Yesterday I made the worst mistake of my life. I write this so should you come to something similar you won't take the path that I did.
Three days ago my youngest son Jonah began to show signs of labored breathing. Me being a Respiratory Therapist I thought that it was something I could easily manage. Up to this point my son had never shown signs of breathing problems and I figured it was just allergies that were causing problems. I was wrong.
Two days later he appeared to be doing really well and had done work around the house to try and impress his Mom. If you ever met Jonah you would meet one of the kindest most loving child you could ever meet. He always has a hug, a moment for you, and always wants to do something to make you happy. Jonah also doesn't complain. In many ways he takes after me. I broken foot I'll laugh it off. He broke his arm and wears the scar with pride that he didn't cry. He likes to say he's tough. Unfortunately, being tough had it's cost.
Around 6:00 PM he began to breathe fast. I gave him a few puffs of an inhaler I had bought, set him on the couch, and told him to rest. That is like telling a kid not to eat candy. He of course says he's fine but something doesn't add up to me. By 12:30 AM I grow concerned. He's breathing really fast and I'm giving him about a puff an hour. He is wheezing both on Inspiration and Expiration. At 1:00 AM I get my wife up. She's really tired but takes a shower. We talk a bit about taking Jonah to the ER but by then it's 2:00 AM. This is where I make my mistake.
2:00 is the magic hour when people with Asthma, colds, flues, etc. begin to have their attacks. The reason for this is your body is getting rid of most of it's waste between the hours of 2:00 and 4:00. ER's become filled, wait times grow, and me knowing this I decide that we can wait till 6:00 to take Jonah in. Part of this decision is my wife hasn't been sleeping a lot. I figured I could keep Jonah from getting worse, we take him in, he'll get a few nebulizer treatments, and we go home. I've treated patients for eight years, myself even, and I figure I had it handled. I was wrong.
By 4:00 I'm giving him a puff every 15 minutes as he sleeps. I'm worried. He should be getting better but he isn't. In fact it seems like he's getting worse. I wake him up and I ask how he is doing. He says he's fine but he isn't.
By 6:00 AM I'm beginning to realize that I should of taken him in when I first felt like he was getting worse. He is struggling using every muscle to breath. My ten year old son tells me, "I'm fine." the only problem is that he has to take a breath between the words I'm and Fine. My instincts kick in. I realize I've screwed up and I've screwed up bad.
I get my wife up and tell her we have to go and we have to go now. As she gets dressed I call around to the nearest hospitals. The first one that says they are not busy is the one we head to. At this point I'm on the verge of calling 9-11 but we can get him to the hospital faster. I don't walk very well thanks to a broken back from six years ago but adrenaline kicks in. I scoop him up and load him in the car. He looks even worse in the morning sunlight. By then my wife has also made it to the car and we are off.
We get to the Hospital and I go right through the Ambulance doors. No time to do the paperwork, wait to see the triage nurse, my son is dying and it's all because I decided to wait. The Doctor thinks he's just having an asthma attack. I try to tell her that this one is different. It's not responding to the medication. She puts a Pulse Ox on his finger and the number comes back at 82%. For those who don't know if this is bad or good it is really, really bad. Normal is 98% and above. Bad is a number between 88% and 96%. Really bad is between 84% and 88%. My son is now at the point that some of his organs in his body are not getting oxygen. It's beyond really bad.
She starts him with 2 liters of Oxygen and his O2 saturation climbs to 84%. Then 4 liters and he rises to 88%. This hospital is used to old people and hardly ever treats kids. I understand this because I have worked here before. For an old person 88% and above isn't too bad. For a kid though it's way worse. Different age needs different ways of working. After the first treatment the X-ray person comes in and takes him off his 02. I'm in the bathroom and when I come back I'm shocked. I'm also done screwing around. My son is grey, around his lips they are blue, and his eyes are sunken in. The space between his ribs is being drawn in on every breath. I do the one thing that makes every Doctor, every Nurse, and every Respiratory Therapist work at the top of their game. I bring out the Notepad and Pen and I begin to document everything they are doing including if they are doing nothing.
You don't every order a Doctor around but what you can do is suggest. Eight years as a Therapist has taught me to be a little Politics in getting things I want done a certain way. I use all my skills that have. I may have screwed up by not taking him to the ER at 12:00 but that doesn't mean I have to screw up now. I get a second treatment ordered, I get him on a 100% Oxygen, but Jonah is getting worse. For the first time in my life I am really really scared. I'm watching my son die and there is nothing I can do. His 02 Sat is at 92 then 90 and then 88. He's on his third treatment and he is only getting worse. He's working too hard to breath and eventually he will tire out. He's hyperventilating trying to get more oxygen in. I have one more trick to use then he is going on a ventilator. I teach my son how to purse lip breathe.
Purse lip breathing is when you pucker your lips so they form a small hole. This forces you to hold your breath in. It creates a back pressure and will force air into the spaces you don't use. Old people with Emphysema are taught to use this tactic to help them breath. For the first time since coming to the hospital my sons Oxygen Saturation gets better. It goes from 88% to 92%. What it also does is it gives the muscles he uses to breathe a break. His respirations go from 56 to 22. His Heart Rate goes from 146 to 116. It is the first real break all of us have gotten.
The Doctor asks me what Hospital would we like him transferred to. One of the best I have ever worked at is also pretty close to my home. I know that they will do the very best that they can do. By the time the transfer team comes the Nurse, the Doctor, and the Respiratory Therapist are on edge. My son is still getting worse even with the pursed lip breathing. You can cut the tension with a knife. They load him up and then they are gone. The Doctor comes to me and places a hand on my shoulder. "I wish you the best." I thank her. She had given her all and that was all I could ask.
My wife drops me off at the house, she grabs some clothes, packs some items, and some books. I've been up for 36 hours now and I'm not even tired. I give her a hug and tell her to keep me informed. She is off. I then talk to the kids about Jonah and that he is really, really sick. After answering all my kids questions I realize I have to inform the rest of my family. I walk into the bedroom, shut the door, and pick up the phone. The first person I call is my Mom. She already knows what is going on because we were keeping her informed as we were at the hospital.
We begin to talk and then something happens to me that has only happened once before. I can't talk and the emotion of the night overwhelms me. "Mom..." I say, "I so @!$%#ed up." and the tears flow. I have to be strong for everyone else but not with my Mom. She is after all my Mom.
Jonah is currently in the Pediatric ICU and is making progress. He is still on 100% Oxygen and they are trying to get him down. Other kids with the same disease are with him. Most of them the same age. Something is going around and it's bad. That helps a little but it still doesn't stop me from knowing the biggest mistake I have ever made in my career was with my son. I also know something inside me has changed. I'm not the same man I was three days ago. I can't explain it just that I can feel it inside. I wish you all the best. My mistake doesn't have to be yours. Go with your gut and listen to it.
Update Day 3: Jonah is being moved to the Pediatric Ward but is still on a Non-rebreather Mask. He is no longer getting nonstop Albuteral Nebulizer treatment but has been changed to every two hours. My wife is saying that he is now coughing up large amounts of yellow mucus so that is a good thing. The Doctors said they think that he had a cold that set off his asthma but I have a problem with this in that Jonah didn't act like he was sick before this. I'm going to start looking for Mold in his room today as some have suggested. We had a roof leak a year ago and I'm going to start there. Either way we bought a house about ten miles from this one and we should be moving in the month. Thank You for your prayers and well wishes. I'm with the ones who said this might be mold. I'm on a mission.
Update Day 4: The Little guy is doing really good. I went in today with my mom to see him and he's back to his normal self (though a little hyper). He's got pink cheeks, good color, and is talking quite a bit. He still has a little labored respirations and his Room Air Saturations is still a little low (93 to 95%) but he is doing so much better. The Doctor was about my age and is really sweet. We talked a bit about what type of medication he should be on and I let her know that we are not restricted to just the Insurance and we will pay for what ever he needs. His health is what matters most. We won't find out about the house for a while yet but to be honest we need to get out of California or at least the Southern part. My wife wants to get her Respiratory license and she wants Brian to graduate first. I think when my settlement is done we are gone no matter what. The grass has to be greener on the other side because it's dead and brown here. Either way Jonah is doing good and he should be headed home soon.
Update Day 5: Jonah came home today with an assortment of medicine. Flovent, Xopenex, Albuteral, and a liquid Steroid. He'll be getting Q4 treatments for the rest of this week (every four hours) then will go to Q6 then 3 a day. Part of the reason he was sent home was that I can treat him and that there isn't anything they can do that me or my wife can't. I want to thank everyone who has left a comment. I do appreciate it as does my family. This experience has been an eye opener and a life changer. I can see the difference in my wife. She seems like she understands why her role as a mother is so important.
As Jonah was leaving another kid with the same exact symptoms was coming in. Another kid on Oxygen barely able to breath. The father and mother both looking just as worried as I had felt the day my boy went in. We all seem to take for granted the ones that are closest to us and yet life is fickle and can be gone in an instant. I'm happy that the ending to this is so much better than the beginning. I was never one to be fond of stories with sad endings... Hold close the ones you love because none of us knows what tomorrow will bring.