Sunday, January 19, 2014

Scary Day

Last night, Calliope felt a little warm. I checked her temperature -- not quite a fever at exactly 100. She had the beginnings of a little dry cough, so I gave her a couple puffs of bronchodilator (via a spacer -- a holding chamber that allows folks of all ages and abilities to use an inhaler) along with her twice daily dose of inhaled steroid. She started taking that a couple months ago because she's been wheezing with every cold this fall.

Not particularly worried, I tucked my little girl into bed, well, crib, and turned out the light.

She started to cry shortly thereafter so I went in to check on her, but could find nothing wrong. And again, thirty minutes after that.

Finally, about 9:30 pm, I hauled her out of bed and checked her temperature again. Up to 101.5. I gave her a tablet of ibuprofen to chew on, a sip of water, and two more puffs on her inhaler.

I went off to bed myself, figuring it might be a long night.

And indeed it was. I lost track of how many times I heard her wailing from the other room, bolted upright, and ran to her crib. Each time she was moaning and crying, rolling in her crib, but not particularly interested in comforting from me. I scooped her up a few times anyway, but she typically twisted away from me and back towards her crib again after a few moments. I offered to bring her to my bed, but she would stop moaning long enough to say distinctly, "No."

At 3:30 am, I gave two more puffs on the inhaler.

She was up for good at 6:30 am, asking for food but then refusing to take a single bite. At that point, she started to wheeze in earnest. I gave her two puffs on her inhaler at 6:30 and 7:30 (I'm supposed to give it not more than two puffs every four hours, ordinarily) and she was showing no signs of improvement.

At 7:30, I called the doctor's office, not sure if they had office hours in their new location. Indeed they did not, but they connected me to the doctor on call who, comfortingly, is Calliope's regular pediatrician. I told her that I thought Calliope needed oral steroids, but wanted someone else to give me permission. She said yes, to start them. And that we would talk during the work week about changing Calliope's preventative meds to something stronger -- she's been having too many episodes like this.

So at 8 am, I gave the maximum dose of oral steroids, and stopped worrying for a bit. I started working out, and coordinating plans with our friends downstairs.

But when I would pause the exercise DVD for whatever reason, I would notice that Calliope's breathing was getting louder and louder.

So finally I unpacked the nebulizer machine that my cousin had handed down to me. I hadn't used it thus far because studies say that the inhaler with the spacer is just as effective... but clearly that wasn't working, and it was time for something new.

So I set up the inhaler, and turned on Elmo's Potty Time. For my non-TV watching child, this is a huge treat. So she was surprisingly cooperative.

She finished the treatment and I went back to working out... but kept noticing that she still wasn't getting better. Her exhales were getting more prolonged and requiring ever more effort. The muscles around her ribs were pulling in. I timed her respiratory rate and it was fast, but it was below the rate another doctor had told me was the true danger sign.

Finally I asked my friend to come up from her apartment downstairs to see Calliope. And I texted the doctor to tell her that C was still getting worse... but was playing happily... and was it safe to wait a bit longer for the oral steroids to kick in?

My friend was reassuring me, reminding me that if my child was playfully trying to pull my shorts off, she couldn't be struggling that badly. And then my pediatrician texted me back to say that it was okay to wait a few hours to see if Calliope got better.

So I told my friend we would be ready to go to the farmer's market in a few minutes.

I got Calliope dressed. Got myself dressed.

And then, suddenly, I just felt wrong. Wrong to go do fun errands with my friend with my child breathing so very noisily.

So I updated my friend by phone, and bundled Calliope into her hat and coat and then into the cozy bunting of her stroller. I threw a few things into a bag, including my phone charger a pair of clean underwear for myself as well as her. Because I had the distinct feeling that hospitalization was not out of the question.

And suddenly she started to whimper. And gurgle. It sounded like she was having trouble swallowing her saliva.

I started to panic. I quickly called my friend back, to see if she could run upstairs. But she didn't answer.

Nervously, I wondered if I should call 911.

I decided that maybe she was just overtired from her terrible night's sleep, and not just tired from working so hard to breathe. And also that she might be overheated.

So I plotted that I would get her outside, into the cold air, as quickly as possible. And then, if she was still gurgling, I would call 911 from just outside my building.

Luckily the gurgling stopped in a couple of minutes. And she mostly stopped crying.

I listened anxiously for the occasional whimpers as I pushed her stroller briskly towards the subway, figuring that as long as I heard whimpering, I knew she was still breathing.

She coughed like crazy on the subway, which made her cry weakly, but otherwise seemed a little less distressed. Probably mostly because she was covered in coats and blankets so I couldn't see the heaving of her chest.

We got to urgent care and were seen quickly. The idiotic medical assistants never even asked why we there, just "so she has a cough?". I let them continue because one was obviously training the other. Finally, towards the end of their interview, one asked, "she doesn't have a history of asthma, does she?"

"Yes, she does! That's why I'm here! Can't you hear her wheezing?"

"Oh, yes, now that you mention it, I do." Seriously?

After that, they got the doctor right away. He put Calliope on a continuous nebulizer treatment for about 45 minutes, with one drug we'd already been using plus a new one.

Thankfully, she started to improve quickly.

The doctor said afterwards that if she hadn't improved so dramatically, she'd have gotten admitted to the hospital for sure.


We are back home now. She's much better, though wheezing a little as she comes close to the end of the four hour window when she's due for more medication.

She's to stay on the oral steroids for five days, plus a bronchodilator every four hours, plus the twice a day inhaled steroid she was already taking as a preventative medication.

And I think I'm taking Tuesday off from work to bring her back to her pediatrician. To discuss taking her to a pulmonologist. To figure out why these preventative meds aren't doing their job. I want to understand why my child, with no eczema and no food allergies and zero asthma symptoms between colds, has this increasingly dramatic wheezing with every viral illness. Wheezing that seems to ramp up from 0 to 60 with no warning.

Today was a frightening wake up call that asthma is not just an annoyance. It's a real danger to the lives of our precious loved ones.

Thank god mine is safe.


  1. Yikes, that does sound like a very scary experience. Glad to hear she is feeling a little better, hopefully you will get some (good) answers soon.

  2. That sounds terrifying. I hope you get some answers.

  3. That does sound awful. I am glad that they got today's episode under control and that you are home. I hope you get some answers soon.

  4. I hope she feels better soon and that a change in her treatments will prevent another day like this.

  5. Very scary. I'm glad they were able to help her at urgent care and I hope that the pediatrician and/or pulminologist has some good answers for you.

  6. I am so sorry that you had to go through this. The scary thing about asthma is that while there are fantastic drugs for it, when they don't work (for whatever reason) things can get out of control very quickly and more and more people die of asthma every year.
    FYI hearing the wheezing sound is not always an indication of how much air is going in. Sometimes there can be a silent wheeze - just a very shallow breath with hardly any possibility for air movement at all.
    If I were you I would ask your pediatrician for a protocol - what to do when etc, which ER, what drugs, how much and how often. Some of the drugs side effect is to keep you awake.
    Hopefully this was a one off episode that won't happen again.

  7. Glad she started feeling better - Calliope is in such loving and skilled arms with you as her mom!

  8. Yes, thank goodness she is okay! Scary, indeed!

  9. I'm really sorry for you both. Good thing you kept your cool and trusted your instinct. Really, really frightening I'm sure...

  10. Oh wow, yikes. I'm so sorry you both had to go through that. Hope she's feeling better and all is well now!

  11. Did you see the recent news special on asthma and mold? I know Calliope's asthma isn't always noticeable, but there might be a trigger like mold in your house that only affects her when she is sick or has weakened defenses. For a short time in adulthood I needed an OTC inhaler on occasion, often after exercising, and in retrospect I think it was because I rented a small apartment in a very old house. As soon as I moved, the wheezing flare-ups stopped. My nephew also had chronic breathing issues and suspected asthma for the first 18 months of his life and sure enough, mold was found in the chimney of their rental.

    1. No, but I would love to see this. Where can I find it?

  12. Thank god indeed that she's so scary!

  13. You can get an spo2 monitor at a drugstore. You put them on the finger and they will show oxygen levels. We have a hard time distinguishing upper airway wheezing from real chest / lung issues. This lets us know when to really get nervous,