Asthma is Serious!

I process better by writing, and I definitely have a lot to process from the last 24 hours. 

Caed was diagnosed with asthma shortly before turning 1.  In fact, we were in the hospital on Easter weekend 2009 because of asthma related symptoms. Caed must like holidays in the peds ward...but who could blame him?  They bombard him with gifts while he's there!  This time, he walked away with a Santa teddy bear, a bag full of firemen and military men toys, a book, a quilt, a bunch of Thomas stickers and a new neb mask! 

Yesterday was supposed to be our annual fun, family trip to the mall to ride the train.  Caed had been coughing since Wednesday and even had a small episode on the way home from the grocery store.  After a treatment of his rescue meds, he was back to his normal self except for the coughing.  But he seemed to be his normal, active self. I mean I found him on top of the washing machine preparing to jump off...surely he's fine, right?  PJ and I even went over his Asthma Treatment Plan over dinner. One of the indicators for seeking medical help is if he's unable to do normal activities...but clearly he was able...so we dismissed it.

I decided to give him a regular neb treatment before leaving for the mall because of his coughing.  He is so very good about sitting with his mask on his face for treatments.  But about one minute after starting this treatment, he started wheezing, coughing, crying and doubling over in pain.  Saying his belly hurt he could not get comfortable.  He turned very pale, then blue around the lips.

We live pretty far out, and our only rescue unit comes from a town about 20 mins down the road.  The last time we called 911, the EMT advised us to never wait at home, jump in the car, head towards the hospital and call 911 on the way so that an ambulance can meet us in route.  So that's what we did. 

There are some images in a parents mind, that I think will haunt forever.  This is one of those images.  The sight of my child crying out my name, then stopping short and pulling in his lips, with fear in his eyes as he tries with all his might to suck in air only to scream my name again...So glad PJ was driving.  The rain was causing traffic to move so slowly and this wretched car in front of us would not pull over despite our flashers and attempts to signal by flashing our high beams at them.  It took much longer than it should have to reach the ambulance waiting for us in Rustburg. Finally the car in front of us pulled over right in front of the lot where the technicians were waiting.  Thanks!

So much rain.  So much fear. Ugh!  Caed's oxygen level upon arriving into the ambulance was 79. It should be 95-99.  He was lethargic, disoriented and pale. Another memory, I'll not soon forget, especially when he reached for my hand and held on tight.  I'm so thankful for "Mr. Justin" the EMT that moved quickly to treat and also keep Caed and his insane mommy calm for the duration of the trip to the hospital. 

By the time we arrived at the hospital, Caed was talking and asking Mr. Justin to drive him on the fire truck some day. Upon entering the ER, immediately the nurses fell in love with my little blue-eyed boy. He looked so small on that huge stretcher and was telling everyone that would listen about Christmas and Lightening McQueen and his future fire truck ride with Mr. Justin.  Otherwise, the ER was the ER: a painfully long wait, especially with an exhausted 2 and 4 year old. 

Around 11pm the doctor decided to discharge us. But as we were preparing to sign the paperwork, I noticed that Caed was still breathing with his belly and had significant retraction (that's where you can see the skin pulling around the ribs).  The doctor was puzzled because all other vitals were fine.  So then we were given the option of admitting him with an advisory from the doctor to do so because of our home's distance from the hospital should something happen in the middle of the night.  I hate that moment when you just. don't. know. what the right thing to do really is. What was best? Was it really necessary?

So we decided to admit and thus create another 1.5 hour wait for ourselves in the ER.  At this point, I really really really wish I had a video camera available so as to show you what we experienced with our children. Caedmon, by this time, had had several breathing treatments and two doses of a steroid. To say he was hyper is a major understatement.  He was literally bouncing all over the bed and talking nonstop: some of it was detectable, some was another form of language yet to be discovered.  And Abby. Dear, sweet, patient Abby (who by the way, figured out how to get food, drinks, a teddy bear and a coloring book from the nurse just by smiling at her as she walked by.)  I'm almost sure that Abby experienced temporary insanity induced by  exhaustion because she carried on a detailed, two-sided conversation with herself for almost 20 mins. She very clearly was taking on the role of two people and even told us that she was talking with the voices in her head.  I'll just leave it at that for now!

Finally we arrived in our room in the new, AMAZING!, peds ward at Lynchburg General.  The nursing staff there is absolutely fantastic!  They were generous to my boy that was now leaping from one piece of furniture to the next, assuring me that he wasn't possessed but was reacting to the large amount of steroids in his system. The way they cared for Caed, and secured his attention amazed and inspired me!  I do have to say that they were very impressed with his willingness to cooperate.  I was extremely thankful that I spent extra time this week praying about and working on being consistent with his obedience.  Character development: check! 

So the night consisted of meds and every hour waking (for momma!) from nurses to see how he is doing.  The intake nurse called it 23 hour Observation Care in our paper work (supposedly that makes it cheaper for us in the billing cycle! I REALLY hope that's the case).

So what I've learned about asthma:
It's real. And it's serious!  Honestly, Caed has been doing so well throughout the fall that I let my guard down and didn't take his symptoms seriously enough.  Partly because I didn't have a full understanding of how asthma works.  A person can be fine in the morning and experience a trigger and struggle the rest of the day.  Also, a person may seem fine in activity level, but really tightening of the airways is going on inside.  In Caed's case, excessive coughing is an indicator of need for rescue meds even if he's as active as normal.  Now I know!

I also didn't have a clear understanding of how to use his meds appropriately. I didn't understand how his long term and his rescue meds should be working together for effective treatment. And being afraid of over medicating, I actually was under medicating. Yes, there's mommy guilt there for me.

Now we have a much more clear Asthma Action Plan.  I know what to look for, and how to respond. I plan to keep a trigger journal to keep track of information (because, really, they asked me SO many questions about when things happened and what triggered it and how many doses I've given. I was lost...it would have been much easier and helpful to have it all documented to begin with.)  And hopefully, hopefully we can stay out of the ER from now on.

One cute side note.  As Caed and I ate our lunch together this afternoon this was his heartwarming prayer after singing the "Open-Shut Them" song he learned at church: "Dear God, Tank you for Mommy, for Abby, for me and for Daddy.  Tank you for Baby Jesus and Jesus and God. Amen!"

The only thing my little guy could talk about in the hospital today was going to ride the trains at the mall.  So, yes, we left the hospital and went straight to the mall for our annual ride!  His smile was incredible!