Goodbye Summer, Hello Enterovirus 68

This Blog was written on Monday, September 21

I cannot believe how quickly the summer has gone and passed us by.  Gone are the days of no suctioning, no fevers and easy nights.  Hello to sleepless nights, spiking fevers and suctioning.

I thought the pebbles that Wyatt had swallowed back at the end of August was hard on us, but this virus... has been kicking all of our butts.  Every person in our house has caught it, except for the dog.  And I'm pretty sure if it was contagious from humans to animals, she would have already caught it!  The pebble incident, albeit serious in nature, (he could have lost his airway at any moment), was in the end a very short stay at CHEO.  We were admitted at 6 pm on a Thursday night and we were discharged by 12 pm on Friday.  Wyatt had to go in for an emergency intubation, so his anesthesiologist, Dr. Corvo, could remove one tiny little pebble lying against his vocal cords.  Do you know what sits right in front of your vocal cords? Your wind pipes.  That is why the pebble incident was so dangerous.  At any given moment, Wyatt could have lost his airway.  For more details on this day, please jump to Wyatt's Anesthesiologist's page.

What I'm trying to get at here, is that although the Pebble Incident was incredibly stressful, it was short lived.  This virus though, has left me stressed out, sick, exhausted and it's just the beginning of the virus season.  Do you know when CHEO typically starts seeing the Enterovirus 68?  Usually in January-February, and yes, they may get a few cases here and there beforehand, but an outbreak??  Unlikely, you'd think.  Right now, CHEO has several cases of the virus, and the testing only began last week.   The good news is that the virus is only dangerous for those who are under the age of 5, and/or have asthma.

Did I mention I have three children under the age of 5, two of them having asthma?

And it's just the beginning of the virus season. Oie.

Aila has been sick since the first day of school, and Jude... two days after school started, he started showing signs of coming down with a cold. Coughing, fever, runny nose and the like.  Wyatt was admitted to CHEO for a severe ear infection during this period of their colds, so it's unlikely they had the same thing.  But now...now, all of their symptoms are the same, and have occured staggartly.  One child became more ill after the other.  My daughter, she's now going week 4 of being in school, and is just now showing signs of getting better.  Our middle child is still coughing, but at least it's not all day long - like his mother.  And poor little Wyatt, is in the hospital, getting a chest xray.  He's been off and on febrile for the last week, coughing during the night (which in turn makes his O2 drop, and heart rate increase), and isn't tolerating his feeds.

Notice Wyatt's eyebrows are raised in that "surprised" look of his. He's in need of an adjustment!

Last night for instance, I was up with him from 10:00 pm to 5:30 am, and my only goal was to make him comfortable.  His heart rate was high, he was sitting at 150 by 1 am.  His O2 fluctuated from 88 to 94%, so his monitor was going off every 15 minutes or so.  Once his O2 dropped I would suction, and reposition.  This would help him settle for about 15 minutes, and then he would drop again.  Every time he would drop, his heart rate would increase, (because he's working harder to breath), so it was a stressful night!  By the time I handed him over to dad, (5:30 am), his heart rate was at 140, and 91% for O2.   By 7:30, when we were leaving for CHEO, he was at 175, and 88%.  So...I guess it's a good thing he's where he is.  He'll be safe there, and they have the proper equipment to take care of him.  And for those of you who are wondering what his norm is: while sleeping, Wyatt's heart rate should be between 95-115, and when awake 120-140.  His O2 should always be between 98-100%.

I have nursing care, but it's not on a full time basis. I'm thinking now Wyatt's care needs to be re-assessed.

What do you think? Do you think it's safe for mom to go without sleep a couple of days in a row?

Parenting 101: Swallowing; and Prerequisite to Parenting 102: Opening the Mouth

For those of you who have been keeping track of Wyatt's progress over the past months, you may have deduced that we haven't been in CHEO for quite some time - if we negate his visit from three weeks ago, a short one-day stint at CHEO for swallowing pebbles (a blog in itself). We have been CHEO-free for almost nine weeks! That was three weeks longer than our last stint, which was in December of 2013 to mid January 2014.

The connection between the two? Well, our beautiful kids were not in school.

School is the reason why Wyatt becomes sick.  My husband, myself and Wyatt's pediatrician are convinced that attending school is THE reason why Wyatt is in and out of CHEO at a bi-weekly rate. If you could check our admissions, you would see a clear pattern, every two weeks we're in, and the following two weeks, we're out. Each virus/bacterial infection would line up with Aila's colds caught from her school.

Needless to say, the last nine weeks have been great. No one was sick in the house, it was wonderful not having to fight off cold after cold after cold... but here we are again.

September - the beginning of a new school year. Grrrreat. Now it's not one, but two children introducing viruses and bacterial infections.

The odd thing is, my children didn't start school until this past Wednesday, and Wyatt was admitted for respiratory distress on Thursday . So, to catch a cold that quickly - without his brother or sister showing any visible signs; seemed unlikely. Dr. Issa and I both thought it was aspirated pneumonia, as I was teaching Wyatt how to eat the week before. His penchant for putting things into his mouth has become strong and I felt, why not control the situation, by allowing him to taste real food, rather than rocks off the ground? Maybe he'd be less likely to put said objects into his mouth...

Wyatt had the usual tests done, blood, stool, and chest xray. I was expecting a positive for pneumonia. High grade fever, his O2 sats were super low, he had mucus coming out of the wazoo.  Surprisingly enough, his chest xray came out clean. It looked 'beautiful' according to Dr. Issa.

So, what was wrong with Wyatt?

Dr. Issa felt that it was mix of a bacterial infection with a virus, (ear infection), and that we came in at the right time. All of Wyatt's symptoms started rearing their ugly head in the middle of the night on Wednesday, and by Thursday, at 6 pm, we were being admitted to CHEO. Whatever my baby has, it hit him like a ton of bricks.

Wyatt has since been discharged, and is happily, crawling around the house. He has extra mucous, but with our nurse on hand, things are more manageable now. The kids are in school, which always helps as well!

So, back to the dangers of teaching Wyatt to eat. One, is obviously aspirated pneumonia. Two, is choking and three being that he loses his airway completely. As Wyatt's mom, I am convinced he swallows. Now, even more-so. If we want to open Wyatt's mouth up with a masseter release (a surgeon takes a knife and cuts the masseter muscles), we have to make sure Wyatt can swallow. We cannot have his mouth wide open, and him be able to stick whatever object he wants into his mouth. That is far too dangerous.

As of two weeks ago, Wyatt has been eating lunch and supper with us. Usually, I place some puréed food in front of him, and he plays with it, coats his hands (face, hair, neck, belly, et al.), and tries to shove the food into his mouth. This didn't really work for him, as he just wasn't getting a substantial-enough amount into his mouth to allow him to feel the food on his tongue, and then proceed to swallow it. What I have done is place a minute amount of food, say, the size of two peas, on a very slender, malleable baby spoon, and lightly rest it on his bottom lip. Wyatt proceeds to use his top lip to suck the food into his mouth, and voilà, he swallows his food. At first, I was venting him to see if there was any food that had made it into his gut, and lo and behold, there it was! Plus, a ton of air. Learning to swallow is difficult, and swallowing air was a newbie mistake. Wyatt doesn't need venting now, because he isn't swallowing air with his food, and he is eating more and more every day.

With that said, he is going to be getting a Feeding Study, which will allow us to actually watch his food go into his mouth, down his esophagus, and into his stomach, simply by adding some Barium to his pureed food. I'm hoping to have to the Feeding Study completed by November.

Some of you may be asking yourself, why is Wyatt swallowing? I for one believe it's from his adjustments with his Chiropractor, Dr. Craig Hazel, from Synergy Wellness.  Dr. Hazel told us we should start seeing some changes with Wyatt's mouth movements within three to six months, and August brings us to the three month mark with him. So, I would like to believe the adjustments are working. On the other hand, one can only guess that it has something to do with Wyatt's physical and cognitive development. He LOVES to put food in his mouth, and wants to be part of the eating routine at our dinner table.

Next Blog: (and we're kind of going back wards in time here) Emergency Intubation