Sick little girl

A1 getting a nebulizer treatment this morning

Sunday evening late K noticed that A1 sounded like she had raspy breathing. She asked me if I noticed, but at that point I couldn't hear anything. Then last night when the kids were running around, up and down the stairs, we noticed that she was having a hard time breathing. When we stopped her and listened more carefully it sounded like she was really forcing herself to breath, although you couldn't tell anything was wrong from how cheerful she was acting.

We called the 24 hour nurse and described her symptoms and held the phone up to her mouth and the nurse said what K dreaded she would say all along, "bring her in" (what is it about children always getting sick after hours?) We weren't sure how serious it was, but the nurse seemed pretty worried about not having her coming in, so at about 10:00 PM last night K took her to the St. Luke's East Hospital emergency room.

Fortunately they got her in to see a respiratory therapist fairly quickly and her oxygen levels were 95% (not so fortunate). Over the course of the night they dropped down to 90% and so they gave her 15 to 20 minutes of a nebulizer treatment of Xoponex (Levalbuterol). This helped with her oxygen levels slightly. The hospital told K that if a baby's O2 level is 95 or less that they have to stay at the hospital. Her O2 levels came up to 96 and so, after doing a chest x-ray and giving her a liquid steroid, they sent her home around 12:45 AM with a diagnosis of viral branchiolitis and a brand new nebulizer machine so we could give her medicine at home (which they said might cost $1000 a week!). They also said she had to see the pediatrician as soon as possible in the morning.

Xoponex - Sci-fi starship or medicine?

K took A1 in to the pediatrician this morning and they tested her O2 level and it was at 92, and dropped down to 89 at one point. Her stomach started sucking underneath her ribs which was alarming. They gave her another nebulizer treatment (albuterol), but it only brought the O2 levels up temporarily. They decided to send her to Children's Mercy South Hospital. They debated sending her by ambulance, but in the end they thought that it would be ok for K to drive her as long as she kept her in from the cold air and hurried there right away.

Thanks to our neighbors, K was able to drop C4 off at their home on the way and took A1 in to the hospital, by this time a little panicky because the pediatricians had been talking about how she might need an ambulance, and said it was possible A1 could be admitted up to 2 weeks! Fortunately Children's Mercy is only about 30 minutes away and when K and A1 arrived it wasn't crowded, although there was some delay because they initially couldn't find the records that Raintree Pediatricians faxed because somehow they mixed up the first letter of our last name.

The good news was that A1 saw an experienced physician, Dr. Shashtri, who especially liked A1's chubby cheeks. (Imagine hearing this in an Indian accent, "I love their plump little bellies and their chubby cheeks!") He checked her out and then he recommended that we do an inhaler instead of a nebulizer, because sometimes children respond better to this style of treament. So he gave her a dose of Ventolin HFA (albuterol) and she responded really well, her O2 levels coming back up and staying at 97 within about 5 minutes. The doc thinks that she may just have a cold that has settled in her lungs, possibly because she won't let herself cough. I guess she is such a polite little girl that she doesn't want to draw attention to herself (yeah, right!)

Giving an inhaler to a baby requires some extra tubing.

This goes over the baby's mouth.

Since her levels were back up long enough she got to go home again, although going outside is out of the question for a while (she has already complained about this; she loves going outside). So now we are giving her the inhaler every 4 to 6 hours, and she seems to be doing fine.

A1 playing her version of Connect 4 as she recovers

It is amazing how quickly what sounded like just raspy breathing turned into a minor emergency. I guess the lesson is that if you hear a baby having trouble breathing, pay attention -- we debated calling the nurse initially, but we're glad we did in the end (although I'm not looking forward to the explanation of benefits from our insurance company!). But as B8 says, would you rather not pay or have an Alive A1?