Emma’s stable at CHEO on low flow oxygen. A chest xray didn’t reveal anything remarkable, and while the leading suspect is still a nasty virus, the rapid onset of symptoms two nights in a row has the medical team considering other potential causes such as reflux. They plan to scope her tomorrow and have a peek. (That’s a nice way of saying that they’ll stick a camera up her nose and down her throat.)
Took Emma to CHEO at 4am. She’s been admitted…again…
One of the theories the doc had last night is that mucous may have temporarily blocked or restricted air flow in Emma’s lungs. Apparently these mucous plugs are quite common and cause some kids to get worse and then quickly better again. Since Emma already has lung problems (BPD), even a small reduction in her effective lung capacity can cause distress. It’s possible that the bronchodialative effect of epi helped loosen things up, or perhaps just the fact that I postponed a two-day business trip did the trick 
In any event, Emma is stable and if her smiles are any indicator, she’s feeling much better. Hopefully we’ll avoid a repeat performance of last night.
For anyone who’s wondering, Emma is posing with her Masimo pulse oximeter in a fashionable orange protective boot. The bottom number (158) is her heart rate. The top number (99) is her oxygen saturation (in percent). We like 99.
Emma started having difficulting maintaining her oxygen saturation levels again Sunday afternoon, especially when asleep. Ventolin provided some relief, but it was too short lived and I ended up taking her to CHEO’s emergency department.
She wasn’t as bad as last Friday, and she was relatively stable, so I didn’t put her on oxygen for the short trip to CHEO. (Emma is not routinely on oxygen, but I do have a kit for emergencies.) Apparently our trip wasn’t exciting enough for Emma, and about 4 minutes after leaving home her sats hit a low of 67% as I pulled over and put her on oxygen…lots of it.
At CHEO a mask of racemic epinephrine did the trick, and a few hours later we were on the way home. So here it is, 2:30am, and Emma is sleeping like a baby and doing just fine. I, on the other hand, expect to be up another hour or two and then Laurie will take over.
Kudos to the CHEO emerg staff for great and fast care.
Although Michaela is not always eager to share our attention with her new sister, even she was happy to have Emma home today She eagerly offered to use her “special soap” (aka Purell) so she could hold her:
After 5 days in CHEO, Emma was finally discharged late this morning. She didn’t need any supplemental oxygen last night, so the docs deemed her “good to go.” She still has some nasal & chest congestion, but otherwise seems to be doing well… We’ll watch her closely and if she has any trouble maintaining her sats., we’ll bring her back, but hopefully that won’t happen and she’s home to stay.
While in hospital, we were able to get a consult with the ENT specialists (better than being on the months-long waiting list we were told to expect!) to check out the possibility of Emma having vocal cord damage. Unfortunately, due to her congestion, the docs weren’t able to see her vocal cords during the scoping procedure today, so we’ll have to go back to CHEO and they’ll try again next week.
In other good news, we had another appointment with the ophthalmologist today and Emma’s eyes now seem “perfect” There’s no longer any evidence of R.O.P.!!! We’ll be having regular follow-up appointments at CHEO to monitor her eyes (because Emma may be prone to other vision problems as a result of her extreme prematurity), but for now the news is very, very good!
Thanks for all your good wishes while Emma was in hospital. As always, they were very much appreciated!
Story at 11.
Emma’s been off oxygen and on again, so she’ll spend at least one more night at CHEO.
Emma is doing fine. She still requires a small amount of supplemental oxygen (about 0.5 l/min) to help her along, and she has a bit of a cough, but her lungs sound much better than they did on Friday and she’s not in any distress. She has tested negative for RSV again. At this point everything seems to point to a virus causing bronchiolitis and that will just have to run its course.
All things considered, this is all relatively minor considering what Emma has been through. She probably has the type of cold that would make any of us feel under the weather for a week or two. With the lung issues she has by virtue of being a 24-weeker, she doesn’t have much reserve capacity, and the bronchiolitis is just stressing her system a bit too much.
For anyone who hasn’t experienced CHEO’s emergency department, the staff there are fantastic. We were seen immediately upon arrival (i.e. zero wait) and there was no shortage of volunteers to hold Emma when I needed to use the washroom or the vending machine.
Looks like we’re not quite there yet…