We avoided a hospitalization by the skin of our teeth last night. We actually went to the MUSC Emergency Room and walked in just as the new year was being celebrated on the east coast of the US. It was exactly 11:59 when the nurse took Caden back for triage.
The week began with most everyone in our house having congestion. Riley and JJ seemed to be getting the worse of it and then it hit Caden. We took Caden to the pediatrician for the first time on Wednesday. They doctor gave Caden a rocephin shot and prescribed an oral antibiotic (Omniceph). The doctor ordered a chest x-ray to look for pneumonia and recommended that Caden be on oxygen when sleeping to keep his SATS in the 90s. He asked us to come back the following day to see how Caden was progressing. We went to MUSC to get a chest x-ray and then went home.
Caden did okay over night but did require lots of suctioning and did need 2 liters/minute of oxygen via a cannula to keep his SATs in the 90s. The next day (New Years Eve) we started off early with the follow up pediatrician visit. Caden’s SATs while awake wee a little worse and the doctor was concerned about a little noise he was hearing in Caden’s lungs. We did a couple of breathing treatments in the doctor’s office and gave Caden an oral steroid. The doctor gave Caden a second round of Rocephin shots and ordered a z-pak (Zithromicin) as a second oral antibiotic. He also recommended that we continue breathing treatments at home along with chest CPT which is a physical therapy treatment to help release secretions from the lungs. We spent nearly two hours in the pediatrician’s office and he flat out told us that if we were anyone else he would be sending us straight to the hospital. Given the fact that we have oxygen and a pulsoxometer sp?at home and a proven history of providing outstanding care for Caden he felt comfortable with sending Caden home with the stipulation that we agreed to take Caden to the ER if things did not begin to improve later in the day.
Things did improve later in the day. Caden played without oxygen and kept his sats well in the 90s. His energy level was great and even got his color back by mid afternoon. Sherry went out for a while with her niece Kat. When she returned she noticed how much better Caden looked and acted. The remainder of the evening was pretty non eventful up until Caden went to bed.
It wasn’t long after Caden went to bed that his O2 meter alarm started screaming. Sherry tried moving the probe to a different finger and we increased the oxygen. Nothing was helping as Caden’s SATs sank into the low to mid 80s. Keep in mind that even though Caden has had multiple heart surgeries his heart defects did not cause low O2 SATs. With his heart repairs his heart move blood as well as any of the rest of us and his SATs are normally 97-100.
After an hour plus of fighting the SATs Sherry and I realized that Caden’s nose was too clogged to let the oxygen get through. Caden was doing a lot of mouth breathing and even though the oxygen was cranked up pretty high we did not have a mask to replace the cannula. We both agreed that we would not be able to keep his SATs above 85 with the equipment we had. We called the pediatrician and asked them to call ahead to MUSC to give them a heads up that we were coming. We decided that we could transport Caden without an ambulance since his SATs stayed up when he was awake. We don;t have a nay portable oxygen tanks but rather only have one of those big bulky machines that makes oxygen and must be plugged in to work. It cdoes no good for a car ride. Once I told Caden we were going to the hospital he sprang up like a jack in the box. He loves the hospital because he generally gets to watch way more videos and TV there because there is absolutely nothing else to do.
I left the house between 11 and 11:30 with bags packed fully expecting to have Caden admitted to the hospital. The ER docs don’t know us like the pediatrician and are much less inclined to let a child go home on oxygen. We got there and Caden’s SATs on their equipment showed exactly what we saw at home. They went ahead and put him on oxygen and get him up to the mid 90s. I told them that once he went to sleep he would dip into the low to mid 80s so they asked that I try to get him to sleep which is no small task in a hospital ER room with all the monitors beeping and blinking. It was near 2AM when I got him to sleep and he started dipping into the low 80s just like at home. They switched him to a mask an his SATs came right back up into the mid 90s. However the mask by design requires twice the amount of oxygen flow to make it work properly. That concerned the ER docs since they don’t like a kid going home on O2 especially this amount. I asked them what else the would be don’t for Caden that we could not di at home with this mask. They agreed that nothing more would likey be done but they still did not feel comfortable making the call to let Caden go home so they called Caden’s pulmonologist. This did not excite me too much either as the pulmonologist have been fairly conservative with Caden.
It was about 5:30 am when the call came. The pulmonologist said that he was okay with Caden going home with a oxygem mask at the higher rate of flow. The mask is what requires the higher flow rate and not Caden’s condition. Had Caden’s nose no been clogged he would have probably been find on 1-2 liters of oxygen via a cannula. That said Caden and I headed home with a mask in hand.  We arrive home at about 6am and immediately went back to bed.
Caden continues to do okay today and is able to play without oxygen and still keep his SATs in the 92-94 range. We are hoping and praying for this head cold to clear up very soon. Your continued prayers for Caden and our family are greatly appreciated.
Happy New Year!!!