The Ups and Downs of the Teaching Hospital

IMG_20130915_064017The hospital the kids go to for their CF is a teaching hospital. It always has been.

There have been many times we’ve gone to clinic and met new residents or fellows that were learning the craft from our top-notch pulmonologist.

Some don’t stick around for a while, others are around for at least a year.

The changing faces can get confusing when you’re in a long-term treatment plan like we are (or are terrible with names like I am).

When you’re in the hospital there are some definite positives – and definite negatives.

Positive – you have a team of doctors working your case. You know you’re getting the best care and a variety of input on your treatment.

Negative – you have a team of doctors working your case. Every morning each member of that team comes in to check breath sounds. Not all together to get it done once…nope, one by one over the course of an hour.

Positive – There are more nurses and therapists working your treatments and procedures.

Negative – sometimes the room is overcrowded with people each dedicated to your care.

This hospital is the best place for care. I know the people care about my child and making him healthy.

I know that there are many people working his case.

But it’s still overwhelming and frightening.

You’re Supposed to get Better (i.e. My Kid is Contrary)

IMG_20130915_064017320 days.

Not even a full year.

320 days ago Denver was admitted to the hospital for diminished lung sounds and functions. He got sick in two seconds flat, and was in the hospital 2 days later. They wanted to keep him for a couple of weeks, but he was able to go home after a week. Then stayed on antibiotics for a month.

Back in the spring he had a short bout of illness that was treated with antibiotics.

A month ago he got sick again.

It wasn’t too bad, his lungs sounded clear. He was put on oral antibiotics for 2 weeks.

Things improved…

For a time…

Until they got worse.

Earlier this week the occasional low grade fever crept back up. Lucky for him, he had a CF Clinic appointment. The pulm put him on another round of oral antibiotics – a larger dose over three weeks again. We thought that would be it.

But he felt poorly enough to skip two Cross Country practices, which meant not running in the meet on Saturday.

I should have known then.

I didn’t.

Saturday night, after having been on antibiotics for 48 hours, Denver came to me. Being the teenager he is, he didn’t say much, just that he was coughing and it hurt when he coughed. Plus, he hadn’t been coughing before.

He didn’t verbalize how much it hurt, but I could see it all over his face.

The pain.

We put a call into the on-call.

We were given a night’s reprieve based on how he felt, and were told that unless he gets worse, we could call back in the AM and we’d have a bed ready for us when we did.

And so at 7AM this morning we hustled on in.

Got him admitted.

Tried to work out details with the kids and our one vehicle and making sure the kid and I have all we need here to make it through a week.

At least.

I told him I didn’t want to be here again this year.

Contrary teenagers don’t listen.

 

The Challenger Laughs in the Face of Challenges…

KKShe is our challenge.

Defiant and fiery – but so easily turns on the charm with her doe eyes and a smile that you find yourself fighting HARD to keep your smile. She’s cute as a button, and the little snot knows it too.

Her whole life she’s looked her challenges in the eye and laughed.

Torticollis?  “Puh…watch me straighten my head out”

Hypotonia? “Pshaw…you say I won’t walk until later? Watch me and my crazy crooked gate at 12 months. (And just wait, I’ll run at 15 months).”

CF?  “Ha!  I got this…”

And she (mostly) has for six years now.

CF? “I told you…I got this…”

But she doesn’t.

Something is falling behind.

It could be a tough infection that’s skillfully hidden from the throat swab.

Or maybe her “poor” weight gain is exacerbating her CF.

Either way, she’s not maintaining weight. In fact, she lost this time.

Worse, her lung functions & saturation levels do not make her pulmonologist happy.

And now the challenger of rules and attitudes and restrictions is going to be challenged again.

Tests.

A Chest CT.

A bronchoscopy.

We’re going to get results quickly. By the end of the month we should know what we’re facing next.

Maybe IV antibiotics.

Maybe a g-tube.

Maybe both.

Doc says CF is more aggressive in girls.

So Doc is more aggressive toward it in girls.

Doc sat on this concern for almost a year.

Watching.

Waiting.

Believing it would improve – that K would knock it out of the park.

And she almost did – back in December we were sure trouble had passed.

But trouble came back.

Now is where life gets interesting.

Where we go on a strong offensive.

Time to once again laugh in the face of this challenge.

Whatever it ends up being.

First step.

Tests.

Answers.

Then we fight.

Reality Bites – Give me Abstract

When Kennedy was diagnosed with CF we were assured that we were likely to see more trouble from her myriad of other issues than we would for CF. With the exception of one hospital stay two years ago, that’s been mostly true.

When Denver got his diagnosis at the age of 13, we knew his situation would be different.  Already he had chronic lung issues (pneumonia, bronchitis, etc).

Still, given the unique nature of both his and K’s CF…and the fact that I have a document stating that genetics can not confirm the diagnosis in either child – therefore making them “atypical” CF cases…

We still never realized how fast it would happen.

We didn’t realize how soon he’d end up in the hospital.

How quickly one hospital stay could change his day to day existence.

Or the perceptions of those around him.

How he would go from being “Oh, I don’t see how they could diagnose him with that” to becoming, “Is it safe for him do this? What about his illness?  We need his doctors information to let him do…”

In heartbeat.

In a cough.

In a moment’s time he went from one life to another.

Change happens fast for everyone.

This lightning speed attack of time & reality threw us all for a loop.

We’re all still adjusting.

It takes time.

Let’s just hope time gives us a little breather to catch up before we get blind-sided with another dose of reality.

There is no way….

There is no way I can handle this.

I’m not strong enough.

How horrible a Mom am I that I can’t help my own baby?

I’m so weak. I can’t even hold her hand when she’s screaming in pain and fear.

I ran from the room, bursting into tears.

How can they think I can do these meds at home?

We were on our way home. I was trembling in fear. We arrived home and Archie kicked into “Super Hubby” mode. Trying to do everything to make the transition run smooth for me. To ease my panic, despite his own level of it.

His attempts were valiant.

I was just not having much success coping.

The rest of the evening and night was a disaster. I was very short-tempered. So was wonder-hubs. All 3 kids were wired, over-stimulated, jealous, hyper, impatient.  It was a mess.

Archie had to do her meds…and I got stuck having to hold & distract Angel – who was unhappy with the PICC line in general.

There was no way this was going to work. I went to bed un-satisfied, un-resolved, almost depressed.

The next morning the panic had subsided. I made myself to busy work – preparing for our Christmas Eve ‘party’ at my house. The neighbor had asked Archie’s help with something…and he was preparing to go right around medicine time.

While Archie took a shower, I stared down the meds.

I dug down deep and called over Angel.

I started the process.

I cleaned the line, and started the saline…and then the meds.

I had done it.

With minimal sensation of nausea…I had administered her medication into the PICC line.

And through it all, Angel hadn’t freaked once.

Maybe…just maybe…there was a way…

*********

Tomorrow, a little bit more of the ugly…how the others are handling Angel’s doses of attention…how we’re handling the schedule (not always so good)…and so on…

Popping the Bubble

When you have your first baby.

When you have surgery.

When your baby is sick.

You’re in the hospital.  In a careful bubble designed to protect and heal.

The ‘real’ world falls away.

Bills are forgotten.

Family drama – gone.

Medicines are administered by trained professionals.

Problems are solved by caring nurses or hospital staff.

You have nothing to do but care for the illness (or newborn).

Safe.

Then they say “You’re going home.”

And delicate as it is, that bubble pops.

Fear attacks you.

Can you do this at home? What if something goes wrong?  The REAL world is out there….waiting with responsibilities and things to do OTHER than care for the illness (or newborn).  You have to divide your attention.

On Thursday we were granted leave. We were going home.

My cabin-fever-filled husband was jumping for joy.

I was trembling in fear.

It has turned out all right.

But on Thursday I was crippled. I was afraid. We had to administer PICC meds at home. There was Christmas. Two other kids. Family. Responsibilities.

It was so hard to be joyful that my baby would be going home – free of the hospital.

All I could focus on was the fear that we’d mess up her carefully maintained schedule. That a dose would be missed. That a child would play with a picc line. The other two kids would add to the chaos, feel jealousy over the constant attention to Angel’s schedule (they have). I couldn’t handle even looking at the PICC line, much less administering a dose. It wasn’t fair to make Archie do it all…but I couldn’t handle it, could I? Everything could and would go wrong.  We were no longer ‘safe’. SHE was no longer ‘safe’.

It was crippling.

I felt guilty.

I should be happy she’s improved so much so fast.

I should be jumping for joy that we would all be together at home for Christmas.

But I couldn’t.

I was too afraid.

****

*I wanted to post this last Friday, but it didn’t seem like a great Christmas Eve post. Over the next couple of days I’ll update on how we’re doing…how I’m doing…how she’s doing…how the other two are coping…how much of a pit our house currently is…all of it – the good, the bad, the ugly, the beautiful (there’s quite a bit of that – & that needs to be covered).  It’s all here. Coming over the next few days.  Her follow up visit with her pulm is on Wednesday and we’ll know more about when the medicine will stop & the picc line will be removed.  Over the next week, I’ll tell it all….