Not flesh of my flesh
nor bone of my bone
but still miraculously my own.

Never forget for a single minute
you didn't grow under my heart
but in it!

Tuesday, December 30, 2008

Christmas in the Hospital

Not quite the way we planned to enjoy Gabriella's first Christmas home, but at least we were together!

On Monday the 22nd, after her doctor's appointment and blood work, Gabriella went home with Grammy to rest. She proceeded to get worse through the day with fever and lethargy and she vomited lots of mucus. I called her pediatrician again and made another appointment for 3:30 PM that same day. By that point all of her blood work results were back and everything appeared normal. They catheterized her to test for a Urinary Tract Infection and that came back negative as well. At that point, the doctor decided to admit her to Morton Hospital, our local hospital, for observation and more testing. Ken and I took her home, quickly packed bags, and were were admitted to the hospital by 6:00 PM on Monday. They did a chest x-ray (to check for Pneumonia) and stomach x-ray (not quite sure what they were checking for with that) and both came back normal.

We knew sleeping that night at the hospital was going to be very tricky. They have the chairs that pull out into very narrow cots for the parents and, of course, a crib for the babies. Gabriella has never slept in a crib. She wants to be in the bed with us and wants nothing to do with the crib. She has a lovely crib at home with a very top-of-the-line mattress, but has yet to sleep in it. She occasionally sleeps in the Pack-and-Play next to our bed, but I have never pushed the issue because after many discussions with our adoption social worker and other adoptive families, co-sleeping is a good option for adopted children. I cuddled her in the cot and then we snuck her into the crib while she was sleeping. The nurses were in and out of the room to check her vital signs at least every hour, so the first time they came in, she woke up, and cried to get out of the crib. We pushed my cot against the wall and I wrapped my arms around her to keep her securely in the cot. She is a little wiggle worm when she sleeps. She wiggled her way to the head of the bed and fell right off of the top edge of the bed. Ken and I screamed, the nurses came running in. Luckily the cot was pretty low to the ground and, thank God, she was not seriously injured. She got a little egg on her forehead. Gabriella cried a bit, but not the screaming that we expected. I moved the cot into a corner and lay awake with her the rest of the night while she slept.

The next morning they re-ran her blood work and compared the results from the previous day. All of the numbers were still normal but slightly improved from the day before. They then took a nose culture to test for Respiratory Syncytial Virus (RSV) and a throat culture to test for Influenza. She tested positive for RSV. Not good news, but I felt a bit of relief because finally we had an answer. RSV is a major cause of respiratory illness in young children. It causes infection of the lungs and breathing passages. It is very serious in children under eight months and appears only as a common cold in adults. Common illnesses hit Gabriella often and hard, so we were expecting a bit of a battle with it for her. RSV is not treated with antibiotics but often triggers other respiratory illnesses that are treated with antibiotics.

The RSV caused extremely labored breathing and wheezing for Gabriella. We began breathing treatments with a Nebulizer in the hospital and the nurses were closely monitoring her oxygen. They were often suctioning her nose as well to help her breathe. She was also very fevery with her fever averaging around 101, but periodically spiking to 103 and almost 104. The key at the hospital was monitoring her and managing the symptoms - her breathing, temperature, oxygen level, and heart rate.

That night Ken had a great idea to bring in our Queen-sized air mattress to the hospital. We snugged it up to a corner of the room and we were able to all get a more comfortable, restful night of sleep. Our hospital room was huge and we were alone in there because Gabriella was on contact precaution because of the C-Diff and now the RSV. The nurses at Morton Hospital were very accommodating, extremely experienced, and simply wonderful.

While at Morton Hospital, Gabriella's pediatrician consulted with an Infectious Disease doctor out of Children's Hospital in Boston to make sure that nothing else was going on. The ID doctor felt that Gabriella was being exposed to new bugs in day care that her body had not previously built defenses against and that regular winter-time illnesses are effecting her hard as a result.

The next day, Christmas Eve, the doctor came in and listened to her lungs. The RSV had caused a mild case of Pneumonia and Bronchiolitis which they began treating with antibiotics. The nurses monitored her through the day and because her oxygen level was above 95%, her fever was relatively low at 100 to 101, and she was drinking okay, the doctor decided to release her. She was even acting a bit silly, eating directly from her high chair tray with no hands! Appropriate to the Holiday, she was acting like Randy from "A Christmas Story!":

We arrived home at about 6:00 PM on Christmas Eve. We got home and Gabriella quickly spiked a high temperature of 103.4. Her breathing was more labored and she wasn't interested in drinking. She vomited more mucus. I consulted with the doctor on-call. They said that some vomiting of mucus was normal with RSV. We decided to keep her home and monitor her through the night. Christmas morning she was still lethargic. Later in the morning we walked her into the play room to show her the toys that Santa brought. She was not enthused by the enormous train table, ball pit, Elmo Live or other millions of presents. She, of course, was not interested in opening any other presents. We laid real low with her and tried to get her to drink. She vomited again. By 2:00 PM on Christmas Day we had our bags packed again and this time we were on our way to Children's Hospital in Boston. During the ride she became almost unresponsive. I had to shake her and call her name to get movement. Her oxygen level was down to 86%, her heart rate was up to between 160 and 180, and her temperature fluctuated between 101 and 103+. Her breathing was extremely labored. With each breath her belly would pull in and her nose would flare further indicating her difficulty breathing. It was very scary. They admitted her, of course. They gave her an IV because she was nearly dehydrated. They felt that the near dehydration and fever were causing her heart rate to be elevated. Plus, we were giving her Albuterol through the Nebulizer, as prescribed, to help her breathing which was also elevating her heart rate. They gave her another chest x-ray and saw some gook in her lungs but her Pneumonia was not that bad. They changed her antibiotic to treat the Pneumonia. They were constantly checking her vital signs and keeping her hydrated through IV. They were real concerned the first night because her oxygen kept dipping real low.

Sleeping was an issue again, of course. She was in a single room because she was still on contact precaution but it was a tiny room. There was certainly no room for an air mattress and they looked at us like we had five heads when we mentioned it! They said I could sleep in the crib with her! Truly! They said it was common for parents...and it worked out quite well. Ken slept on the cot.
The next day, Friday the 26th, they continued to manage her symptoms and she seemed a bit better. The doctors had told me and Ken that we would most likely catch a cold from her. He and I automatically knew that that meant Bronchitis for the two of us! Colds for me always turn into Bronchitis and Ken has Asthma so he commonly gets Bronchitis as well. My coughing was worsening and I was concerned about waking her every time I had a coughing fit. So I went the the ER next door at the Brigham and Women's Hospital to get antibiotics while Ken stayed with Gabriella. Ken's Bronchitis held off a bit and he did not get antibiotics until today.
Gabriella's oxygen had consistently increased to 91% and her fast heart rate was finally slowing. Her temperature was holding at about 100 to 101. They wanted to release her on Saturday the 27th. I would not let them and had to fight with them to keep her another night. I did not want her to leave the hospital until she was able to keep her oxygen level above 95% on room air. They grudgingly obliged. By Saturday afternoon she was more energetic and full of life again.
She was released from the hospital on Sunday the 28th. She still has a tiny bit of wheezing. We followed-up with her pediatrician yesterday, Monday the 29th, and he was pleased with her condition and progress. He said some of these final symptoms should last for about another week.

Gabriella learned a few new things during her hospital stays this week. She learned the words "all done" and would often yell it out beneath her face mask while we were struggling with her during breathing treatments. She now adds hand movements, flipping her palms up and to the sides, while saying it. She also learned what a hospital vomit pan is for! When it appeared that she would likely vomit I would position the pan near her. So now, when she sees a vomit pan she positions her head over the pan, sticks her tongue out, and makes the vomiting sounds! She also learned what a stethoscope is for. She would take the end of the nurse's stethoscope and place it on her belly.

It certainly was a scary, tiring and trying week. Ken and I were dying for a decent meal and for a restful night sleep. Christmas flew by in a blur. The good thing, of course, is that Gabriella is feeling better. We will continue to open a few Christmas presents each night and continue to lay low. She loves her new rocking chair from Grammy and Grampy (the NC State shirt is from her Aunt Donna, of course!):

We began the year off in a hospital because of my car accident and we ended the year off in a hospital with Gabriella. The time in between has not been too smooth either. We know, at the same time, that we have tons to be thankful for. Being in a hospital such as Children's Hospital certainly reminded us of that. We are still very excited to ring in the new year!

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