Monday, February 11, 2008

RSV Continues...

Days 4, 5, 6 and 7 of Abby's hospitalization brought some unexpected excitement and stress.

Tuesday (day 3) went fairly smoothly, especially after we settled into our new room on the peds floor. We had actually been hopeful to be discharged the next day. HA! Little did we know what was in store for us.

That night Abby's respiratory status gradually spiraled out of control. Early evening I noticed she was occasionally dropping her O2 sats into the high 80's. I watched it for a while until I realized they weren't coming back up. She was miserable with incredible congestion and a painful sounding cough. The nurse put her on some nasal canula O2. As the hours progressed so did her respiratory distress. By 2 am she was struggling to breathe on the non-re breather bag, delivering 6 L of 100% oxygen. This is what she was on in the ER Sunday before they intubated her. So, needless to say I was rather nervous and stressed. Even on this high amount of O2 she was barely keeping her sats at 94!

They drew blood cultures, called the Doc, tried to get IV access (5 attempts!) and got some breathing treatments started. She stayed on the bag until the sun came up and we were able to put her back on the canula at 3 L O2. They started chest PT (firmly patting the chest to loosen her secretions) and continued to suction her frequently. As you can imagine, she loves this part!

Wednesday was more of the same; restlessness, fever, terrible coughing and lots of suctioning. By this point the Pulmonologist had come to see her and determined she also has pneumonia! Probably from an aspiration event during her 1 hour long seizure on Sunday. So now she's on antibiotics every 8 hours.

Thursday- not much change, until that night. Another repeat of Tuesday night where she started dropping her sats and her chest was heaving and retracting with each breath. They had to put her back on the non-re breather bag and there was talk of returning to the ICU. Of course they didn't have any beds available, so we continued to suction and give her the breathing treatments more frequently. And once again, she started to improve when the sun came up. Not sure what it is about night time, but things definitely get worse for her.

Friday was a little more restful. Her fever wasn't as high, and the breathing treatments were starting to thin out her secretions so we could more successfully suction her airway.

Friday led to Saturday, and Saturday to Sunday where we reached our one week mark of being in the hospital. Her O2 requirement was still higher than we would have liked, around 2-3 Liters. She was able to rest more comfortably in between suctioning, breathing treatments, diaper changes, medication and just plain interruptions.

They also brought in a new machine to try on her. It's called a "cough assist" machine. It's rather barbaric looking as they hold a large mask over her nose and mouth while the machine forces bursts of air into her lungs, and then pulls it back out with just as much force. It's supposed to make her cough, and boy does it ever! She gets very worked up and mad during this treatment, leaving both of us winded and exhausted. It's supposed to help her cough up the mucous because she is too weak and unable to do it herself. Whew.

It's been quite a week.

How can she be so sick and be so darn cute!?