An unexpected turn of events

You wouldn’t believe this but baby Alex had to be hospitalized again. This time it’s not because of jaundice, which he has completely recovered from. Instead he had a slight fever and suffered from a bad case of nasal congestion. It happened early last week when we noticed Alex making guttural breathing noise in the middle of the night when he was sleeping, and even when he was feeding, he appeared to be wheezing. He slept with us in the bedroom with aircon switched on at night. So we thought the dry aircon environment might have caused mucous buildup that blocked his nasal passage. So my husband moved his cot to the living room, and installed a clip-on fan on the cot for better ventilation. He also downloaded this neat app called ‘iSitter’ for US$2.58, which allows you to capture images and sound of baby using iPhone or iPad and view on another mobile device. So instead of getting an expensive baby monitor, this app allows us to do the same using our existing devices. Alex seemed to be doing slightly better in a non-aircon environment. Still the breathing noises continued, and when we fed him, milk spilled from the side of his mouth and we had to use a lot of tissue papers to soak up the milk to prevent his top from getting wet. We should have suspected that he wasn’t breathing well from his nose and so had to use his mouth, but unfortunately we didn’t. So poor Alex didn’t have any good sleep and feed because of the breathing problem, which in turns affected us.

Last Sunday my husband googled and found an article that suggested we inject saline into the baby’s nostrils and suck out the mucous using a suction bulb. But my mom didn’t think that it was a good idea for us to perform DIY treatment, but we couldn’t take Alex to the pediatrician since the clinic isn’t open on Sunday. We decided not to wait till Monday, and so took him to the children’s emergency services at KK hospital. That turned out to be the right thing to do. At the department, there’re nurses who perform triage. Alex had his temperature, blood pressure and oxygen level measured, and found to have temperature of 38.1 degree C (100.6 degree F). KKH takes any fever in infant (particularly those below 3 months of age) very seriously. I was told to take him to the consultation area for a doctor to see him ASAP.

The doc, a matronly Indian lady, took Alex’s temperature again and it had dropped below 38 degree. My husband suggested that he might have gotten rather warm from being swaddled in the car seat, and hence the higher temperature. Dr Indian Mama accepted that could be a possibility but she also listened to his lungs and found that there was noise. When she asked if anybody was sick in the household, I immediately recalled that one of my nieces had a cold a couple of days ago, and my mom, who takes care of her, has been in contact with Alex. Indian Mama thought it could be possible Alex got infected by a cold or flu virus. She arranged for Alex to have his nose cleared. A nurse sucked out the mucous from his nose which was rather uncomfortable for Alex, but the procedure improved his breathing tremendously. When Indian Mama looked at Alex again, she noticed that he was breathing a little harder than normal. Though his temperature had fallen steadily, the fact that it was initially above 38 degree got her to take the cautious approach and she felt Alex should be hospitalized for tests to be done to eliminate any dangerous infections. My husband arranged for him to be warded in the non air-con B2 ward (6 beds) as the nursery was full. A young intern, in scrubs, who looked like she just got out of junior college, came by to get his medical history to fill up some forms, and we basically had to repeat what we told Indian Mama. According to the intern, if Alex had a fever without the nose congestion, it would be cause for concern since he might be suffering from more serious infection like urinary tract infection or worst, meningitis. Shortly after the intern left, an Indian registrar (aka registered doctor), who looked like he should hit the gym, came by with a side-kick, and also asked some of the same questions. Honestly, why can’t Indian Mama put the info into the computer system so that the others can easily assess it without repeating the questions? Again Dr Non-gym goer also told us that it was likely Alex had a cold or flu infection, but to be on the safe side, they had to take blood and urine samples from Alex for tests. They would decide if he was ok to go home the next day.

That was absolutely a long day for us. When we left the children ward for dinner, it was almost 10.30pm. But we had to return the next morning to catch the doctors on their rounds. This time a senior pediatrician was leading a posse of young interns, like a mother hen. Alex had just had his bath, and looked like he was hungry. We found out from the nurse that he had his last feed 2 hours ago. We thought he should have another feed then. Dr Mother Hen did a check on him and told us his stomach was still full, and advised us we to follow a schedule instead of providing demand feeding to Alex which would exhaust us. (Well, we’re already exhausted!) She also noted that Alex’s weight of 4.6 kg (10.1lbs) was rather heavy for his age of 3 weeks and 3 days. When she found out we were giving him 120ml per week, she said he was over fed and the correct amount was 90ml. (But Dr Mamas and Papas and staff at Thomson told us he should be given 100ml last week and increase the feed by 10ml every week.) No wonder his cheeks are so chubby and his neck develops folds, like a little Buddha. Anyway Alex was still kept for observation on his temperature while waiting for the test results.

While keeping Alex company, I had an interesting observation: those in the healthcare industry tend to be short, to be more specific, those becoming doctors and nurses tend to be shorter than average. Mother Hen and her posse are good examples; and also many others including Indian Mama, Dr Mamas and Papas, Lady M (from O&G Specialist Clinic), and Miss France from KK IVF center etc. I might get bitch-slapped for saying this but even though I’m only of average height of 5ft4, I feel like a runway model standing next to them. And those interns, they look like they’re wet behind their ears, particularly one guy. Even my husband couldn’t help wondering if he was over 21. I was reminded of what Natasha been through when baby Liam was hospitalized at KKH shortly after birth. As any parents of newborns can attest, it’s pretty trying for a parent to have to see her child suffering from discomfort and having to be hospitalized, particularly a first-born. Naturally Natasha was crying, and the interns asked her why. I told her if I were her, I would have kicked them all the way to Jupiter. But from this observation, I think it’s more likely they would have ended up in the next galaxy. Anyway I digress, so far the interns who spoke to us are pretty considerate.

Back to Alex, we were told he had to stay for another night for further monitoring because he had another spike in temperature in the afternoon though it had fallen to normal. To be honest, my husband and I were a little relieved cuz it gave us a chance to have some non-interrupted sleep. We literally knocked out once we hit the pillow that night. The sleep deprivation has seriously affected us. During lunch time that day, we went to Ion Orchard to get a bite. In order to stay awake, I went on a caffeine overdose of iced tea and mountain dew since I’m allergic to coffee. (I used to take mountain dew for headache cuz it has pretty high caffeine.) I think I can even doze off while standing like Churchill.

Both my husband and I are pretty impressed with the experience of the KKH nurses, who seem to be even better than those at Thomson Medical Center. We learned quite a few baby care tips from them. Like a nurse suggested to us to use the nappy rash cream brand ‘Desitin’ instead of Pureen, which was given by TMC, as the former is thicker and more effective than Pureen. I used to apply Baby Akin Organic bottom balm on Alex but found that it wasn’t effective on nappy rash. The same nurse also reminded us to lift Alex’s head during bath time to clean the creases on his neck to prevent fungal growth. Another showed us how to better burp the baby (sweeping the back in an upward motion) and encouraged us to use the dummy aka pacifier to stretch the time between feeding to 2.5 or 3 hours. In fact at KKH, the nurses use the dummy to pacify babies.

KKH is the place to go to for any baby/child emergencies. They have all the equipment and staff available to treat the child at any time of the day, unlike TMC which only has a general practitioner on standby during non-office hours. The only thing you have to bear with at KKH is the numerous interns and doctors you’ve to deal with. And consultation fee is higher cuz you’re provided with full service. My husband also likes the baby products used at the hospital. He asked if he could buy the swaddling cloth or the dummy, but the nurse referred him to Mothercare shop which has different products. My husband thinks KKH should try selling their products to interested patients. Unfortunately we were not allowed to take back the swaddling cloth or the top Alex was wearing. Here’s Alex looking rather comfy wrapped up in the hospital’s swaddling cloth.

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Anyway Alex’s temperature was found to have stabilized during the second night and following morning, and the test results were also negative so he was discharged on Tuesday morning. I’ve to say I wasn’t as worried about Alex this time despite the slight fever as it was temporary and likely due to the swaddling. Alex is a warm baby, which means he tends to get warm easily and sweat a lot. He was also not lethargic during the hospital stay which I believed was because the cold infection wasn’t serious. But I understand the concerns of the hospital and why they take fever in young infants seriously, and I appreciate that.

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2 thoughts on “An unexpected turn of events

  1. Oh dear! Sorry to read that Alex had to be hospitalized again. And thanks for voicing out similar concerns re. intern looking docs on duty. 🙂
    I use the nasal spray/seasalt water spray on Liam whenever he sounds like he’s wheezing and within 10minutes, some of the mucus would fall out enough for me to twirl or quickly pull out. I also bought the ‘nose frida’ which is basically a more sophisticated tool of sucking out the mucus (the traditional way). Those silly little suction thingies don’t work. They’re better off just cleaning one’s camera lens I reckon.

    I know this is frowned upon in Asia but in Europe/western countries, an infant’s fever is not considered serious till it hits above 39 degrees, plus PDs usually expect parents to do fever management first before going to see them because they would do the same too – sponge, wear lighter garments, soak in cool water, place a water pillow below to absorb the heat etc. But also good that the medical industry here is more anxious at any first signs of fever regardless how mild the rise in temperature is, as that sort of gives assurance to parents too.

    I noticed KKH tend to err on the side of caution and usually have their patients stay for one more night to monitor/observe – as with Liam’s case. And while I appreciate their due diligence, hearing that Liam needed to be warded for another night when I was looking forward to bringing home with me bothered me a little then.

    • Yeah, we bought this nasal aspirator from Guardian and it turns out to be useless. The PD also advised us not to use it. Instead she suggested a Q-tip with the end moistened with cooled boiled water and placing one end just outside the nose and slowly pull out the mucous.

      I guess in Europe, the national healthcare systems are bursting at its seam, and so they can’t afford for everybody to go to the hospital and receive treatment immediately.

      Anyway we realize that for minor problems during non-office hours, we can go to the 24-hr children clinic at TMC. For something more serious or fever, best to go to KKH.

      Sent from my iPhone

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