Baby's First Hospitalization

We've had quite a rough couple of days with poor Audrey.  As I mentioned in her Monthly Update, she has been sick again recently.  Over last weekend, she would have periods of looking rough- lots of retracting, grunting, tugging, etc., but then it would sort of get a little better and we wouldn't feel AS worried. We specifically noticed a huge decline in her appearance and heightened breathing trouble after she would drink her bottle. However, we decided to go ahead and send her to Miss Jamey on Monday since she appeared to be better on Monday morning.

On Monday afternoon Jamey let us know that Audrey wasn't looking very good and so Paul called and got her an appointment with our pediatrician.  He took her in and she received a breathing treatment (albuterol) to see if she couldn't do better.  Her pulse oxygen level was in the high 80s...normal is close to 100.  Our pediatrician observed her for a while and decided she needed to go to the emergency department at the hospital to be assessed there.  Around this time I was getting out of work and called Paul, who told me what was happening.  I quickly called my in-laws to come down and help us, and called Jamey to see if Emily could go over there for a little while while we took Audrey to the hospital.  Luckily it worked out that my in-laws could make it and Jamey was a saint and allowed Emily to come play over there too.  We were (and are!) so grateful to all of them.

I met Paul at the hospital and we were seen by the peds residents and attendings.  Audrey was checked for RSV and the flu and tested negative for both of them.  She had a chest x ray and it was found that she has a pneumonia in one of her lungs. At this point we started talking about doing a barium test on her to rule out any malformations in her digestive tract or esophagus, and a swallowing study to see what was causing her to have such trouble breathing after she eats.  Unfortunately, neither of those tests is available in the middle of the night (well, probably if it's an emergency they are but this wasn't an emergency), so she got admitted.  We headed up the the 6th floor around 10:30 and got settled.  Paul went home and got me some clothes, my contacts case, toothbrush, etc., and then I sent him home to get some sleep. 

I stayed with Audrey and she was very uncomfortable.  Her O2 sats kept going around 90-91, which was better, but still not good.  Between her machines beeping, vital signs every hour, the helicopter landing, etc, I think I slept around 2 hours!  It was such a long night!  Thankfully in the morning Paul came and brought me some breakfast (for whatever reason, the food at the hospital is kind of crummy, but their breakfast is amazing!  I was so glad to be there for that meal, lol).  After breakfast the team rounded on Audrey and told us that they had ordered the barium and swallowing studies so we could be getting ready for that.  We headed upstairs and waited just a little while before the tests began.

First was the upper GI x ray... for this one they had her drink 2 ounces of a barium solution and then x rayed her while she drank it.  She liked the drink but HATED being confined to the x ray table- as with all babies, she had to be velcroed to a board with her arms over her head...definitely NOT her favorite position for sure!  The x ray showed that she didn't have any malformations but that she DOES definitely have reflux-- we watched the solution go down, down, down into her tummy and then some of it came right back up into her esophagus.  She was already receiving Zantac for that so we will just keep on giving her that.  She had 2 more of these x rays throughout the day to make sure she has no intestinal problems and everything looked clear and normal- so thank Heavens for that!

Next was the swallowing study.  She was put in a little carseat-like chair and they took xray video of her drinking a variety of different fluid consistencies (all with barium for contrast).  THIS was the test that gave us our answer!  It turns out that when she is drinking plain formula or breastmilk- consistency liquid, she is aspirating fluid up into her nasal cavity (causing her chronic runny nose and congestion) and also into her lungs (causing her frequent upper respiratory infections AND the pneumonia that was discovered the night before).  The test was AMAZING- to see her swallowing everything and aspirating some of the liquid.   speech pathologist was conducting the test and she was SO nice and gave us so much information...but I was just so impressed with how well she did her job.  My highly untrained eyes were missing the aspirations so she slowed down the playback and pointed them out...we're talking like a SPECK of white on an x ray film and she was catching that every time.  We experimented with a lot of different consistencies and finally got the right mixture for Audrey to successfully swallow-- something called "nectar thick". 

Basically, we have to add a gel thickener to all her bottles to ensure that she doesn't aspirate the fluid anymore.  We ordered the gel stuff (it's super expensive AND not covered by insurance...AWESOME!) and the hospital gave us a bunch of samples to use until that arrives.  I can attest to how much of a difference this stuff is making already- just the first few bottles she's had have been entirely different than her usual feeding behavior!  She is still coughing a little and sputtering after she eats but that probably has more to do with the fact that she definitely has pneumonia and the attending yesterday said she believes she's fighting a virus right now too.  Poor girl!  But just in the past day she has improved so much... we are so thankful for all the resources that are at the hospital here that helped her to get diagnosed.  It's so wild to think that this swallowing problem has accounted for most of her illnesses this winter!   We are so relieved to have an ANSWER and to know that she's not just some sickly little kid who catches everything she gets exposed to.  We are definitely looking forward to her getting better and being so much more comfortable when she eats.  Thank goodness for modern medicine!