Showing posts with label sats. Show all posts
Showing posts with label sats. Show all posts

Tuesday, August 14

Home Sweet Home

Dear little blog, 

Sorry for neglecting you. It's that daughter of mine you see. She got sick again. Like all the other times; very very quickly.
Sunday evening she was a bit of a grump with a runny nose. Sunday middle-of-the-night she had a hacking cough that barely gave her time to catch her breath in between. Monday first-thing she was all over the place. Optimistically I secured the first doctors appointment of the day. My GP reached for her telephone and rang an emergency ambulance.

They were so kind, so calm, the two paramedics. Ladies, both with cropped hair probably mid-forties. Not that it matters. They popped Wriggles on my knee, attached four sticky ECG leads pads to her chest and started up oxygen through a mask. 
"I think we just need some speed," one said gently. "Hold on!"
It was so bizarre, speeding through the familiar little streets we walk every day. NEE NAW NEE NAWWW NEE NAWWWWW past the church where we go to music groups NEEE NAWWWE NEE NAWWW past the coffee shops we meet friends at NEEE NAWWW NEE NAWWW past the park NEEE NAWWWWE NEEE NAWWWW why aren't her sats (oxygen saturation levels, measured in %) picking up? NEEEE NAWWWW NEEEE NAWWWWW! 

And then suddenly we were in a&e being quickly guided to bloody 'resus', the resuscitation bays again. The emergenciest bit of accident and emergency. The bit with very scary machines and bits of equipment. The ones that have everything for every occasion because they cannot predict what the patients will do. Back in the same bed as last autumn, the one by the door in the corner. An army of doctors and nurses were waiting for us and immediately swarmed around us, sticking things here, putting things there, fiddling with machines and buttons, barking questions and taking histories at breakneck speed. A chest x-ray was ordered and some poor nurse tried to administer steroids to Wriggles, who by this point was clearly terrified and hysterical. She clung to me like a limpet and would not settle unless I was physically next to her on the bed. So there I stayed. My daughter, the social butterfly, was quite definitely sick if she wanted me. Normally, I am tossed aside for whoever else is in her sight line or has something shinier so this was very unusual.

It seemed hours, but I think it was only an hour or two until we were declared stable enough to travel down the corridor to the paediatric section. There we stayed, in the room adjoining the nurses desk to be closely monitored. Wriggles was still on a lot of oxygen with at least hourly nebulisers and as many drugs as they could persuade her to take spit out. As the day wore on, we were secured a bed on the respiratory ward, wheeled over to the day unit and settled down into a state on not-so emergency. I dared to breathe a sigh of relief, that maybe the drama had passed and we would be in and out in a few days after a blast of oxygen and a course of antibiotics. Maybe, I thought hopefully, we would still make our flight on Friday to join my family in Devon. 

Oh! Someone must have been laughing at me.

Upon getting to Ward 2, the respiratory ward, Wriggles began to crash. She began struggling far worse than when we had arrived, and her machine barely quietened between alarming. Her heart rate was flirting with 200 bpm and her sats were dipping below 80. The oxygen went up. 10 litres and counting. The monitor still alarmed. More doctors swarmed in. Cannulas were placed, blood gases rushed Upstairs. The place that needed no name, no introduction. Upstairs. Ward 12, Paediatric Intensive Care, level 4. Upstairs, my nemesis of nightmares. 
Time ticked on. 11pm. Midnight. Nothing was getting better. A consultant from Upstairs was called to assess her. She agreed to enquire about beds. 
In a daze of horror, I began to pack, so convinced that we were going. By 12:30 I was ready to move again, completely switched off and living on fear. I would not leave the cot, rigidly stuck holding my sick child's hand.
And then my guardian angel, in the form of the respiratory SHO, came and worked some magic. Finally, Wriggles' sats stabilised in the 90s and a sigh of relief was breathed all round. We were on a very fine line, but for now, the acute drama has passed.

The next 24-48 hours was similar: Tuesday night we escaped a similar near-transfer to PICU after being formally accepted there, but thankfully never actually getting around to leaving our ward. In the early hours of Wednesday, I was warned we were on very shaky ground and all it would take was one small wobble and Wriggles would be on a ventilator again. I firmly believe that if we had had a less experienced consultant, we would have ended up on one. Our saving grace was the depth of knowledge and willingness to take risks of our consultant who guided us out the shakiest moments and of the PICU consultant we borrowed who knew Wriggles' history inside out. Wednesday, we had another scare when a coughing fit sent her de-saturated to 64 and in 18 litres of oxygen which took a long time to wean down and Upstairs alerted for the third time. Come Thursday, things began to subside, and slowly more lucid periods began to creep in and litre by litre the oxygen began to come down. 

From then on, it was a long slog, with it taking a further 8 days to manage any time oxygen free. It took days to get her off IVT fluids with a decision being made that we would go home tube-feeding as the consultants suspected intermittent aspiration into her lungs-something that has been considered in varying degrees for over a year. And so here we are, back home at last, with a pump and a NG feeding kit and a date set for a more permanent PEG (gastric) tube being placed. I feel so drained and exhausted, and I suspect it will take a while to process some of the more traumatic moments from the 15 day stay. Wriggles, although outwardly herself once more, has kittens if you dare go near her face or feet, where so many blood tests were performed. She is wary of people, and can spot medical equipment a mile off. If she catches sight of a syringe or spare-NG tube, she screams and hides. As so many have said, it is no surprise she has become so orally aversive. My poor baby: so much, soon soon. So much of her innocence dirtied and her small life tested and tried when it should be pure enjoyment and joy. 

So. A new chapter begins, of tube feeding and investigations by different teams. I have half expected tube feeding for a while, but for dietary and nutritional reasons. Despite the end being the same, it feels a struggle to get used to it although I know it will have many more longer-term benefits. Although it ended up being placed for respiratory safe-guarding, it will help so much as we eventually return to feeding once more.

Little blog, I am tired.

Mouse x

Friday, January 20

Growing up: Wriggles in Review Rooming in and Going Home

If SCBU was fraught with mixed emotions and sadness, rooming in was sheer elation. It marked a very significant point in our journey: 1. home time and beginning of my true journey of parenthood and 2. the first private moment with Wriggles since the very first moment of birth, (which to be honest was not great as I was trying to speak to emergency services whilst administering CPR whilst holding her in the crook of my arm still attached via umbilical cord in a state on intense shock).

The nurses had tried three times to leave Wriggles in air to test whether she was dependant totally on the oxygen. Unfortunately she was, and her sats would dip to worryingly low levels quickly without it. And this was without energy consuming activities like feeding! So the oxygen tanks were ordered and on Saturday 13th November, exactly two months old, I moved in to the parents flat with my overnight bag and a jittery sense of excitement. It was bizarre but just what I needed. Being on our own was bliss. It was such a relief to be able to cuddle her for as long as she would tolerate, feed her on demand and say whatever I wanted without someone listening it. And best of all, it was how I imagine! I fell in love even further and it confirmed that my deepest wish was to have my baby with me forever. The weekend went smoothly and on Monday we were officially signed out and free to go! I was slightly nervous; being a mum in hospital was one thing but home with no one to ask advice of right away was another. Plus she was on oxygen, increasing SIDS risk and everything had to be super-sterile as the risk of germs to a premature baby are well, risky, and even more wobbly to one on oxygen with Chronic Lung Disease.

I think unstrapping Wriggles out of the carseat in my flat is possibly one of my proudest moments to date. It officially marked the end of SCBU and the beginning of complete Independence. I kept expecting the hospital to ring up and say there had been a mistake, but of course they didn't. Everything felt such a novelty being at home.


Later that day, one of the community nurses came out to check we were settling in fine and to go over any questions about the oxygen cannisters. Someone would visit twice a week to check her sats (to ensure they were 94% and above) and weigh her weekly to make sure that she was still growing at a suitable rate, as having weaker lungs meant that much more energy was diverted into breathing rather than being a baby. Wriggles settled in very well. So well, she rapidly went for a nap. Seeing her in the moses basket, dwarfed, was a lovely moment. It was so homely and cosy, and no-one had wanted to take her temperature and count her respiratory rate for at least 24 hours! Oh dear. That meant it was down to me.....