Friday, February 14, 2014

Hearing Impaired

My Dad is hearing impaired.  He started losing his hearing in his 40s and without his hearing aids, he cannot hear very much.

Two thoughts on hearing aids:

1) Did you know hearing aids are NOT covered by insurance?  Losing one of your 5 senses and being able to repair that damage with medical equipment is NOT, I mean NOT!!, covered by insurance.  That is my definition of a sin.

2) As a mother, I can certainly see the benefits of turning off and/or taking out one's hearing aids on occasion.

SPEAKING of which (ha! a pun!), my eardrum ruptured last Saturday night.  That means that I cannot hear much out of my left ear.  The last time this happened was in 2005 (I remember because it was right after my first miscarriage).  I only had one quiet child then, so I don't remember much about hearing problems at home.  I do, however, remember being incredibly frustrated during a grad class because I could not understand what my students were saying.  This is a real problem when the whole point of a grad class is discussing the readings and I couldn't understand what my students were discussing.

This latest loss of hearing occurred during Charlotte's worst snow storm in a decade.  So I haven't had class (yet) but I have more (and louder) children at home.  More than ever, I am wondering what it is like to be my Dad.  One of the most surprising things was how overwhelming all the background noise has become.  If I'm trying to talk with or listen to Dave, I cannot stand the kids' normal noises in the background.  It is too much muted stimulation and too much effort to try to understand what is being said around me.

I also have to repeatedly tell everyone around me that I cannot hear them.  I know they are talking at me, but I have NO IDEA what they are saying.  Sometimes I guess correctly.  And sometimes I guess wrong--as evidenced by the puzzled glance my way.  Sometimes I just pretend that I understood what they said and smile and nod my head figuring that if it's really important, they will try to communicate again.

All this gives me so much more empathy for my Dad. I don't ever recall my Dad telling anyone he has a hearing loss. I can't go three hours without repeatedly reminding folks I have no idea what they are saying. Dad has always done a good job of figuring out what we are saying, or coming back with some (purposefully) misinterpreted sentence sort of based on what we saying that has turned into Jokes of Family Lore.  That said, the improvement in hearing aids over 40 years has been AMAZING.  And I think some of the time, Dad has developed a real intuition for what is going on.

But I have to think that for at least some periods of my father's life, it's been pretty frustrating to have all of that muted background noise and not be able to hear us.  And yet, he did not scream at everyone to be quiet (ummm, maybe like I have) so he could hear.  He has been very generous to us in his loss.  And I'm not sure we've been as generous back to him.

I don't wish a perforated eardrum on anyone.  But it might help all of us to understand a disability we can't see or even imagine.

XOXO to you, Dad.

Monday, February 03, 2014

Bring on the Advice

For the first time since Bridget was a baby, she has an ear infection.  And Dave and I have decided we are going to do everything we can to heal it at home with alternative medicines rather than take her to the doc.

"Why?" you ask.

She's already on a boatload of meds.  She has a lot of antibiotics over the last year.  Earaches often heal on their own without antibiotic intervention.  And we know, for sure, she'll be back in the hospital at some point in the future and, at that point, she will be exposed to some gross germies there.  We want her to be as sensitive as possible to the antibiotics she might need then.  We don't need her losing her sensitivities to antibiotics when she doesn't need to.

So...moms and dads:  what do you do?  We're massaging around her ears with essential oils.  Any other advice?  Or assvice, because we all know this is the interwebs.

Sunday, January 26, 2014

It Wasn't All Bad

Certainly, when Bridget and I are in the hospital, it is not all kitten whiskers and fairy dust.  It's stressful and boring and too many monitors going off all at the same time.

That said, this last trip to the hospital had some pretty AWESOME moments to it, not the least of which was the big family party we had on our last Friday night there.

The Child Life Specialists let us borrow Chicken Run.  Bridget was completely off oxygen and had found two skateboards you sit on and wiggle to move.  That's how I would describe it.  It is actually this:
and it is way cool.  She stashed one for Christopher and one for her to ride around the room.  Our hospital room was actually big enough for them to ride around in these.  

Dave stopped by Trader Joes and got a bottle of wine for us, root beer for the kids, and a big bag of popcorn. 6:30 arrived and we started our family movie night.  

And wouldn't you know that about 7:00, I realized one bottle of wine was not going to cut it for the amount of adrenaline I needed to quell.  You can judge me as you'd like, but Dave and I knew early on that this was a two bottle night.

So I did what every other no other mother in a hospital does : I updated my Facebook status to ask for any of our friends who live close to the hospital to drop us off a bottle of wine. Within minutes, I was negotiating types of wines and in less than 10, I was in the driveway at the front of the hospital making the exchange.  John T., you blew our freaking minds.  He even included a bottle opener, because the first one Dave brought was a screw cap. (Classy!!)

I came back up to our room and resumed our incredibly noisy, loud, family party.  Kids were scooting.  Popcorn was flying.  Nurses and respiratory therapists were in like deer in headlights and out as soon as they could.  Actually, that is not true:  our RT for that night was one of 5 kids. He had just moved to NC from San Diego. He was so at ease with all of us and all that noise, I think we actually reminded him of home.   

And seriously, if you want to know just how messy we were, our nurse the next morning came in and tugged on the sheet of the bed, and multiple popcorn bits went flying around the room.  

You want to know what was even more amazing?  The next morning, I woke up and there was an unfamiliar bag on one of the "sofas" in the room.  I looked in it:  another bottle of wine, two glasses with napkins, SNACKS, and a beautiful cutting/serving board (along with a cork screw).  ANOTHER friend had dropped off more wine and snacks.  She did this at a reasonable hour, but after those two bottles of wine and my post-adrenaline crash, I was already fast asleep. We won't say "passed out," but I didn't hear anything.

Here is where I first felt guilty.  One bottle of wine delivered to the hospital is amazing.  Two bottles feels selfish.  Now here is where I feel grateful.  We left the hospital that day, dancing our way out the door.  But when I got home, it felt like I was supposed to jump back into the Working Mommy routine and have a typical Saturday doing chores and making meals.  It actually takes me a couple of days to get back to normal.  My mind still echoes from all the noises at the hospital.

So late that afternoon for Happy Hour, with real tears in my eyes, we opened up our second bottle of wine, drank it, and greedily ate all the treats. Well, most of them: she gave us a lot!  That first day out of the hospital is almost as emotional as that first day in. And sometimes, like the time Bridget was finally diagnosed with her Funky Lungs, it is worse than any time in the hospital because that is when I have to face all the information we received and emotion I've repressed in front of Bridget. That said, how could I possibly ask for help when we are out of the hospital?  Thank you, Allegra H., for making that first day back less stressful and I didn't even have to ask for help.  Sigh.  

We ended up buying Chicken Run on Amazon and I think the whole family would agree it's one of the happiest movies we've ever watched.
  

And our new (old) favorite movie quote "I don't want to be a pie. I don't like gravy."

Sunday, January 05, 2014

Chronic Illness: Parents Part II

So this is actually the blog entry that's been rolling around in my head for the last, oh, six months since Bridget was diagnosed with her Funky Lungs.  That's the official name: Funky Lungs.  And her official cure? Coughing massive amounts of phlegm up into her mouth.  I saw it Thursday night.  It was gross.  Really gross.  But she immediately went to 100% oxygen saturation while on room air.  She had never hit 100% on any amount of oxygen support during this trip to the hospital.  I also finally got to see (up close and personal!!!) the crap clogging up her lungs when she gets her Funky Lungs.

So back to me.  This feels like a selfish and highly vulnerable blog entry.  It's about the effects of Bridget's ongoing and long term Chronic (but not Critical) illness on me and, well, my career.  Yes, Dave is affected, too, but he needs to write his own blog to process through his Midwestern emotions.  Both of them.

So what's the scoop? First, and strangest for someone who always honors commitments, everything is tentative.  Sure, we'd love to come over to dinner (as long as Bridget isn't in the hospital).  Sure, I can go to that academic conference (as long as Bridget isn't in the hospital).  Sure we can host a big party at our house (as long as Bridget isn't in the hospital). Sure we can have our regular lab meeting on Friday (as long as Bridget isn't in the hospital).

Yes, she's only been in the hospital 3 times last year (8, 10, and 6 days each), but there have been at least other 4 respiratory incidents that we were worried she might have to go back in.  Plus, for each hospital visit, she was sick about 5 to 7 days before.  Then there are the visits to the multiple doctors to see how she is doing afterward and how we should tweak our treatment protocol. Regular colds are two weeks of time spent worrying.  Hospital visits take around a month.  I'll do the math for you:  we've had about 6 weeks since April where life was "the old normal."

So tentative.  Everything.  And for the previous 40 something years in my life, deadlines were deadlines and they were hard. Commitments meant I would do what I said.  Now there's an asterisk to much of what I say I can do.

Similarly, I am behind on most of my research and teaching prep.  In the hospital, I can get up at 4 am and get some things done.  But then around 2 pm, I. Am. Done.  And Bridget doesn't willingly take naps anymore.  So I spend a few hours lying in the hospital bed while Bridget lovingly (to her) touches my face and asks me when I'm going to get up.  At home, I try to stay on a normal schedule, but checking her stats throughout the night don't make for a restful night's sleep. Hypervigilance, doncha you know.

And I've gained back nearly all the weight I lost last year, mainly because it takes me a while to recover from her hospital visits.  And by "recover" I mean drink wine and sleep longer.  Neither of those are good for running 1 hour early in the morning.

Finally, and most annoying, I don't have a lot of interest or energy for all the things that used to be so much fun.  Knitting, sewing, and gardening still sound appealing and exciting, but in a distant and remote way.  If I have a few hours free, I'm more likely to take a nap than finish up that sweater I started last April (when I was at a different weight and wouldn't fit now anyway).

So the things that make me feel good about myself:  exercise, teaching/mentoring, working on my research, and my fun stuff have all taken very big hits since Bridget's diagnosis.  I really don't give a crap about cleaning, so there's no "hit" there.  I just live in an exceptionally messy house.

And I don't know when it's going to change.  The big realization from this last hospital trip is that Bridget IS going back to the hospital. Our treatment protocol made massive improvements in her condition.  But she will still need oxygen support at some point in the future.  We're going to start prednisone earlier next time.  And I am (for the first time) enthusiastic about doing that.  But I'm not convinced that with another bad virus, it will still keep her off oxygen support and at best 4 or 5 days in the hospital.

And I want to stress again, Bridget has a chronic illness that is not life threatening.  My brain and my heart cannot even fathom adding in those emotional factors into the equation.  As one Mom in the chronic/critical illness club once told me: "You don't get to quit.  You don't get to sit down on the sidewalk and say I'm done with this. Somebody else take over."

So I guess we just figure it out, eh?  Important: sleep.  Not important:  Clean.  Need to figure out:  exercise, work, hobbies probably in that order for my mental health.

Friday, January 03, 2014

Chronic Illness: The Parents Part I

As I said yesterday, we now know that Bridget’s issues are not life threatening.  But we also now know after this visit that they are likely to be long term (more on that in another post). 

However, we didn't always know what her prognosis was.  It’s emotionally easier now, but it wasn't emotionally easy at all the first two trips to this rodeo.  Or even, for that matter, Christopher’s trip to the hospital. 

When we welcome parents to this club, or actually more like console parents when they reach this club, the first thing I try to share with them is to be gentle on themselves when they start experiencing the PTSD aftershocks.  I know there must be levels to this PTSD: finding out something’s wrong, going to the hospital, finding out something is really, really wrong, and further along the path to hell than that, which we have not gone 

But at every step on that path for us, there has been some hellish moment that I will not forget.

  • ·       Driving Christopher to the hospital for a direct admit from the pediatrician.  I was an exhausted, scared, and completely drained automaton trying to reach Dave in a meeting at work.  Then I remembered it was Wednesday and they serve fried chicken and collard greens at Novant Presby Main and I distinctly recall being a little bit excited about that.  Silver linings kind of girl, you know.  In all fairness, should you be judging me, Dave had the exact same double reactions:  CRAP!  Oh, but fried chicken!
  • ·       Bridget’s first trip to the hospital when the doctor noted her sats were really low, but the machine wasn’t beeping. The doctor’s look of panic sticks with me. The machine had not been hooked up with the hospital’s alarm system yet, a situation soon remedied, which also started a whirlwind of panicked activity from all the available doctors, nurses, and respiratory therapists. 
  • ·       When the doctor told us that Bridget needed to go to PICU.  The funny thing about that one is that she immediately told us Bridget’s life wasn’t in danger, so this moment is not as hellish as it could be, but it is still held in a tender part of my soul.
  • ·       Bridget’s second trip to the hospital where we went to bed at 2 liters of oxygen and woke up with her at 5 liters of oxygen.  I said “Jesus Christ” and not at all in a religious way.  This moment is probably the deepest and scariest one of all.  This is the moment I knew things were very, very bad. By the way, it’s never a good day to have the first words out of your mouth be significant cursing.
  • ·       At the time, it wasn’t scary.  But now, looking back at it, when all (and I mean ALL) the doctors and respiratory therapists were bringing up cystic fibrosis during Bridget’s second trip.  This is the path to hell that we go on the off ramp.  Statistically speaking, we should still be on that path, but Bridget has such an incredibly rare illness that we were blessed enough to the tiny off-shoot.  Plus, you may recall, I kept licking her and she tasted dirty, not salty.


The crazy thing about this is how even just writing about this, I am accessing a very tender, soft, vulnerable, emotional, scary spot in my soul.  I get teary. I get sad.  I process through a little of those feelings---and I know everything is going to be ok!!  Yet, those spots are still there.  And, of course, writing about these moments is going to let me access them. 

So what’s the point of this blog entry?  (That question may have occurred to you earlier, but you can just shut your fried chicken hole!!)  It’s not a pity party, believe it or not.  I would love to help other parents when they get here.  I don’t think we have PTSD, although I do think we have residual stress and adrenaline (in spades), especially when we hear Bridget cough.  I think that’s normal for parents who have been anywhere along this path. It’s ok to be a bit hypervigilant when they get sick again.  It’s ok to get teary months and (I will assume) years after some incident on this path. 


Welcome to this crappy club.  Come over here and get a big hug.  

Thursday, January 02, 2014

Chronic Illness: The Kids

I've been thinking about this post for a while, pretty much since we figured out that what Bridget has is long term and it affects our whole family.

I don't know if I can properly hit the right tone with how this affects us.  Bridget has a chronic illness, but the long term prognosis for her health is very good. This is not cancer.  It is a manageable respiratory problem.  But it appears likely that we are going to be hospitalized frequently.  The doctor rumor mill has suggested that our pulmonologist has already squashed the idea of home oxygen.  Squashed it and decapitated it like a mole under Fred's furry paws.

So it's not cancer, which is a whole other level of hell. Nonetheless, it's still very disruptive and stressful for the whole family.  Since Thanksgiving, Conor has been seriously worried about Bridget having to stay in the hospital on Christmas Eve. I mean, seriously worried.  We assured him that Santa would find Bridget if she was in the hospital.  As an aside, the nurses and docs shared that it WAS PACKED here on Christmas Eve.  Kids were shooting up from ER (or the "ED" as we who are Silver Elite know to call it) until the floor was full and they were putting kids in the observation room.  Fortunately, Santa did find all these children and their families and was extremely generous to them, a fact which still makes me teary.  (Thank you, Hemby Children's Hospital Elves who made that happen)

One afternoon this fall, on the way back from the bus stop, I told Conor that although Bridget has lung problems but she isn't going to die.  He let out a huge sigh, and said "OH GOOD!  I didn't know." That floored me.  When he comes to visit in the hospital and her alarm goes off, he moans, jumps up, and shouts out the number. At home, when we are monitoring her oxygen he gets upset at low numbers.  Even the kids' best friend and neighbor, A, gets upset when she sees low numbers***.

While Conor can at least express fears about Bridget, Christopher is all over the place emotionally.  He alternates from being incredibly smoochy to incredibly angry.  Christopher is not a bad kid.  But he does feel more deeply than most children.  We try to be as sensitive to him as he is to his surroundings.  I'll tell you what, though: that kid can hold a grudge.  Don't cross him because he'll still bring it up years from now. He really misses Bridget and me when we're in the hospital and he shows it by clinging to and ignoring us.  He's kind of a like a cat.  If I come home and find he's peed in my gym bag, I won't be too surprised.  

On our admission night, it was the first time I've ever seen Bridget have some adult emotions about what is going on to her.  She and I had been talking about and really hoping to stay out of the hospital.  The night she was admitted she was very stoic and very tired.  When we finally got to our room, she wanted to potty before she got into bed.  We went in together and shut the door.  It was the first time she had any privacy since we'd gotten to the ER (ED!  Ha!  We're insiders! Um.  Yuck.  We're insiders)

She got very quiet and whispered, "I hope.  I hope.  I hope Daddy comes to see me tomorrow." Her face turned red, she grimaced, her eyes closed and tiny, tiny tears came out of her eyes.  She has never cried about being here.  The only time she cried during a needle stick was when they took a arterial blood gas measure (which makes adults cry).  She looked very much like a tiny adult trying to deal with some real shit.  I gave her a big, big hug until she squeaked "You're hugging me too tight!  I can't pee!!"  And just like an adult who wants to cut a highly emotional moment, she made us both laugh.

That squirrel blows me away.

***Noting that Conor was starting to "take responsibility" for Bridget.  We have had several talks (our own instinct and coached by my colleagues) stressing that it's ok to be upset and concerned but that Daddy and I will ALWAYS take care of Bridget.  We are on top of this, and he can be worried, but he should be a kid.  It works, but we have to keep reminding him.  He's an incredibly empathetic kid.

Wednesday, January 01, 2014

Happy New Year From Team Squirrel....

Moose, Monkey, Kangaroo, and Giraffe!  What?  You didn't know we all had animal names?  

A friend of mine believes that whatever you do on New Year's Eve is what you'll spend the rest of the year doing.  I can guarantee you that on Dec. 31, 2012, none of our activities (which included a boatload of family dancing Gangnam style) suggested how much time we'd spend in the hospital. So I'm hoping Dec, 31, 2013 is just as predictive as Dec. 31, 2012.  We didn't family dance Gangnam style another day in 2013, so let's hope we don't spend another day in the hospital in 2014.

Bridget, despite being in the hospital for going on three days is doing very well.  Again, we started this episode with medical personnel being shocked, SHOCKED I say!, at how good she looked at how crappy of an oxygen level.  I am now considering this as a "data point."  My squirrel is pink, happy, alert, and talkative (!), even when her O2 levels suck out loud. 

And even though we came in at a low O2 (really, not that low--intake was 87% whereas I was seeing her at 84% asleep at home), she IS DOING GREAT!!!  Even when her first night nurse asked if she was "always this bad?" at 3 liters of oxygen  and 94% oxygen and I fairly shouted "THIS IS GREAT!!!! She's not in PICU and she's not on a rebreather.  She's FANTASTIC!!!"

We'll probably be in here 5 days and Dave and I are psyched about that.  Yes, I'm fully aware that other kids who seem much sicker get out quicker than we do.  But for us, 5 days is Bridget's Personal Record in the hospital when she's sick. It's also patently obvious that our treatment protocol for Bridget is working very, very well. We clearly have some room for improvement (maybe?  Will she always have atelectasis when she gets a bad virus and require O2 support?!).  Still, she is doing SO MUCH BETTER than before. Even with a likely 5 day stay in the hospital ((le sigh)).

So let me share with you what it is like to be a frequent flier at the pediatric ward in the hospital, because you are probably lucky enough not to experience it.  You may recall when the Squirrel first came in last April, many people thought they recognized us from Christopher's stay.  When we came back in April, folks were like "weren't you just here?"  Now, CNAs, RNs, and the Child Life specialists just stop by to say Hi! And catch up on how we're doing.  Seriously, it's a little reunion with our support folks and it's nice.  Dave says we are now Silver Elite members.

Even funnier, when the first teeny tiny room we were supposed to be assigned to was still dirty and we were reassigned to a much larger room, there was a not-so-silent cheer among the staff who knew us when we got a "family suite".  Indeed, this room is about the same size as my apartment in Greenwich Village, except there is no loft/bedroom and no fantastic view of the Empire State Building.  

Best of all, when our nurse walked in the room on Tuesday morning, the first thing she said was "Hello, Miss Squirrel!!"  Actually, what I should say is that best of all, when she started listening to Bridget's lungs, she knew exactly what they sound like healthy and what they sound like with atelectasis and immediately called for respiratory.  

Being at  hospital is not great.  Being Silver Elite at the hospital is not great.  But not having to explain every quirky detail of our daughter's illness, being liked by and feeling cared for by the staff, having folks be clearly bowled over by the charm of my daughter, that does not suck.  It's actually nice.

Happy New Year, y'all.  

Thursday, December 05, 2013

Twins' Christmas Pageant

The twins had their Christmas pageant tonight.  Bridget was the "lead angel" and had actual lines.  Lines in which she rehearsed them as "DON'T FREAK OUT!  THERE'S A NEW BABY JESUS!"  While I thought that would have been adorable (i.e, viral) she stuck mostly with telling the shepherds "Don't be afraid!  There's a new savior born, Baby Jesus Chris the Lord.  Go to Jerusalem to find him!"

In the video, she has her back to the camera (must work on the diva moves, and Christopher helps her with her lines....because THEY ARE TWINS.  He took her role very seriously.  She did not.  :-)  He's the Shepherd with the mustache and red head covering.  Adorbs.

I must say, my favorite part of the play is when Bridget is finished with her lines and hamming for the camera. That's the girl we know.




Wednesday, December 04, 2013

Home Use of Our Pulse Oximeter

So here we go.  I've found that Dr. Google does include a lot of information out there on how parents should use, interpret, and/or fret about using a home pulse oximeter (pulse ox) to monitor one's child's oxygen levels.  I'm not professing to be an expert in this area and this is NOT a medical site, but I want to put this out there in the blososphere so that other home users can share what we know about pulse oxs with each other and hopefully get some support.  Here is some general information I've found on Pulse Oximetry at home.  Also, most of the links here will take you to a medical publication or an expert opinion.  I'm happy to add more as you share them.

Because I am a professor, I currently think about oxygen saturation levels (ox sats) as "grades":

97-100%:    A
95-96%:      B
92-94%:     C
90-91%:     D
Less than 90%: F

One might note we are not grading on a curve here.

In any case, my perceptions are that an A or  B is fine.  Everyone wants an A, but a B is perfectly fine.  And even a C is not all that bad, even though, personally, I freak out when Bridget starts hanging around 92%.  It's the D and F grades, however, that need some attention.

HOWEVER, IT'S MORE COMPLICATED THAN THAT.

Here's the tricky part:  To continue the analogy, you have to determine if the grades are a "pop quiz" (not a really big deal) or a "midterm" (which could require some remedial attention).  As a high achieving student (!), I personally don't like any time Bridget gets a 92 or below.  I know I said 92 is a "C" above, but it's borderline and I don't like it.

Still, a dip down to a low pulse ox should not be a cause for alarm.  It's when the sats are persistent that one is supposed to worry.  What does persistent mean?  From what I can tell from talking to my friend, a former respiratory therapist, and our pediatrician there are many criteria.  And honestly, I don't know if they should be considered together or if one is enough.  First, if the ox sats stay below 90 for 5 minutes or more, that's the time one should run like a bunny to the ER.  I've seen some places suggest calling 911.  We live close enough to the hospital not to worry about that.  Also, respiratory rate is important here and a rate above 40 absolutely means get expert medical attention NOW.

So that's the worst case scenario.  What about the others?  Here's where I get confused.  My pediatrician says that if my daughter's ox sat hovers around 91 but occasionally (or frequently) moves up to 92, that's ok.  I don't feel like that's ok.  We haven't had that scenario yet, but I'm thinking that must mean it is really and truly time for oral prednisone, but probably not oxygen.

The more common scenario we've had is that Bridget dips down to 91 (or 89 or 8-freakin-6), but then bounces back up to 93 or 94.  It's really hard not to panic when that happens.  In fact, the first time we saw 86 is when we went to the ER, where she subsequently stayed at 99% for our whole visit.  One cool thing is that our new pulse ox has an alarm on it that you can silence for 30 seconds.  So I now know if I silence it 8 to 10 times, it's time to worry.

Also, now what I would do with a low number like (whether she was awake or asleep), I'd switch fingers to see if there was something funky with that finger (we often get lower readings on her index as opposed to her middle finger), and I'd likely use our old pulse ox  to see if we were also getting the same reading.

Home pulse oxs have an accuracy rating of +/- 2%.  And while both of ours have tracked with the ones at the hospital and doctor's offices, they still sometimes don't always agree with each other.  So, if we were getting really low readings on one, I'd like to see if the other one has a similar score.  Also, I no longer freak out if one has a low reading and the other one is high, because it's apparently very difficult to get a false high number---the pulse ox can't report more O2 than is actually in the blood.

So that is what I know.  Persistent 91 or below on multiple fingers with multiple pulse oximters requires some attention.  I am open to learning more and sharing it here.  Note this is also for children only.  I know squat about adults, but I'll include that information here, too, if anyone is interested.  I'm also hoping this keeps us out of the hospital and off oral steroids for good.  Here's hoping it helps you, too.  

Update #1: Some insurance companies will pay for a home pulse oximeter.  It sounds like it could be a useful avenue to explore.

Saturday, November 30, 2013

Words I am afraid I will forget

Bemember, you can't put your nernaid in your pookpag.  She lives in water and you can't put water in your pookpag when its your back.

Thursday, November 14, 2013

Parental PTSD Part 753

So, I'm chatty today.  I've gotta get this out somehow.

So, um, yeah.  PTSD from a child's illness.  It's a thing.  It's nice to have some validation, but it's not a surprise to anyone who has had a child whose been in the hospital.

Here is where we are with that, based on yesterday's hospitalization.

1)  The beep of the pulse oximeter alarm. Ugh.  I forget about it until I hear it.  And because there are a lot of children in the peds ward with respiratory illnesses, I heard it almost as soon as we got there.  It's a punch in the stomach that I can do without.

2)  Fortunately, Bridget did not have any alarms go off, but the child beside of us did. And every time it went off, I could imagine the parent in there straining his/her head to look at the number on the alarm and praying that it stops, the number goes up, or the nurse to arrive and up the O2 level. It's not fun.

3)  As soon as we got home today, I went into vacuum cleaner mode, eating every piece of high fat and/or salty food I could find as well as wondering if 11:30 am is too early to open a bottle of wine and drink by myself.

The good news about this trip with Bridget is that what we are doing is working.  They did an X-ray and she did not have any atelectasis.  YAY!  She did have junk spread around her lungs but nothing like what happened in June.  So Yay!  Yay!  Yay!

An ever so slight boo in that I realized as we left that we don't know where we are in this virus's progression, and, thus, where we are in her mucus-y lungs:  beginning, middle, or end?  My vote, along the lines of Churchill:  "Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning."

Blergh.  At least Dave is home now and we can open up that wine.  

Well, This has been an Interesting Week

I am exhausted.  And by "exhausted", I mean that the bags under my eyes have exceeded their two carry-on limit and my head is about to collapse forward on the keyboard so I can take a quick nap.

EXPECT ANOTHER WITTY BLOG ENTRY!!

So what the heck happened?!?!?!?

Bridget started her cough on Saturday morning and we started the hypertonic saline treatment and everything (i.e., her oxygen saturation levels) were fine and dandy.

Then Monday night, while she was going to sleep we had enough funky readings to start her shaky vest Tuesday morning.  But all was fine at school and before bed Tuesday morning.

Then Wednesday morning at 4 am, she woke up coughing.  Dave and I felt around the dark in the bed trying to find the pulse oximeter (I had put them in my pajama bottoms thinking--in my sleep--that was a good idea), we checked her O2 levels, which were stable but around hanging around 90-92.  These are not good levels.  We asked her and she agreed to do a shaky vest at 4:15 am.  Her O2 got back up to 97.

Yay!

We went back to bed.  And while they started to nod off, I noticed the numbers started slowly slipping back down to about 91 but stable.  That isn't a great number, but it's a number I can wait to see the doctor in the morning.  I got up to do some work.  I came back in to check on her and she was steady at 88.

88 is bad.  Not brain damage bad.  But 88 is the level my RTs (respiratory therapists) say you really need to start oxygen.  Of course, I have mom/RT mentors (cough, cough, Liz, thank you) who have taught me there is a difference between hanging at a bad number (bad) and dipping to a bad number (OK and probably normal).  I watched Bridget.  I sat down beside Bridget.  She slept soundly for at least a few minutes ad her numbers held steady at 88.  I went to tell Dave downstairs that she was 88.  I came back to the room and she was 86.

Crap-Effing-Shite.

I threw on my clothes, came back to her, and she was back up to 88.  I grabbed her and told her we were going to the hospital.  When she was getting her coat on, Dave said she was back up to 94.  I didn't really care because that 88 scenario was playing in my head.

We got to the hospital. I told them the story.  And they hooked her up to the pulse ox in ER.  She was 100% O2 saturation.  What the fuckity fuck?  I told the nurse everything, she was supportive.  I told the doctor everything and he thought I was an idiot.  (I'm not)  He also said "Well, it looks like she might have an ear infection."  (She doesn't).  I asked the nurse if we could just let her calm down for a few minutes and see if we can get her O2 to do what it had just done 20 minutes ago.  She said Yes, and turned off the lights.  One minute, the doctor walked in, turned ON the lights, had the nurse give us a ginormous dose of oral prednisone, and told us it was time to go.  Neither the nurse nor I were amused.  REALLY!?  REALLLLLLLLY!?  I just told you she was at 86-88 O2 and you think I am so stupid that I'm in an out of  ER in 45 minutes?!?!?!

We get back home and within, I don't know, 30 minutes, Bridget was back to 92-94 O2.

I talked to our various pediatricians, pulminologists, and w(h)ine partakers and thought we'd give it a bit of time to see if the prednisone worked before we did anything.  I also told our ped there was no way in H-E-Double-Hockey sticks I was going back to ER.  If there was a problem, I wanted a direct admit from the pediatrician's office.

I *KNOW* ER docs see a lot of stupid people.  I know that.  I also know that at 6 a.m. in my comfy and old pants and sweater with no makeup and graying temples, you would be surprised to learn that I am not as dumb as I look.  (Or as old:  Thank you ER doc for asking if I was mom and then joking about me looking like the Grandma.  Actually, suck it, you old poop*).

ANYHOO, we/I/someone decided to see what would happen during Bridget's nap with her O2 levels and we'd decide then if anything needed to be done.

Her nap was fine.  She had one dip down to 93, but for the most part, she was hanging between 94 and 96.  Not bad numbers and certainly not worth going to the hospital.  So when she woke up, I called the pediatrician to give an update and ask about the antibiotics for the ear infection I knew didn't exist**.

While I was on hold, in my (mother) mind, all hell broke loose.  Bridget started coughing crazily, and her number dove to about 90-92 with no upticks.  I was on hold for 6 minutes and it stayed at that level the whole time.  I say "mother mind" because I've also developed a "nurse mind" on oxygen sats and may not have been so worried about that.  But Mama mind freaked.  I got in to see the doctor right away, carrying BOTH our home pulse oximeters with us to see how they compared with the doctor's office.  Bridget stayed at that level the whole time over.

We got in quickly and they immediately hooked her up--92 O2, consistent and stable.  My pulse ox was actually registering a little higher than theirs, which freaked me out even more.  Nonetheless, this whole experience was starting to seem an awful lot like what we had seen before.  So our pediatrician called in a direct admission.

I call Dave.  I get to the hospital.  They check us in.  And WOULDN'T YOU KNOW:  she immediately registered a 100% ox saturation and pretty much stayed between 97 and 99 for the next 16 hours--until we were discharged. And WOULDN'T YOU KNOW, both of our pulse ox's registered either the same number or 1 off the hospital's pulse oximeter the whole time, too.  In fact, we had one de-sat on the hospital pulse ox, but I told the nurse that OUR pulse ox stayed at 98 the whole time so I didn't believe it.  She agreed.

What the fuckity fuck, part II?

So I felt very over-reactive to have gone to the pediatrician and freaked out, although she absolved me by saying this was a team decision.  Dave gave me the best absolution for spending the night in the hospital unnecessarily by saying the alternative--her desatting in her sleep overnight at home--would have been much, much worse.

Still.  I have decided that I'm going to write a post on what I've learned about how to use a home pulse oximeter that will hopefully be helpful to others.  I'll link to it once it's done and I'll update it when I hopefully hear from others.  These devices are getting more common but there is precious little info on how the lay person should effectively use them and when to freak out and when to wait another hour.

Meanwhile, I'm trying to figure out what day it is, where we are, and if Bridget's current cough scare is at the beginning, the middle, or the end.  I am pooped.

*I get saltier when I am this tired.
**I didn't tell any of the doctors about his diagnosis, and everyone else commented how nice BOTH of her ears looked.

Monday, November 11, 2013

Camping with the cautiously pessimistic

We had a blast camping at the beach in relatively chilly weather.  I am freaking exhausted, but I have a very busy week coming up, so this exhausted blog update will have to do.

First:  cold camping is not nearly as bad as I thought it would be.  Granted, we were only down to the upper 30s, but it was not the uncomfortable pain and crying I thought it would be.  (And seriously, I'm talking about myself, not the twins.  Or Dave.)

By the second morning, waking up at 48 degrees (and calm winds) was comfortable enough to not wear a jacket.  I'll be honest though:  waking up the 3rd day at 48 degrees and strong winds was freakin' ash cold.  Brrrrrr.

Also, I just really love camping.  This was our first group camping with about 6 families and three flocks of children of youngish, mid-elementary, and teens ages who all hung out and played with each other and impressed this adult with their conversation.  My strategy with kids--including college age ones--is to let my freak flag fly. They find that interesting enough to talk with me and sometimes even "hang out."  I figure their parents will figure it out soon enough (i.e., I'm not a normal adult), and I might as well cut to the chase and get to know the interesting kids quicker.

As for the Cautiously Pessimistic:  that is how I describe myself with Bridget.  The phrase I'm supposed to use is:  Cautiously Optimistic, meaning that I should think good things are going to happen, but I'm not going to get too excited about it.  I, on the other hand, am cautiously pessimistic:  I'm pretty sure bad things will happen, but perhaps it will be better than I think.

So, one of our neighbor children got a really bad cough two weeks ago.  Then Conor got the same cough a week ago.  And Dave and I have been hovering over the twins for the last week waiting to see if they would cough and we would need to cancel the trip.  Hooray, they did not!!!

Until Saturday morning, when both woke up with some serious snotty noses and wet coughs. Saturday was actually fine and not so many coughs.  More coughs Saturday night and Sunday during the day and substantial coughs last night and pretty much ongoing for Bridget today.

So was it sleeping in the cold or the onset of this crappy ass cold/cough that is going around?  I vote cold.  But I'm not sure it matters.  Bridget's numbers have generally been good until today.  She's asleep right now bouncing between 95 and 96.  Those are not bad numbers.

But, you know, I'm cautiously pessimistic.  So we'll see.

UPDATE Continuing on the cautious PESSIMISM: last night were Bridget's worst continuous numbers we've seen out of the hospital, but I will CAUTIOUSLY add that they were clearly better than the hospital numbers because we'd have gone last night. In any case, this cold is the real deal. We'll see how she handles it.  I did a mild amount of chest PT overnight to help her out.  Starting the shaky vest this morning.    It's amazing how much the coughing helps get a 92 to a 96, which is a very, very good thing.

Monday, October 14, 2013

Faculty Coach Follow Up

That was a lot of fun.  As Dave and I sat on the porch having a glass of wine/beer (as the case may be) on late Saturday afternoon, I told Dave that was one of the best days of my life.

He cut me some serious side eye, so I clarified.  It was not as good a day as marrying him or having Conor or bringing the twins home from the hospital.  But it was up there with going to the Mondrian Hotel, getting into the Skybar and drinking the Dom Perignon that Grant Hill had bought for my friend and me, or having our wedding announced in the NY Times.

We felt special and it was fun.  As we were doing laps around the field before the game, we saw some of my students who called out to me.  Definite highlight.  We saw and talked to Wilson from a huge variety of media around Charlotte.  We ate dinner Friday night with extremely polite players of the team and Conor watched most of Iron Man 3 with them beforehand.  (The twins were watching the Lorax on my iPad, but the scenes in the movie were too much for them and we left)

Yes, it would have been more fun if we had beaten UNC Pembroke.  I had no idea beforehand that Pembroke was doing really well this year, so. Booooo.

But it doesn't matter. I'm still in love with Football at UNC Charlotte.  As soon as I can figure out why my computer is blocking me out of the my pictures file because I don't have enough "permission" (?!), I'll post some of our fantastic pictures from the day.

We're still a bit pooped from this weekend.  I have no idea how the players and coaches do it.

Niner nation, y'all!  Go enjoy yourself some UNC Charlotte Football love.

Friday, October 11, 2013

Faculty Football Coach for the 49ers

So this is the personal account of being chosen as the guest Faculty Coach for the first homecoming football game for the UNC Charlotte 49ers.  You can read my professional thoughts about football at UNC Charlotte here.

The gist of my reaction?!  IT'S SO FLUFFY!!!

I am not cool and I'm not going to pretend I'm cool.  I am so excited about this!  The kids are practically vibrating and levitating they are so excited about it!  Even Dave is a bit keyed up, in his own Midwestern way.

So here's the scoop:  earlier in the semester, an email went out describing an honorary "faculty coach" position for each of the home football games for our inaugural football program.  I, along with several hundred other faculty, volunteered.

Imagine my surprise and IT'S SO FLUFFY delight when I found out Tuesday, I'd been chosen for the upcoming game. WOOHOO!!!

On Tuesday afternoon, I took a tour of the Judy Rose Football Center along with the other faculty coach.  Then I picked up Conor at the bus stop (in Myers Park), surprised him with the news, and ZOOMED back to the football practice fields at the University to watch the team practice.

It was way cool.  We talked to Coach Lambert (the head coach) for a bit.  We watched the players do the things the players do when they practice.  We learned about how we are modeling ourselves after UT San Antonio, another university in a big town that is successfully starting up a football program, and we generally felt pretty special.  Conor, taking after me, was completely uninhibited in showing his delight in being on the practice fields.  He was thrilled when the head coach high fived him.  When one of the players said "Hi!" to him, he swooned.

We are not cool people and it is not our aspiration to be such.

Tonight (Friday), the whole family is going to watch a movie with the football team at the Student Union. (Who knew the Student Union had a cinema?!) And then we will eat dinner with the team at the main student dining hall.  Tomorrow, we watch the team do their "traditional" 9:49 walk down the sidewalk to the stadium and then watch the game, cheer, and otherwise feel pretty darn special.  We also have some pre-game field passes that we are looking forward to using.

It's going to be a long, fun Friday night and Saturday.  And I have no doubt the twinnies are going to have a few meltdowns.  But IT'S SO FLUFFY!!

Faculty, compared to employees in larger for-profit corporations, get so few perks in our work lives.  No one tries to woo us with free tickets to the Panthers, Bobcats, Wells Fargo Golf Championship.  We don't get free cookies/popcorn/muffins from the insurance brokers or other sales people trying to win our business.  Free coffee from the student honor's club is rare enough (once ever that I can remember?!) that it gets faculty worked up and in a happy mood, even if it is stale and cooled off by the time we find out about it. Leftover bagels from a dissertation defense is still worth an email to all the faculty.

But THIS.  THIS EVENT Freaking ROCKS.  And the kids think I am an extra-special, cool mom for getting this honor.  Indeed, Bridget stood up on her chair and shouted YOU ARE SO ROCKING ON!!! at dinner on Tuesday night.  I don't mind being the hero to the kids.

I am psyched about this.  I even dreamed about it last night.  The game is on local TV this weekend.  Look for me, the middle aged, overly excited professor in green cheering on the team and being thrilled about being a 49er.

Monday, October 07, 2013

Handling It

Apparently, we are handling it.  "It" being Bridget's atypical asthma with hypersecrtion (aka, wet asthma).  We finally visited the real expert in the pediatrics pulminology field today and come some more words for me to search on.  They are good words and I have already found a few things.  The good news, all signs continue to point to Bridget's problem as isolated from a variety uhderlying causes of autoimmune, structure, reflux, allergy problems and most importantly, cystic fibrosis.  We can pursue these avenues if we want and we may, for peace of mind, but nothing indicates a that her asthma is a bigger problem than "asthma."

It was kind of cool to discuss the other issues and get a reasoned response on allergies, reflux, CF, etc explaining to me why he didn't think it was these causes.  It was really logical, explained kindly, and nice to be respected.

And the good news is that although we are getting some pretty crap ass O2 sats---87 on a check this morning--I can get her back up to 94 with her shaky vest.  (87 sucks for O2 in case you were wondering)

So the marching orders are:  keep do what we're doing. Start the shaky vest earlier; we waited a few days this time.  If/when RSV goes around daycare, keep her home.  If her sats go down, but we can get them back up, yay!  If her sats go down and we can't (i.e., hanging in the 80s) go to the hospital.

Of course, I am also exhausted because some lost soul ended up outside our house at 2:45 screaming for help and that he wanted to go home.  I don't want to sound heartless, but he sounded pretty whacked out and violent.  In fact, Dave and I think that his friends  must have dumped him out in the neighborhood because if he'd walked from the main drag, he could have easily gotten help without scaring the bejeesus out of everyone.

Also, I think I woke up slightly before Dave when he first started ranting and thought I heard him say something like "I've got a gun!" and something else to do with his head. He may not have and Dave didn't hear it and I know enough about eyewitness testimony (and how much it sucks) to doubt what I heard was accurate.  That said, it is exactly what I believed I heard when I ran down to get the phone and OH MY GOD(DESS) I was shaking so hard I could barely dial.

When we got back upstairs, the twins asked what was going on.  We told them a man needed help and the police were going to help him.  I asked Bridget if she heard what he said and she replied, "Yeah! He was freaking out!!!"

Also: I hate boys.  Christopher and Dave fell back asleep almost immediately. Bridget and I lay awake for a while, kissing and snuggling and calming each other down.  Her O2 sats were 99.  What?  You don't think I'd check them!?


Sunday, October 06, 2013

The Ways of the Interwebs Announcement Gods

All it took was me writing on Facebook some version of "It looks like we're going to skip the hospital with this cold" to have to make the decision twice in one day, when the numbers were looking really bad, whether to go to the hospital or not.

We decided No and there are a couple of reasons for this.

1) We made the conscious decision to see if we can keep Bridge off prednisone AND out of the hospital.  So we decided in the morning that we wouldn't even go to the sick clinic at the peds with the first bought of low numbers. They wouldn't have put her in the hospital but they would have put her on prednisone and that would be 4 doses in 8 months.

Oh! Wait a sec.  Why did we even get worried in the morning? Bridget woke up at scale 11.  You live life on an energy basis of 1 to 10.  Bridget lives at 11.  All the time. Constantly.  As soon as she wakes up until she falls asleep.  Or actually, until her numbers start to tank a bit.  But sometimes not even then.

It was time for her treatment, she was at running around at ll, and I convinced her to stop for a sec on the sofa to "read her finger" as we put it.  (And sometimes, she gives me the right finger to read. Nod. Nod. Wink. Wink)  It started at 93 and then went down.

93 is not an O2 number that makes me happy.  But going down makes me less so.

2)  Thank goodness for my Mom mentor who is/was a respiratory therapist, Liz, to help us through this.  Liz and I "met" through Salon.com's blogs 11 years ago.  We've kept in touch through blogs, Facebook, and twitter and no, we haven't even met "in person."  I don't know though. I feel like after knowing someone for 11 years and following their lives and ups and downs and day-to-day experiences more closely than I do some of my neighbors, I consider her Someone I Really Know, and clearly someone close enough to start IMing and texting about what was going on.  She gave us more info to look for, clear "go to hospital" criteria, and Bridget's numbers came back up after treatment.

They came up and stayed up at really fine numbers, until night time--after most of her treatments and while we were watching the family movies.  And then they tanked hard for *us*.  She was between 91 and 88 for 5 minutes. I packed a bag for the hospital and Dave realized we hadn't done the shaky vest.  We did the shaky vest. She figuratively showed us which finger we could measure from now on.  And her numbers came up to a fine 97.  Monitoring overnight, she was often at 99.

3) So here's what we think is going on.  I think we are handling this cold at home.  She's got stuff moving around her lungs and occasionally it clogs up some portion or another of her lungs before she gets it ALL the way out.  (Happened like that at the hospital)  That's when we get the bad numbers. But then she moves it up and out and she's doing better.

I don't know if we'll always be doing this "well."  I can foresee a really bad cold that gets ahead of us on moving the junk out of her lungs, but I think we can do this for the most part.

I will tell you of two new stress signs I've developed. One is a need for more sleep.  And I mean massively more amounts of sleep.  The second is that it's harder to focus on recreational activities.  I cannot run for crap lately and it's because I can't keep myself focused enough to use my good tricks when it gets tough.  It'll be fine though.

Once Bridget's cold regimen becomes the new normal, it won't be so hard to just do it and take all her numbers in stride, until we shouldn't.

But I should stop tempting the gods by making proclamations that everything is ok and we've got a handle on this!!

Friday, October 04, 2013

Chronic Squirrel

We're starting to figure out what life in the near term is going to be with an energetic, rambunctious, lives life-at-11 girl whose lungs fill up with gunk when she gets even a mild cold.

The first cold in August occurred during her "well-visit" and the doctor was concerned enough about the wheezing she heard to give Bridget prednisone.  It cleared her up in 12 hours. Yay!!  Third round of prednisone since April....BOOOO.

Sunday morning, Bridget woke up with that croupy cough every parent knows so well.  For most folks, it would just signal a cold coming up.  And for the  most part, that's what we've had.  Except for a couple of hours in  the late afternoon and early evening in which her O2 stays around 93 with a few dips down to the upper 80s.  It hasn't stayed there long enough for us to go to the hospital, but it stays in the low 90s long enough for me to sleep with Bridget with her monitor on until it stabilizes at 95 or above.

ALSO, I have turned into an automatic night monitoring machine, waking up every hour or so to fish around the bed for the pulse ox, find it, read it, be reassured and go back to sleep.

HOWEVER, 98 and 89 look awfully similar when they are upset down and you are half asleep.

ADRENALINE, BABY!

Dave and I are both trying to figure out how to negotiate our career ambitions with a child with a chronic illness.  So far, we're not back in the hospital.  Yay!  But I find it hard to make long or short term plans when I'm pretty sure I'm going to spend part of the day putting together little piles of food and medicine and tea (I really like tea in the hospital) in case I need to throw them together to run out of the house.  Or to direct Dave to gather together if B and I are already there.

I know it's all going to be fine.  And next year at this time, we'll know SO MUCH MORE about how to handle all of this and when to worry and when to let it ride.

It all gets better. Sometimes it gets worse.  But it gets better.  Eventually.

I'm tired.  I can wake up 5 times a night to monitor B, but I can't really write as witty a blog afterwards.

Thursday, August 29, 2013

Scatological Lesson

From our family to yours:

You should not toot while walking up the stairs.  Because if you realize at the top that you left something at the bottom, you will essentially end up tooting in your own face.

You are welcome.

Monday, August 26, 2013

Ack! Phht! Phht! Ack!!

Well, that's a descriptive title. But it pretty much sums up my feelings in the aftermath of a (new) doctor's visit today.

The twins were supposed to have their 4 year old well visit today, but I essentially waited to schedule it until they were healthy , and the only opening was 4 years and 2 months.  UNFORTUNATELY, the appointment was at 9 and I thought it was at 3.  Whoops.  So they missed their well visit.  No big whoop-dee-do. We can reschedule.

Except Christopher had that 103 fever 10 days ago?  Which developed into nothing?  And then developed into a cold?  And then he woke up with his "asthma cough" as we call it, yesterday morning and today.

OK.  Still no problem.  His oxygen sats are fine.  It's the Squirrel that concerns us.  We've got his treatment regimen down pat.  But so far, the path seems to be: when he gets asthma symptoms, she goes to the hospital.

So we wanted to see our doctor just to get on her radar that our journey down the path? It has started.

Well, our doctor is very popular and was fully booked when we showed up at the wrong appointment time.  So, instead we saw Doogie Howser, the new doc in the clinic.  Remember how I wish I had that "I Know Stuff" button when I go to the doctor's office?  It's even more the case when the doc is new and not familiar with one's family or the particulars of one squirrelly Squirrel.

So what did we learn today? Since I am always LOOKING FOR THE FREAKIN' BRIGHT SIDE, this is what we learned:

*Do not use the term "atypical asthma."  Use "atypical reactive airway disease."  It's the same dadgum thing, but medical professionals get stuck on the asthma part and forget to focus on the more important atypical qualifier.
*Throw in "albuterol insensitive" as soon as they start talking about treatments.
*She presents "like cystic fibrosis" gets more attention than she presents with atelectasis.

And Dave made this suggestion:  Doctor's are told that if they hear hoofbeats, look for horses, not zebras.  I appreciate that.  However, we are dealing with elands here and helping them understand that sooner rather than later reduces my need for an extra anti-anxiety medication.

Bleargh.