make sure Michael and I didn't overreact as four or five nurses actively treated Sam -- taking his temperature, attaching sensors, suctioning his airways, applying an oxygen mask, starting an IV, administering breathing treatments and drawing blood.

If we had to be in this situation, we wanted to be with these people. Everyone was wonderful.

We had a specialist from Child Life Services assigned to just care for Michael and me. She brought us tissues (believe me, we needed them), explained what was going on, answered questions, etc. We were welcome to stay in the room and even stand next to Sam and talk to him during the treatment if we wished. At first, though, we were just so stunned that all we could do was stare in fear at all the activity and severity of the situation. Didn't we just park the car 10 minutes ago??

There was another specialist from Child Life assigned to just care for Adam, who didn't seem at all phased by the commotion or view anything scary about it. He gladly went with the nurse to a small room with a sofa and desk to watch Chuggington on her iPad and eat cookies and juice. iPad! Chugginton! This girl is good. So thankful for her.

Ready for transfer

Talk about girl power... everyone in the room (aside from the guard) was female! Dr. Bennett was fantastic. I knew I liked her when I overheard her on the phone with the Attending doctor in the pulmonary ICU describing Sam as a "vigorous little champ." That's our robust boy! Dr. Bennet kept us so informed, telling us his stats and explaining the treatments, or she'd simply give us a thumbs-up from across the room as Sam made progress.

We had a moment of panic when we heard 'intubation.' Dr. Bennet ordered another breathing treatment and continued high-flow oxygen. Fortunately he responded to these and he did not have to be placed on a ventilator. More thanks.

Finally, he was stable. When he arrived they had him on 12 liters per minute (lpm) of O2 at 100% O2, and they were able to help him down to 80 lpm at 80%. And finally, comfortingly, he looked relaxed and we were relieved.

In the ambulance

The transport team arrived to take our little man to the main downtown hospital since this location couldn't serve his needs. About this time Adam pushed his way back in the room looking for us. He never questioned our red eyes. He just excitedly blurted out, "I'm watching Chuggington!" I told him Sam was going to ride in an ambulance, and responded with, "and I'm going to ride in a firetruck!" Love him so.

I rode with Sam, and Michael took Adam to Aunt Amy's house, since he isn't permitted at the hospital with us due to flu-season visitor restrictions. On the drive I talked with the emergency pulmonary specialist, Rob. He explained Bronchiolitis and RSV.

RSV is the leading cause of hospitalization in infants less than 1 year of age, and there are several other young patients in the ICU afflicted by it. I had never heard of it. When adults or older children contract the virus, it manifests as a chest cold. When little ones under the age of 2 get it, their small systems have more difficulty. The virus can lead to other complications, like Bronchiolitis. 

RSV is the most common cause of Bronchiolitis. Our lungs are like upside-down trees, and at the very end of those branches are small "rooms" that have walls covered in "balloons", called bronchioles, that transfer oxygen to the blood. When a virus attacks them, they swell and build up mucus and the airways close. The high-flow oxygen forces air into the lungs and bronchioles and doesn't let them fully contract. This "stents" the bronchioles and makes it easier to inflate, much like how a balloon inflates easier if it has some air in it to start.

So that's what we were dealing with.

The treatment is simply IV fluids, high-flow, humidified Oxygen, and Tylenol for the fever. Test results confirmed RSV and fortunately there was no bacteria in the blood. The doctors have no concerns of long-term effects. And once he was settled in the ICU we could hold him again. Now we just wait for him to get better, which we wish was a faster process.

Sunday was a long day.

I'll update in another post since this one is long enough, but be assured that he's making great progress and we hope he's home this weekend.

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Thank you, Amy, for watching Adam while we were at the hospital. Thank you, Mom, for rushing up here to care for Adam overnight.

And is it wrong that I kept taking pictures while Sam was being treated? I felt so helpless.. it gave me something to do!