Fear and Loathing In The Diaper Pail

I saw an inchworm this morning! I can’t remember the last time I saw an inchworm. He was so cute. He just made my day. Funny little green inchworm.

Monday Liam had what can only charitably be described as Baby’s First Asthma Attack.

Our story, which I have retold to dozens of healthcare personnel, begins on Saturday, which was lovely and sunny, so we played outside. Dad dethatched the lawn and I watered my flowers. Liam rubbed his eyes and let his nose run into his mouth. We figured he had allergies.

Sunday, said runny nose had turned a little yellowy. There was more sneezing and a little coughing. We changed our parental diagnosis to “cold”. But he seemed fine otherwise and we took him to the Museum of Transportation, where he had a good time looking at real trains and sitting in the engine room of the Atchison, Topeka and Santa Fe. He tired more easily than usual, but it was hot out and there was a lot of walking and stair-climbing to go along with his cold.

When he fell asleep for the night, we could hear him breathing. Not snoring, but a phlegmy rumble in his chest while he slept. He woke up Monday and the cough had gotten worse.

By noon, the cough had turned even more phlegmy sounding. And his breathing had a little bit of a wheeze to it. I called the doctor to see if she could check him out. We were told to come in at 2:30.

By 1 p.m., Liam had completely tanked. He was burning up with a fever and his head and chest were bright red. His breathing became extremely rapid and shallow, about 60 breaths a minute. His ribcage was sucking in and his upper chest was puffed out. “Hyper-inflated” I later learned this is called. I debated canceling the appointment and taking him to the emergency room. But he didnt seem all that uncomfortable. Just sick. I’d never seen anything like it before. I set him up with a movie and kept a close eye on him. We left a half-hour early for the doctor’s office, even though it’s only three blocks away.

At the doctor’s, he walked into the waiting room and played with the toys, despite his difficulty breathing. But he was so tired out, he actually let the nurse lie him down on the baby scale and take his temperature. A first in his entire medical history. He had a 102.5 degree temp.

Our doctor listened to his lungs and set him up with an albuterol treatment, given via nebulizer. The nurse showed me how to use it and Liam started to doze off while he breathed in the mist. Then the doctor came back in to check the percentage of oxygen he was taking in. It was low, about 90 percent.

She told us he had either pneumonia or asthma or both but we wouldn’t know for sure without a chest X-ray, so we needed to go to the hospital. However, it was 3:15 in the afternoon and there’s tons of construction between our house and Children’s Hospital. She said she’d never forgive herself if we were stuck on 170 and he got worse. So she called for an ambulance.

The paramedics arrived in a couple minutes, while I talked up the “awesome” ambulance ride we were going to take and wouldn’t that be cool? To see the inside of a real ambulance? Wow! Meanwhile I was on the verge of puking.

The EMTs let me carry him out so he wouldn’t freak and everyone in the waiting room looked worried, especially when they saw it was a little guy. Liam saw the ambulance and said, “Am-bince! Wawoo wawooo!!” and we climbed in. They have a special jumpseat that converts to a car seat and the EMT buckled him in.

Liam was SO brave. He held onto his water cup and the EMT stuck patches to him with monitoring wires. Then he gave Liam his own patch to hold, which he did. He looked all around the van and pointed to the heart monitor and the EMT showed him the interior lights. Then he gave Liam an oxygen mask. He told us we were going to St. John’s Mercy. We did get stuck in traffic and the driver turned on the sirens and drove on the shoulder and honked at people. It was loud, but Liam didn’t cry or look startled once. I think he was blown away by the whole thing. And too sick to care.

We got to the hospital and I carried him off the ambulance and into the pediatric emergency room where I laid him down on a bed and was finally able to call Adam and tell him what was going on and where we were. Liam was given steroid medicine and another albuterol treatment. His temperature was 101.8 and oxygen percentage, as measured by a monitor attached to a sensor on his toe, had dropped into the high 80s. Not good.

I blur of doctors and nurses and respiratory therapists came in and listened to him and gave him things and asked me questions. Adam arrived and our ER doctor ordered Liam a third, hour-long albuterol treatment and some Motrin. He snoozed during the treatment and by the time he woke up, the fever had broken and he was sweaty. Then it was time for the chest X-ray.

We carried him to the X-ray room and the radiologists suited Adam and me up in lead aprons. Then we had to hold Liam down on the table. Adam held his arms and I held his legs. We did our best to be cheerful and said how the lady was going to take a picture, so say Cheese! Which he did, which was funny and sad at the same time. Then we rolled him on his side for another shot. Cheese! All done! And he was given a Spider-Man sticker for his troubles.

The rest of the afternoon and evening was spent waiting and resting, with another albuterol mist and an oxygen tube in his nose and taped to his face, which he HATED. The oxygen meter hung off his toe, beeping away. We had to keep it covered up with a blanket because if he saw it, he’d take the sensor off. I ended up finding some tape and taping it on. We watched A Bug’s Life, 101 Dalmatians and Lady and the Tramp on the VCR. We turned off the lights and tried to be quiet. Adam went out to find some dinner for us around 7 and didnt get back until 7:45. Liam ate a few french fries and that was it.

Liam dozed off, although it was fitful with the occasional doctor, nurse or respiratory therapist coming in. His oxygen meter was reading in the 80s again and Adam and I became concerned as to whether we should let someone know. I flagged down his nurse and asked if there was a number that was too low. She said anything in the 80s. I said he was at 84 percent oxygen intake and she came right in and adjusted the oxygen flow in his tube.

Eventually the doctor made her way in. It was a busy day at the emergency room. Kids were waiting on stretchers in the hallways and the doctor said they were so busy, they were closed to ambulances with pediatric emergencies.

The doctor told us Liam needed to be admitted so he could be on oxygen all night, but there were no beds available. One might open up in the PICU, but then we couldn’t stay with him. So she planned on having us stay in the emergency room all night.

The doctor also told us how he came to have this attack and that “asthma” isn’t a diagnosis that’s made with a first-time attack, but for all intents and purposes, that’s what he has, not that we heard it from her. So he was being admitted for “respiratory distress”. She went on to explain how an attack works and what we should be looking for in terms of symptoms and what we should do about them. She said by the time Liam arrived at the ER, he was in severe distress. His ribs were retracting all the way up his ribcage, the hollow of his throat was sucking in, he had a nostril flare when he tried to breathe and a pale upper lip. The doctor said she couldn’t hear any exchange of air, which explained the lack of wheezing. He was past wheezing. She said if this happens at home, we should call 911 and our pediatrician was right to send us in an ambulance.

Finally we got a room. We covered him up with blankets so the light and noise woudn’t bother him, since he’d fallen asleep. The transport guy wheeled him out of the room and Liam looked very tiny all curled up on the stretcher. A nurse passing by said she’d thought there was nobody in the bed at all, he was so small and covered up.

When we got to his room and put him in his new bed, he woke up and was cranky. He was yelling at the new nurses and respiratory therapists to “Go back! Away! Away!” He fell in and out of sleep all night. I slept in the bed with him and Adam slept in the rock-hard recliner next to the bed. You would think, that in a gigantic, tertiary hospital like St. John’s, they would give parents a SLIGHTLY more comfortable place to rest. This was one step above a rock for a pillow on the ground. Eventually Liam oke up enough and was feeling better enough to rip the oxygen tube off his face. I called a nurse and she outfitted him with a mask, which was only a slight improvment. He would take it off and I’d put it on his stuffed bear to show how Bear was getting his treatment and now it was his turn. Only Liam was only all too willing to let Bear get better. So whenever Liam would doze back off, I’d hold the mask up to his face so he’d get more oxygen.

By morning, Liam was fine. He’d been off the oxygen (his own doing) for a few hours and his oxygen percentage was in the mid-90s. The albuterol treatments made him hyper and he ran all over the halls, jumping and shouting and playing. YOu’d never have guessed he couldn’t breathe 12 hours earlier and that he’d had no sleep.

Later in the day we were discharged with a steroid medication, amoxycillin for the ear infection and a nebulizer. We had to give him nebulizer treatments every 4 hours for 24 hours, which he protested as a matter of principle, but once we turned the machine on, he’d practically shove his face into the mask. It made him feel that much better.

So now he’s off the nebulizer and he’s doing fine, although he sounds a little hoarse and when he runs around, he coughs a lot, getting all that mucus out of his lungs. I’m keeping him home from playdates and preschool just in case this virus is still around, but he’s come along with me to the grocery store a couple of times and he acts plenty fine. It’s hard to get him to take it easy, even if I set up his favorite movies and markers and paper.

So that’s that. We’re just keeping an eye on him and hopefully this was just a one-time thing caused by a virus. But somehow I doubt it.

I’m writing this down here because I don’t want to forget it. Or if I do forget it, then I want it recorded. Sunday morning we headed out to the zoo and had a nice time. While we were walking along, we could overhear a family behind us.

DAD: Do you guys want to go to the Children’s Zoo?
KID: No, I don’t like the Children’s Zoo.
DAD: How come? It’s the Children’s Zoo!
KID: I hate goats.
DAD: Oh, there’s no goats there. It’s the Children’s Zoo. They keep children in cages.

Fake bologna sinks in water.

Not much up here, really. Adam is out of town this week. He’s at Tyndall AFB in Panama City doing computer things, so it’s just me and the Big L this week. So far so good, but it’s only been one day. I don’t think it’s dawned on him that Dad won’t be here again tomorrow. Or the next day. Or the day after that. Once he starts missing Adam, he might get harder to handle.
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This weekend went well. My cousin was in town for Easter with her daughter who is Liam’s age, so we got them together to play. They had a good time and it was interesting to see how much neater our basement was after a playdate with a girl, rather than his usual standing date with his friend Christopher. Liam and Christopher TRASH the basement every time. Every single toy is strewn about. If if can be taken apart, it has been. Liam calls Christopher “Ka-ka-fah”. Liam’s cousin is named Ella and is easier for him to say, although it sounds like “Ala”. When they leave, he waves and says sadly, “Kakafah come back. Come back Kakafah.” And he did the same with Ella. “Ala come back. Come back Ala.” It was so sad. He must be the loneliest kid on the planet.
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So the Easter Bunny brought way more candy than should be allowed by law for a kid that age. Our neighbors dumped off a huge bag of candy that I suspect was the wife’s way of getting rid of her extra Halloween and Christmas candy, since there were four plastic candy canes full of red and green M&Ms. What am I supposed to do with all this candy? I guess I better start eating …
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Week before last when the weather was nice, Liam picked me my first flower. It was a wild yard onion. It’s in a shot glass full of water in the kitchen. I can’t bear to throw it out.
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Liam’s new thing is running around as fast as he can until we catch him when we need to change his diaper. He informs us he’s going to poo, then he poos, then we go get a fresh diaper and he takes off laughing. As Mater from Cars would say, he’s a precisional instermint of speed and aromatics.