If it's Tuesday evening, it must be time to throw up!
This has been a hell of a week. A hellish hell of a week...
It all began a week ago, last Tuesday evening. K was out to dinner with a friend and it fell to me to pick up M from daycare and give him dinner and put him to bed. No problem, I've done it before. We are exceptionally lucky, too, to have a baby who goes to bed pretty promptly at 7PM. So I picked him up at 5, brought him home, fed him, gave him a bath, and I was rocking him to sleep when he looked up at me, smiled at me, opened his mouth and threw up his entire dinner all over himself, me, the rocking chair, the rug.
I ran him to the bathroom and gave him another bath, and put him to bed... and then cleaned up the mess.
Well, these things happen, right? In a way, it was kind of like a giant spit-up, although it's been months since the last time that happened. (Though some kids do spit-up until their first birthday or even later, so this actually wasn't outside the realm of possibility.) I resolved not to worry too much, and just let him be.
At 9, K called to let me know she was on her way home, and I told her what happened. While I was on the phone, I heard M suddenly start yelling, so I hung up and went to check on him. He'd thrown up again, so this wasn't a fluke or a late spit-up, but a GI infection type thing. I called the doctor's office to figure out what I should be looking for and doing; they said there wasn't much to do but wait. He should stop throwing up within 8 hours, and maybe have some diarrhea after that, and be done in 24 hours. We should watch for dehydration and call back if he seemed dehydrated.
He throw up a couple of more times, and then slept soundly the rest of the night. The next morning he'd started coughing, but he was eating food again (a small and easy-to-digest breakfast), and kept it down. Late morning he took a bottle, and threw up again. He was running a 100+ fever despite Tylenol, too, and coughing coughing coughing. So we called the doctor, and they said to come in.
We went to the doctor's office where his temperature was 103.7F, and the doctor said he seemed dehydrated, so we should go to the ER for an IV. Which we did. While there, they tested him for a couple of other things -- blood infection, urinary tract infection. The UTI test was the worst thing I've ever had to deal with. To test for UTIs, you need a sterile urine sample -- you can't wring out a diaper. So to get the sample, you have to run a catheter. Ugh.
Well, all the tests came back negative, so it seemed he'd picked up two things at almost the same time: a stomach bug, and a cold. We got the IV and went home.
Thursday, he was still running a temp, so K stayed home and I went to work. I got home to find he hadn't really been eating, and we were running a slow losing battle to keep the hydration. And then, late that night, I got sick. Stomach bug.
I don't really remember Friday, except that I slept until 1PM, and K looked after both of us. M's cough was getting worse, though, and his breathing getting shallow. So that night we went back to the ER, where they gave him some treatment and more tests before concluding that his cold was actually RSV.
In summary, RSV infects adults just like a cold. You can't really tell them apart although they are two separate viruses. (I've got RSV right now. Just like a cold. Really.) But in infants, RSV is significantly more serious and frequently leads to bronchiolitis (not bronchitis) which is an infection of the smaller airways in the lungs. In infants this is problematic because those airways just aren't that big. And, it seemed, this was the problem with M.
They treated him with Albuterol, a drug that asthmatics are probably familiar with. It opens up the airways of the lungs. We weren't sure we saw much of a difference, though. Saturday morning, despite the Albuterol, he still seemed to be in bad shape, and still wasn't really drinking anything, although we could get fluid in by feeding him very watered-down oatmeal. We called the doctor -- again -- and this time got an appointment with M's actual PCP, who had just returned from vacation.
Sometime between making the appointment in the morning, and actually going to the appointment in the afternoon, M turned a real corner. He was much more lively and interactive by the afternoon appointment. Dr. Y noted that and said he thought things were looking up. He was keeping hydrated -- barely -- and as long as that kept up and his breathing stayed good, we should be fine. It'll take a few weeks for the coughing to clear up (this is common to bronchiolitis), but he'd be fine.
Saturday night, M went to bed a little early (he'd been up super-late at the ER the night before, after all) and slept until 1:15 when he awoke with a tremendous coughing fit that went on for literally a minute. Try to imagine someone coughing for 60 seconds straight and barely getting breaths in. Very scary. I held him and lightly pounded his back, and he finally got over it, and flopped back to sleep. But he was awakened by coughing every couple of minutes for the next hour, and I finally tried giving him some Albuterol. This seemed to help, lessening the frequency of the coughing down to once every ten or fifteen minutes. But it was still a rough rough night.
At 6:15, the coughing got much more frequent again, and this time the Albuterol didn't seem to help. He just couldn't stop coughing, and wanted so desperately to be asleep. One of the warnings we'd been given at that point was to watch out for coughing that severely impacted his sleep. This seemed to fit the criteria, so back to the ER we went.
This time they decided to admit him rather than have us keep coming back. Unfortunately, there isn't a lot you can do for a viral infection like RSV. They put him in an oxygen tent, a plastic cube that was fed by a pipe with highly humid oxygenated air. Not pure oxygen, just air that was around 30% or 35% O2. And very humid. Ultimately it seemed that the humidity was helping more that the O2, so at some point they stopped the oxygen, and just kept him very humid.
He was not confined to the tent; we could take him out and hold him, feed him, play with him... but he did better in the tent than out of it.
Monday morning, K had the stomach bug. Of course.
We got him home from the hospital on Monday evening, as he seemed to be doing much better, and we reckoned that we could turn up his humidifier full blast and keep him comfortable. We brought him home and had a nice evening with him. He showed a lot more of his personality -- he is a very cheerful and happy baby usually, full of smiles -- and some willingness to eat and go to sleep at his usual time.
Come 12:05, though, he started in with a monster marathon coughing fit again. I gave him some Albuterol, which helped, and we then brought our humidifier into his room and turned it on full blast, which helped even more. (For the record, yes, this is two humidifiers in a 12x14 room, both going full blast.) Still, every time our forced air heating kicked in, he started coughing again, subsiding when it did. The second humidifier has a humidistat on it which showed that the air in there was 75% humid, dipping to 50% when the heat was on.
He slept much better the remainder of the night, and was nearly his old self today. We had a follow-up appointment with Dr. Y, who said he looked very well. But then, listening to his chest, he said he heard a hint of pneumonia in there, which apparently can happen when a baby with RSV gets dehydrated and then pumped full of fluids. So now M is on a course of antibiotics.
After the doctor's appointment, M fell asleep in the car, and we let him continue napping at home. When he woke up, we gave him the first round of antibiotics. He got very upset at us forcing this on him, and started to scream. Then started to cough. Cough cough cough cough cough vomit. His lunch and the antibiotic, all over K.
Well, it does happen that a severe coughing fit can lead to vomiting. Which is what we hoped happened. After we got him washed up and dressed in his PJs, we fed him dinner, and he was ravenous. Now he is asleep, and has been for some time. It's been 4 1/2 hours since him threw up, and I'm hoping we are in the clear vis a vis him having another stomach bug. Hopefully, it was just the coughing...
I don't like the week I've just had. Can I have a different one please?
It all began a week ago, last Tuesday evening. K was out to dinner with a friend and it fell to me to pick up M from daycare and give him dinner and put him to bed. No problem, I've done it before. We are exceptionally lucky, too, to have a baby who goes to bed pretty promptly at 7PM. So I picked him up at 5, brought him home, fed him, gave him a bath, and I was rocking him to sleep when he looked up at me, smiled at me, opened his mouth and threw up his entire dinner all over himself, me, the rocking chair, the rug.
I ran him to the bathroom and gave him another bath, and put him to bed... and then cleaned up the mess.
Well, these things happen, right? In a way, it was kind of like a giant spit-up, although it's been months since the last time that happened. (Though some kids do spit-up until their first birthday or even later, so this actually wasn't outside the realm of possibility.) I resolved not to worry too much, and just let him be.
At 9, K called to let me know she was on her way home, and I told her what happened. While I was on the phone, I heard M suddenly start yelling, so I hung up and went to check on him. He'd thrown up again, so this wasn't a fluke or a late spit-up, but a GI infection type thing. I called the doctor's office to figure out what I should be looking for and doing; they said there wasn't much to do but wait. He should stop throwing up within 8 hours, and maybe have some diarrhea after that, and be done in 24 hours. We should watch for dehydration and call back if he seemed dehydrated.
He throw up a couple of more times, and then slept soundly the rest of the night. The next morning he'd started coughing, but he was eating food again (a small and easy-to-digest breakfast), and kept it down. Late morning he took a bottle, and threw up again. He was running a 100+ fever despite Tylenol, too, and coughing coughing coughing. So we called the doctor, and they said to come in.
We went to the doctor's office where his temperature was 103.7F, and the doctor said he seemed dehydrated, so we should go to the ER for an IV. Which we did. While there, they tested him for a couple of other things -- blood infection, urinary tract infection. The UTI test was the worst thing I've ever had to deal with. To test for UTIs, you need a sterile urine sample -- you can't wring out a diaper. So to get the sample, you have to run a catheter. Ugh.
Well, all the tests came back negative, so it seemed he'd picked up two things at almost the same time: a stomach bug, and a cold. We got the IV and went home.
Thursday, he was still running a temp, so K stayed home and I went to work. I got home to find he hadn't really been eating, and we were running a slow losing battle to keep the hydration. And then, late that night, I got sick. Stomach bug.
I don't really remember Friday, except that I slept until 1PM, and K looked after both of us. M's cough was getting worse, though, and his breathing getting shallow. So that night we went back to the ER, where they gave him some treatment and more tests before concluding that his cold was actually RSV.
In summary, RSV infects adults just like a cold. You can't really tell them apart although they are two separate viruses. (I've got RSV right now. Just like a cold. Really.) But in infants, RSV is significantly more serious and frequently leads to bronchiolitis (not bronchitis) which is an infection of the smaller airways in the lungs. In infants this is problematic because those airways just aren't that big. And, it seemed, this was the problem with M.
They treated him with Albuterol, a drug that asthmatics are probably familiar with. It opens up the airways of the lungs. We weren't sure we saw much of a difference, though. Saturday morning, despite the Albuterol, he still seemed to be in bad shape, and still wasn't really drinking anything, although we could get fluid in by feeding him very watered-down oatmeal. We called the doctor -- again -- and this time got an appointment with M's actual PCP, who had just returned from vacation.
Sometime between making the appointment in the morning, and actually going to the appointment in the afternoon, M turned a real corner. He was much more lively and interactive by the afternoon appointment. Dr. Y noted that and said he thought things were looking up. He was keeping hydrated -- barely -- and as long as that kept up and his breathing stayed good, we should be fine. It'll take a few weeks for the coughing to clear up (this is common to bronchiolitis), but he'd be fine.
Saturday night, M went to bed a little early (he'd been up super-late at the ER the night before, after all) and slept until 1:15 when he awoke with a tremendous coughing fit that went on for literally a minute. Try to imagine someone coughing for 60 seconds straight and barely getting breaths in. Very scary. I held him and lightly pounded his back, and he finally got over it, and flopped back to sleep. But he was awakened by coughing every couple of minutes for the next hour, and I finally tried giving him some Albuterol. This seemed to help, lessening the frequency of the coughing down to once every ten or fifteen minutes. But it was still a rough rough night.
At 6:15, the coughing got much more frequent again, and this time the Albuterol didn't seem to help. He just couldn't stop coughing, and wanted so desperately to be asleep. One of the warnings we'd been given at that point was to watch out for coughing that severely impacted his sleep. This seemed to fit the criteria, so back to the ER we went.
This time they decided to admit him rather than have us keep coming back. Unfortunately, there isn't a lot you can do for a viral infection like RSV. They put him in an oxygen tent, a plastic cube that was fed by a pipe with highly humid oxygenated air. Not pure oxygen, just air that was around 30% or 35% O2. And very humid. Ultimately it seemed that the humidity was helping more that the O2, so at some point they stopped the oxygen, and just kept him very humid.
He was not confined to the tent; we could take him out and hold him, feed him, play with him... but he did better in the tent than out of it.
Monday morning, K had the stomach bug. Of course.
We got him home from the hospital on Monday evening, as he seemed to be doing much better, and we reckoned that we could turn up his humidifier full blast and keep him comfortable. We brought him home and had a nice evening with him. He showed a lot more of his personality -- he is a very cheerful and happy baby usually, full of smiles -- and some willingness to eat and go to sleep at his usual time.
Come 12:05, though, he started in with a monster marathon coughing fit again. I gave him some Albuterol, which helped, and we then brought our humidifier into his room and turned it on full blast, which helped even more. (For the record, yes, this is two humidifiers in a 12x14 room, both going full blast.) Still, every time our forced air heating kicked in, he started coughing again, subsiding when it did. The second humidifier has a humidistat on it which showed that the air in there was 75% humid, dipping to 50% when the heat was on.
He slept much better the remainder of the night, and was nearly his old self today. We had a follow-up appointment with Dr. Y, who said he looked very well. But then, listening to his chest, he said he heard a hint of pneumonia in there, which apparently can happen when a baby with RSV gets dehydrated and then pumped full of fluids. So now M is on a course of antibiotics.
After the doctor's appointment, M fell asleep in the car, and we let him continue napping at home. When he woke up, we gave him the first round of antibiotics. He got very upset at us forcing this on him, and started to scream. Then started to cough. Cough cough cough cough cough vomit. His lunch and the antibiotic, all over K.
Well, it does happen that a severe coughing fit can lead to vomiting. Which is what we hoped happened. After we got him washed up and dressed in his PJs, we fed him dinner, and he was ravenous. Now he is asleep, and has been for some time. It's been 4 1/2 hours since him threw up, and I'm hoping we are in the clear vis a vis him having another stomach bug. Hopefully, it was just the coughing...
I don't like the week I've just had. Can I have a different one please?