Tuesday, January 12, 2010

Josh sick, Last days of Steff's pregnancy


Josh has been fighting some congestion troubles (like the rest of us) for a couple of weeks or so. But over the weekend (Jan 9-10), seemed to get worse. I let him sleep in on Saturday. He didn't wake till almost 1 in the afternoon! And his face was so swollen - the worst I've ever seen it - especially his left side (the side he sleeps on). And his poor nose was completely blocked. I deflated his trach, so he could blow his nose, and it took three tissues to get it all out! (I know yuck - but when caring for a patient with a trach, secretions are important to note - and Josh's were very yellow - a sign of infection).

I was really worried about him, but he got up and used ice packs and wet wash rags to help with the swelling in his face. He also complained of pain on the top (back) of his right hand. He was holding an ice pack to it, too.

The swelling slowly went down and he looked much more normal by nightfall. We had no nurse Friday night or Saturday night. One of our nurses was taken off our case and re-assigned (long, drama story - I won't get into that). But it meant our weekend night nurse is now covering weeknights and some afternoons (scary, crazy shifts for her - but she is dedicated, thank God).

Anyway, Saturday night, Josh needed oxygen again (he did Friday night, too) to keep his O2 sats above 94. I let him sleep in some Sunday, too - even though that means we miss church. But I was hoping the extra rest would mean he'd be better for school Monday. He woke late Sunday morning with more swelling - not quite as bad as Saturday - but still feeling awful.

Josh felt a little better Sunday afternoon and went with James and me on some errands, then to church for AWANA Sunday evening. He was hoping to have his name drawn for some sweet court-side seats to the Spurs game. But he was disappointed when he didn't win them :(

Sunday night, our nurse returned - which meant more sleep for me - yay! And Josh seemed a little better Monday morning - even though he still complained of feeling bad. I know he wanted to stay in bed and sleep, but I talked him into going to school and I'd call his doctor.

Before I did, I got an update from his school nurse around 9:30. She said the sweating he was doing early that morning had subsided and instead of being all red, he was now pale. His temperature was normalizing (it had been 99.5 when he woke up but we have him extra Cortef - a mild steroid - and ibuprofin). He was overbreathing the ventilator (which she had him on at school instead of the pacers) by 14-16 breaths per minute - but they were shallow breaths. She really felt it would be best for him to see a doctor, too. So, I called and they could see him at 3:40 that afternoon. That would allow him to finish out the school day and for me to go in to work a couple of hours or so.

He and his afternoon nurse were getting ready for the doctor visit when I got home from work. We made it on time, but still had to wait a bit. Josh didn't look too bad at that moment - which always makes me worry the doctor won't realize how bad he did look before and he may get that way again at any time.

The nurse who checked his vitals found his blood pressure was fine, temp good, but heart rate was VERY high at 191. She didn't seemed alarmed by it and sat us in a room to wait for the doctor. Before he could come in, though, a nurse came to swab and check for the flu. Josh has had his flu shot but not the swine H1N1 flu shot. So I figured if it came back positive, he would likely have H1N1.

The doctor came in as we waited for results of the flu test. He said Josh's lungs sounded clear - no pneumonia or anything like that. Because his congestion had lasted this long and required the oxygen, etc. it was likely a sinus infection. The flu test results came back negative (thank God!). So, he went ahead and prescribed Omnicef - an antibiotic.

I did ask the doctor if it was advisable to give Josh the H1N1 vaccine while he was sick like this. He said probably not because if then Josh got worse, it would be difficult to determine if it was because of his sinus infection or from the flu vaccine. He would rather we wait a week or so and as soon as Josh recovers from this infection, give them a call. They would get him right in and give him the H1N1 vaccine at that time.

He also felt of Joshua's hand - because of the pain there - and said it did not have any point tenderness or indication of a break, so to continue with ibuprofin as needed and if it was not better in a few days, to give him a call and he'd order an xray.

The doctor (Josh's pediatrician) also had not seen us since Josh got his pacers, so we showed them off to him. He was surprised how small the transmitter box was and that it only took 2 9-volt batteries to operate.

We also got this doctor to prescribe Josh's allergy eye drops since he wasn't due to see his eye doctor again for months and Medicaid will only pay for the drops for 6 months after a prescription is written. He was happy to do it and Josh was glad to get them.

So, our next doctor appointments scheduled for Josh are as follows:

Endocrinologist - Friday, Jan 15th
Dentist - Wedneday, Feb 10th
Pulmonologist - early March
Eye Dr - in May

When I woke up this morning (Tuesday the 12th), I heard Josh's oxygen concentrator going. His nurse told me he'd had a rough night. So, I decided to have him sleep at home today and not go to school. I called his school nurse to inform her and emailed all his teachers. I am listening to his ventilator and O2 concentrator going in the next room as I write this now. At least no alarms are going off. His nurse has gone home to get some sleep. She will come back in a few hours so I can go to work this afternoon.


Steffany's due date is less than a week away now. She has been hoping the baby would come early, but it does not look like that will happen. Her doctor told her last week on Monday she was not dilated at all, so it would not likely happen that week. Which was good, because she and her hubby were moving into a new apartment at the end of last week.

James, Josh and I went over to take her some of her baby stuff she'd left here to her new apartment Saturday (9th) even though Josh wasn't feeling too great. James helped her put together her baby bed. Then, we took Steffany out to eat, picked her up a few grocery items, and headed for home. Steff really wanted me to stay and help her organize the place. I told her I needed to go get Josh home and settled with his dad, then I would come back and help her.

Josh and James watched the Dallas Cowboys game while I went and worked on the apartment with Steff. We got all the clothes on hangers, etc. and put away and broke down a bunch of boxes. The place was finally looking much more livable by the time I left. I kept thinking she could go into labor at any moment. She is getting so big (but only in the belly). Here is a picture I took of her right before I left Saturday night:

Steff had another doctor appointment yesterday (Mon 11th) but reports she is still not dilated. Her doctor thinks she will make it to her due date (Jan 18th) or beyond. They may decide to induce around the 19th or 20th - maybe. She came over after the appointment and did laundry and visited. She says the doctor told her she lost 3 pounds! I told her she better eat then! She should be gaining not losing weight at this point!

Anyway, it looks like I could possibly have a birthday buddy yet - January 26th is just around the corner :) Either way, I should be a grandma (MiMi - pronounced me-me) by the time I am 37. Wow!

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