Just a little cold….

It’s just a little cold…

I’ve just got a bit of a sniffle…

Got the sneezes…

It’s still ok to come isn’t it?!

No actually – it bloody isn’t!

You see for my Bear, and hundreds of his friends, ‘just a cold’ can mean so much more, so before you send your snotty child to school, or you ‘have’ to go to work.  Think about who might be sharing your germs – the siblings they’ll be taken home to, the colleagues you’ll turn into carriers.  The people who have limited immunity and no means to fight even the mildest of viruses.

This time last week my beautiful boy was 4 hours into weekend leave of absence from hospital – he was just fine.  Overnight his oxygen levels dropped below our acceptable limit so I kept an eye on him for other symptoms – he slept well and woke happy.  As Saturday progressed his work of breathing increased, his temperature started to creep up and he needed more and more suction.  By the time Daddy came home he was having bouts of uncontrollable coughing which his nebulisers weren’t calming.  We called an ambulance to take him back to hospital where he was given humidified oxygen via trache mask and he went to sleep, he had a reasonably settled night but needed more oxygen than normal.   Sunday saw me and his lovely Welsh nurse tag teaming control of the suction – incessant coughing and rivers of secretions running out of his trache and under it, his seizure threshold lowered due to the viral infection and he started having longer seizures than his daily ones, needing rescue medication.  The pattern went on into the night and by the early hours of the morning he was so tired he was admitted to the high dependency unit, by shift change he was needing such a level of care he was admitted to the intensive care unit – which in our hospital is an adult ward.  Bear is 4.  They changed his breathing support from optiflow to CPAP and had a chest xray which showed bilateral pneumonia.   They started stronger antibiotics and hoped to stabilise him so the paediatric team could have him back – but he didn’t show any signs of improvement so the Paediatric Intensive Care Retrieval Team were called to transfer him to the Children’s Hospital. 

A condition for transfer, for safety reasons and to keep him stable on the journey, was that he was sedated – which is ok cos he’s got a tracheostomy – you’d think.  Bear’s trache is uncuffed,  which means that air can pass around it – or ‘leak’.  It also means they can’t ventilate properly through it as it’s not a closed circuit.  They do a cuffed version for this – but because we were on an adult unit they didn’t have one small enough so the anaesthetist decided to intubate via his mouth using an ET (endotracheal) tube with a view to switching back to his trache on arrival (which was a great idea in principal but it turned out they didn’t have one either!!).  He was put to sleep and ventilated, the retrieval team arrived (anaesthetist/Dr and a nurse) and spent an hour and a half meticulously changing each line and machine over to the transport ones and lifted him onto the trolley and wrapped him up tightly in his quilt.  They wheeled him through the hospital to the purpose built ITU ambulance and loaded him in the back, Mama travelling in the front and Daddy and Bug following on in the van. 

He arrived safe and sound at the Children’s Hospital after an uneventful journey and the whole meticulous loading process happened in reverse.  They needed to take blood but he was so cold peripherally they couldn’t get access so he had an arterial line placed in his groin, he had a catheter placed so they could monitor his fluids better.

He has stayed stable since he arrived, he’s getting regular physiotherapist visits to help break down the gunk (proper medical term that 😉 ) that is accumulating and consolidating in his lungs – one lung has partially collapsed.   The initial lack of an appropriately sized cuffed trache means his ET tube remains for now, they attempted to place a cuffed tube today (acquired by mama from one of our very lovely friends) but his tracheostomy has started to heal and the stoma is too small to access so he has been placed on the emergency list for this weekend for surgery to make the hole large enough to accommodate the new tube.
So here we are, in limbo, waiting and hoping that he can kick this – because many children in this position don’t.

And it’s only a cold….

Right?