4.20.2008

Maddie's Hospitalized! Part the Third

In the ERIt's time for another episode of "Maddie's In The Hospital!!!"

On Thursday and Friday Maddie threw up a few times. While she has stomach issues, she doesn't usually throw up multiple times a day two days in a row. So there was our first red flag. Then Friday night she started to get a familiar rattle in her chest. On Saturday morning when it wasn't better, we decided I would take her to the urgent care at her Pediatrician's office, just to be on the safe side.

We got to urgent care a little before two pm. There were only three people in front of us. Excellent. I settled down with the only magazine there that wasn't a coloring book and waited. I finished my magazine and started playing with my blackberry. I caught up on all my websites, I updated my facebook, I went over my schedule for the next few months. I fed Maddie, and rocked her back to sleep. HOURS went by. It wasn't like more urgent cases came in. The receptionist at the desk didn't ask anyone what was wrong, so there wasn't a ranking system of the most needy. Maddie gets a breathing treatment at three pm every day, and as that came came and went, her breathing got worse. I couldn't avoid the overlap, though, since the urgent care was only open for a few hours. Maddie was finally called back into the doctor's office at 4:15 pm.

The urgent care doc had me go over Maddie's history and was fascinated by everything. Maddie is medical porn to doctors! The UC doc gave Maddie an exam, then took her pulse ox level - only 76. At that point, I just KNEW she was going to be admitted. The UC doc told me to take Maddie back to Santa Monica UCLA Emergency Room for a chest x-ray and evaluation. Yipee.

I went back to the house to get Mike and packed an overnight bag for myself and Maddie. We gave her a breathing treatment, and then went to the ER. On the way there, I cancelled our evening plans - my cousin Leah was going to babysit Maddie while Mike and I went to a party in honor of our friend Brianne's birthday. Sigh. At the ER, we were called into triage right away, and then immediately put in a room. I was much more pleased with how quickly Maddie was attended to. At least, I was at the time. The ER doc (who looked more like Doogie Howser than Doug Ross) came in and I went over Maddie's whole history again. He noticed that Maddie's breathing rate was up, and that she was really pulling with her stomach when she breathed in. We told him that he normally works a lot harder than your average kid to breathe, and we were backed up by Maddie's well-developed ab muscles. She has a six pack! The doctor decided to give her breathing treatments of xopenex and albuterol, and ordered oral steroids, blood cultures, urine cultures, a nasal cannula, and a chest x-ray.

Most of the nurses we've come across are not comfortable drawing blood from a baby as small as Maddie. She doesn't have any real prominent veins, and she requires a needle much smaller than any they have ever dealt with. Unless they are a pediatric nurse or NICU nurse, of course! the nurse that drew her blood in the ER was so determined to get the perfect vein. He spent 20 minutes looking for a vein before he settled on one in her foot. It took another nurse, a respiratory therapist, and me to hold Maddie down when he drew her blood, she was that pissed off. Unfortunately, the blood draw in her foot didn't work, so we had to hold her down again for a draw from her hand. Poor little thing cried so hard, it about broke my heart.

The ER doc came back in to talk to us at about 8, after we'd been there for about two and a half hours. He said that her oxygen levels and everything else looked good, so he was going to leave it up to us whether or not we wanted to have her admitted. Mike and I were like, um, YOU are the doctor, shouldn't that be your decision? And then the doc said, "well, when I look at her, I freak out, but you two know her since you're her parents." Um you FREAK OUT? Thanks for the wonderful bedside manner! When we asked him to elaborate, he said that he meant that in a baby that didn't have Maddie's history, he would have been extremely alarmed by her oxygen levels (in the low 90's), respiratory rate (over sixty breaths per minute), and her retractions (how hard she had to pull with her stomach muscles to fill her lungs with air). I asked him how her chest x-ray looked, and he said, "oh yeah, I forgot about that. Let me go look at it." Nice.

When he was gone, Mike and I talked and decided that, unless her x-ray said something crazy, we were going to take her home. Of course, when the doctor came back, her x-ray said something crazy. The lower left part of her lung was collapsed. So the decision to admit her was made for us. It was 8:30. We were told that it would take about two hours for her to be admitted. A silly amount of time, but we could deal. I signed the admitting paperwork while Mike got us food from the deli across the street, and then we waited.

At 9:15 a pediatrics resident came down to examine Maddie. We'd met her the last time we were here. She told us that the pediatrics floor had been a bit crazy with a code and a transfer, but things had calmed down and we would be up shortly, especially since the peds unit had just added a bunch of beds. Around 11, we asked the nurse what was up. She said that they were just waiting for Maddie's room to be cleaned and sterilized by housekeeping, and that it wouldn't be much longer. At midnight, we were told that our nurse had been "yelled at" by the charge nurse on the pediatrics floor because she'd been calling too much. Whatever! At one, I was flipping out. Another nurse said, "they're just looking for a room for her." Um, what about the room that was being cleaned for her at 11? He didn't know.

At 2 am, we'd HAD.IT. I told Mike that we were leaving. That if they didn't have a bed for her in the next 15 minutes we were just going to come back in the morning. Mike managed to talk me off the ledge for a while, but by 2:30, even he'd had enough. He went out and found the nurse that had drawn her blood some SEVEN HOURS earlier. I could hear them talking out in the hall but I couldn't quite make out what they were saying. I started yelling, "It's been over six hours since she was admitted!" and "I WANT THE CHARGE NURSE"! Well, turns out Nurse Pokey IS the charge nurse in the ER. I'm sure he was thrilled to speak with the crazy tired mom. Luckily Mike was more rational. He pointed out to the nurse that Maddie was laying on an adult bed where the rails weren't close enough together to prevent her from falling. We were too tired to hold her safely. Nurse Pokey looked at him, then at me. I started crying, "We're just so TIRED and we've been here FOREVER and I know it's not your fault but you have to understand where we're coming from! We are just going to take her home and come back in the morning!" He told us not to leave and that he'd go call the nursing supervisor to find out what was going on.

Wouldn't you know, fifteen minutes later we were being taken up to Maddie's room.

I sent Mike home to take poor Rigby out to the bathroom. The nurse brought me a roll away bed and I laid down, hoping to get some sleep. Wishful thinking! Nurses were in and out. Maddie woke up every hour hungry, only to fall asleep after only eating about an ounce. Her pulse ox alarm would go off, then the monitor started beeping because it was low battery. The x-ray team came in to get another picture of her chest. She needed blood drawn. In all, I got about an hour and a half of sleep.

Maddie's amazing pediatrician came by at about 10:30 and we told her everything that had happened the day before. She was horrified by how long it had taken for Maddie to get a room. She was also the voice of reason, cancelling all orders for blood draws and other unnecessary treatments. She examined Maddie and said that while her lungs sounded really junky and full of phlegm, she seemed MUCH better than the last time she was in the hospital. Her x-ray showed that the area of collapse had slightly improved. And then she said the magic words, "if she doesn't have any other problems, she'll go home tomorrow." Great to hear, but we'll believe it when she's in the car on her way home.

She's been on and off oxygen through her cannula, but mostly off. Right now her oxygen levels are in the low 90's with no oxygen, which is normal for her. Through it all, Maddie has been her usual happy self. She is eating like a champ (not gaining any weight though, grrr) and is, of course, smiling at everyone she sees. We're so glad that even with her coughs, sneezes, and wheezes, she is still our spirited little girl.
I love you Daddy

4 comments:

Kristin.... said...

Oh Heather. I've been checking all day to hear how Maddie is doing. I will send good thoughts your way. I hope she has a good night.

Memphislis said...

Thanks for the update. You guys are such troopers, poor Maddie. Please do kep us posted when you can!

Gemini Girl said...

Heather!
First of all, I hate hospital politics. I was in one way too long to know how it works.

Sorry you guys had to have a rough few days. If maddie is looking better, I pray she comes home soon. Are the doctors saying why shes not gaining weight? Is it because she is burning calories by trying to breathe?
Let us know!

Lane said...

Hang in there Mom and Dad and Maddie! We're thinking of you--The Millers (parents of a preemie, too!)