Ups, Downs, and Rebounds

I got some really good medicine to pull me out of the doldrums on Monday...football practice. Not watching it, doing it! The twins' team has their final game on Saturday, so after that they are going to face their toughest opponents yet - their moms! Not wanting to look completely foolish on game day, we've decided to have three practices first. It did wonders for me to be running around, perfecting the "pitch left pass" play (boys, watch out!)

Later that evening, still in somewhat of a funk, I heard a commercial that simply said, "When you feel like giving up, remember why you hung on so long to begin with." Great point.

Tuesday was a terrific day; I felt well, got a lot accomplished and Abbie had a good day as well. God was gracious in giving us this day, because we certainly needed to catch our breath to deal with the Wednesday that followed it.

Abbie was on oxygen all night, but when I went to get her out of bed the cannula wasn't even in her nose, and her sats were 96-97. Being slightly grumpy still, I decided we wouldn't go for a morning walk as we had the previous two days. I felt sort of guilty about that, but God was about to teach me that what is right on one day may not be the right thing on another. Shortly after I began feeding her, Abbie vomited just a little and began coughing out a lot of mucous. This doesn't happen regularly, but it's not totally uncommon either, so I wasn't overly concerned. Then her sats started dropping quickly. I put her on two liters of oxygen, but she continued to drop, all the way down to 82. I bumped her up to three, and then four. She still wasn't quite stable at four liters, and at that point I began considering calling an ambulance because I was home alone.

Thankfully, Debbie arrived shortly after I turned her up to four liters, and quickly did an assessment. She hates seeing Abbie go to the ER as much as I do, but we agreed that we really didn't have a choice, so began packing everything up for the trip.

Dr. E. was an ER doc I hadn't yet met, but with whom I was very impressed. It didn't take him long to burst my bubble by saying, "Plan on her being admitted. This is a high oxygen requirement, especially since she normally doesn't need any. Unless something miraculous happens, like her coming off the oxygen, I think we need to keep her here." Darn it! He suspected, as we did, that Abbie had aspirated something during the vomiting/coughing episodes. He ordered a chest Xray and an IV to start antibiotics.

We went to radiology first, with Abbie being driven by her "Uncle Mike." Mike is the radiology tech we got to know so well when he came to give Abbie a chest Xray each morning in the PICU after her injury. We have seen him many times since, and he has a real soft spot for Abbie. He and I teamed up to sit Abbie on a stool and take a couple quick pictures. As we were loading her back in her chair she broke into a HUGE grin for Mike, who had never seen her smile. His joy was infectious and overrode the sickened feeling I had from being in the ER again.

Back in the ER I worked on slowly weaning the oxgyen. I had her down to 2 1/2 liters when the nurse came to put in the IV. I asked her to wait, knowing that if the line went in, we'd be staying for sure. She got Dr. E's approval to hold off, and within an hour I had Abbie down to one liter, with my hopes rising that we wouldn't be going upstairs.

The chest film came back, showing no evidence of aspiration, but giving an explanation for why Abbie has been on and off oxygen for the last month or so. There is a technical name I am not even going to try to spell, but the bottom line is that in the lower portions of both of her lungs there is a bit of collapsing going on. This is caused by not using that portion of the lung and not moving around enough. As we put the pieces together, they all fit --- after her leg was burned she couldn't wear the orthotics we use for standing, so she hasn't done much standing since then. For a while after she was burned her activity level was much lower as we tried to protect the wound and she guarded it. Her breathing was also much shallower because of the pain she was in.

Just like most things in this journey, it's never one simple issue, there are always secondary, tertiary, and kajillionary things to deal with. I didn't see this one coming, and felt bad that we have allowed her to get to this point. The good news is that is reversible. We are going to concentrate on getting her up, even without orthotics, moving her around a lot, and enouraging her, through activity, to take deep, large breaths.

They gave her a nebulizer treatment before we left the ER, and it helped her significantly. So much so, that by the time we left she was off oxygen. The "miraculous" hurdle Dr. E. had set took only three hours to overcome...praise God. As we were leaving I realized again that I had seen the hand of the Romans 8:28 God. We needed that chest film to figure out what has been going on with Abbie so that we can fix it. Without an acute problem we never would've had an Xray taken. All things work together for good...

She got a neb treatment in the evening and then slept deeply, without oxgyen all night. We plan to give her about 3 treatments a day until we start to see improvements in her lungs. She looks noticeably better and brighter this morning.

Another day, another step -- and even the steps that hurt get us closer to the finish line.