Tiny babies aren’t supposed to get colds. It just shouldn’t happen, and when it does, it’s pretty much the saddest thing ever. It would seem, though, that with having so many little germ-carriers in our home, nasty tiny baby colds are something we are just doomed to keep having to deal with.
Coraline and I are just back from a day-and-a-half hospital stay for RSV (respiratory syncytial virus) and bronchilitis. Unfamiliar? Not me. Our family’s lived through it once before, when poor Romilly was just 11 days old.
Romilly, February 2006
This time, poor Cora started having a rough time right in the middle of the holiday weekend. Not particularly wanting to head to the ER on New Year’s Eve, we watched and waited, remembering the signs of real respiratory distress from last time around. By Sunday evening, it was clear she was struggling, so I called our pediatrician, who advised us to call Monday morning and make an appointment.
RSV usually runs its course in about 10 days, with a peak (or trough?) at about day 5. Sunday, we now know, was Coraline’s “day 5”, and by the time we got to the doctor, she was already over the worst. But she was still struggling enough that the doctor walked us over to the ER with the intention of having us transferred to a children’s hospital in the city.
We waited for 10 hours in the ER, thankfully in our own room rather than a waiting room, before the transport team from the children’s hospital turned up. Coraline received two treatments of epinephrin through a nebulizer, despite the fact that her O2 was generally staying at the lower end of the acceptable range, which seemed to help her some.
We finally got settled in our room at about midnight, greeted by a party of doctors and nurses asking us a million questions I had already answered many times that day. After the doctors cleared out, the nurse whispered to me, “I’d have sent her home from the ER.” Super.
Though her oxygen dipped down enough to require a teensy bit of oxygen through the night, she was really doing much better by morning, even back on room air, and we got discharged by late afternoon.
So, for posterity, or just in case we ever happen to come across RSV again (apparently 60% of babies get it in their first late fall/winter/early spring season but only 2-3% require hospitalization. If I believed in luck I’d say that makes us exceptionally unlucky, but I don’t. I will instead acknowledge that God certainly had good reasons for both times He allowed us to go through this ordeal, some of which we have already been able to see. But I digress…), here are somethings I’ve learned (or relearned) about RSV and about life in general in the last few days.
- Blood oxygen saturation, sometimes called “sats” (UK) or “pulse ox” (US, at least on the show ER) is measured as a percentage. 100% is really good. Below 92% is cause for some concern. This number, measured by a little ET-like red light on a finger or toe, is the main indicator of how serious one’s respiratory distress is, though there are other signs.
- Watching this number fluctuate from 87 all the way up to 100 all day can make you go insane, so I tried really hard not to stare at the monitor. Tried.
- Oxygen levels normally dip when you sleep, because your body doesn’t work as hard at breathing. So basically, in order to get to go home, you have to be a straight-A student, even in your sleep.
- Another sign of distress is belly breathing or “retractions”. You can see this happening if you watch the chest of struggling little one as they breathe. The skin under the ribs seems to pinch in and the belly gets big with each breath.
- If you happen to use the word “retracting” when talking to a doctor, they will think you are either really smart or really unlucky.
- Other signs of respiratory distress include grunting, head-bobbing, flaring nostrils, “gunky” chest sounds, and a paler or bluish skin color. We never got to blue, thankfully, but I’ve heard. Another biggie is failure to feed or vomiting. This was the big red flag with Romilly, who had to have IV fluids for a couple days. Coraline never stopped nursing, but they gave her an IV anyway, “just in case.”
- The bits of nose around your nostrils are called your “nares”. Did you know this? I did not.
- If epinephrin (aka adrenaline, and the same stuff they jab into you with an epi-pen if you have a bad allergic reaction) is administered as a breathing treatment, you will not be going home in the next 24 hours, because it can cause elevated heart rate and blood pressure. They should tell you this before they give it to your kid.
- Most of the parts of RSV that are scariest to behold (the I’m-dying-Mommy cough, the sleeping with the neck arched way back and mouth wide open, the crazy snuffle-scream) are actually some of baby’s most effective defenses against her own stifling snot. I was amazed more than once to watch Coraline have a crazy scary coughing fit in her sleep only to see her oxygen level then jump from 91 to 95. Coughing works. Our God has indeed made our bodies fearfully and wonderfully.
- A 36-hour hospital stay feels surprisingly like a vacation to a mother-of-five, poor sick baby notwithstanding. I finished the book Trevor gave me for Christmas and half-finished crocheting Romilly’s birthday present. It is amazing how many hours there are in a day when you only have yourself to look after.
- My husband is amazing. He makes looking after four small children look easy. They even did school while I was away. Wonderful!
- And here’s a freebie. Nothing to do with RSV, but I did have many occasions to use this recent revelation during Coraline’s sick spell, and so I will share here anyway since it took me *five* babies (six if you count cousin Ellie) to figure it out: In case of diaper blow-out, onesies can be removed downward instead of upward. This, I’m quite certain, is why they all have that funny widen-able neckline. Clever stuff. Now I’m wondering how many times I had to smear grossness up and over my poor babies heads over the years in order to figure that out… Did you know?! I feel so silly.