Matthew's ER visit

Friday night around 10pm, Matthew started complaining he was having trouble breathing. It was obvious he working hard to breathe, but I was hesitant to rush him to the ER. I started a shower in their bathroom and closed to the door to make a steam room. I sat with Matthew in there, put Vick's Vapor Rub on his chest and then went to get my stethoscope so I could listen to his lungs. When I came back, Matthew said he was scared to be in there all by himself. He was audibly wheezing when he breathed, he was even sticking his tongue out and almost "panting" when he complained of the difficulty. I listened to his lungs, and they sounded horrible - wheezing all throughout. We obviously had to take him somewhere. I always try my hardest to avoid the ER. I looked up Urgent Cares open after 10pm - only 1 - Cook Children's - was open until midnight. They were full, but accepted walk ins. Then I came to my senses, and thought: This is ridiculous. Why am I shopping around for the best place to take him. I know the best place - Cook Children's ER. They won't send me somewhere else if I take them there, and this is clearly the kind of emergency that ER's exist for. 

At 10:30 we finally left for the ER, 30 minutes after he initially complained. Looking back, I would have left sooner, but I was in denial that he really wasn't going to get better without medical intervention. I left Alan at home with the other two kids, and Matthew and I rushed to Cook's. (Alan had to help him steady himself, because he was feeling so weak.) By that time I didn't even think an ambulance would be much faster than us. I wanted him to talk to me on the way there, so I would know he was okay, but he was having to take frequent, wheezing breaths to talk, so I told him to save his energy for breathing. Then he would get really quiet, so periodically I would call back to him, "Okay, don't talk, but is it still hard to breathe - yes or no." The only purpose of this was to make sure he was, in fact, still breathing. It was dark, so I couldn't see him. I prayed the whole way to the hospital. 

We arrived at 10:45, parked, and walked into the ER. Immediately a nice man at the entrance asked if we needed to see a doctor. Of course, Matthew had been complaining he could barely "hold it" on the way there, so I said, "Yes, but first we need a restroom."

We checked in at 10:55 and we were called back 3 minutes later. The triage doctor actually followed us back to the triage room to assess Matthew. He pulled up his shirt (which I hadn't done at home), and we could all see him using his neck, intercostal, subcostal, and abdominal muscles to breathe. All of this extra work he was doing to breathe was at least keeping him oxygenated, as his oxygen saturation was 99%. I was so happy to see that number, since I was worried about hypoxia. The doctor said he was definitely wheezing as well, and ordered a strong breathing treatment and steroids immediately.

The charge nurse asked a one or two more questions, then wheeled Matthew to a room. On the way she called the ED RT, and the RT met us in his ER room. She said, "Here's what we're going to do, Matthew. You're going to watch TV, and you're going to start breathing better." He nodded. He got to watch Mickey Mouse Clubhouse (one of his favorites that I rarely put on for him) while the RT gave him a "mega" breathing treatment of 6 doses of Albuterol and 6 doses of Atrovent. The RT later told me she hadn't heard many breath sounds at all before his treatment, since he was so tight. His vital signs continued to be good. I could tell he quickly began to breathe easier during the treatment. (Still working to breathe, but not as hard as time went on.) By 11:20, Dr. Neil (the ER doctor), the RT and RN were out of the room. The breathing treatment started around 11:10 and lasted until 11:40. At 11:29, Matthew finally said, "I'm breathing good now." (1.5 hours after he had first complained.)

The RT checked on us about every 10 minutes, and after the treatment, the nurse gave him two chewable steroid tablets. His hands and feet were shaking now (a side effect of the breathing treatment), and his teeth were chattering. His pulse was pounding at 130-140bpm, which is also a normal side effect they had warned us about before the treatment. I was just happy he was breathing so much better. Matthew said, "I'm glad there are doctors that know what to do."

He was still wheezing and retracting some. The doctor checked on him often. He would ask me what I thought. They all knew I was a NICU Nurse by this point, since I had told them I heard wheezing in his lungs when I listened with my stethoscope at home. (Usually I try to avoid telling medical people I'm a nurse.) About an hour after the treatment, the nurse commented, "I have a sneaking suspicion he may be staying with us." 

They also did a chest X-Ray (since this was his first incident of wheezing). I didn't hear any results for over an hour. I asked the nurse, but she said she didn't have access to the results. (So of course I assumed that meant she didn't want to tell me the horrible results.) About 30 minutes after that, the doctor came in, and very seriously started listening to Matthew's lungs. I just knew he had pneumonia, or lung cancer, or.. 

Then the doctor said, "Oh, did I tell you his X-Ray was normal?" I replied nonchalantly, "Oh. No, I hadn't heard." 

It was around 1:30am now. Matthew was still working a little to breathe, but much improved. We had to wait a full two hours after the treatment to see if it had worked. So we settled in. The nurse gave him a Blue Yoshi plush toy, which is exactly the kind of thing Matthew loves. (The kids have a whole collection of Mario plush toys.)

At this point I decided we should probably try to rest, since it was just a waiting game now. So we turned off Mickey Mouse and turned out the lights..

Matthew fell asleep and didn't wake up for any other time they checked on him. At 2:50am, his wheezing and retractions had completely stopped, so since this was a full two hours after his treatment, the doctor cleared us to go home. He was diagnosed with mild intermittent reactive airway disease, which has the same symptoms as asthma, but can just be a temporary response to an irritant in the lungs.

The doctor prescribed him steroids for 5 days and a rescue inhaler. We had to wait for the RTs to come and teach us how to use the inhaler. At 3:20am, two RTs had to wake Matthew up (very difficult!!) and together they taught us how to use it.

It was weird going to sleep that night in our own beds. Even though we'd only had the monitors for a few hours, it felt strange just trusting that he would be okay through the night. I told him to tell me if he had any trouble breathing at all.

He was fine all day the next day. As he was going to sleep the next night, I heard a little wheezing in his lungs, so I gave him the inhaler before he went to sleep. So far, that's the only time we've used it.

I am definitely thankful to Cook Children's ER, they did an amazing job! Thanks to our friends and family for their prayers as well :)