5.3.2008 - No Naps Yet...
Yesterday (Friday) was actually a pretty good day for Gracie. She coughed a bit, but not very often (which, can actually be a bad sign sometimes, she needs to cough it up to clear it up), she did get easily winded when running around the house playing with her siblings, but her stats stayed up in the low to mid 90's for the day.
She kept running up to me, breathing fast and loud, to tell me that she feels fine and isn't sick anymore... I can hear otherwise...
She has been on the oral steroids and antibiotic since Tuesday morning, and the inhaled steroids and bronchodilators since Monday, when she first complained of pain when she breathes, one would think that would be enough medication to nip this thing in the bud, yet this saga continues.
I came very, very close to bringing her back in to the ER last night (which would have made 3 times in one week). By the time I got the other girls down to bed and was ready to give Grace her neb, it was 9:30. She was still doing just fine and I told her she was doing well enough and had been on her meds long enough to be able to go sleep in her own bed after her neb (she's been sleeping on the floor next to me, I've been sleeping on the couch next to her). I put the pulse oximeter on her finger and sat with her during her neb.
She started out at a whopping 97%, for a minute, then 96, then 95... I started to wonder how far it would dip. By the time the neb was done she had dipped down to 90%, which seemed odd after doing so well all day. I didn't feel comfortable sending her up to bed, so I had her lay down right where she was on the living room floor. She was very sleepy and drifted right off, as her O2 stat drifted right down to the mid 80's again. Then all the way down to 81%- that's too low. I was starting to panic, and dreading another late night run to the ER (it was now 10 pm) when she coughed a bit and changed position a bit and her O2 came up to 86%, still not good, but not quite panic level.
After about 15 more minutes and no improvement I decided to try the wonderdug Duoneb, which did great Wed night/Thurs morning. I had only been about 45 mintes since her last neb, but they've told me if she's not responding that it is okay to 'stack nebs' and do one right after another, if need be. Well, I figured close to an hour with O2 stats in the 80's called for more meds. It did nothing. No change, zip, nada, nothing. I thought (hoped) maybe the Duoneb takes a while to kick in.
I decided to call the ER and talk to a triage nurse before running in, especially after being sent back home twice already this week. Her stats always seem to come up into the safe zone after waking up and walking about... I thought, do I wake her up every hour all night long? to get her stats back up every hour? It took a while for the nurse to call me back, by the time we chatted Grace's O2 level had been in the 80's for about 2 hours...
I explained our week, and our current evening's issues. She said the Duoneb should have some effect right away. So why didn't it? No one knows. She also said that as long as she was sleeping and not waking up and/or sitting up gasping for air that she really didn't need to be on oxygen... I'm not so sure how I feel about that. I've had 2 doctors say she needs O2 whenever she spends any amount of time below 92% and I've had another doctor say that it's okay to dip to 88 or 89%, as long as she's sleeping comfortably. But now I'm being told that even mid to low 80's is okay? She conceded that it obviously wasn't ideal, that Grace was obviously sick, but said she didn't think she was in any danger. She added that if she dipped into the 70's at all, get her to the ER. How much better is 81 stinking percent than 79??!!
We need to get back in to see the pulmonologist or respiratory therapist, where I will ask many questions, including where to draw the line. I think I am wanting to get some marching orders from the specialists, so I'll just know yes, take her in, or no, she's okay for now, from someone who specializes in pediatric respiratory issues rather than a triage nurse who seemed to think that mid 80's was an okay oxygen level for a child to be at for the night...
After another hour her O2 came up to 90%. It slowly climbed though the night, and was at 95% by 6 am. I got some sleep the second half of the night, but not enough for optimal functioning, if you know what I mean...
She's been acting pretty normal today, for a child on steroids- rambunctious, kinda rude and whiny, and not exactly the easiest child to get along with... This too, shall pass, I know... I'm hoping it passes quickly! And permanently wouldn't be too bad, either...
Trying to enjoy each and every one of them, wheezes, crackles, and all,
only by the grace of God,
ali
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