Little Boy, my fourth child, has been sick with a cold for 4 days now. So he and I are hanging out at home, in our pajamas, this beautiful Sunday morning. I'm listening to sermons online and praying for him. It's his second cold ever, but this one seems to be a tough one -- he's coughing a lot and is clearly miserable.
I know I should be calm about this. After all, he's my fourth and I've seen an awful in my 8 1/2 years as a mom.
But that's part of the problem, I think. I have seen too much go too wrong. In fact, with my first child, Elli, everything that could go wrong did (and pretty much still does - she has quite a reputation for being a difficult case!). Elli spent almost as much time in the hospital as she did at home during her first year of life. She survived half an hour of cardiac arrest when she was 4 days old, had 2 open-heart surgeries, and struggled through several viruses that sent her to the ICU. The very fact that she is about to celebrate her 8th birthday is a miracle, for which we thank God every day. I learned a month ago that she is "famous" in our children's hospital's cardiology department. Not exactly the notoriety a mother dreams of, but far better than the alternative!
Unfortunately, Little Boy is taking after his big sis. He is currently living with a significant heart defect. He had open-heart surgery at the end of October and will have another sometime this spring ("May-ish" according to his doc.). Overall, he is doing much better than Elli did, but everyone is very careful with him anyway.
I spent several weeks in December and January working to get our insurance to approve Synergis and looking for financial aid for the extremely high copays for this. (Synergis is a monthly injection that protects against RSV, a respiratory virus that can be life-threatening in preemies or babies with other health issues.) If he'd been old enough, he'd have gotten the flu vaccine too (you have to be 6 months old, and everyone's out of it now).
So I'm a teeny weeny bit paranoid about this cold. I have it too, though I'm keeping it at bay with zinc supplements, so I am reasonably sure it isn't influenza (I got the vaccine this year). However, I don't have a good feel for how he handles viruses yet. So I'm being super-vigilant. At least once every 24 hours, I check all of these:
- Temperature
- Respiration rate
- Ease of breathing
- Appetite
- Fluid intake
- Fluid output
- Skin color
- Oxygen level, if he'll hold still (one perk of having another chronically-ill child is that you have nifty little gadgets like pulse oximeters laying around your house!)
I have my sick-child toolkit handy. Behold:
I'm not going to show you my medication bin -- it's amazing what you learn and collect with a chronically-ill child! Unfortunately, most in my med kit only works for children 2 years and older. The only things I can give Little Boy are acetaminophen, ibuprofen, and diphenhydramine HCI (Benadryl). Technically, according to my pharmacy, babies can also take pseudoephedrin (Sudafed), but with Little Boy's heart defect, I prefer not to, as it can be a stimulant.
I've decided on my criteria for a trip to the Urgent Care or the Emergency Department (if he gets really bad really fast). He's going if I see any one of the following:
- Fever
- Labored breathing
- Dusky color
- Yellow or green mucus (it's clear or cloudy right now)
- Disappearance of his bubbly personality
- Low pulse-ox reading, if I can get one (for him, this would be below 90%)
Any one of these would indicate an infection or that he has lost the ability to maintain sufficient oxygen levels in his blood.
I also decided that if Little Boy isn't improving any by tomorrow, I'm going to take him to the pediatrician. I just so happen to also have an appointment for Elli with her pulmonologist first thing tomorrow morning (8am -- should be fun getting 5 of us out the door by 7:45!), and I am confident that he would also listen to Little Boy for me if I asked him to.
I really really really hope I'm just being paranoid. But I can't shake the feeling of foreboding today. I guess I thought I'd see an improvement in him by today if he was going to get better. I've been wrong before, though, so hopefully I'm wrong about this one.
