By the time we got home, M. was very out of sorts, crying a lot and refusing to nurse. He'd been intermittently refusing to nurse throughout the day, going 4+ hours without nursing, then guzzling, then crying afterwards. He was definitely uncomfortable. I suspected ear infections, so in the morning I took him and T., who was still feverish, to the pediatrician. T's oxygen level was a little low, but she responded to a breathing treatment, and they determined that she had walking pneumonia. When they checked M's oxygen levels, they were in the low 90s. They gave him a breathing treatment, checked again, and they hadn't improved. In addition, his respiratory rate was too high and he was working hard to breathe--his chest was really sucking in as he was using a lot of muscle power to breathe. So I got the bad news--he needed to go to the ER. I called Daryl, who didn't answer, and our babysitter, who said she'd meet me at the pediatrician's office to pick up T., K. and A. She lives 30 minutes away, however, and when they heard that they said it was too long, and that she should meet me at the ER. I headed to the ER, and along the way I got hold of Daryl, who said he'd meet me there.
Once we were at the ER, and M. had been thoroughly examined, they said they wanted to observe him to see what happened when he went to sleep. They administered another breathing treatment and x-rayed him. He didn't have pneumonia, which was good news. When he fell asleep, however, his oxygen levels fell into the low 80s, which was unacceptable. When asleep, he wasn't working as hard to breathe and consequently he was getting a lot less air. He needed oxygen during those times, so he was admitted. He had bronchiolitis, which it turned out was caused by RSV. They swabbed his nose and ran a culture to determine what organism was causing it, in order to know what to expect based on the typical course of that particular illness.
As the evening went on, his oxygen levels were very good even while sleeping, and he was receiving only a tiny amount of supplemental oxygen. Since they had told me that he would have to not need oxygen for 24 hours before he could be released, I requested that we try turning it off around 8pm to see how he did. The respiratory therapist was happy to do that. The rest of the evening and through the night his oxygen levels were in the low 90s when asleep without any oxygen, which they said was acceptable.
His roommate also had bronchiolitis. I was never told whether she also had RSV. Hopefully she did, so they weren't exchanging germs. She was 11 months old, and her father and grandmother visited, but did not stay the night with her. She was sicker than M., and had previously been in intensive care. Her condition, combined with being alone, made her cry most of the night. The nurses did come in and attend to her, a lengthy routine of suctioning her, changing her diaper, giving her a fresh bottle, and comforting her, which she cried through. The staff levels aren't sufficient to provide continuous one on one with a child. I felt sorry for her, and for me, as I was totally exhausted.
Our room was small, filled with 2 giant cribs and other equipment. Parents weren't allowed to use the bathroom, despite the fact that neither of the patients in our room could use it, because it was shared between 2 rooms, and there were older children in the adjoining room that did use the bathroom. I had to walk a long way down the hall to a restroom, and leave M. behind, since he was attached to an oxygen tube and pulse-oximeter. There was a short, narrow padded bench in the room for each child's parent(s). It was only about 4 feet long, and impossible to sleep on. Since M. likes to sleep with me, and I was worried that if I feel asleep on the bench while holding him I'd drop him, and his crib was bigger than my bench, I got into the crib with him. I did fall asleep for a short while, despite the crying and constant interruptions.
Then I was rudely awakened by a doctor that I hadn't met. (This is a teaching hospital and consequently you meet many different doctors, residents, medical students, etc.) She wanted to know if M. had a wet diaper on or not, because the previous diaper had not been weighed, which is what they were doing to measure output and be sure M. was not becoming dehydrated. I had left it in the proper place but apparently the nurse had forgotten. The doctor informed me that if M. didn't have a wet diaper on they would have to put in an IV right away because that would mean he was dehydrated. I knew he had a very wet diaper on because he'd fallen asleep with it needing to be changed, and I hadn't wanted to wake him to do it, so I left it on, thinking he'd wake up later and I'd do it then. He was now sound asleep, of course, but I had to change it immediately. I handed it to her, saying, "Here--now you can weigh it." She took it with a look of disgust, then set it down and said, "A nurse will do that." An IV was not necessary.
In the morning our pediatrician came. She felt that he was doing much better and could go home. Of course, it took a long time to get the paperwork completed, etc. and he was actually discharged around 11am.
This was the University of Michigan's Mott Children's Hospital. They are in the process of building a new children's hospital, which the nurse told me will feature private rooms that contain a bed for the parent. This is essential, since if a child were there for a lengthy stay the abysmal accommodations would really take a toll on the parents. I know that the hospital expects parents to stay and help care for their child because Daryl's niece had surgery there recently, and in the pre-op packet her parents received was a letter stating that.
I am so lucky that we have never had a child admitted to the hospital before! It was a learning experience.
M. is fine now. He recovered quickly, thankfully.
6 days ago