Hi everyone! It is me, Honormommy, again!
First I want to thank my wonderful, beautiful, fantastic SIL, Steph, for updating all of my online friends and family about what was going on with Samuel so you could all pray for us. I think I was told at one point that Samuel was on 30 different prayer chains...AMAZING! THANK YOU SO MUCH FOR PRAYING FOR US...your prayers made a HUGE difference!
Although I didn't have a computer, I didn't stop writing while in the hospital so now you will have to suffer through 3 REALLY long blogs about our experience...from my point of view. Of course...you don't have to actually READ them, but I will write them up none-the-less.
So, let's start at the very beginning (a very good place to start...okay, I've got my Sound of Music reference out of the way...) Hmmm....
Well, February 8th, I stayed home from church with Samuel because he had a little cough and a runny nose and I didn't want the other kids in the nursery to catch it. I was actually MUCH more concerned with Ariana because she had been vomiting the day before. Samuel was playing and acting pretty much normal...no fever, eating, sleeping, etc. Every once in a while he would make a small cough and kind of a choking noise and we thought he was coughing up junk and swallowing it back. But it only happened a few times throughout the day. All of my kids have had worse colds and we didn't think anything of it.
Sunday night we put a humidifier in our room (my dad was visiting so Samuel was sleeping in our room), rubbed on the Vicks and put him to bed. Around 4 a.m., I heard him make the little choking cough and got up to check on him. While I watched him, he did it again, but this time he vomited up a bunch of mucus in his mouth. He didn't turn himself over, so I quickly did. I cleaned up his crib and realized he was burning up. We got him some Motrin and I held him in the rocking chair until 6:30. Then he got restless and wouldn't be comforted. So I ran a bath to calm him down. He seemed fine. Around 7 am I brought him downstairs and he sat tiredly on my lap and watched the news.
Around 7:30 my dad came downstairs. I asked him if he would watch Samuel while I took a quick nap/shower. I called my doctor's office while I was upstairs around 8 am and left a message asking if we should be seen. When I came downstairs around 8:45, I was told that Samuel had vomited 6 times while I was upstairs and he was basically passed out on the floor. I didn't wait for the triage nurse to call back, I called and scheduled an appointment for 10 am.
The doctor said his lungs sounded clear, but was worried about how quickly the symptoms progressed with the fever and vomiting (and at the office added diarrhea). But he was most concerned by his rapid breathing. A good breath per minute rate is less than 40--Samuel was breathing around 60 and his oxygen levels were a little low--around 92% (95% or more is considered okay). So he gave him a breathing treatment in the office and then sent us to a lab to get chest X-Rays. The X-Rays showed questionable pneumonia in the lower left lobe so he gave us a prescription for antibiotics, requested we give him breathing treatments every 4 hours and keep his fever down with the Motrin and come see him on Tuesday. Normally pneumonia is easily treated at home and my doctor hates to put small children into the hospital unless absolutely necessary because of the risk of picking up something else.
Tuesday he seemed to be getting better. He talked to me (he was VERY lethargic all day on Monday) and even asked for a cracker. We thought the antibiotics were working and he was on the mend. The doctor said his lungs still sounded clear and told me I only needed to come back if Samuel's condition seemed to worsen--increased breathing, fevers that won't go down, etc. We went home feeling good.
Wednesday he seemed even better--even eating lunch! I however went to the doctor and found out I had strep throat. The rest of the day was a blur as I was forced to get the sleep my body had been missing. Thankfully the antibiotics seemed to be working right away. Samuel still wasn't his same ol' self. He refused to do anything but sit on the couch...preferably on some one's lap.
Thursday I woke up concerned for Samuel. He STILL wasn't playing like himself and still wasn't talking much. He had been on antibiotics for 3 days...he should show some kind of improvement. I called the triage nurse at our doctor's office and told her that I'd seen little improvement and asked if we should come in. She told me that pneumonia takes at least a week to show improvement and not to worry about it too much. So I asked about his blistery lips/slight rash on his cheeks--could it be an allergic reaction to the breathing treatment? For that she thought it would be a good idea to be seen so we scheduled another appointment for later that morning.
This visit wasn't as pleasant as the previous visit.
Samuel's stats upon first arrival were good: 99% O2 level, Breaths per minute stable between 40-45...not great, but definitely improved from even Tuesday. BUT he had a fever and the doctor could hear some stuff in his lungs. He told me sometimes you could be getting treated for one kind of pneumonia in one part of your lung and have another kind attack the other part of the lung--that would need a different kind of antibiotics. He wanted another X-Ray. STAT.
An hour later we were back in his office, but Samuel's stats had gotten worse FAST. When they rechecked his O2 levels, he was now at 90 and his fever was spiking. His breaths per minute had gone back up to 60. The doctor ordered an antibiotic shot. The X-Rays showed rapid growth of the pneumonia and it now covered his entire left lung. Samuel would need to be hospitalized. He called over to the ER and told them we were coming.
The ER staff moved us through immediately. They had a bed waiting for us in a private ER room--we were actually quite comfortable. They put Samuel on oxygen and IV antibiotics right away. We were told that unfortunately we would have to wait for a bed in pediatrics--apparently there was a lot of this junk going around. About 2 hours later, we were told that the ER doctor wanted to move us to another hospital because there just wasn't enough beds there. An ambulance took us away.
This new hospital was BEAUTIFUL. I was so thankful we were there. It was quiet, brand new, and actually had very comfortable sleeping arrangements. Not too bad. We spent the night there feeling pretty good about staying there for 2 or 3 days until the antibiotics kicked in and we could go home.
In comes Friday. Samuel was perking up. He even smiled a little. When the doctor came in, I was expecting to hear all was going well. Not so. It seems he was very concerned about the X-Ray and the rapid advancement of the symptoms and wanted to do a CT scan right away. The CT scan showed that he was suffering from pleural effusion--the doctor basically explained that this was the pneumonia leaking out into the pleural cavity (the area around the lungs that allows them to expand in your rib cage) and that Samuel would need to have this drained. Ummmm...okay.
Unfortunately, the hospital we were in did not have pediatric surgeons on hand so we would need to go back to the first hospital (which was why my pediatrician was so set on us going to that particular hospital in the first place)...another ambulance ride. When we got there, we were greeted by the surgical physicians assistant. He told me that although Samuel would have little bursts of energy here and there, he is actually MUCH sicker than he looks. He then explained that not only did he have pleural effusion, but he had pleural empyema and went on to describe the surgery for me.
Samuel would be put under anesthesia, the doctor would make two to three small incisions on his left side. One would be for inserting a camera to monitor the situation (the assistant I was talking to would be running the camera), the others would be for draining the mucus and scraping off the junk that had hardened on the outside of the lungs. Then a tube would be inserted between his ribs to continually drain out mucus for a few days. Although Samuel was extremely sick, he was stable for the night and they would wait until tomorrow around noon to do the surgery.
To complicate matters, Samuel was critically low on potassium and some other protein and it was causing him to bloat. This made keeping an IV in him nearly impossible. That night they had to reinsert an IV in 3 different places. Right before the surgery, they had to remove the 3rd IV. The anesthesiologist would insert one in his neck anyway so they didn't bother replacing it.
The surgery was a success! We were told that it would take 60-90 minutes...it ended up taking a little more than 2 hours. Here are the "before" and "after" shots of Samuel's left lung for your viewing pleasure.
As you can see, there is still some white stuff left on the lung. The way that makes the most sense to me is to think of it like a cup of jello (the pleural cavity/lungs making up the cup). If you are making jello, it is mostly liquid, but then it starts solidifying around the edges first. If you were to empty out the liquid part of the jello out of the cup, you would still have stuff on the sides. Before you could put it in your dishwasher, you would want to make sure you scraped off as much of the solid jello as possible, but there would still probably be a little film leftover. Well, that is basically what they did. They scraped off as much of the empyema as possible and then flushed the cavity with antibiotics, sealed it up, put a tube in place and sent him to Pediatric Intensive Care Unit.
Happy Valentine's Day for me!
We were in PICU for a few days (I think four days??? They kind of all blurred together). They kept him on the ventilator for a little longer than they would most people because of how bad his empyema had been--they wanted to give his lungs as much help as possible before taking him off. Once they were sure he was breathing all right on his own (with the help of an oxygen tank), they shipped him over to general pediatrics.
I was really worried about general pediatrics because I absolutely hated the first room we were put in at this hospital--it is an older hospital and the first room reminded me of a jail cell--including an iron crib with a lid on it! But we were blessed with a much better room for the duration of our stay in the pediatrics overflow area--with a normal crib (well it was still a hospital crib, but much more normal looking). The room was actually quite cozy--except they were out of chair beds so I had to sleep in a recliner for 10 days...oh well!
Samuel improved fairly slowly at first. After our third day in general peds, they took out his chest tube and he really started to perk up. Then he started to get fevers. And it took him longer than most to wean off of the oxygen. The chest X-Rays started showing an increase in the pneumonia. The doctors (hospital pediatric and infectious disease doctors) got worried and tested him for everything under the sun. All the tests came back negative, but we were told that he would need to stay on IV antibiotics for a 14 day stint (from the day of the surgery).
They discovered that the bacteria that brought on the pneumonia was Group A Strep...the same bacteria that causes Strep throat. Little known (to me) fact told to me by the infectious disease doctor...this is also called the "flesh eating" bacteria...nice, huh? However, the good news is that this particular bacteria responds VERY well to antibiotics so that's a positive. However, this particular bacteria is REALLY bad stuff with all sorts of symptoms and they decided that all the fevers and vomiting and peeling of his skin was simply more of the Strep A. They also informed me that the pneumonia would continue in his lungs for 6-8 weeks and he would get worse before he got better....and he would act better long before the pneumonia was gone.
Thursday morning out of the blue Samuel vomited again. The doctors said it was just a side effect of the pneumonia causing strain on his diaphragm and that I shouldn't worry about it. 1 am Friday morning he vomited again. The doctors again said not to worry about it, but gave him a few doses of IV nausea medicine just to be on the safe side. His fevers finally went away and we were sent home today...YEAH!!!
But that is not the end of the story... you see, Samuel started vomiting again this evening...and he hasn't stopped. I called our doctor and they said to treat it like a 24 hour stomach virus--liquid diet, pedialyte sips...once he can keep liquid down for 8 hours add in starches, etc. AND...if I'm worried, I can always take him back to the hospital... So we'll see where we are tomorrow...
KEEP PRAYING!!!
Well, that's a play-by-play of our hospital stay. I told you I have more...but it's getting late--time for bed! I can't wait to share with you all of the amazing blessings God gave us throughout this ordeal though...stay tuned! :-D
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