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Sunday, November 05, 2006

1st major illness

dd was recently hospitalised with bronchiolitis, caught whilst in the uk on holiday last week.

it all started with an innocent enough little cough on thurs 25 oct, which became more frequent as the hours passed. then on friday night dd vomitted all her last milk feed, which entailed changing the bedsheet, pillowcases and her sleepsuit (and my t-shirt) since i had been nursing her in bed. as this was the night before we flew out of heathrow, i was concerned that her vomitting might continue on the plane...my fears were realised.

we got up really early on sat for the 3 hr drive to heathrow. dd slept in the car and was generally okay till we were checking in at the airline counter. she was fidgeting a bit in the wrap (yes, i had her in a short cross carry using my brand new-to-me iris didymos wrap) so i loosened it a little and nursed her a bit. this seemed to mollify her but seconds later she threw up. thank goodness she had not been drinking lots so it was just a little puke. still, i began to get very worried, wondering if she's got an upset tummy or stomach bug.

heathrow itself was a nightmare and i will elaborate on the diabolical regulations in place at the immigrations queue in a separate post.

an hour or so later when we were in the airline lounge i decided to nurse dd again. after that i gave her a little cough mixture that dh had bought from the pharmacy in the departure lounge. but this turned out to be a bad move: dd instantly threw up all the feed. perhaps the flavour of the cough mixture wasn't to her taste.

by this time both dh and i were nearly panicking, wondering how we would be able to cope with a sick child on an economy flight (we couldn't get our points upgrade for the return journey, so our cushy business flight to london was soon a receding memory).

suffice to say dd threw up yet a third time while in the lounge, so both dh and i reeked of eau de puke as we self-consciously boarded the plane.

we had to explain to our neighbours on the flight (those who made eye contact or who smiled at what they thought was a cute, harmless baby) that dd was ill, in the hope that they would be understanding later on if she cried and vomitted. all pretty necessary efforts at politeness as we found to our dismay.

it was one of the longest flights (emotionally, mentally) i had ever taken. dd was so discomfited by her coughing and in such obvious pain that she could not sleep at ease. it was highly unusual for her as we often expect a little grizzle before she settled down for a nap/sleep, but this time, she was just near inconsolable. it was excruciating as i was embarrassed and helpless. i tried to nurse her, but she sometimes puked and sometimes would continue to cry. also, during the flight, dh and i noticed that dd's breathing was sounding more wheezy, adding to our worry.

i have lost count the number of times she vomitted on the flight, and by the time we got home to kl, i was seriously worried that she might become dehydrated. i told dh about this and we both agreed that after dd had a nap/rest, we would see if we need to send her to the hospital, or wait till the morning before seeing our paediatrician.

when we finally got home sweet home, dd and i near collapsed onto the bed and i nursed her until she fell sound asleep. i too slept.

four hours later, dd woke up and seemed to be in a better mood. as she was hungry i fed her again, but then she threw up almost immediately. dh and i looked at each other and i saw a rare look of fear in dh's eyes as he said, "we need to go to the hospital."

we went to the hospital's a+e as the children's clinic was closed (that being a sunday). the dr who saw us said there was a possibility of pneumonia or bronchiolitis and sent dd for a chest x-ray and blood tests. The dr then said that the hospital could ring our paediatrician to come see dd, but that dd needed to be admitted into the hospital.

the x-ray was certainly not a favourite experience for dd, but taking blood samples was probably the worst thing to happen to her. the dr couldn't find a vein on dd's chubby wrists, and had to resort to one on top of her left foot.

it was probably incredibly painful. we (2 nurses and parents) had to pin her down (by restraining her arms, legs and torso) as she cried and wailed most pitifully. i was nearly in tears myself to see her in such pain, especially since she was calling out "mama" as well.

after the x-ray, the dr said it was unlikely to be pneumonia (thank heavens!) and she ordered a nebuliser for dd, who surprisingly took it very well. after that dd’s wheezing became less pronounced.

about an hour after we first stepped into a+e, we were in a single room acclimatising in the new environment and getting our heads round the idea that we would be spending 24 hours or more in that box. the paediatrician soon arrived and told us that he thought it was indeed bronchiolitis (which is caused by a respiratory virus) judging from the x-ray. he said that there might be a worry about secondary (bacterial) infection later, but for now, because the blood tests came out negative, we didn't need to use any antibiotics. regular nebuliser bursts were scheduled and the nurses would check dd's temperature to see if any medication for fever was required. (any spike in temperature may also indicate the presence of a secondary infection.)

dh had to leave the next morning on a business trip, which was not the most fortuitous of timings. but at least he had a restless night at home (evil grin from mommy) while i accompanied dd and nursed her at intervals all night.

that 1st night in hospital dd still managed to vomit a few times. her wheezing, which seemed to have abated after the 1st nebuliser, returned. however, she slept much better in the hospital than on the plane, and somehow, i slept better too, knowing that she was receiving the best care possible and that we did the right thing by bringing her to the hospital asap.

that night her temperature went up and down, which was the pattern for the following night too. when dd’s temperature rose the nurses would administer an orange-flavoured drug. it was fed to dd via a syringe and she didn’t like the taste of it one bit.

the next morning (mon) the dr said that it was unlikely that dd would be discharged the next day and that a third night in hospital would be necessary, mainly because of the low level fever she had been having on and off.

but after the 2nd night in hospital (i.e. on tues) dd seemed to be back to her old self again. she had quite a few admirers among the nurses and her physiotherapist. all who came by on their rounds always exclaimed "chomel" or "chubby".

on tues evening, the dr said that he would likely recommend we be discharged the next morning or afternoon.

later that evening, dd was still bright-eyed and alert. so i put her in the cotbed (there were 2 beds in the room - a regular hospital bed and a baby one) and dragged up her blanket to keep her warm.

instead of going to sleep, i saw her tug at the blanket with both hands. then i noticed that she was pulling it up and down over her face a few times. when she had pulled it down, she would turn to look at me. and it dawned on me that she was doing it deliberately: she was playing peekaboo, the game i had often played with her, except previously i was the one pulling the blanket to cover and uncover her face. i was delighted and encouraged her to continue the game, "where's leah? where's leah?", "peekaboo!" i took a short video on my handphone and zapped it to dh as well as my parents. dh texted back to tell me that he couldn't get any sound on it but was amazed she could initiate this game herself. i bet he was also relieved that she was obviously in better spirits and more her usual bubbly self since she was playing.

on wed am, the dr said we were free to go, but had to keep up the doses of ventolin (sp?) with an inhaler and also to take a daily dose of antibiotics (to stave off possible infections). i immediately texted my parents (who said they would drive up to see us at home that afternoon), dd's other set of grandparents and dh.

once home, we found that dd hates the inhaler (a large plastic tube with a slot for the ventolin metal inhaler at one end) and the taste of the antibiotics. it was a struggle to fit the clumsy inhaler over her nose and mouth, depress the ventolin, count to 10 and do another squeeze, before dd swipes the whole contraption away with her hands.

but we went for the follow-up check up today, and with much relief, we found that we can stop the inhaler exercises and antibiotics. the dr pronounced the wheezing over, although he cautioned that the chesty cough would continue and that we had to be careful about a recurrence of bronchiolitis, as that could lead to asthma.

it's been a long long week for all of us. during the ordeal i had discarded our normal routine, since i just wanted dd to get as much rest as she wanted/needed, and to nurse as often and as much as she wanted. so the last couple of nights at home has been exhausting catering to an alert dd wanting to play in the middle of the night (obviously suffering the effects of jetlag and the off-kilter routine).

that said, it does seem that since she's been on the mend, she has been slowly adjusting back to her normal routine. so we'll see if she gets back on track next week.

during the past week she had lost her appetite for solids and was only interested in milk. luckily i am still bf-ing. breastmilk is supposed to be the best for bronchiolitis (with the mother's antibodies hopefully passed on to baby). but today, we found that dd's appetite is returning. (her poos have also returned! she filled her nappy three times today.) this morning she would only have a few mouthfuls of baby cereal, then she had more of her lunch (a puree of multigrains with fish/tomatoes/carrots), but she ate up all her dinner (more of the same lunch)!

it will be so wonderful to have our bouncy baby girl back.

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