Monday, June 23, 2014

"We are the Champions, My Friends"...well, at least of Wallace Falls!

Now that Ty was feeling better, Amy and I were ready to get back to adventuring! We'd missed out on 2 of Amy's days due to Ty's hospital stay, and I had a huge list of northwest wonders I wanted her to see. We saw that Saturday was predicted to have good weather, so we crammed a LOT into it. The first item planned for our 134 mile drive that day was hiking up good old Wallace Falls.
Oscar and Tyler spent the day hanging out with Oscar's parents. It was a real comfort to me to know that Tyler was having fun and in good hands after his recent illness. He was just delighted to be crawling and cruising around without any cords getting in his way. Who would guess that this cute baby had just been in the hospital one day earlier?

Adventure time!
As with our Columbia River Gorge trip, we started off the day driving into ominous clouds, but they cleared up for us by the time we arrived at the trail. It's so nice when the clouds are accommodating! At the beginning of the trail you come upon this William Wordsworth quote "Come forth into the light of things. Let nature be your teacher." And shortly after beginning the hike, there's a small spur trail leading over to "Small Falls."

There's a fair amount of hiking before you reach anymore drops, but there are some nice views of the Wallace River and a peek out at the valley.

Lower Falls and a glimpse of Middle Falls

Amy and I took a break and grabbed a snack once we arrived at the lookout for Lower Falls. It's cool that you can see Middle Falls from here too. Although it's called lower falls, there are actually two additional drops below. I wonder what they're called - Lower, Lower Falls and Lower, Lower, Lower Falls? The lowest drop is the most difficult to view. From what I could tell it seemed pretty similar to the drop just before it.
I should order a Wallace Falls license plate

And after I bent my finger backwards catching myself falling forward in the mud, we made it to the gorgeous main drop. The other time I made this hike, I twisted my ankle on the way down. I wonder if I'll ever be able to hike Wallace Falls without injuring myself.

We attempted to take a double selfie, but failed miserably. Fortunately there were plenty of people there, so we were able to get a cute shot of the two of us with the main drop before continuing on to Upper Falls.

It may be steep to get to the valley overlook, but it's a great payoff when you arrive. There's also another set of small drops here. 

Darn! We had to change our plans to fall down the waterfall after reading this sign. 

After a grueling climb we finally made it to Upper Falls. There we celebrated our victorious climb with some loud, extremely off key caterwauling of Queen's "We are the Champions."

And we found a little spur trail on our way down that led us to yet another pretty drop.

You're probably thinking "what a fun day you just had! Now it's time to go home, have a nice dinner and rest, right?" Nope! That was only the start of our adventures for the day. Stay tuned for Snoqualmie Falls, seriously enormous Root Beer Floats, riding the Seattle Great Wheel and getting up close and personal with the Freemont Troll.

Wednesday, June 11, 2014

Portland with Amy and a Baby: Part III - Ty's Bronchiolitis and Hospital Stay

On what was intended to be our final day in Portland, Ty woke up sounding like he'd just sprinted the last mile of a marathon. He'd had a hard time going to bed the night before, crying for about 45 minutes before falling asleep, but his breathing was normal when I put him down. Ty typically struggles to fall asleep in an unfamiliar environment, so I wasn't particularly concerned by this. We heard a few small cries that night, but each time he soothed himself back to sleep in less than a minute. Again, this didn't appear to be anything out of the ordinary. Around 6:30am, however, he woke us up to full blown screaming and extremely rapid breathing. I figured he'd just had a particularly traumatizing nightmare and needed a chance to calm down. We comforted him, I nursed him, and Oscar gave him a relaxing bath while Amy looked up a nearby doctor's office, but the breathing didn't improve. It was time to get professional help. 

By this point we knew Tyler was definitely sick, but since the last time we'd taken him to the doctor with breathing problems had turned out to be a false alarm, we didn't realize just what an emergency this was. We found a walk-in clinic in Tanasbourne, OR where the doctor told us he was extremely ill and recommended he take an ambulance to the hospital, even though it was only a few miles away and we had our own car. He was breathing heavily because his airways were obstructed and he had to work extra hard to take in the amount of oxygen he needed. She was worried his little body might run out of steam trying to keep up with the pace, which could lead to severe brain and organ damage or even death. In the ambulance they could keep him hooked up to an oxygen tank and have an EMT trained and ready to perform CPR if necessary, things we wouldn't have access to if we drove Tyler to the hospital in our own car. Plus anyone arriving in an ambulance is treated immediately as opposed to going into a busy ER on your own and needing to fill out paperwork and such before you're seen by a doctor. While we waited for the ambulance to arrive, they strapped a sensor to Ty's foot and had Oscar give him a nebulizer treatment to clear out whatever was blocking his airways. When oxygen saturation levels are lower than 90%, oxygen is unable to be transported to your cells, tissues, and organs. You can maintain this level during heavy exercise without serious consequences, but you'll naturally slow down as your body begins giving out and demanding more oxygen. At the walk in clinic, Ty's readings fluctuated between 84 and 89. It haunts me to know how long we left him in this state simply because we didn't realize how serious it was. We noticed the rapid breathing around 6:30am but didn't get him into the doctor's office until around 9am. Readers please learn from our potentially tragic mistake and call 911 or take your baby to a hospital immediately if they're breathing rapidly for no apparent reason.

Oscar was a bit concerned about the cost of the ambulance. We'd never taken one before and weren't sure how much of the bill our insurance would cover. Luckily it ended up not costing us a dime. We recently learned that Ty has a $1,250 out of pocket annual maximum, money we would end up paying for his 2 day/1 night hospital stay ($400 deductible plus $250 hospital stay co-pay plus 15% for our part of his treatments adds up very quickly). Any medical care Ty requires for the rest of the year is now covered in full, including his ambulance charge. 

The EMT's arrived and said it'd be best if they could strap Ty's car seat to the stretcher. Ty was not thrilled about being taken out of daddy's arms and then getting hooked up to an oxygen cannula (he particularly hates when things touch his nose). But once the ambulance got moving he calmed down and fell asleep for the drive. When we pulled up to St Vincent's hospital in Portland, a nurse had come out to help the EMT's bring the stretcher in. She, of course, had no idea who the patient would be, so she absolutely squealed and cooed with delight when she saw Ty. "It's a baby!" 

Because Ty had gotten some sleep on the ride, he was in a better mood by the time we made it to the Emergency Room. He did not want to be in his car seat anymore and really wanted to get on the floor and crawl around. The emergency doctor was sure based on how Tyler looked that we'd be going home in a few hours, but when they took him off his additional oxygen, his numbers dropped too low to be released safely. It required additional oxygen to keep him at 91%, and he'd come down with a slight fever of 101.4, most likely due to his extra exertion. The doctor was optimistic, though, that based on Ty's appearance his numbers would improve significantly over the next few hours, but they didn't. He was very confused by how sick Tyler was yet how good he looked. He said he'd never had a baby appear so happy with this low of numbers and had to go consult with the in house pediatrician to find out what to do next. The nurse confirmed it, saying "this is the healthiest baby we've ever seen who needs oxygen." Usually when babies come in with this condition, they feel too sick to be mobile. In fact, bronchiolitis is most likely to occur in babies between 3 and 6 months, who aren't breastfed, who live in crowded conditions, and/or who are exposed to cigarette smoke. Ty was 11 months, still being nursed 4 times a day, is an only child in a 1589 sq ft house, and comes from a non-smoking home. 

Ty would normally have a nice long nap in the morning, so his energy did eventually wane and he fell asleep in Oscar's arms. About 45 minutes later we wheeled him in for a chest x-ray to verify that he didn't have pneumonia or any lung blockage. Oscar got on the stretcher so Ty could stay sleeping for as long as possible. I have to say I absolutely love looking at these two pictures. There's nothing more attractive to me than seeing my husband loving and caring for our baby boy.

The x-ray tech was great! Ty woke up as we were arriving, so the tech made all kinds of silly faces and noises to keep Ty looking in the right direction. The results turned out normal, which was a relief to know that he didn't have pneumonia or developing asthma.

We brought Ty back to the room, and he did not want to stay still. He was playing, nursing, blowing raspberries (a recently developed skill) and really wanted to get our of our arms. He was too active for the monitor on his toe, which kept fluctuating wildly, and he kept trying to pull his oxygen cannula off. While I nursed Tyler, Oscar went to pick up some food for us and grab Ty's pack and play and toys from the Hansen's house. The doctor came back in to say that the on call pediatrician believed he needed to be admitted for the night until his O2 levels could be brought back to acceptable levels. At the moment they were at 91 with oxygen. They needed to be at 92 or above without oxygen while he slept (when levels naturally dip a few points) before they could send us home. We found this out around noon, and we didn't leave the hospital until about 4pm the next day.

It turned out we didn't even need the pack and play since Ty was given a pretty cool crib in his room. The bars on both sides could be adjusted up and down to make it easier to give him treatments, but then the bars were raised up again to keep him from falling out. There was also a plastic crib tent to keep babies from crawling out, but Ty wasn't tall enough to require it. 

Bronchiolitis is caused by a virus, most typical being RSV, so Ty had a private room and all of the medical professionals coming in had to wear surgical masks. In a healthy adult or child over 2, you wouldn't know the difference between RSV and a minor cold, but in a baby it can lead to bronchiolitis because the airways are too tiny to take in sufficient oxygen from the resulting blockage. Oscar and I weren't required to wear masks because we weren't visiting other sick children in the hospital, but the medical team had to make sure they didn't pass on Ty's virus from one sick baby to another.

As the day progressed, Ty's numbers showed little improvement. They even had to move him up to 2 liters of oxygen. He really fought against the nebulizer treatments since he hates things touching his nose, and very little of the gas was actually inhaled. He also got really upset when they flushed out his sinuses and gave him a bloody nose. We weren't sure if the treatments were helping at all. We were basically there waiting for his body to fight off the infection while he was fed additional oxygen.
Ty didn't seem to have the vaguest idea that he was sick. He really wanted to get out and play, and he hated being connected to so many cords. We're not sure how accurate his readings were since he kept stomping on the sensor. On an older person, the sensor goes on the finger and the patient is old enough to know not to play around with it. On a baby it's put on their toe so they don't try to suck on it or pull it off, but usually the babies feel more sick and aren't nearly this active. Ty had to have his sensor replaced multiple times. It was also incredibly challenging to keep the oxygen cannula in place since Ty kept trying to pull it off. He ended up with a LOT of tape on his face.

Oscar fed Ty some solids and helped cheer him up after a rough day.

Just get me out of here already!
There was only room for one adult to sleep in the room, and the nurses requested I nurse him frequently so he stayed hydrated and had some comfort after his traumatizing treatments. About 7pm, Ty's bedtime, I told Oscar he might as well go back to the Hansen's and get a good night's sleep, but I ended up calling him around 9.:30pm. Ty puts himself to sleep these days, but he needs to be left alone to do it. I didn't have that option that night or he would stomp on the sensor and send the alarms off, pull on his oxygen cannula and get the sensor cords wrapped around his legs. After attempting to nurse and rock him to sleep for nearly 2 and 1/2 hours (by which I mean, wrestle a 24 pound bag of snakes), I asked Oscar to come back. I had attempted to put him down and failed around 10 times already and my arms were turning into jello. He'd fall asleep in my arms with me hunched over swaying up and down, I'd put him in the crib, pull up the bars, and snuggle up into my bed right when he'd wake up, stand up, and start wailing. I even tried hiding in the bathroom or behind the curtains so he could put himself down, but I'd peak in to find he'd entangled himself in the cords. I called Oscar crying saying I couldn't do this all night long. Oscar came back, but by the time he arrived, I'd finally successfully managed to get Ty to stay asleep in the crib. We hoped to drive back the next day, so I figured Oscar should go back and sleep so that he'd be well rested for our drive. I decided to just tough it out, and boy was I in for a LONG night. I slept about 2 hours between 7pm and 7am while fighting to get him Ty sleep for the rest of it.

After Oscar left, Ty was resting happily when the nurse came in to say he was going to need a treatment soon. This woke him up and horrified him, and I had to take nearly an hour getting him back to sleep again. I must have nursed him at least 6 times throughout the night when he never eats at night anymore. Finally I got him back to sleep, and after about 30 minutes, he decided to turn over on his tummy. He stayed asleep, but the oxygen cannula came detached from his nose, sending his 02 level to 89 and making the alarm go off. He still slept happily, but the nurse came in and tried to make a cup to feed him his oxygen through. We were very quiet, but Ty woke up. As long as he was awake, they decided to give him the cannula again and this time used gobs of tape to keep it in place. I had to fight to put him back to sleep again, but at least this time when he rolled over, the cannula stayed where it was supposed to. This is when I finally got my 2 hour chunk of sleep. Otherwise I'd only get little 10 minute intervals since Ty woke up so frequently that night. Even though he wasn't due for another treatment for another hour, I had them give it to him then. After that they didn't need to do anything for 4 hours, but Ty and I both barely slept. It was awful!

In spite of a terrible night of constant waking up and treatments, Ty woke up ready to pay at his usual wake up time. Things still didn't look good, but that's because the sensor hadn't been changed all night long. Once they changed them, the O2 reading jumped up considerably. It still wasn't enough to send us home, but they were able to lower him from 2 liters to .75 oxygen and shortly after to.25 oxygen.
Ty loves sticking his fingers into any holes he can find, so while I was using the computer that morning, he stuck his thumb into one of the holes that the crib tent attaches into when it's in use. At first he was perfectly happy, and I hadn't noticed his finger was even in the hole (in spite of the fact that I was taking pictures of him), but once he tried to get his thumb out of the hole, he started wailing. Since he'd cried like that multiple times simply out of boredom, I ignored him at first and finished up the Facebook post I was working on. Then when I went to pick him up, I noticed his thumb was stuck. I had to yank it out hard, which left a mark around the entire thumb. I yelled for help from the nurses and they got it all bandaged up. We had to replace the bandage multiple times over the next few days since he kept sucking on it or peeling it off. They said they'd never had a baby stick his finger in those holes before (again probably because most babies are too sick to be very active when they're admitted to the hospital). There were 4 holes total, and Ty of course, continued trying to stick his fingers into all of them. I had to request they bring in some medical tape to block them off from him.
Oscar came and helped cheer Ty up after his traumatic experience. You can hear Ty's wheezy little laugh in this video.

Before the sensor was replaced, we thought we'd be here another night, but a few hours later Ty's readings started picking up considerably. We were thrilled to see him napping at 95 with only .25 oxygen. They decided to test him again without any oxygen on his next nap, but that meant we had to hang out awhile and wait for him to get sleepy. Fortunately Oscar was there to help with putting him to sleep this time.

They brought in a therapy puppy to help cheer Ty up. It worked! Ty totally loved the doggy. The doggy was less thrilled, but it definitely got Ty smiling and giggling.

And by his next nap they were able to take him off the oxygen. We knew we'd be able to leave soon since he napped at 92/93 the entire time, but for some reason it took them a super long time to finally discharge us. Ty ended up getting another nap and napped at 97 without oxygen. We were thrilled to see he almost had complete use of his lungs back.

After we told Oscar's parents about Ty needing to be hospitalized, they decided it'd been too long since they'd seen him and ended up driving up to meet us. They got to the hospital just for those final hours while we waited to be discharged. We had Ty in just a diaper so he could have his final vitals check. He loved the little computer the staff had brought in, so Marcus and Martha decided to get him one of his own the next day.

And finally we were discharged and were able to drive home. They gave us a little portable nebulizer in case Ty needed it. We gave it to him a couple times over the next few days, but he was fine without it by Sunday. Marcus and Martha drove up as well and checked in at the Best Western near our house. Ty initially slept when we started the drive, but then he spent nearly 2 hours crying before falling asleep again. We finally got him back home and Oscar put him to sleep. He sat up at first like he always did at the hospital, but then immediately put himself to sleep and slept well the rest of the night. Oh it was so nice to have my Tyler back home sleeping soundly and breathing comfortably in his own crib! And on Tuesday we had his follow up at his pediatrician's office. His lungs were clear and he had 100% oxygenation. It was a terrifying, stressful couple of days, but we made it through.

This is part III of a 3 part post. To read about our considerably more pleasant adventures in Oregon, click here and here