Thursday, November 29, 2012

Hospital Stay for Chloe

So, let me start from the very beginning...14 days ago, I left to go to NC for my grandmother's funeral. When I arrived, I called David to let him know I had made it safely and he told me Chloe had started hacking and coughing but that she was okay. I knew I couldn't do anything about it so I let it go and knew I would be home within a few days.
Fast forward 7 days and we are about to leave for Thanksgiving in Atlanta with David's family. Chloe was still coughing and wheezing somewhat but I had started her on breathing treatments and felt we were managing okay. No fever, oxygen levels were fine, and there was no increased work of breathing. On Black Friday though, things changed drastically. Chloe's cough became so violent she began throwing up with some coughing spells, she spiked a fever, and couldn't speak a full sentence without stopping to cough in between words. I took her to the Urgent Care by my in-laws house and sat there for almost 2 hours waiting to be seen. After finally getting into a room and waiting another 20 minutes, the doctor came in and spent 5 minutes with us. I told her that I had listened to Chloe's lungs because I am a nurse and felt like Chloe was decreased in her lung bases. I told her about Chloe's history with asthma and how concerned I was becoming as she was getting worse. She responded that she didn't sound like she had pneumonia and she diagnosed her with bronchitis. We left with a steroid and an antibiotic. Within 8 hours, Chloe's oxygen level had dropped to between 82% and 87% and we were on our way to the closest ER.
After arriving, Chloe was taken straight back in front of everyone else and was placed on oxygen immediately. A continuous Albuterol nebulizer was ordered and given and she was taken for a chest x-ray. We were told that Chloe had a left lower lobe pneumonia and that the antibiotic given to her earlier was useless as it wouldn't touch a pneumonia. The doctor's plan was to transport her to Scottish Rite Children's Hospital via ambulance for admission and to start an IV for antibiotics and do some blood work before the ambulance came. Then plans changed and the docs at Scottish Rite wanted to do the IV and blood work there so we held off. We took a little ride to downtown Atlanta in the ambulance with Chloe on oxygen and getting another very powerful breathing treatment en route.
Once we arrived, we were put in the ER and the doc there evaluated us immediately. He didn't think she needed an IV and felt that as long as she would drink fluids that she would be okay without it. He wanted her on Zithromax for the pneumonia and didn't think blood work was necessary since we were treating her with a great antibiotic for pneumonia. Then, we were taken up to the 3rd floor which was our home away from home for the next 3 nights.
We were assigned a hospital pediatrician since we were out of town and didn't have our own and THAT doctor thought the pneumonia was viral and did not order any medicine at all other than oxygen and breathing treatments. These treatments didn't really make a difference as she was not getting off the oxygen so they changed her to a different type of treatment where the respiratory therapist gave her extra breaths with an ambu-bag during the nebulizer. The thought was that this would help push the medicine deeper into her lungs and thereby clear up the airways better and help her get off the oxygen and stop the cough.
This worked a little and by the 3rd night Chloe went all night without oxygen but her cough was worsening again!!! She again started coughing so hard that she would puke. I asked for an antibiotic and the doctor said no again. They did repeat an x-ray and said it appeared to be getting better so they felt confident it was viral. They sent us on home though and told us to follow up with our pediatrician in 2 days. They told me to double her Albuterol dose from now on and give 4 puffs every 4 hours for 24 hours and then 4 puffs every 6 hours for 24 hours and then just give it as needed for the coughing. She also was sent home with some breathing exercises to do and I was told to monitor her oxygen level at home while she slept and bring her back if she went below 90%.
For 2 nights she stayed right at 90-91% when she slept and coughed all night long. When we went to our pediatrician, I told her all about how concerned I still was because she seemed to be worsening again. Her fever was starting up again and she was just really really puny looking. She was down 5 pounds, wasn't drinking and her lips were so dry. Our doc ordered blood work and another chest x-ray. Come to find out, Chloe's pneumonia WAS bacterial and it was obvious on the xray that it was not resolving. It was BIG! She should have had an antibiotic all along! I am angry that the doctor at Scottish Rite didn't listen to us, didn't listen to the other 2 doctors who thought she needed antibiotics, and didn't do any blood work to see if it was in fact viral or not. My child suffered un-necessarily for 6 days when she could have been better by the second day after being admitted. Now that she has had 2 days of the Zithromax, she is about 90% better. Her cough is greatly decreased, she isn't requiring as many breathing treatments, and she is playful and energetic.
What a crazy, long, tiring, and worrisome Thanksgiving vacation. Whew... I need a vacation from my vacation.

oxygen level at home before we went to ER...and before we could 
leave it had dropped to 82%...and just FYI, it should not be below 93% EVER

in the first hospital ER waiting on the ambulance to come get us
 and take us to Scottish Rite Children's Hospital

night number 2 on oxygen. Very sick and very very sad.

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