Jeanie | respiratory issues

Well, I mentioned in a previous post that Jean had a hospital stay a few weeks ago. I thought I’d share what happened, just as much for my record keeping as for informing all of you!

Jean woke up on a Thursday morning and I noticed some mild wheezing, however it was an isolated symptom and came and went through out the day. The next day, she had a well baby one year check with our pediatrician who noticed the wheezing as well. She agreed we should start albuterol as needed and keep an eye on it. By now, I’m pretty aware of the symptoms of respiratory distress. She had one albuterol treatment Friday and her wheezing cleared for the rest of the day. She had no other cold symptoms. Saturday afternoon, her wheezing returned but went away after an albuterol nebulizer treatment.
Sunday, she woke up from nap with significant wheezing, retractions, and an elevated respiration rate. When it had not resolved 15 minutes after an albuterol nebulizer treatment,  we headed to the ER.
When we arrived, her oxygen level was steady at 98% but she had major retractions in her ribs, wheezing, and her respiration rate was in the 90s. They gave her three hour nebulizer treatments with a new mix of steroids and an oral steroid (which was the main reason I went, we can only get that there!). By late evening, her wheezing was gone, her respiration rate was down to the 60s, her retractions were reducing, so they sent us home with a prescription for four more days of an oral steroid and around the clock four hour nebulizer treatments, standard.

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We had an early morning follow-up with the pediatrician,  who felt like she was stable for the moment. However by the afternoon, after her nap, she woke up with an extremely high respiration rate, in the 90s again. Keep in mind, this is on four-hour albuterol nebulizer treatments and two doses of an oral steroid.
If you have followed my kids at all in the past two years, this is basically the same point we have reached three other times (twice with Jonah and once with Jean.) And the last time with Jonah, I waited too long and the rapid respiration rate exhausted his body nearly to the point of failure and he spent five days in the Pediatric Intensive Care Unit. I now know when it’s best to just head back to the ER.image

So Monday afternoon we went back in, and of course faced some initial disbelief that we were back. Partially because we had just been released 20 hours before, but also because despite a respiration rate of nearly 100 and severe retractions, Jeanie never stopped playing and smiling and giggling. Her wheezing was gone, but she was now showing signs of a runny nose and some upper airway congestion. They put her on an hour and a half continuous flow nebulizer, hoping that might jump-start her lungs and get us back home.

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However, her improvement was minimal after the continuous nebulizer treatment. So we were admitted to the hospital. She received one more continuous flow nebulizer treatment in the ER (they don’t have the ability to do them in the rooms), and then we were sent upstairs. She was put on three-hour nebulizer treatments and minimal monitoring. She slept just about as well as can be expected in the hospital, but at least it was a crib for her and a bed for me. The hardest part of multiple hours in the ER is trying to hold a baby who just wants to play on a standard hospital bed!

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Overnight, there was a respiratory emergency and one of her nebulizer treatments was an hour late. When she woke up on Tuesday morning, she had regressed significantly in all regards. So they bumped her back to two-hour nebulizer treatments,  which are considered acute,  which means constant heart rate, respiration, and pulse ox monitoring. That is a lot of wires on a very active baby!!! Exhausting! However it was a new set up for that hospital and I was able to show them some tricks how to keep the wires contained that I had learned at the PICU at Children’s with Jonah. Ha!

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She was doing better by the evening and was put on three-hour nebulizer treatments.  They were concerned that she might relapse again overnight, but she was clear in the morning. Her respiration rate was finally dropping down into the 40s when she was sleeping (below 30 is normal for a one year old), and in the high 50s when she was awake. Still high, but slowly coming down. Her wheezing was clear,  but she had a rough breath due to upper airway congestion.
Wednesday morning, they cleared her for four hour nebulizer treatments and we were released that afternoon.

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We are working on getting her into Jonah’s pulmonologist, but basically, from now on, at the first sign of wheezing, we will start a more aggressive treatments to head off the issue early. Although she had some minor signs of a cold, we can’t determine for sure if it was viral, allergies, or what. Basically the same issue as Jonah.

So yeah, we are experienced in ER trips and hospital stays! It was all a little scary for mommy, because the last time I sat in that room, I was nine months pregnant with Jean, holding a Jonah whose body was shutting down as it struggled to maintain his oxygen level.  it was very surreal. Jean never got close to that, mostly because I was much more proactive due to experience. Overall, it was just exhausting for the two of us, as no one rests well in a hospital, especially a very social and active baby who wants attention. We were very glad to be home, safe and sound!

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