Bronchi-NO-Likis

The nurses and respiratory therapists in the NICU put the fear of God into us about RSV.  RSV is a virus that to anyone over the age of 2 is just a cold.  But for those under the age of 2, it can develop into a condition called bronchiolitis which can be life-threatening to little ones with premature lungs and a history of lung disease (that would be Lucy and Sage to a lesser extent).

So we took measures to protect the girls.  We convinced our insurer to pay for Synagis shots at a cost of $1500 per shot per girl every 28 days.  There's no vaccine for RSV, so Synagis delivers antibodies directly in to the girls' bloodstream.  We got together with Abby to provide childcare so that all four of our preemies could stay out of daycare.  I have committed to breastfeeding through this first winter so the girls will benefit from the antibodies in my blood system.  We enforce hand washing before allowing people to touch the girls.

Despite these efforts, the girls came down with bronchiolitis anyway.  It is believed that their cases (and most of the cases going around right now) were caused by a virus other than RSV.  Last weekend Lucy began coughing.  It was surface level.  Grammy even told Lucy that she was faking it (babies this age do this).  But Sunday night she coughed through the night and by Monday morning, it was in her chest.  Given Lucy's history of being ventilated and taking more than 10 weeks to wean off respiratory support, we took her to the pediatrician thinking it was in an abundance of caution and nothing was really wrong.  It was there that we realized things were more serious.  Lucy's breathing was fast and she was retracting (she was breathing so hard the skin pulled in around her ribs with each breath).  Dr. Gollnick diagnosed bronchiolitis (and a double ear infection) and gave her a breathing treatment (same as what asthmatics get).  Luckily, Lucy responded well and we were sent home with a nebulizer and instructions to keep in touch.  But within hours, we were back in touch and talking to Dr. Gollnick's colleague about when we would know it was time to go to the hospital.

Wednesday morning she woke me up with her coughing/breathing around 6:30.  I immediately started a breathing treatment and realized things were far worse.  Lucy was bluish around her lips and she was limp in my arms.  She would open her eyes a crack and then close them weakly.  I yelled for Brian who was in the nursery with Sage and called Grammy to come stay with Sage.  Lucy rebounded with the breathing treatment, but Brian thought she was still worse than the day before.  So to the ER we went.

There, they gave her 3 more breathing treatments, a dose of prednisone and took x-rays.  Her blood oxygen level was in the low 90's (not too bad).  She was breathing very fast, though (as high as 72 breaths/minute) and was retracting strongly.   The decision was made to admit her.  So after a number of hours, and only short bits of naps, we were given a room in the pediatric unit.

We were back at Community North - the same hospital where I was in the maternity ward for 2.5 weeks and where Lucy spent the first 12.5 weeks of her life.  In many ways, it was comforting to be on familiar turf, but being in an entirely new department also had us a bit off-balance.  The Peds unit does not do things the way the NICU does.  The NICU also had the benefit of being able to set the standard for how things were done - we didn't have other routines and methods for the girls as they were only minutes old.    But going into the pediatric unit, we had both the routines of our daily life (naps are of primary importance!) and our memories of the routines of the NICU.

In the meantime, Grammy took Sage to the pediatrician as Sage was pulling at her ears and her cough had increased in frequency and depth.  Dr. Rob found her ears and chest clear - but reported that some new teeth are on their way (we've had just the two bottoms for each girl for a couple of months now) and that she was congested.  But for that day, no bronchiolitis or ear infections.  Whew!

After running home to feed and bathe Sage and put her to bed (and grab a shower for me, too), I returned to the hospital to stay with Lucy through the night.  Lucy did pretty well, but not feeling well, the prednisone (an upper), the disrupted nap schedule, and the unfamiliar surroundings had us both up at midnight, 3 and 6:30 (a schedule awfully similar to when she was in the NICU...).  She would try to burrow her head into my shoulder and just moan.  Poor little peanut.

But by Thursday, the sparkle was back in her eye.  I got the first belly laughs I had heard out of her in days.  She continued to eat (her appetite had gone down, but never went away).  There was some concern about low urine output, so we stuck around through much of the day while she continued to get breathing treatments every 4 hours.  Finally, late in the afternoon, Lucy was given the green light to come home.

Since bringing Lucy home, both girls have made great improvements.  They are taking long naps and sleeping through the night (except for when we wake them for breathing treatments).

We are lucky things didn't get worse than they did.  We thought the Synagis would protect us this winter and were a bit blind-sided when they developed bronchiolitis anyway.