Yesterday my daughter (the one in my picture, but older now) started sneezing—a lot. Allergy season in this part of the country is brutal. We keep a box of kleenex on every flat surface in the house. But this morning she started coughing, and had a low-grade fever, so we knew she was sick, not just allergic. My wife stayed home with her while I represented us at our family’s Passover Seder. When I got home, she was still coughing—a lot. I grabbed a stethoscope and listened to her chest. It wasn’t perfectly clear, but she was coughing and crying so it was hard to hear (also, I’m not a pediatrician). I stepped back for a minute and looked at her. She was miserable. She was using her neck and chest muscles to help her breathe, and her stomach was moving in and out in what’s called a paradoxical pattern. She was clearly not doing well. We grabbed a few things and jumped in the car, heading for my hospital.
When we got there, she was really struggling. Thankfully, lots of people I knew were working, and we got plugged in pretty fast. After a breathing treatment, she was a little more cheerful, but still breathing about 40 times per minute.
Any parent knows what it’s like to see your child ill. When I look at her as a patient, I can see how sick she really is, but I try to keep a calm demeanor for her and for my wife—inside I’m screaming, tearing at my clothing, shaking. Her oxygen saturation is in the high 80s to low 90s, but she’s improved since we came in. My wife sends me home to get some rest (like hell!), and the plan is for me to pick them both up in the morning when I come in to round—assuming the little one is well enough.
I feel horrible leaving them there without me, but one of my residents is taking care of them and I know he’ll call me if anything is going on. Still, it’s laughable to think I can just come home and sleep.
It turns out she has respiratory syncytial virus (RSV), a nasty little respiratory virus that makes little ones miserable. Unfortunately, there is no vaccine for this one. We’re stuck with chance, and I don’t like chance very much tonight. In fact, I don’t like anything very much tonight except my daughter and her big, brown eyes that shine when she laughs, which is most of the time. When she coughs so hard that she can’t speak, I want to vomit.
But instead, I’m sitting at home next to the phone, typing, and hoping and waiting.
So, as soon as I settled in at home, I got called back to the hospital. She’s doing a little better, but not well enough to go home. More later.
More under the fold—>
She’s finally sleeping, giving me a moment to reflect. My wife, having realized that sending me home wasn’t the best idea, called me back to the hospital at about 3:00 a.m. My sweetie was still breathing hard, and I climbed in bed with her to hold her oxygen to her face (and of course to cuddle her). I could feel her heart pounding at 130-160 beats per minute. Her respiratory rate was in the 30s-40s, and her oxygen sats were in the high 80s to 90s. Needless to say, neither of us slept.
It helps to know people. The resident on-call is one of my trainees. He kept a very close eye on us. The ER doc, while not recognizing my face, knew my voice immediately—we probably speak to each other at least three times a week. We’re in a private room, but not because I’m on staff here—RSV is quite contagious. We’re getting the best care available in the world, but as my Dad always says, ” a hospital is no place for sick people.” At 6 a.m., after my little girl finally fell asleep, housekeeping came in and started loudly changing the garbage. I told her to get out and come back later, but she said she would finish quickly. That was the last time until now that my baby slept, and if she pulls that again I can’t be held responsible for what I do.
I sent my wife home for a shower and a nap. I grabbed some clean scrubs out of the machine.
Sleeping seems to make a difference for my little patient. Her respiratory rate and heart rate are slightly lower. Mine, though…
Anyway, for some reason, live-blogging this helps me, and perhaps something useful will come out of reading this. More to come.
First, she’s doing much better. Her breathing has improved dramatically. I mentioned earlier that housekeeping woke us up. After that, we put up a “do not disturb” sign. And who do you think had the arrogance to ignore the sign? It doesn’t apply to nurses or doctors, but otherwise, it’s pretty clear—but not to the random hospital clergy member. A guy of unknown denomination walked right in, and despite my immediate, “thank you, you can go now”, he kept at it.
Collar: “I just wanted to…”
PalMD:: “Please go.”
Collar:”…there is a Passover service at…”
PalMD:“We’re tired. I asked you to leave. Please go.”
Collar:”Well, I just want to tell you…”
PalMD:“I don’t know how much clearer I can be…leave now.”
Collar:”OK, well, I’ll pray for your daughter.”
PalMD:“Fine, as long as you go.”