Please excuse me absence from NaBloPoMo. It was one crazy week. As many of my "facebook" friends know we brought Jameson to the ER Sunday night for the croup. Actually, right after I pressed "publish post" on my Sunday's blog he woke up in severe respiratory distress. He had what is called "Stridor" (when the hole between the collarbone is sucking in) and caving in of his ribecage, almost all the way back to his spine. It happened very fast, and was (and still is very scary). I immediately called Kevin upstairs to tell him we needed to go to the ER, we bundled Jameson up and we were out the door in about five minutes. It was a ten minute drive to the hospital and Jameson was very calm even though he was having a difficult time breathing. We assumed he would need a nebulizer treatment with steroids to help calm his breathing and bring the swelling down. We assumed it would be a 3-5 hour hospital stay in the ER. I guess its good we didn't know it was going to be much longer, or we might not have been so calm.
Upon arrival we were immediately, and I do mean IMMEDIATELY, escorted back to triage where we immediately were taken to the pediatric doc in the ER. They got a breathing treatment started and took his information. We began to grasp how worried they were when the ER doc said she would not be leaving our side. They asked if he was sick before croup: Not really, a fever on Wednesday night that broke early Thursday. Is he sick often: No never, maybe had one cold his entire life. Is this his first time with croup: Yes.
After a second breathing treatment and no change with a dropping blood-oxygen rate they decided to move us to the Trauma Room. As we entered the trauma room, which was filled with doctors, nurses and assistants, the Peds. doc told us we would have to sedate him with a paralytic drug (ie put him under) intubate him and he would be in the PICU (Pediatric Intensive Care Unit). What?!?!?! How did this get so serious? My son was just up, moving around today, talking, helping his dad put together his treadmill. They said it was the "A" of the acronym (ABC?) and it stood for airway, which I actually knew and it surprised her enough to ask how I knew it. Umm, shouldn't everyone know that after they have a first-aid or CPR class? No, I guess I randomly store medical facts in my brain.
By this time Jameson was almost finished with his third breathing treatment and had grown very listless, and its when the doctors really started to get worried. He was already undressed down to his "training" pants and socks. They told me they were going to get an IV going, did I want to stay and hold him? Yes, I didn't want to let him go. Its when my tears started falling. I couldn't help it, and its when I saw worry in my son's eyes that Mommy might not be able to help him. They quickly gave him the IV (bless the amazing nurse who hit a vein the first time), almost immediately he was out, but it was still the hardest thing I had to do handing him over to the doctors. (I am crying even as I write this).
The Peds. doctor, Summer Smith, is an amazing woman and told us we could stay if we so chose. We chose to stay, no way was I leaving that room. Kevin and I were both incredibly calm, whether it was shock or we just knew the doctors had a job to do. She "assigned" someone to sit with us and explain what was happening every step of the way. They had heart monitors on him, blood pressure, oxygen monitors, and there were about 15 people surrounding him and another 5 running around getting stuff as it was being called for. The intubation process was a long one. His airway was so swollen that they couldn't get a tube past it to give him oxygen. They began decreasing the tube size, and again, and again. If his oxygen levels got too low they "bagged" him, in other words pumped oxygen into him, which made his stomach get distended. Then, in order to get the air out of his tummy they put an NG ( tiny tube through the nose) to suck the air out.
At this point, (possibly 3o minutes into the intubation process) everyone was getting nervous, the doc was shaking, the guy watching the vitals began calling anesthesiologists, or the adult trauma doctor, pretty much anyone who could come in and try to intubate this 2.5 year old with a swollen airway. The adult trauma doctor was available and very calm, and had not been involved in the situation from the beginning. As they began to prepare to intubate him again his vitals began dropping, quickly. I watched that monitor go lower and lower and my heart began racing. Surely, they could see what was happening, right? Then I saw all the lines go flat. Just like on the TV shows the monitor started beeping. Then I heard, "He needs an epi-push (epinepherine in the IV to the heart), begin chest compressions now."
I remember looking at my baby and thinking how hard she was pushing on his chest, it was almost going flat against the table, and thinking, how the heck did we get here, this is the healthiest kid I know, would he have been ok if we didn't bring him in, is he worse off now? I could leave this place without my baby, what was the last thing I said to him, this isn't supposed to be like this... So many things were going through my mind that I can't even explain. Luckily, the doctors were (are) amazing and his heart began again and they got his oxygen levels up. What a welcome relief to see those monitors come to life, again. The adult trauma doc took his turn at the intubation, after the second try he was successful, and immediately his oxygen levels went up to nearly 100%. The tube size they had to use was meant for a newborn because his airway was so swollen.
After he was stabilized, he was x-rayed and then they moved us up to the PICU. He was doing fine, and all the doctors told us he was going to be great, even with the difficulty intubating him, but it was very scary to see him hooked up to tubes, and monitors. I can definitely go a lifetime without seeing my child like that again. Once up in the PICU we were told he would be under anywhere from two days to a week. Again, we were shocked and confused, this was a boy who just two days ago was running around with his friends in the green-space across from our house. After he was set-up in the PICU, the doctors checked on him and the ER doc came up to see how we were doing, exhaustion set in for us both. Around 2:30 am I told Kevin to go home and take care of the dogs and get some sleep. I lay down on the couch that the nurses helped me set up like a bed. I couldn't sleep because I had terrible dreams every time I closed my eyes and I was replaying every little thing that happened. He was out of the woods and was doing much better than when we brought him in, even though he didn't look it. I didn't know when he would be coming home, but at least I knew he WAS coming home.
Just writing that has taken it out of me tonight. I will finish the rest of our story tomorrow.