February 26th, 2005
Coughing His Lungs Out
If I were reading our story in a novel right now, I think I’d toss the book. The timing of overly melodramatic events is far too contrived to be true. Any author resorting to such plot devices should not be published. Yet, there it is – real life. For a change, this posting is not about Spencer’s cancer. He plays largely a peripheral role in this chapter.
As I write this, I am sitting in Children’s Hospital of Austin. I am not here with Spencer, though we expect sometime in the next few years we’ll be admitted for problems with Spencer. Instead, I am here with Jacob. He’s doing well right now. His respirations are down below 40 per minute, from 60-70 much of the time and 90 for a while last night. His pulse is a stately 140, not the 160-170 with a high 204 of last night. He is on 1 liter per minute of oxygen through a nasal canula and with that assistance his blood oxygen saturation is 94%, up from to 88% last night – contrast with a desired 99 or 100%. His temperate, with a recent dose of Tylenol, is normal, not the 104.7 we had last night.
It all started Tuesday. I mentioned here that I had to go get Jacob out of day care. We went to the doctor on Wednesday. While I was on the way to the doctor with Jacob, I got a call from Spencer’s school. Spencer had start vomiting. I called Rachel to find somebody (Sharron to the rescue) to pick up Spencer while Jacob and I were at the doctor where we ruled out flu with a rapid flu test for Jacob. This was good news since flu is a top ten worry for Spencer right now. Plan was to take him back if needed Thursday.
Wednesday night was not so great and his ribs were still flaring when he was breathing. We called the doctor’s office and they wanted us to come in right away. We had an appointment at 10:30 with a neuropsychologist to talk about an evaluation plan for Spencer so we could have a baseline for long term learning disabilities or delays resulting from chemotherapy. It had taken us a month to get in and we want to get Spencer evaluated before chemotherapy actually damages his brain, so we scheduled a 1 PM for Jacob. The doctor who said he wasn’t quite bad enough to go to the hospital, started a test for RSV, and said we should watch carefully and return on Friday morning to check O2 saturation.
Thursday night he was up a lot coughing, breathing fast, a little bit of a fever. Rachel and I started having symptoms as well; fortunately for adults RSV is more like a really annoying cold that a debilitating virus. We waffled on bringing Jacob in to the hospital, but by around 3 AM, he was getting better. Friday morning, I took Jacob in the car, dropped Spencer off at school, and then dropped by the clinic. The plan was to get a quick O2 saturation and to figure out the next steps. Jacob’s O2 was 89% and the RSV test had come back positive – time for the hospital. He wasn’t in immediate distress, so we decided not to take an ambulance ride, spend hours in the ER, get stuck with IVs, and wait for a bed while in the ER. Instead we waited at the clinic while our doctor arranged an admission. After 30 minutes waiting, I drove straight down with Jacob and checked in directly with no delays. This was definitely the better plan. Fortunately, I had the foresight to pack my backpack with enough stuff to spend the night.
RSV sucks for babies. For those less than 6 months, it’s very serious. For older babies, it’s still pretty annoying. The description from the attending is that the virus breaks down the cell walls in the alveoli and the resulting inflammation and debris makes it hard to breathe. For babies, with smaller bronchioles that can get pretty serious. They have trouble breathing, can’t keep blood oxygenated, and have a really bad cough. Basically with RSV, you are literally coughing your lungs out – well the dead part your lungs the virus leaves anyway.
Rachel arranged for Sharron to pick up Spencer again. Rachel still can’t drive because her current van sometimes stalls and she wouldn’t be able to control it. Our initial plan for Friday night was for Rachel to not visit, but her carpool companion, Chris Almond, offered to take Rachel and Spencer down here. They had dinner out with the Almonds and then came by the hospital to see Jacob briefly, and drop off some stuff for me to make my weekend here a little easier. Jacob was pretty beat when they were here and Spencer was upset that he had to wear a mask and didn’t get to touch his brother. RSV is very contagious and, though Spencer probably already has it and it’s not a big problem for older kids, we really don’t want needless exposure.
After they left Jacob got better for a while with O2 saturation of 96% (on oxygen), normal temperature, but still very rapid breathing. Later things got worse for a bit with 104.7 temperature, 90 respirations per minute, 88% O2 saturation, but he got through that. For a while this morning, we took him off O2, but his saturations were getting to low, his breathing too fast, and discomfort too much, so he’s back on oxygen again.
In the course of surviving this week, we will have had someone pick up Spencer from school twice, two dinners cooked for us, four people help with getting Rachel to and from the hospital, another friend to take Spencer to church on Sunday, and two families willing to take Spencer for afternoons so Rachel can spend time with Jacob. We are lucky to have such friends in our life. Spencer’s cancer and Jacob’s hospitalization would be insurmountable without those friends.
So, here I sit coughing my own lungs out (Rachel and I both appear to have RSV as well, Spencer has either escaped it or was not bothered by it) while Jacob sleeps lying on Rachel’s chest. His O2 saturation is 94%. heart rate 129, respirations 48 per minute, and temperature normal. Our life is indeed an overly contrived and melodramatic novel.
