Buddy has been sick since Wednesday. That morning, he had a slight fever, around 38 degree C, and so I gave him paracetamol, hoping it was just some mild infection. Unfortunately, in the early afternoon, he puked out the porridge he had at infant care. Later in the mid-afternoon, he was given milk and again he puked. When my husband went to pick him up in the early evening, Buddy was warm to the touch. The teacher had taken his temperature and it was 38.5 degree C. My husband called me, and luckily I was already home then. He decided that we should send Buddy to the children emergency at KKH. I quickly got together the necessary stuff for buddy while waiting for them.
My husband took Buddy’s temperature and it was 40 degree C, the highest he had ever had! I’ve to admit I got a little panicky as I was worried it might be dengue fever. The country is now having a dengue epidemic like not before. My husband told me to give Buddy Ibuprofen which works well to bring down high temperature. He doesn’t think it’s dengue since Buddy had a blood test done more than a week ago at KKH. Yes we were there last week because Dr OK suspected Buddy had dengue after he had fever for a few days and some apparent rash on his body.
Luckily the test was negative for dengue but buddy definitely had a viral infection. The doctor prescribed the usual fever medicine and told us if Buddy had high fever again or vomit, we should send him back. Buddy didn’t and in fact, he recovered after that day and was doing well until early Wednesday morning.
I gave Buddy some milk after the ibuprofen, on the way to the hospital. The medicine is advised to be given with food or after food as it may cause gastric problem. When we arrived at the children emergency, Buddy started coughing and puked out some milk. I thought buddy was still having high fever and the Ibuprofen wasn’t working.
In fact Buddy would become delirious whenever he has high fever at night and gibber in his sleep. Luckily when the triage nurse took his temperature, it had fallen to below 39 degree C. She had to measure Buddy’s oxygen level and heart rate using a probe that is clipped onto to his toe, Buddy doesn’t like it whenever it’s done on him, and always ends up struggling and crying.
After the triage, my husband took buddy to the waiting area to see a doctor while I had to make payment first at the registration counter. Yes over at KKH, you have to pay for the emergency registration fee before getting treatments. There were lots of sick kids at the waiting area, most were having fever, which is very common with babies and young children. We didn’t have to wait long to see the doctor though, compared to the previous Wednesday. The doctor suspected Buddy of being asthmatic because of his wheezing condition and also the fact thar he has eczema. Whenever Buddy has an infection, his eczema and respiratory problems will flare up. The doctor also explained that Buddy’s vomiting is due to his coughing. He arranged for Buddy to undergo nebulizing to clear his airway. Turned out not just one time, but twice. And that’s not enough, we were also prescribed the nebullizing puff to continue the process at home for the next couple of days.
Unfortunately Buddy didn’t recover immediately and was still having fever spikes. Not only that, he couldn’t take puree or cereal which he puked out. It’s also not easy to nebullize Buddy. He just doesn’t like to probed, examined or being treated. He hates the silicon mask over his nose and mouth, and tries to yank it off all the time. He will end up distressed whenever he is nebullized, and when I tried feeding him after, he would puke out some of the milk, and I end up being stressed as well. In fact it had been pretty trying caring for him in the night and working in the day. After we returned from KKH on Wednesday night, it was close to 11pm, and that night I had less than 5 hours of sleep.
When the weekends arrived I was hoping for some rest and maybe Buddy would get better. Yesterday (Saturday) early morning, we found him breathing very quickly and heavily with high fever. My husband made the call that we had to send him to KKH emergency treatment. Thank God at that hour of 7am, there was hardly any babies or children around. The doctors had Buddy nebullized immediately, and decided that his condition warranted him to be admitted. His lungs were tight and he wasn’t getting enough oxygen. In fact his oxygen level was below 90 and heart rate was going above 200 per minute. He had to be nebullized once every 30 minutes to open up the airway to stabilize his condition. He also needed direct oxygen intake, which means wearing the oxygen mask over his nose, and a probe taped to his toe to measure oxygen level and heart rate. As expected all these cause quite a problem for Buddy, who struggled and cried over the oxygen mask and the taping, which unfortunately caused his heart rate to go up. But there was no other choice.
The hospital staff brought along a wheelchair for us to take Buddy to the ward. I was told to sit on the wheelchair and carry buddy in my arms. I said to the nurse that I didn’t require the wheelchair; I means it makes me look like an invalid. But she said Buddy required the oxygen tank which is also transported by the wheelchair, so I obliged.
Buddy was sent to a 4-bedded ward with shared bathroom (B1 ward) as the single-bedded rooms (A1 ward) are not available when I registered for admission. I requested for him to be on the wait-list for transfer once a room is available. The difference is an estimated amount of S$731 (which I had to pay upfront). Thank God I bought a hospitalization insurance for buddy a month after his birth, which will cover the costs.
The problem with the B1 ward room is that we had to share the bathroom with strangers, the friends and family members of 3 other young patients and the patients themselves. Not only this, foldable bed for parents/guardians who want to stay overnight is only allowed to be brought out at night. While we were there, we had to bear with the crying and talking of the other patients and their friends and family, and likewise they had to bear with Buddy’s crying. I mentioned the dengue epidemic earlier, and there were two patients in the same room as Buddy, one is a young boy who keeps crying and the other doesn’t look like a kid, more like an older teenager. Her friends asked her, “what are you doing in a children’s hospital?” Then there is a young girl who needed ultrasound scan. She is also a whiny one, lamenting about the scan and what if it was painful. We were relieved when We were informed by a nurse in the early afternoon that a single-bedded room was available; and I quickly agreed to the upgrade.
The single-bedded room is not as fancy as the premium single bed room that I had at Thomson Medical Center during my childbirth. It’s actually quite bare-boned in that there is only a long couch (for an accompanying parent), an arm chair and a movable safe in it, though the room including the attached bathroom is bigger. But the couch is more comfortable than the one at TMC, which caused my husband to get a sore back after a couple of nights sleeping on it. My husband remarked that the room reminded him of Holiday Inn Express. My only gripes are the miserably low water pressure of the shower and the small bath towel. (Lucky my husband went home to get a bath towel for me, among other things.) We also realize the reason for the simple furnishing; Buddy’s eczema cleared while in the hospital. We met with Dr Mother Hen again. (Remember her? She was mentioned in ‘An Unexpected Turn of Event’ dated 28 June 2012.) I was concerned that the regular puffing (which had been extended to once every hour) couldn’t allow Alex to nap and he got cranky. But Dr Mother Hen explained that it was more important to get his lungs to open and allows better breathing for him, and she wanted to make sure that he was progressing well before extending the lead time each puff. Otherwise it would prolong the need for the puff, and to go start all over again if the lungs close up once more.
We were told it’s very likely Buddy is asthmatic, though we will get a confirmation from a respiratory specialist, whom we have an appoint by on 16 July. Dr Mother Hen told us not to have carpets in the house (we do have a small one that Alex plays on), no pets, no smoking, no soft toys etc, to minimize triggers. But his breathing problems, so far, are not due to allergies but from viral infections which he caught in infant care. Still when my husband went home yesterday afternoon, he washed the mosquito net, and kept away the carpet. We have also decided that we should launder our curtains once every 6 months. We also have to give away all the soft toys, which is alright by Alex since he doesn’t play with them. My husband realized that the mozzie net traps a lot of dust which causes his nose to act up (he has sensitive nose and also suffers from sinusitis), and the washing doesn’t help, so it has to go too. We definitely have to take a leaf from the hospital room.
Over the course of more than 12 hours yesterday, Alex’s breathing got better and his heart rate also fell to reasonable level. The lead time between puffs lengthened to 3 hours, though he still required the oxygen mask. He was initially ok with it over his face, even when he had a nap. But at night, he was in distress over the puff, and he got even more agitated when I tried putting the mask on him. I stayed overnight with him and had to spend an hour each time rocking him to sleep after each puff in the night. He tried to pull out the mask and also yanking the probe from his toe. This caused the monitoring machine to go beeping non-stop, which made it more difficult for Buddy to sleep. The poor boy was so exhausted since he hardly had any nap yesterday that he slept from 2am till 10am this morning. As for me, the so-called rest during the weekend had already gone up in smoke. My husband joked that this was our staycation.
But I’m glad that buddy’s condition continues to improve today. Dr mother Hen who saw him again this morning said he is so much better now. He’s been able to go without the oxygen mask for much of the day. The X-ray that Buddy took yesterday shows that his lungs are not infected, which is very good news An intern, who looks like he’s fresh-out-of-school declared that he can have the puffs every four hours. (I hope he knows what he’s doing.) So we’re still in the hospital to monitor Buddy’s progress. If the 4-hourly buff works for him, and he can do without the oxygen mask overnight, he can be discharged tomorrow. Fingers crossed. We’re sure Buddy also wants to go home as he’s been eyeing the floor longingly. We don’t want him to crawl around in the room unlike at home. I mean, this is a hospital, a place laden with germs despite relentless disinfections. We brought him the iPad to play songs and musical stories for him, as well as his lovey, the panda rattle, and his latest interest, a plastic spoon and plate set. But he gets bored of them soon enough (seriously who wouldn’t), and he doesn’t get to go out of the room a lot. We sure are looking forward to going home.
(Updated on 11 July)
Buddy was finally discharged from the hospital on Tuesday. He wasn’t allowed to go home the day before because his oxygen level was not optimal during rest. The nurses monitored the level during his sleep and found that it was hovering at around 92 instead of the normal level of 95. The senior doctor came along on Monday morning and explained that he was concerned that without oxygen support at home, the oxygen level might be not maintained and could have serious implications. So he was kept for another day for oxygen support and also to continue monitoring while he received the regular 4-hourly nebullizing to open up his airways.
To be honest, by the 3rd day in the hospital, Buddy was bored since he didn’t have the chance to crawl around and play ball. The night before, after I rocked him to sleep and put him down on the bed, he woke up immediately and started crying. He didn’t want to lie down and instead wanted to be carried. Worse when he was awake he rejected the oxygen mask, and when the oxygen level falls to 91 or below, the monitoring machine started beeping, which was really noisy. When Buddy refused to sleep by 11.30pm, I had no choice but t put him in the stroller and pushed him around till he fell asleep. By then I could put him back onto the bed.
Throughout Monday, Buddy must have felt dejected because he didn’t feed much. Over 24 hours, he had less than 400ml of milk, and nothing else. A young doctor suggested that he be put on a drip, but I felt it would be can more distressful for Buddy and said we could try to feed him small meals frequently. Unfortunately even into the night, Buddy kept swiping away the milk bottle. A nurse suggested giving him glucose water, but he rejected it too. In the night, I offered him the paci to try to eat him to sleep, he even pushed it away. When he eventually fell asleep at around 10ish, the nurse was then able to put on the oxygen mask and the probe. The oxygen level rose slightly to 93.
In the middle of the night, as I was trying to adjust the blanket on Buddy, that caused him to stir, and the oxygen mask was moved away from his face. I tried adjusting it and unfortunately that caused him to wake up. He only wanted me to rock him to sleep, and didn’t want to lie on the bed. By 2.30am, I was totally exhausted. My husband who was texting me, told me to get the nurse to put him to sleep instead. So I did, and when she brought him back at 5am, she had managed to get him to take 30ml of milk.
Luckily over Tuesday, Buddy’s condition continued to improve. When he was sleeping, his oxygen level was able to maintain at 95. He was well enough to be discharged in the late afternoon, and his appetite was also slowly coming back. He has to undergo nebullizing for another week. But we’re so glad to be home. Buddy is now able to play and crawl around. We have replaced the carpet with another foam play mat for him. All the plush toys have to go, only two cushions on the couch, no more mozzie net, and curtains are removed for cleaning. But I understand that it’s also not right to sterilize the house too much since baby also needs to build his immune system. So the floor is cleaned every other day, and Buddy is allowed to crawl around.
Now that Buddy is able to play and be active, after the evening bath he is tired enough to sleep almost immediately. He is feeding more now and yesterday, after several days of hiatus, he got a jar of apple and apricot purée. We have sent him back to infant care with a new medication puff, mask and chamber bottle, after I found out the teachers are experienced in using it. (Turns out Alex is not the first kid to require nebullizing at the center.)