In the end, we did go to the emergency room, and a very good thing too. As I said in the postscript to my last blog post, E2 got me back up again around 3.15am (though I say she “got me up”, I had yet to actually sleep) and, this time, she was having to work very, very hard to breathe. She was asking for milk, but what she really needed was an immediate breathing treatment, and I carried her straight downstairs to set it up.
The medicine is a strong stimulant — this is what forces the airways open again — and the result is almost always a burst of activity, as if she’s suddenly ingested four cups of strong coffee. It’s hard to judge her breathing at this point — I have to wait until she’s calmed down a bit to get a true idea of whether the treatment has worked. She ran around until around 4am, and then slowed and I could begin to see… and I just wasn’t happy with what I saw.
She was still working to breathe — less than before, for sure, but still visibly working. And that meant it was probably time to go to the emergency room. But… I wasn’t sure. It was 4am, I hadn’t had much sleep for nights on end and no sleep that night at all, I was exhausted… it was chucking down rain and cold, and dark, and hospital has recently moved to a new location which I don’t know that well… I thought of my other daughter, fast asleep in her bed upstairs… I wasn’t sure what to do. She was working for the breath but… was it that bad? Or was it just the usual struggle from having a cold? I couldn’t decide.
I woke M from his deep sleep and made him watch her breathe. He wasn’t sure either. She was so happy and lively in herself, smiling at her daddy, but still… there was that rasping, the belly working with each breath, a slight collapse at the base of the neck… “Mmmm… ” he weighed it up, “I think she’s ok. Let’s just wait a bit and see.”
I agreed, relieved to share the burden of the decision. “But I don’t want to put her in her room. I want her to sleep here with us.” It was a sign of his true uneasiness that he agreed immediately — he has always been adamantly against the girls sleeping in our bed.
She didn’t sleep. She tossed and turned, and sang, and played with her daddy’s ears and his nose, and smacked me gently on the face. So exhausted was I that I managed to slip into blessed unconsciousness even still, and so grabbed my only sleep of the night — about 30 minutes. But when I came to again, there was no question — she was not getting better. I rang the doctor’s office — it was now about 5am. The nurse on call listened to my description and then said, “You know what I’m going to say, don’t you?” I did. “I’ll ring ahead to let them know you’ll be coming…”
Poor E1 sat up with a start start when I rudely flicked on the light, and she blurted out in confusion, “What’s… what’s going on?!?” I told her we were going to hospital and I needed her to get up, use the toilet, and get dressed. My recognised my tone and followed the orders without complaint. But when her knickers wouldn’t cooperate, the sleeiness got the better of her and she faltered. “Mummy, I think I might cry…” Big eyes, wobbling lip. I fixed the knickers, gave her a squeeze and a big kiss, and she composed herself again and carried on — so exactly the big girl I needed her to be at that moment.
I rang my mother and asked her to meet us at the hospital, then grabbed a change of clothes and whatever food I could find — breakfast would be corn muffins and leftover pasta with garlic-tomato sauce — and bundled everything and everyone in the car.
I took a wrong turn in the dark and got lost in the city, then found my way again, then took another wrong turn and got lost again. “Sweetheart, are you ok?” I called out every few seconds, and she’d squeak a small sound in reply. I barked at E1, “Watch her! Watch her breathe! Is she breathing?” This time, the nurse had not suggested an ambulance. And we’d made the trip every time before in the car so I just hadn’t thought… Oh, why hadn’t I called an ambulance?!? I turned left… found it was a road I recognised, worked out the way to the hospital, and gunned it.
She didn’t respond to the first treatment, even after a full hour. The wheezing continued, the effort with every breath still painfully apparent. And, more worryingly, even the stimulant no longer perked her up much — she laid on the hospital bed, listless in a little blue gown covered in dinosaurs. They tried another treatment, with a different medicine and, thankfully, that one. She began to breathe more easily and her eyes brightened. We stayed another hour for observation, and then we were released, and left feeling disorientated, surprised to find that it was lunchtime.
The doctor had asked me — no, ordered — to take her for a follow-up the next morning. He was adamant that he did not want it delayed until after the weekend. But when we arrived, the pediatrician was running behind, and we sat in the waiting room for over an hour, surrounded by all the other children who also so sick that they couldn’t wait for Monday. One mother, her arm around a bleary-eyed, coughing girl, told the woman next to her that 300 children had been out that week from her daughter’s school with suspected or confirmed swine flu. I made E2 put her book down, and slipped into the bathroom to wash her hands.
The doctor’s eyes went immediately to E2’s chest and belly, from the moment she walked in the room. “She’s working for it now, isn’t she?” she observed before we’d even begun. “She needs a treatment now. We could do it here… but, no, that will cost you. How far are you from home?” Ten minutes, I told her, and we agreed we could do the treatment the minute we got home.
I like this doctor very much — she is gentle and respectful with my daughters, shows them all the instruments before she uses them, and sings a quiet and soothing song as she examines them. More importantly, she genuinely understands that I am generally hesitant to resort to medication, because she is of the same persuasion herself. So when she suggested at our previous appointment (that is, after the last breathing-trouble run to ER) that perhaps we should consider giving E2 a nebulised steroid treatment — daily steroid, for the next six months — my initial gut instinct to reject the idea was tempered by the knowledge that she wouldn’t be suggesting it if the situation weren’t really that serious. And yet… and yet, I couldn’t hide my revulsion. “Think about it for awhile,” she had said, writing the prescription. “Pick up the medicine from the pharmacy… Maybe discuss it with the allergist too. But the way she goes down so fast… I think we might need to do something to help her get on top of this, for the future.” And now the doctor brought the subject up again, suggesting in her gentle manner thatperhaps we should be using that daily steroid treatment — and this time I had to agree with her. It all gets so critical so quickly with E2… It’s dangerous to carry on like this.
I asked about swine flu: could the girls be vaccinated, given their egg allergies? No, but M and I can. In fact — she pointed her pen at me, concern on her face — we probably should be as soon as possible. With E2’s history… She didn’t finish her thought, but I understood. I have no doubt that if this child contracts swine flu, it will not be the “mild case” that we’re told most people get. I will be that mother praying fervently, with her forehead resting on the edge of a hospital bed, next to the child fighting for her life. I need to register the two of us with a doctor — or perhaps ring the allergist — and hope my explanation of the situation is enough to persuade him or her to bend the rules and give the two of us the H1N1 vaccine.
But for now, sat here at the computer and up far too late again, I am just counting my blessings — grateful that we made it to the hospital in time, and that my daughter responded to the treatments at last, and that tonight she is sleeping peacefully upstairs… her little chest rising and falling gently in the dark. The last few days have been exhausting, draining. Tackling the next hurdle can wait until tomorrow.
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