Friday, August 19, 2011

The continuing saga, part II

Timmy and I have had a very exciting and busy week. We have been so busy that I will not be able to tell you all about it in one post, but I promise that eventually I will finish the story! (To give you a preview, in one week's time, Timmy and I have been in three hospitals in three different cities, we have visited two different ERs, we have been admitted overnight twice, and the only days in the last week that we have not been in a hospital were Sunday and Monday. It has been fun!)

So, to continue my story...On Friday, once Timmy was feeling up to it, we left Cincinnati to drive back to Columbus so that Timmy could see his grandparents and aunt. While Timmy is sleeping and while we are in the car, we keep Timmy hooked up to a little machine that tells us his heart rate and his oxygen saturation levels (sats). Timmy normally has sats around 98%. In the week or so leading up to Friday, Timmy's sats had been a little low (around 94), but not horrible. In the car he was a bit low--around 91 or 92. But it is not unusual for Timmy to be a little low when he comes out of anesthesia, so we were not worried. (First mistake!)

Timmy was very tired and he slept a lot Friday afternoon. When he was awake he was extremely lethargic and just wanted to cuddle. Normally he is a very active little boy who does not like to sit still for very long. But on Friday afternoon, Timmy was not even interested in waving me around and banging me on stuff--one of his favorite past-times. We kept a close eye on him, and by 5:30 or 6:00 we were starting to get worried. We could not get his sats above 88, and they would often drop below that. We called Cincinnati, and they told us to take him to the ER at Nationwide Children's in Columbus (where Timmy spent his first two and a half months). They called ahead and told Nationwide to put Timmy on oxygen when we arrived.

We got to the hospital around 7:00 and had a very frustrating experience. Nobody believed us that this was not normal for Timmy, and nobody agreed with us (and Cincinnati) that Timmy needed oxygen. Apparently they do not realize that mooses with purple antlers are experts in respiratory issues. The nurses and doctors in the ER were very nice, but we do not think that they see Timmys with trachs and G-tubes very often. At one point, Timmy's nurse asked me, "If I do need to give him oxygen, how do I do it? Does it go in through his trach?" That was when we knew that we were in trouble.

In all it took 2 hours and 40 minutes to put Timmy on oxygen and here's why: We had to wait a long time before we saw anybody (even though Timmy's chart clearly said he was there for "respiratory distress"). Then I had to tell the resident all of Timmy's medical history which took quite a while. Then the resident met alone with the doctor there and told him Timmy's whole medical history. Then the doctor came in and had to clarify quite a few details about Timmy's medical history with me and Timmy's parents. It all took quite a while and this moose was tap tap tapping his squeaky hoof quite a bit which didn't seem to move things along very well. Even then, the doctor wouldn't put Timmy on oxygen until Timmy had an x-ray of his chest which took a while for them to see the results. (During the x-ray, Timmy's sats dropped to 70 for several minutes, and they still insisted nothing was wrong.) Once the x-ray results were available, the doctor came in and told us that Timmy's x-ray was completely clear and he didn't see what the problem was (all the while, his pulse ox monitor was alarming every few minutes). We were all very frustrated when finally a familiar friendly face walked by our room. I quickly squeaked and Dr. R turned around and came in to say hi. We told him our frustrations while the resident was in the room and suddenly a few minutes later the doctor came in telling us that the same x-ray where Timmy's lungs were completely clear a half an hour ago somehow got all cloudy in the upper right hand part of Timmy's lungs (meaning at least a quarter of his lungs were not working to their full capacity).

Finally we got Timmy on oxygen at 9:40pm. It made an immediate difference, and Timmy was much more comfortable. A little while later, we had a suctioning crisis. The nurse needed a trach culture which requires basic suctioning skills. Soon, though, it was apparent that she had never suctioned anyone before. She put way more saline than necessary down Timmy's trach, stuck the suction catheter in two centimeters too far (and brought up blood), and then realized that she forgot to hook up the suction so all the saline that she put down, instead of suctioning it out of Timmy's trach, got shoved down even further into his airway. Timmy's sats plummeted, and Timmy's daddy scrambled around for our suction machine. He got Timmy suctioned out. Timmy's sats was really low for an hour or two after that (even on 40% oxygen) but eventually he bounced back. No harm done, and we learned a valuable lesson. :)

Around midnight or twelve-thirty, Timmy was admitted to the pulmonary ward. He and his daddy got to ride on a bed with wheels all the way upstairs.

As soon as we got upstairs, we noticed an immediate difference in the quality of care, though Timmy's mommy, daddy, and I were afraid to leave Timmy alone for even a minute. We are starting to learn that the best way to judge whether or not someone knows what they are talking about is to listen to the questions they ask. If they ask the right kinds of questions about Timmy, there is a good chance that this moose can trust them! (And this moose is currently very annoyed that he just used 3pl to refer to gender neutral 3sg, but he cannot figure out a way to reword the previous sentence.)

We spent the next couple of hours rehashing Timmy's entire history with the nurse, and then with the junior resident, and then with the senior resident, and the RT, and I am not sure who else. Finally, Timmy was settled and we could all go to bed at 2am (don't forget, we had been up since 4:15 that morning for Timmy's scope). There were certainly quite a few bags under my purple antlers!

The next morning Timmy got another x-ray and guess more cloudiness in his lungs! His sats looked better than they had in weeks! So the doctors decided that we were ok to leave the hospital.

(Watch for Part III of the continuing saga, where Timmy and I have some fun!)

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