My Mother-in-Law, who is a respiratory therapist, called us at 1:30am. They were enjoying an overnight visit with C, but she'd become concerned about his breathing, his respiratory rate was about 38. At that point, it wasn't bad enough that we needed to meet at the hospital, but it was bad enough that she wanted us to be with him because we knew his baseline better. C's breathing was noticeably raspy, junky and crackly. He sounded awful. We dug out his inhaler from his RSV a month ago and gave him a couple puffs. Over the next half hour, it improved but not by much. I counted his respiratory rate and he was up to 43. C hadn't slept yet, he was working too hard at breathing. He was happy, playful and alert, but his respiratory rate was getting higher and higher.
We finally decided to go to the ER. We broke out the hospital packing list and quickly packed enough to survive being in a small room at 4am with a very alert toddler. We arrived at 4am and were taken immediately into triage. His pulseox was 96, respiratory rate in the low 50s. We were taken to an observation room and offered the opportunity to watch TV, they didn't know what DVD if any was in the player. I told her not to worry, we'd brought our own. C's show of choice is signing time and I suspect they don't have that DVD readily available. This trip marks the first time we've kept C busy in an ER or hospital room by watching TV. He was way too young on previous trips. Though it has worked for his echos in the past, so we knew there was a pretty good chance we'd be able to get away with it in this setting as well.
We passed the next 5 hours in the ER. We'd get a breathing treatment from respiratory and then get checked periodically over the next hour. My husband attempted to sleep on the bed in the room, I sat in the recliner with C periodically nursing him and rocking him.
The doctor came in one final time just before shift change and told us she was handing us off to the day crew. If the next breathing treatment didn't improve his lung function enough, she thought we'd be admitted. Thankfully, the morning doctor was a lot more laid back. He asked us if we were comfortable with him and stated he thought C was doing fine. They let us go home at 9am, 15 minutes after C finally fell asleep. C falling asleep was how I knew he was fine to go home. As long as he was working to breathe, he wasn't willing to sleep.
We came home after a long exhausting night, we all took turns napping. C had 5 hours of sleep, my husband had the interrupted sleep at the ER + 2 extra hours and I had 3 hours. A very long end to our weekend.
A follow up visit with our pediatrician showed his lungs clearing nicely. We can expect issues like this for the 6 months following his RSV infection. Thank goodness for Synagis, we'd be in a much worse place without it.